HomeMy WebLinkAbout052626 AGENDA PACKET1
AGENDA
Jefferson County Board of Commissioners
Regular Meeting – Tuesday, May 26, 2026 at 9:00 a.m.
This is a Hybrid meeting: Virtual and In-Person Attendance at
Jefferson County Courthouse – Commissioners’ Chambers
1820 Jefferson Street, Port Townsend, WA
Heather Dudley-Nollette, District 1 | Heidi Eisenhour, District 2 | Greg Brotherton, District 3 – Chair
To view Agenda items, meeting materials and comments received, click here: www.co.jefferson.wa.us – Services
Laserfiche Web Portal (username and password is: public)– Board of Commissioners – BOCC Agenda Packets
2026 Weekly Agenda Items – Month of the meeting – Day of the meeting
You can join this meeting by using the following methods:
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all methods first before calling 360-385-9100 to report any issues.
Individuals may provide Public Comment using the following methods:
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Email: You may submit comments/correspondence to us at: jeffbocc@co.jefferson.wa.us up through
11:59 p.m. the day before the meeting.
Public Comment Periods are dedicated to listening to the public. Each person may address the Board one time
during these periods. To ensure equal opportunity for the public to comment, all comments shall be limited to 2 or
3 minutes per person, depending on the volume of public in attendance. Some Agenda items may have additional
Public Comment Periods – these comment periods are for listening to comments specific to that Agenda item. The
Chair may add additional Public Comment Periods throughout the meeting.
9:00 a.m. CALL TO ORDER
9:01 a.m. PUBLIC COMMENT PERIOD – ALL TOPICS
Zoom Meeting: https://zoom.us/j/93777841705
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In-person: You are welcome to join this meeting in-person.
Agenda: May 26, 2026
2
No set time APPROVAL AND ADOPTION OF THE CONSENT AGENDA:
Items listed below have been distributed to the Commissioners in advance for study and will be enacted by one motion. If
separate discussion is desired on an item, that item may be removed from the Consent Agenda and placed on the Regular
Agenda, at the request of any of the Commissioners).
1. INTERLOCAL AGREEMENT re: Warrant Clerk; $100,000; Jefferson County Sheriff; City of
Port Angeles
2. INTERLOCAL MUTAL AID TEMS AGREEMENT re: Crisis Response Team (CRT); No
fiscal impact; Jefferson County Sheriff; Clallam County Fire District 3
3. AGREEMENT re: Engineering Services; $145,955; Public Works; Sargent Engineers, Inc.
4. AGREEMENT, Amendment No. 14 re: Public health services: An additional amount $12,233
totaling $6,292,517; Public Health; State of Washington Department of Health
5. ADVISORY BOARD RESIGNATION AND APPOINTMENT re: Jefferson County Rural
Library District Board of Trustees: 1) Resignation: trustee Michael Kubec and 2) Appointment:
Trustee Stephen Chappuis
6. ADVISORY BOARD REAPPOINTMENT re: Jefferson County Intellectual/Developmental
Disabilities Advisory Board (IDDAB); Amber Kent
7. APPROVAL OF PAYROLL WARRANTS: Dated May 20, 2026 totaling $76,099.93
8. APPROVAL OF ACCOUNTS PAYABLE WARRANTS: Dated May 26, 2026 totaling
1,800,051.63
REGULAR AGENDA:
No set time LETTER OF SUPPORT re: Jamestown S’Klallam Tribe Land Transfer Act of
2026
10:00 a.m. CONTINUED DISCUSSION and POTENTIAL ACTION re: Follow up to
Workshop on Artificial Intelligence Policy-Proposed Revised AI Policy
Shawn Fredrick, Central Services Director
Not set time DISCUSSION and APPROVAL re: HEARING NOTICE to Deliberate and
Adopt by Ordinance Amendments to JCC 8.75 to Ban Fireworks in Jefferson
County, hearing to be held June 15, 2026 at 3:00 p.m. in the Jefferson County
Courthouse, Commissioners Chambers located at 1820 Jefferson St. Port
Townsend, WA 98368 (HYBRID)
No set time COMMISSIONERS BRIEFING SESSION
12:00 p.m. QUARTERLY ELECTEDS AND DIRECTORS’ COORDINATION
MEETING
Roundtable
No set time RECESS
2:00 p.m. AFTERNOON SESSION
Agenda: May 26, 2026
3
No set time ADDITIONAL DISCUSSION ITEMS
No set time ADJOURNMENT (Adjourn by 4:30 p.m.)
COMMISSIONERS MEETING SCHEDULE
The Week of May 26, 2026
A snapshot of the meetings the Commissioners will be attending this week are notated below, and are
subject to change. If you would like to get more information on these meetings, please contact the
Commissioners’ Office at 360-385-9100 or send us an email at: jeffbocc@co.jefferson.wa.us
Monday, May 25, 2026
HOLIDAY
Tuesday, May 26, 2026
9:00 a.m. BOCC Meeting - Board
12:00 p.m. Electeds/Directors Meeting - Board
Wednesday, May 27, 2026
9:00 a.m. Jefferson Transit Authority Finance Committee - Greg
2:30 p.m. Housing Fund Board Meeting – Greg, Heather
Thursday, May 28, 2026
9:00 a.m. Jeffcom Administrative Board Meeting - Greg
2:00 p.m. North Olympic Development Council Monthly Meeting 2026 – Heather
Friday, May 29, 2026
12:30 p.m. KPTZ - Greg
The County has various Boards and Committees that are subject to the Open Public Meetings Act (OPMA).
Agendas for those meetings will be posted to the Jefferson County website calendar 24 hours prior to the start of
the meeting. Agendas will contain information on how to provide public comment, meeting access, and meeting
materials (if available).
For more information, go to: www.co.jefferson.wa.us and click on the Calendar tab.
COMMISSIONERS MAY ADD AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA.
Americans with Disabilities Act (ADA) Accommodations Provided Upon Request
a_gON
44' 0G2
4411
9Sf(N V'CO
ACCOUNTS PAYABLE WARRANT REPORT
WARRANT DATE: 05/26/2026
TOTAL: $1,800,051.63
RECORDS OF ALL CLAIMS SUBMITTED FOR PAYMENT ALONG WITH VOUCHERS APPROVED BY THE BOARD
OF JEFFERSON COUNTY COMMISSIONERS ARE RETAINED BY THE JEFFERSON COUNTY AUDITOR AND
PUBLIC WORKS DEPARTMENT.
I THE UNDERSIGNED BOARD OF COUNTY COMMISSIONERS DO HEREBY CERTIFY UNDER PENALTY OF
PERJURY THAT THE MATERIALS HAVE BEEN FURNISHED, THE SERVICES RENDERED OR THE LABOR
PERFORMED AS DESCRIBED HEREIN,THAT ANY ADVANCE PAYMENT IS DUE AND PAYABLE PURSUANT TO
A CONTRACT OR IS AVAILABLE AS AN OPTION FOR FULL OR PARTIAL FULFILLMENT OF A CONTRACTUAL
OBLIGATION, AND THAT THE CLAIM IS A JUST, DUE AND UNPAID OBLIGATION AGAINST JEFFERSON
COUNTY AND THAT I AM AUTHORIZED TO AUTHENTICATE AND CERTIFY TO SAID CLAIM.
CHAIRPERSON, COMMISSIONER
COMMISSIONER, MEMBER
COMMISSIONER, MEMBER
FUND SUMMARY
CHECK RUN DATE 5-26-2026
Row Labels Sum of AMOUNT
1 155583.95
107 178.85
108 785.08
109 11075.84
123 48498.62
125 6622.75
143 18009.27
148 159541.19
149 52559.58
174 992.12
175 6370.22
180 14793.57
401 69383.76
405 1084383.43
406 1136.34
501 9938.62
506 153358.47
507 6839.97
blank)
Grand Total 1800051.63
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
CONSENT AGENDA REQUEST
TO: Board of County Commissioners
FROM:Bonnie Obremski, Intellectual and Developmental Disabilities Coordinator
DATE: May 26, 2026
SUBJECT: ADVISORY BOARD REAPPOINTMENT re: Jefferson County
Intellectual/Developmental Disabilities Advisory Board (IDDAB); Amber
Kent
STATEMENT OF ISSUE:
The Jefferson County Intellectual/ Developmental Disabilities program requests reappointment of
member Amber Kent to the Jefferson County Intellectual/Developmental Disabilities Advisory
Board (IDDAB).
ANALYSIS:
On March 20, 2026, member Amber Kent completed the unexpired term of the vacant seat she filled
and now desires reappointment. A legal notice advertising the vacancy ran in the Port Townsend
Leader on Wednesday, March 11, 2026, with an application review deadline of Wednesday, May
20, 2026. No applications were received by the deadline.
FISCAL IMPACT:
Amber Kent meets the criteria to serve a "self-advocate"position on the IDDAB. As such, Amber
Kent is eligible to receive a $50 stipend per meeting attended as specified in the board's bylaws.
RECOMMENDATION:
The Jefferson County IDD program coordinator requests approval of the reappointment of Amber
Kent to the Jefferson County Intellectual/Developmental Disabilities Advisory Board.
REVIEWED BY:
Piedt240 t/ ( 61/)-4.
Jo D. Peters, County Administrator Date
Consent Agenda
Commissioners Office
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
FROM:Wendy Housekeeper, Executive Assistant
DATE: May 26, 2026
SUBJECT: ADVISORY BOARD RESIGNATION AND APPOINTMENT re: Jefferson
County Rural Library District Board of Trustees: 1) Resignation: Trustee
Michael Kubec and 2) Appointment: Trustee Stephen Chappuis
STATEMENT OF ISSUE:
On May 19, 2026, notice was received from Jefferson County Rural Library District Board of Trustees
Acting Director Annie Scott, that the following board member will be resigning from his term effective
May 1, 2026:
1. Trustee Michael Kubec
The Jefferson County Rural Library Board of Trustees considered applicants for this open position left
vacant upon the end of Trustee Miachel Kubec's resignation. After consideration of the candidates, the
Trustees request that the Board of County Commissioners (BOCC) appoint the following individual:
2. Trustee Stephen Chappuis
ANALYSIS:
After said recommendation the Jefferson County Rural Library District Board of Trustees is recommending
that the BOCC approve the following resignation and appointment of the following individuals:
1. Trustee Michael Kubec—Resigned effective May 1, 2026
2. Trustee Stephen Chappuis—Appointment to a(5)year term ending on May 26, 2030
RECOMMENDATION
1. Accept the resignation of Trustee Michael Kubec
2. Approve the appointment of Trustee Stephen Chappuis
REVIEWED BY:
e-t:) 1 /914'
Josh . Peters, County Administrator Date
615 Sheridan Street
Port Townsend, WA 98368
c9eiTehson www.JeffersonCountyPublicHealth.org
Consent Agenda
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Josh D. Peters, County Administrator
FROM: Apple Martine, JCPH Director
Veronica Shaw, JCPH Deputy Director
DATE: k/1I
SUBJECT: Agenda Item — Consolidated Contracts Amendment #14 with the Department
of Health; January 1, 2025 — December 31, 2027; $12,233 additional
STATEMENT OF ISSUE:
Jefferson County Public Health (JCPH) requests Board approval of Consolidated Contract Amendment #134
between JCPH and State of Washington Department of Health (DOH); January 1, 2025 — December 31, 2027;
additional funding of $12,233 for a total to date of $6,292,517.
ANALYSIS/STRATEGIC GOALS/PROS and CONS:
The purpose of this agreement is to provide public health services to the people of Washington State. This
amendment adds and/or amends statements of work (SOW) and funding for the following program(s):
Maternal & Child Health Block Grant (MCHBG) — this revision adds funding which supports interventions
that impact the target population of the MCHBG (additional funding of $12,233).
FISCAL IMPACT/COST BENEFIT ANALYSIS:
Total consideration for this Contract Amendment is $12,233. The Consolidated Contract is funded by DOH,
and comprises both Federal and State funds.
RECOMMENDATION:
JCPH Management recommends BoCC approval of Consolidated Contract Amendment #14 between JCPH and
DOH; January 1, 2025 — December 31, 2027; additional funding of $12,233.
REVIEWED BY:
5i,
Josh D. Peters, County Administrator Date
Community Health
Developmental Disabilities Environmental Public Health
360-385-9400 360-385-9444
360-385-9401 (f) f) 360-379-4487
Always working for a safer and healthier community
CC-25-001-A14
CONTRACT REVIEW FORM Clear Form
INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: State of WA Dept of Health Contract No: CC-25-001-A14
Contract For: Consolidated Contracts, Amendment 14 Term: 1/1/2025 - 12/31/2027
COUNTY DEPARTMENT: Public Health
Contact Person: Apple Martine
Contact Phone: x 443
Contact email: amartine@co.jefferson.wa.us
AMOUNT: $12,233 additional,for a total of$6,292,517
PROCESS' Exempt from Bid Process
Revenue: $12,233 Cooperative Purchase
Expenditure:Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s) of Matching Funds Vendor List Bid
Fund # 127 RFP or RFQ
Munis Org/Obj 12756220 Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COM / CE W 3 080 AND CHAPTER 42.23 RCW.
CERTIFIED: . N/A: ! May 13, 2026
Glenn Gilbert Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEB BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: N/A: G May 13, 2026
Glenn Gilbert Date
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche):
Electronically approved by Risk Management on 5/15/2026.
STEP 4: PROSECUTING ATTORNEY REVIEW (will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 5/14/2026.
State contract--difficult to change.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
Page 1 of 9
JEFFERSON COUNTY PUBLIC HEALTH
2025-2027 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH32053 AMENDMENT NUMBER: 14
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
DOH", and JEFFERSON COUNTY PUBLIC HEALTH, a Local Health Jurisdiction, hereinafter referred to as "LHJ",
pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract and any
subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
htlas://stateofwa.sharepoint.com/sites/doh-ofsfundi ngresources/sitepages/horne.aTy? eI:9a9.688da2d94d3ea80ac7tbe32e4d7c
Adds Statements of Work for the following programs:
Amends Statements of Work for the following programs:
Maternal & Child Health Block Grant—Effective January 1, 2025
Deletes Statements of Work for the following programs:
2. Exhibit B-14 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-13 Allocations
as follows:
Increase of$12,233 for a revised maximum consideration of$6,292,517.
Decrease of for a revised maximum consideration of
No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C Federal Grant Awards Index, incorporated by this reference, and located in the ConCon, Funding& BARS
library at the URL provided above.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
JEFFERSON COUNTY PUBLIC HEALTH STATE OF WASHINGTON
BOARD OF COUNTY COMMISSIONERS DEPARTMENT OF HEALTH
Greg Brotherton,Chair Date Date
APPROVE AS TO ORM ONLY: APPROVED AS TO FORM ONLY
I Assistant Attorney General
C May 14, 2026
Philip C. Hunsucker, Date
Chief Civil Deputy Prosecuting Attorney
Page I of 1
CC-25.011-A 1 1
EXHIBIT B-14 Page 2 of 9
Jefferson County Public Health ALLOCATIONS Contract Number: CLH32053
Contract Term:2025-2027 Date: May 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 11 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 1,994 23,449 27,516
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 9 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 722)
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WAI Amd 8 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 6,061)
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 4,8 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 28,238
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 11 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 1,994) 4,067
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 8 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 6,061
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 4 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 ($28,238) 0
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 2 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 28,238
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 8 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 3,448) $144,669 144,669
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 4 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 3,975
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 2 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 $144,142
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 13 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 62,893 113,693 113,693
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 12 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 25,400
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 11 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 10,837
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 9 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 14,563
FFY25 Farm Mkt Ntr Prog Mgmt USDA 7WA810WA7 Amd 4 10.572 333.10.57 01/01/25 09/30/25 10/01/24 09/30/25 637 637 637
FFY26 Swimming Beach Act IAR(ECY) 03J18701 Amd 12 66.472 333.66.47 03/01/26 10/31/26 07/01/25 11/30/26 8,000 8,000 21,500
FFY25 SWIMMING BEACH ACT IAR(ECY)01J74301 Amd 2 66.472 333.66.47 03/01/25 10/31/25 01/01/25 11/30/25 13,500 13,500
FFY25 PHEP BP2-CDC-LHJ Partners NU9OTU000055 Amd 9 93.069 333.93.06 07/01/25 06/30/26 07/01/25 06/30/26 14,857 34,384 48,138
FFY25 PHEP BP2-CDC-LHJ Partners NU9OTU000055 Amd 7 93.069 333.93.06 07/01/25 06/30/26 07/01/25 06/30/26 19,527
FFY24 PHEP BP1-CDC-LHJ Partners NU9OTU000055 Amd 1 93.069 333.93.06 01/01/25 06/30/25 07/01/24 06/30/25 13,754 13,754
FFY25 OD2A OID Prevent CDC NU17CE010218 Amd 13 93.136 333.93.1'3 09/01/25 06/30/26 09/01/25 08/31/26 30,667 128,667 248,344
FFY25 OD2A OID Prevent CDC NU17CE010218 Amd 10,13 93.136 333.93.13 09/01/25 06/30/26 09/01/25 08/31/26 98,000
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 10 93.136 333.93.13 07/01/25 08/31/25 09/01/24 08/31/25 21,788 38,121
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 6 93.136 333.93.13 07/01/25 08/31/25 09/01/24 08/31/25 16,333
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 2 93.136 333.93.13 01/01/25 06/30/25 09/01/24 08/31/25 32,556 81,556
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 1 93.136 333.93.13 01/01/25 06/30/25 09/01/24 08/31/25 49,000
FFY25 FPHPA Title X Family Plan FPHPA006560 Amd 9 93.217 333.93.21 04/01/25 03/31/26 04/01/25 03/31/26 21,049 38,072 55,038
FFY25 FPHPA Title X Family Plan FPHPA006560 Amd 5 93.217 333.93.21 04/01/25 03/31/26 04/01/25 03/31/26 17,023
FFY24 FPHPA Title X Family Plan FPHPA006560 Amd 3 93.217 333.93.21 01/01/25 03/31/25 04/01/24 03/31/25 8,345 16,966
FFY24 FPHPA Title X Family Plan FPHPA006560 Amd 21 93.217 333.93.21 01/01/25 03/31/25 04/01/24 03/31/25 8,621
FFY24 CDC PPHF Ops NH23IP922619 Amd 1 93.268 333.93.26 01/01/25 06/30/25 07/01/23 06/30/25 10,000 10,000 10,000
FFY20 ELC EDE LHJs CDC NU50CK000515 Amd 1,7 93.323 333.93.32 01/01/25 12/31/25 01/15/21 07/31/26 15,580 15,580 15,580
Page 1 of 3
EXHIBIT B-14
Page 3 of 9
Jefferson County Public Health ALLOCATIONS Contract Number: CLH32053
Contract Term:2025-2027 Date: May 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY19 ELC ED Immunizations CDC NU5OCK000515 Amd 9 93.323 333.93.32 07/01/25 06/30/26 07/01/25 07/30/26 10,000 10,000 10,000
FFY21 CDC COVID-19 PHWFD-LHJ NU90TP922181 Amd 3 93.354 333.93.35 01/01/25 06/30/25 07/01/23 06/30/25 51,330 51,330 51,330
PH Infrastructure Comp A1-LHJ NE110E000053 Amd 9 93.967 333.93.96 01/01/25 11/30/27 12/01/22 11/30/27 $200,000 350,300 350,300
PH Infrastructure Comp Al-LHJ NE110E000053 Amd 3 93.967 333.93.96 01/01/25 11/30/27 12/01/22 11/30/27 $150,300
FFY25 HRSA MCHBG LHJ Contracts B04MC54583 Amd 1 93.994 333.93.99 01/01/25 09/30/25 10/01/24 09/30/25 27,525 27,525 27,525
FFY25 MCHBG Special Pr HRSA 2 B04MC54583 Amd 9 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 3,376 3,376 3,376
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 14 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 S12,233 S28,736 S28,736
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 13 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 7,646
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 12 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 2,140
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 11 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 6,717
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 9 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 ($36,700) 0
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 7 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 36,700
SFY25 SBHC Proviso Amd 1 N/A 334.04.90 01/01/25 06/30/25 07/01/24 06/30/25 59,000 59,000 59,000
SFY26 Sch Based Hlth Cent 1225 Proviso Amd 7 N/A 334.04.90 07/01/25 06/30/26 07/01/25 06/30/26 $140,000 140,000 140,000
SFY25 DUH Naloxone DDO HCA IAR Amd 4 N/A 334.04.91 03/01/25 06/30/25 12/10/24 06/30/25 15,000 15,000 15,000
SFY26 Drug User Health Program Amd 6 N/A 334.04.91 07/01/25 06/30/26 07/01/25 06/30/26 $80,500 80,500 120,750
SFY25 Drug User Health Program Amd 1 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 40,250 40,250
SFY26 Sexual&Rep Hlth Cost Share Amd 9 N/A 334.04.91 01/01/26 06/30/26 07/01/25 06/30/26 41,664 41,664 137,061
SFY26 Sexual&Rep Hlth Cost Share Amd 7 N/A 334.04.91 07/01/25 12/31/25 07/01/25 06/30/26 47,404 47,404
SFY25 Sexual&Rep Hlth Cost Share Amd 1 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 47,993 47,993
SFY25 SSPS Opiod Harm Red Proviso Amd 2 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 8,000 8,000 8,000
SFY25 LHJ Opioid Campaign Proviso Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 24,500 56,000 56,000
SFY25 LHJ Opioid Campaign Proviso Amd 1 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 31,500
Rec Shellfish/Biotoxin Amd 6 N/A 334.04.93 07/01/25 06/30/26 07/01/25 06/30/26 7,500 7,500 11,200
Rec Shellfish/Biotoxin Amd 1 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 3,700 3,700
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 07/01/26 06/30/27 07/01/25 06/30/27 6,571 6,571 68,200
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 07/01/25 06/30/26 07/01/25 06/30/27 36,611 36,611
Page 2of3
EXHIBIT B-14
Page 4 of 9
Jefferson County Public Health ALLOCATIONS Contract Number: CLH32053
Contract Term:2025-2027 Date: May 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 8,763) 25,018
Small Onsite Management(ALEA) Amd 4 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 1,363
Small Onsite Management(ALEA) Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 32,418
SFY27 Wastewater Management-GFS Amd 8 N/A 334.04.93 07/01/26 06/30/27 07/01/26 06/30/27 31,822 31,822 49,824
SFY25 Wastewater Management-GFS Amd 8 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 8,763 18,002
SFY25 Wastewater Management-GFS Amd 4 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 1,363)
SFY25 Wastewater Management-GFS Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 10,602
SFY26 FPHS-LHJ Funds-GFS Amd 9 N/A 336.04.25 07/01/25 06/30/26 07/01/25 06/30/26 ($75,000) $2,128,000 4,461,000
SFY26 FPHS-LHJ Funds-GFS Amd 7 N/A 336.04.25 07/01/25 06/30/26 07/01/25 06/30/26 $2,203,000
SFY25 FPHS-LHJ Funds-GFS Amd 1 N/A 336.04.25 01/01/25 06/30/25 07/01/24 06/30/25 $2,333,000 $2,333,000
YR 1 Stimulus- Local Asst(10%of 15%)SS Amd 12 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 1,800 3,850 3,850
YR1 Stimulus-Local Asst(10%of 15%)SS Amd 11 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 250
YR1 Stimulus-Local Asst(10%of 15%)SS Amd 6 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 1,800
YR 28 SRF-Local Asst(15%)SS Amd 11 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 200 200 200
YR 28 SRF-Local Asst(15%)SS Amd 6 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 2,200)
YR 28 SRF-Local Asst(15%)SS Amd 4 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 2,200
YR 27 SRF-Local Asst(15%)SS Amd 4 N/A 346.26.64 01/01/25 06/30/25 07/01/23 06/30/25 2,200) 0
YR 27 SRF-Local Asst(15%)SS Amd 1 N/A 346.26.64 01/01/25 06/30/25 07/01/23 06/30/25 2,200
Sanitary Survey Fees SS-State Amd 12 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 1,800 4,050 4,050
Sanitary Survey Fees SS-State Amd 11 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 450
Sanitary Survey Fees SS-State Amd 6 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 400)
Sanitary Survey Fees SS-State Amd 1,6 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 2,200
YR 1 Stimulus- Local Asst(10%of 15%)TA Amd 12 N/A 346.26.66 01/01/25 12/31/27 07/01/23 06/30/28 1,000 2,000 2,000
YR1 Stimulus-Local Asst(10%of 15%)TA Amd 6 N/A 346.26.66 01/01/25 12/31/27 07/01/23 06/30/28 1,000
YR 28 SRF-Local Asst(15%)TA Amd 6 N/A 346.26.66 01/01/25 12/31/27 07/01/24 06/30/29 1,000) 0 0
YR 28 SRF-Local Asst(15%)TA Amd 4 N/A 346.26.66 01/01/25 12/31/27 07/01/24 06/30/29 1,000
YR 27 SRF-Local Asst(15%)TA Amd 4 N/A 346.26.66 01/01/25 06/30/25 07/01/23 06/30/25 1,000) SO
YR 27 SRF-Local Asst(15%)TA Amd 1 N/A 346.26.66 01/01/25 06/30/25 07/01/23 06/30/25 1,000
TOTAL 6,292,517 $6,292,517
Total consideration: 6,280,284 GRAND TOTAL 6,292,517
12,233
GRAND TOTAL 6,292,517 Total Fed S1,156,382
Total State S5,136,135
Assistance Listing Number fka Catalog of Federal Domestic Assistance
Federal revenue codes begin with"333". State revenue codes begin with"334".
Page 3 of 3
Page 5 of 9
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: Maternal& Child Health Block Grant— Local Health Jurisdiction Name: Jefferson County Public Health
Effective January 1, 2025
Contract Number: CLH32053
SOW Type: Revision Revision#(for this SOW) 6 Funding Source Federal Compliance Type of Payment
Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: January 1,2025 through September 30, 2026
El State FFATA (Transparency Act) Fixed Price
Other Research& Development
Statement of Work Purpose: The purpose of this statement of work(SOW) is to support local interventions that impact the target population of the Maternal and Child Health
Block Grant.
Revision Purpose: The purpose of this revision is to add additional FFY26 MCHBG LHJ CONTRACTS HRSA YR1 funding.
Master Assistance BARS Allocation
LHJ Funding Period ChangeIndexListingRevenueCurrentg Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
FFY25 HRSA MCHBG LHJ CONTRACTS 78101251 93.994 333.93.99 01/01/25 09/30/25 27,525 0 27,525
FFY26 MCHBG LHJ CONTRACTS HRSA YRl 78101261 93.994 333.93.99 10/01/25 09/30/26 16,503 12,233 28,736
FFY25 MCHBG SPECIAL PR HRSA 2 7810125A 93.994 333.93.99 10/01/25 09/30/26 3,376 0 3,376
0 0 0
0 0 0
0 0 0
TOTALS 47,404 12,233 59,637
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
Maternal and Child Health Block Grant(MCHBG)Administration
la Report actual expenditures for the six-month period Submit actual expenditures using the MCHBG May 16,2025 Reimbursement for actual
from October 1,2024 through March 31,2025. Budget Workbook to DOH Community costs,not to exceed total
Consultant.funding consideration.
lb Develop 2025-2026 MCHBG Budget Workbook for Submit MCHBG Budget Workbook to DOH September 5,2025 Monthly Reports must only
October 1,2025 through September 30,2026 using Community Consultant. reflect activities paid for
DOH-provided template. with funds provided in this
lc Participate in DOH-sponsored annual MCHBG meeting. LHJ Contract Lead or designee will attend September 30,2025 statement of work for the
meeting. specified funding period.
Exhibit A, Statement of Work Page 1 of 5 Contract Number CLH32053-Amendment 14
Page 6 of 9
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
I d Report actual expenditures for October 1,2024 through Submit actual expenditures using the MCHBG December 5,2025
September 30,2025. Budget Workbook to DOH Community See Program Specific
Consultant.Requirements and Special
I e Report actual expenditures for the six-month period Submit actual expenditures using the MCHBG May 15,2026 Billing Requirements.
from October 1,2025 through March 31,2026. Budget Workbook to DOH Community
Consultant.
1 f Report annual FTE billed to MCHBG.Submit FTE information on DOH-provided July 1,2026
template.
I g Develop 2026-2027 MCHBG Budget Workbook for Submit MCHBG Budget Workbook to DOH September 4,2026
October 1,2026 through September 30,2027 using Community Consultant.
DOH-provided template.
l h Participate in DOH-sponsored MCHBG fall regional LHJ Contract Lead or designee will attend September 30, 2026
meeting. regional meeting.
Implementation
2a Report 2024-25 MCHBG-funded activities and Submit monthly reports to DOH Community January 15,2025 Reimbursement for actual
outcomes using DOH-provided reporting template.As a Consultant.Describe in your updates within February 15,2025 costs,not to exceed total
foundation of your MCHBG work determine how each activity of the monthly report how you March 15,2025 funding consideration.
processes and programs can close gaps in health are intentionally focused on closing gaps in April 15,2025 Monthly Reports must only
outcomes.health outcomes. May 15,2025 reflect activities paid for
June 15,2025 with funds provided in this
July 15,2025 statement of work for the
August 15,2025 specified funding period.
September 15,2025
2b Develop 2025-26 MCHBG reporting document for Submit MCHBG reporting document to DOH Draft-August 15,2025 See Program Specific
October 1,2025 through September 30,2026 using Community Consultant. Final-September 12,2025 Requirements and Special
DOH-provided template. Billing Requirements.
2c Report 2025-26 MCHBG-funded activities and Submit monthly reports to DOH Community September report due
outcomes using DOH-provided reporting template.As a Consultant.Describe in your updates within October 15,2025
foundation of your MCHBG work determine how each activity of the monthly report how you November 15,2025
processes and programs can close gaps in health are intentionally focused on closing gaps in December 15,2025
outcomes.health outcomes. January 15,2026
February 15,2026
March 15,2026
April 15,2026
May 15,2026
June 15,2026
July 15,2026
August 15,2026
September 15,2026
Exhibit A, Statement of Work Page 2 of 5 Contract Number CLH32053-Amendment 14
Page 7 of 9
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
2d Develop 2026-27 MCHBG Monthly Reporting Submit MCHBG reporting document to DOH Draft—August 14,2026
Template for October 1,2026 through September 30, Community Consultant. Final—September 11,2026
2027 using DOH-provided template.
Children and Youth with Special Health Care Needs(CYSHCN)
3a Complete intake and renewal,per reporting guidance Submit data to DOH per CYSHCN Program January 15,2025 Reimbursement for actual
supplied by DOH, on all infants and children served by guidance. April 15,2025 costs,not to exceed total
the CYSHCN Program as referenced in CYSHCN July 15,2025 funding consideration.
Program guidance. If no CYSHCN care coordination Monthly Reports must only
enabling service)is provided in a given quarter,email reflect activities paid for
the CHIF administrator at DOH-CHIF@doh.wa.gov and with funds provided in this
indicate that zero clients were served during the quarter. statement of work for the
No spreadsheet is necessary when zero clients are specified funding period.
served.
3b Identify unmet needs for CYSHCN on Medicaid and Submit completed Health Services 30 days after forms are See Program Specific
refer to DOH CYSHCN Program for approval to access Authorization forms and Central Treatment completed. Requirements and Special
Diagnostic and Treatment funds as needed. Fund requests directly to the CYSHCN Through September 30, Billing Requirements.
Program as needed. 2025
3c Review your program's entry on ParentHelp123.org Document in the Administrative box on your September 30,2025
annually for accuracy. MCHBG report that you have updated
information on your local CYSHCN program
with WithinReach/Help Me Grow.
3d Support improvements to the local system of care Submit updates as part of monthly reporting January 15,2025
public health services and systems/policy,systems,and document. February 15,2025
environment)for CYSHCN.Refer to the Focus of Work March 15,2025
document for example activities and priority areas. April 15,2025
May 15,2025
June 15,2025
July 15,2025
August 15,2025
September 15,2025
3e Complete intake and renewal,per reporting guidance Submit data to DOH per CYSHCN Program October 15,2025
supplied by DOH, on all infants and children served by guidance. January 15,2026
the CYSHCN Program as referenced in CYSHCN April 15,2026
Program guidance. If no CYSHCN care coordination July 15,2026
enabling service)is provided in a given quarter,email
the CHIF administrator at DOH-CHIFAdoh.wa.gov and
indicate that zero clients were served during the quarter.
No spreadsheet is necessary when zero clients are
served.
3f Review your program's entry on Help Me Grow's Document in the Administrative box on your September 30,2026
ParentHelp 123 Resource Finder annually for accuracy. MCHBG report that you have updated
Exhibit A. Statement of Work Page 3 of 5 Contract Number CLH32053-Amendment 14
Page 8 of 9
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
information on your local CYSHCN program
with WithinReach/Help Me Grow.
3g Support improvements to the local system of care Submit updates as part of monthly reporting September report due
public health services and systems/policy,systems,and document. October 15,2025
environment)for CYSHCN.Refer to the Focus of Work November 15,2025
document for example activities and priority areas. December 15,2025
January 15,2026
February 15,2026
March 15,2026
April 15, 2026
May 15,2026
June 15,2026
July 15,2026
August 15,2026
September 15,2026
MCHBG Assessment and Evaluation
4a As part of the ongoing 5-year MCHBG Needs Submit documentation as requested by DOH. September 30,2025 Reimbursement for actual
Assessment,participate in activities developed and costs,not to exceed total
coordinated by DOH using DOH-provided reporting funding consideration.
template. Monthly Reports must only
4b Provide summary of outcomes of MCHBG-funded work Submit documentation as requested by DOH. November 21, 2025 reflect activities paid for
completed from October 1,2024 through September 30, with funds provided in this
2025 using DOH-provided reporting template. statement of work for the
4c As part of the ongoing 5-year MCHBG Needs Submit documentation as requested by DOH. September 30, 2026 specified funding period.
Assessment,participate in activities developed and
coordinated by DOH using DOH-provided reporting See Program Specific
template. Requirements and Special
Billing Requirements.
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to finance@doh.wa.gov.
Federal Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Exhibit A, Statement of Work Page 4 of 5 Contract Number CLH32053-Amendment 14
Page 9 of 9
Program Specific Requirements
Special Requirements:
All training costs and all travel expenses for such training(for example: per diem,hotel,registration fees)must be pre-approved,unless identified in pre-approved Budget
Workbook. Submit a paragraph to your Community Consultant explaining why the training is necessary to implement a strategy in the approved work plan. Details should also
include total cost of the training and a link to or brochure of the training. Retain a copy of the Community Consultant's approval in your records.
Program Manual,Handbook,Policy References:
CYSHCN Information and Resources:
Children and Youth with Special Health Care Needs Website(wa.gov)
Restrictions on Funds(i.e.,disallowed expenses or activities,indirect costs,etc.):
1. At least 30%of federal Title V funds must be used for preventive and primary care services for children and at least 30%must be used for services for children with
special health care needs. [Social Security Law, Sec. 505(a)(3)].
2. Funds may not be used for:
a. Inpatient services,other than inpatient services for children with special health care needs or high-risk pregnant women and infants,and other patient services approved by
Health Resources and Services Administration(HRSA).
b. Cash payments to intended recipients of health services.
c. The purchase or improvement of land,the purchase,construction,or permanent improvement of any building or other facility, or the purchase of major medical
equipment.
d. Meeting other federal matching funds requirements.
e. Providing funds for research or training to any entity other than a public or nonprofit private entity.
f. Payment for any services furnished by a provider or entity who has been excluded under Title XVIII(Medicare),Title XIX(Medicaid),or Title XX(social services block
grant).[Social Security Law, Sec 504(b)].
3. If any charges are imposed for the provision of health services using Title V(MCH Block Grant)funds, such charges will be pursuant to a public schedule of charges;will not
be imposed with respect to services provided to low-income mothers or children;and will be adjusted to reflect the income,resources,and family size of the individual
provided the services. [Social Security Law, Sec. 505(1)(D)J.
Monitoring Visits(i.e.,frequency,type,etc.):
Check-ins with DOH Community Consultant as needed.
Billing Requirements:
Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable A19-1A invoice voucher.Payment to completely expend the"Total Consideration"for
a specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices must be submitted monthly by the 30th of each month following
the month in which the expenditures were incurred and must be based on actual allowable program costs.Billing for services on a monthly fraction of the"Total Consideration"
will not be accepted or approved.
Special Instructions:
Contact DOH Community Consultant for approval of expenses not reflected in pre-approved Budget Workbook.
Exhibit A, Statement of Work Page 5 of 5 Contract Number CLH32053-Amendment 14
Page 1 of 27
JEFFERSON COUNTY PUBLIC HEALTH
2025-2027 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLU32053 AMENDMENT NUMBER: 13
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
DOH", and JEFFERSON COUNTY PUBLIC HEALTH, a Local Health Jurisdiction, hereinafter referred to as"LHJ",
pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract and any
subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
httos://state.fiva.sharelxoint.conllsites/doh-ofsfundinuresottrces/sitettages/home-asos? e1:9a94688da2dc)4d3ea8Oac7fbc32e=4d7c
Adds Statements of Work for the following programs:
Q Amends Statements of Work for the following programs:
Infectious Disease Syndemic Prevention Services-SSP- Effective July I, 2025
Maternal & Child Health Block Grant— Effective January 1, 2025
WIC Nutrition Program - Effective January 1, 2025
El Deletes Statements of Work for the following programs:
2. Exhibit B-13 Allocations, attached and incorporated by this reference,amends and replaces Exhibit B-I2 Allocations
as follows:
Q Increase of$101,206 fora revised maximum consideration of S6,280,284.
Decrease of for a revised maximum consideration of
No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C Federal Grant Awards Index, incorporated by this reference, and located in the ConCon, Funding& BARS
library at the URL provided above.
Unless designated otherwise herein, the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof.
JEFFERS N COUNTY WASHINGTON STATE OF WASHINGTON
BOARD F COUNTY COMMISSIONERS DEPARTMENT OF HEALTH
05/12/2026
rel, rot erton,Chair Da
i —
Date
APPROVED AS TO FORM ONLY: APPROVED AS TO FORM ONLY
04/29/2026 Assistant Attorney General
fy
Jeremia . L rer, Date
Deputy Prosecuting Attorney
Page 1 of
CC-25-0I I-AI ti
EXHIBIT B-13 Page 2 of 27
Jefferson County Public Health ALLOCATIONS Contract Number: CLH32053
Contract Term:2025-2027 Date: April 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 11 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 1,994 23,449 27,516
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 9 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 722)
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 8 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 6,061)
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 4,8 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 28,238
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 11 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 1,994) 4,067
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 8 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 6,061
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 4 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 ($28,238) 0
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 2 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 28,238
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 8 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 3,448) $144,669 144,669
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 4 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 3,975
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Mid 2 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 $144,142
FFY26 WIC Client Svs Contracts USDA 7WA700Vi a` Amd 13 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 62,893 113,693 113,693
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 12 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 25,400
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 11 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 10,837
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 9 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 14,563
FFY25 Farm Mkt Ntr Prog Mgmt USDA 7WA810WA7 Amd 4 10.572 333.10.57 01/01/25 09/30/25 10/01/24 09/30/25 637 637 637
FFY26 Swimming Beach Act IAR(ECY) 03J18701 Amd 12 66.472 333.66.47 03/01/26 10/31/26 07/01/25 11/30/26 8,000 8,000 21,500
FFY25 SWIMMING BEACH ACT IAR(ECY)01J74301 Mid 2 66.472 333.66.47 03/01/25 10/31/25 01/01/25 11/30/25 13,500 13,500
FFY25 PHEP BP2-CDC-LHJ Partners NU90TU000055 Amd 9 93.069 333.93.06 07/01/25 06/30/26 07/01/25 06/30/26 14,857 34,384 48,138
FFY25 PHEP BP2-CDC-LHJ Partners NU90TU000055 Amd 7 93.069 333.93.06 07/01/25 06/30/26 07/01/25 06/30/26 19,527
FFY24 PHEP BP1-CDC-LHJ Partners NU90TU000055 Amd 1 93.069 333.93.06 01/01/25 06/30/25 07/01/24 06/30/25 13,754 13,754
FFY25 OD2A OID Prevent CDC NU17CE010218 Amd 13 93.136 333.93.13 09/01/25 06/30/26 09/01/25 08/31/26 30,667 128,667 248,344
FFY25 OD2A OID Prevent CDC NU17CE010218 Amd 10,13 93.136 333.93.13 09/01/25 06/30/26 09/01/25 08/31/26 98,000
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 10 93.136 333.93.13 07/01/25 08/31/25 09/01/24 08/31/25 21,788 38,121
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 6 93.136 333.93.13 07/01/25 08/31/25 09/01/24 08/31/25 16,333
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 2 93.136 333.93.13 01/01/25 06/30/25 09/01/24 08/31/25 32,556 81,556
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 1 93.136 333.93.13 01/01/25 06/30/25 09/01/24 08/31/25 49,000
FFY25 FPHPA Title X Family Plan FPHPA006560 Amd 9 93.217 333.93.21 04/01/25 03/31/26 04/01/25 03/31/26 21,049 38,072 55,038
FFY25 FPHPA Title X Family Plan FPHPA006560 Amd 5 93.217 333.93.21 04/01/25 03/31/26 04/01/25 03/31/26 17,023
FFY24 FPHPA Title X Family Plan FPHPA006560 Mid 3 93.217 333.93.21 01/01/25 03/31/25 04/01/24 03/31/25 8,345 16,966
FFY24 FPHPA Title X Family Plan FPHPA006560 Amd 21 93.217 333.93.21 01/01/25 03/31/25 04/01/24 03/31/25 8,621
FFY24 CDC PPHF Ops NH23IP922619 Amd 1 93.268 333.93.26 01/01/25 06/30/25 07/01/23 06/30/25 10,000 10,000 10,000
FFY20 ELC EDE LHJs CDC NU50CK000515 Amd 1,7 93.323 333.93.32 01/01/25 12/31/25 01/15/21 07/31/26 15,580 15,580 15,580
Page 1 of 3
EXHIBIT B-13
Page 3 of 27
Jefferson County Public health ALLOCATIONS Contract'Sumber: C1.1132053
Contract Term:2025-2027 Date: April 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding hart of
Federal Award Assist Revenue 1.11.1 Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY19 ELC ED Immunizations CDC NU5OCK000515 Amd 9 93.323 333.93.32 07/01/25 06/30/26 07/01/25 07/30/26 10,000 10,000 10,000
FFY21 CDC COVID-19 PHWFD-LHJ NU90TP922181 Amd 3 93.354 333.93.35 01/01/25 06/30/25 07/01/23 06/30/25 51,330 51,330 51,330
PH Infrastructure Comp Al-LHJ NE11OE000053 Amd 9 93.967 333.93.96 01/01/25 11/30/27 12/01/22 11/30/27 $200,000 350,300 350,300
PH Infrastructure Comp Al-LHJ NE110E000053 Amd 3 93.967 333.93.96 01/01/25 11/30/27 12/01/22 11/30/27 $150,300
FFY25 HRSA MCHBG LHJ Contracts B04MC54583 Amd 1 93.994 333.93.99 01/01/25 09/30/25 10/01/24 09/30/25 27,525 27,525 27,525
FFY25 MCHBG Special Pr HRSA 2 B04MC54583 Amd 9 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 3,376 3,376 3,376
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 13 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 7,646 16,503 16,503
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 12 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 2,140
FFY26 MCHBG LHJ Contracts HRSA YRI B04MC55473 Amd 11 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 6,717
FFY26 MCHBG LHJ Contracts HRSA YRl B04MC55473 Amd 9 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 ($36,700) 0
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 7 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 36,700
SFY25 SBHC Proviso Amd 1 N/A 334.04.90 01/01/25 06/30/25 07/01/24 06/30/25 59,000 59,000 59,000
SFY26 Sch Based Hlth Cent 1225 Proviso Amd 7 N/A 334.04.90 07/01/25 06/30/26 07/01/25 06/30/26 $140,000 140,000 140,000
SFY25 DUH Naloxone DDO HCA IAR Amd 4 N/A 334.04.91 03/01/25 06/30/25 12/10/24 06/30/25 15,000 15,000 15,000
SFY26 Drug User Health Program Amd 6 N/A 334.04.91 07/01/25 06/30/26 07/01/25 06/30/26 80,500 80,500 120,750
SFY25 Drug User Health Program Amd 1 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 40,250 40,250
SFY26 Sexual&Rep Hlth Cost Share Amd 9 N/A 334.04.91 01/01/26 06/30/26 07/01/25 06/30/26 41,664 41,664 137,061
SFY26 Sexual&Rep Hlth Cost Share Amd 7 N/A 334.04.91 07/01/25 12/31/25 07/01/25 06/30/26 47,404 47,404
SFY25 Sexual&Rep Hlth Cost Share Amd 1 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 47,993 47,993
SFY25 SSPS Opiod Harm Red Proviso Amd 2 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 8,000 8,000 8,000
SFY25 LHJ Opioid Campaign Proviso Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 24,500 56,000 56,000
SFY25 LHJ Opioid Campaign Proviso Amd 1 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 31,500
Rec Shellfish/Biotoxin Amd 6 N/A 334.04.93 07/01/25 06/30/26 07/01/25 06/30/26 7,500 7,500 11,200
Rec Shellfish/Biotoxin Amd 1 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 3,700 3,700
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 07/01/26 06/30/27 07/01/25 06/30/27 6,571 6,571 68,200
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 07/01/25 06/30/26 07/01/25 06/30/27 36,611 36,611
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 8,763)25,018
Small Onsite Management(ALEA) Amd 4 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 1,363
Small Onsite Management(ALEA) Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 32,418
Page 2 of 3
EXHIBIT B-13
Page 4 of 27
Jefferson County Public Health ALLOCATIONS Contract Number: C1,1132053
Contract Term:2025-2027 Date: April 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program"Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
SFY27 Wastewater Management-GFS Amd 8 N/A 334.04.93 07/01/26 06/30/27 07/01/26 06/30/27 31,822 31,822 49,824
SFY25 Wastewater Management-GFS Amd 8 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 8,763 18,002
SFY25 Wastewater Management-GFS Amd 4 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 1,363)
SFY25 Wastewater Management-GFS Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 10,602
SFY26 FPHS-LHJ Funds-GFS Amd 9 N/A 336.04.25 07/01/25 06/30/26 07/01/25 06/30/26 ($75,000) $2,128,000 4,461,000
SFY26 FPHS-LHJ Funds-GFS Amd 7 N/A 336.04.25 07/01/25 06/30/26 07/01/25 06/30/26 $2,203,000
SFY25 FPHS-LHJ Funds-GFS Amd 1 N/A 336.04.25 01/01/25 06/30/25 07/01/24 06/30/25 $2,333,000 $2,333,000
YR 1 Stimulus- Local Asst(10%of 15%)SS Amd 12 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 1,800 3,850 3,850
YR1 Stimulus-Local Asst(10%of 15%)SS Amd 11 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 250
YR1 Stimulus-Local Asst(10%of 15%)SS Amd 6 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 1,800
YR 28 SRF-Local Asst(15%)SS Amd 11 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 200 200 200
YR 28 SRF-Local Asst(15%)SS Amd 6 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 2,200)
YR 28 SRF-Local Asst(15%)SS Amd 4 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 2,200
YR 27 SRF-Local Asst(15%)SS Amd 4 N/A 346.26.64 01/01/25 06/30/25 07/01/23 06/30/25 2,200) 0
YR 27 SRF-Local Asst(15%)SS Amd 1 N/A 346.26.64 01/01/25 06/30/25 07/01/23 06/30/25 2,200
Sanitary Survey Fees SS-State Amd 12 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 1,800 4,050 4,050
Sanitary Survey Fees SS-State Amd 11 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 450
Sanitary Survey Fees SS-State Amd 6 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 400)
Sanitary Survey Fees SS-State Amd 1,6 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 2,200
YR 1 Stimulus- Local Asst(10%of 15%)TA Amd 12 N/A 346.26.66 01/01/25 12/31/27 07/01/23 06/30/28 1,000 2,000 2,000
YR1 Stimulus-Local Asst(10%of 15%)TA Amd 6 N/A 346.26.66 01/01/25 12/31/27 07/01/23 06/30/28 1,000
YR 28 SRF-Local Asst(15%)TA Amd 6 N/A 346.26.66 01/01/25 12/31/27 07/01/24 06/30/29 1,000) 0 0
YR 28 SRF-Local Asst(15%)TA Amd 4 N/A 346.26.66 01/01/25 12/31/27 07/01/24 06/30/29 1,000
YR 27 SRF-Local Asst(15%)TA Amd 4 N/A 346.26.66 01/01/25 06/30/25 07/01/23 06/30/25 1,000) 0
YR 27 SRF-Local Asst(15%)TA Amd 1 N/A 346.26.66 01/01/25 06/30/25 07/01/23 06/30/25 1,000
TOTAL 6,280,284 $6,280,284
Total consideration: 6,179,078 GRAND TOTAL 6,280,284
101,206
GRAND TOTAL 6,280,284 Total Fed 1,144,149
Total State 5,136,135
Assistance Listing Number fka Catalog of Federal Domestic Assistance
Federal revenue codes begin with"333". State revenue codes begin with"334".
Page 3 of 3
Page 5 of 27
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: Infectious Disease Syndemic Prevention Services- Local Health Jurisdiction Name: Jefferson County Public Health
SSP-Effective July 1,2025
Contract Number: CLH32053
SOW Type: Revision Revision#(for this SOW) 2 Funding Source Federal Compliance Type of Payment
Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: July 1,2025 through June 30,2026
2] State FFATA(Transparency Act) El Fixed Price
Other Research&Development
Statement of Work Purpose: The purpose of this statement of work(SOW)is to provide Syndemic Prevention Services for infectious diseases(HIV,STI,and Adult Viral
Hepatitis), supporting the Office of Infectious Disease(OID)within Department of Health(DOH)
Revision Purpose: Add additional funds to FFY25 OD2A for a start date of 9/1/25.
Master Assistance BARS Allocation
LHJ Funding Period ChangeIndexListingRevenueCurrentg Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
SFY26 DRUG USER HEALTH PROGRAM 12405160 N/A 334.04.91 07/01/25 06/30/26 80,500 0 80,500
FFY24 OD2A OID CDC PREVENT 12405241 93.136 333.93.13_ 07/01/25 08/31/25 38,121 0 38,121
FFY25 OD2A OID PREVENT CDC 12405252 93.136 333.93.13 09/01/25 06/30/26 98,000 30,667 128,667
0 0 0
0 0 0
0 0 0
TOTALS 216,621 30,667 247,288
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
1 Syringe Services Programs: Support for Operations: SSP operations outcomes include delivering Enter deliverable data into the Reimbursement of
services and tracking: DOH/OID issued database for actual costs incurred,
Provide comprehensive Syringe Services Programs(SSP) • number of sterile syringes distributed tracking SSP activities by the not to exceed$80,500
to people who use drugs(PWUD). This plan of action is • number of naloxone kits distributed 15th of each month following for 07/01/25—06/30/26
directed to distribute syringes to communities that use • number of participant encounters service.
drugs to prevent transmission of infectious disease. SSPs • number of referrals to health and social
will operate during scheduled hours to provide all services
required harm reduction supplies,naloxone,and syringes
to prevent transmission of disease and overdose. SSPs Submit Performance Objectives&Work
will offer referrals to address social determinants of Plan within the first six months of contract
health. period that will include:
Outcomes aligned with program
strategies and activities.
Exhibit A,Statement of Work Page 1 of 11 Contract Number CLH32053-Amendment 13
Page 6 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
Priority populations for Syringe Services Programs SMART objectives aligned with
include people who use drugs,with a focus on: performance targets
People systemically marginalized and Activities aligned with program
underserved due to racism—Black/African outcomes
American,Latino/Latina/Latine/Latinx, Timeline for implementation(including
American Indian/Alaska Native people and staffing of the proposed program,
other communities for whom there are training,etc.)
documented health disparities in your region. • Anticipated capacity building or
People who are unhoused or unstably housed. technical assistance needs.
People engaged in sex work.
People involved in the criminal legal system. NOTE: See Special Requirements,Terms
Gender expansive/transgender individuals. and Conditions—Section 7 Performance
Gay,bi,and other men who have sex with men. Objectives&Workplans for additional
deliverable information
NOTE: See Special Requirements,Terms and
Conditions—Section 4 Syringe Services Programs:
Support for Operations Program Requirements for
additional task information.
Syringe Services Programs:Clinical Services SSP Clinical services outcomes may
include,but are not limited to,delivering
Provide direct access to clinical services to improve the services and tracking:
health and well-being of people who use drugs.At Number of wound care sessions
minimum,services must include onsite,low-barrier Number of infectious disease tests
access to wound care,infectious disease testing,STI and conducted(hepatitis C,HIV,
hepatitis C treatment,and medications for opioid use gonorrhea-chlamydia,syphilis)
disorder.Additional services can include mental health • %positive of infectious disease tests
services,sexual and reproductive health care,and other hepatitis C,HIV,gonorrhea-
primary care and psychosocial support services. chlamydia,syphilis)
Number of participants started on
NOTE: See Special Requirements,Terms and hepatitis C treatment
Conditions—Section 6 Syringe Services Program, Number of participants inducted on
Clinical Services Requirements for additional task
medications for opioid use disorder
information.
2 Syringe Services Programs:Harm Reduction Service Harm reduction care navigation outcomes Enter deliverable data into the Reimbursement of
Navigation include delivering services and tracking: DOH/OID issued database for actual costs incurred,
number of participants enrolled in care tracking SSP activities by the not to exceed$38,121
Provide appropriate referrals to SSP participants; navigation services 15th of each month following for
facilitate access to receive health care and medical number of care navigation sessions service. 07/01/25—08/31/25
services,social services,behavioral health counseling and • number of referrals to health and social
other services including substance use treatment services
Exhibit A,Statement of Work Page 2 of 11 Contract Number CLH32053-Amendment 13
Page 7 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
including medications for opiate use disorder, or number of linkages to care for health Reimbursement of
MOUD);housing;and advocacy,including but not and social services actual costs incurred,
limited to criminal legal involvement,medical providers, • number of outreach attempts per not to exceed$984104
benefits navigation,and family reunification. participant 128,667 for 09/01/25—
06/30/26
NOTE: See Special Requirements,Terms and
Conditions—Section 5 Syringe Services Program,
Harm Reduction Care Navigation Requirement for
additional task information
3 The LHJ will engage in OD2A-S evaluation activities for Quarterly submission of collected data and Enter quarterly data into the
work completed using OD2A-S funds. Evaluation answers to qualitative questions(as it DOH/OID issued template on
activities will involve: applies to your OD2A-S activities)on a the following dates:
As applicable,collecting data on CDC performance DOH-provided template For reporting period
measures to support DOH evaluation plan.9/1/25-11/30/25
o Total number of harm reduction service December 1,2025
encounters(e.g., in-person,mail,telephone, For reporting period
online)
12/1/25-2/28/26
o Zip code where harm reduction services March 1, 2025
were provided(list"unknown"when
For reporting periodlocationisunknown)
o Total number of navigators located in a
3/1/26-5/31/26
harm reduction setting or other setting June 1,2026
o Number of referrals to harm reduction For reporting period
services for each race ethnicity 6/1/26-8/31/26
o If possible,total number of hours spent by September 1,2026
each navigator on linkage to care or referral
efforts
o Type of organization where naloxone was
distributed(SSP, faith-based organizations,
schools,etc.)
o Zip code where naloxone was distributed
list"unknown"when unknown)
o Number of naloxone doses distributed at
each type of organization
o Number of service encounters involving
drug checking
o Zip code for drug checking encounters(list
unknown"when unknown)
o Number of referrals to MOUD for each
race/ethnicity
Exhibit A, Statement of Work Page 3 of 11 Contract Number CLH32053-Amendment 13
Page 8 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
o Number of referrals to behavioral health
treatment only(without MOUD)for each
race/ethnicity
o Number of other referrals,if not to MOUD
and behavioral health,with a description of
the type of referral
Providing answers to contextual performance
measures questions.
o How has access to care or treatment has
been improved,and what new/existing
community assets were leveraged?
o What are the barriers for people accessing
harm reduction services in your
jurisdiction?
o What are barriers to accessing or receiving
naloxone?
o Describe what types of navigators are
included in the data reported
o Describe methods to support navigators
Collaborating with the DOH evaluator on a Targeted
Evaluation Project(TEP)that will provide a greater
understanding of navigation activities.
Supporting other evaluation tasks as requested,to
meet overall CDC evaluation requirements.
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to financeAdoh.wa.gov.
Federal Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Program Specific Requirements
Special Requirements,Terms and Conditions
1. Definitions
a. ANONYMOUS SERVICES-HIV Prevention services including condom distribution,outreach and light touch.
Exhibit A,Statement of Work Page 4 of 11 Contract Number CLH32053-Amendment 13
Page 9 of 27
b. CAPACITY BUILDING-The process by which individuals and organizations obtain,improve,and retain the skills,knowledge,tools,equipment,and
other resources needed to do their jobs competently.
c. CONTRACTOR—For the purposes of this Statement of Work Only,the entity receiving funds directly from Washington State Department of Health
DOH)for client services to prevent or treat conditions named in the statement of work will be referred to as contractor.
d. HARM REDUCTION-Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.
e. INTEGRATED TESTING-For the purpose of this Statement of Work, Integrated Testing includes Human Immunodeficiency Virus(HIV), Gonorrhea
GC),Chlamydia(CT),Syphilis,Hepatitis C(HCV)and Hepatitis B(HBV).
f. SOCIAL DETERMINANTS OF HEALTH-Social determinants of health(SDOH)are the conditions in the environments where people are born, live,
learn,work,play,worship,and age that affect a wide range of health, functioning,and quality-of-life outcomes and risks.
g. YOUTH-For purposes of this agreement,the term"youth"applies to persons under the age of 18.
2. Submission of Invoice Vouchers—
a. On a monthly basis,the CONTRACTOR shall submit complete and correct A19 invoice vouchers with amounts billable to DOH under this statement of work
and the corresponding OID Expense Summary backup form.All A19 invoice vouchers must be submitted by the 25th of the following month. Prior approval is
required for a different frequency of billing.
i. The CONTRACTOR must provide all backup documentation as required based on the assigned risk level and/or as identified by DOH program staff
to determine allowability of billed expenses. Risk assessments are completed at the beginning of a new contract for all sub-recipient contracts.
Contact your contract manager if you are unaware of your assigned risk level.
ii. DOH may ask for additional backup information to pay invoices based on the needs of the funding sources supporting the work.
b. The CONTRACTOR shall submit all final claims for payment for costs due and payable under this statement of work by July 31,2026. DOH will pay belated
claims at its discretion,contingent upon the availability of funds.
3. Program Organization—CONTRACTOR must
a. The CONTRACTOR must provide a full updated organizational chart,including Board of Directors with contact information if applicable, and staffing plan
referencing positions described in the budget narrative.
b. The CONTRACTOR must provide job descriptions for any new or changed positions in the updated organizational chart.
i. Any new positions funded through the original contract funds,must have prior DOH approval.
c. The CONTRACTOR must notify their DOH contract manager within 30 days of any staff vacancies related to contracted positions and provide an updated
budget.
i. Any new fiscal staff responsible for invoicing on this contract will need to meet with the assigned OID Contract Manager within 60 days for DOH
invoice overview and training.
4. Syringe Services Program: Support for Operations Program Requirements
a. Operate for a minimum of 8 hours per week and 2 days per week.
b. Provide mobile and/or street outreach(note:programs must have a vehicle for mobile outreach.)
c. Offer safer injection supplies(see list of required safer injection supplies below).
d. Submit monthly SSP data in accordance with DOH standards.
e. Attend required capacity building/training opportunities provided by DOH.
f. Participate in annual site visits with DOH staff.
g. Demonstrate structure for receiving and incorporating participant feedback about services.
h. Partner with relevant local agencies to ensure effective outreach and service provision. (See Scope of Work narrative below for details on MOUs required.)
i. Develop and maintain a Universal Precautions and Sharps Handling policy and procedure,including clear,written policies on handling biohazardous waste,
avoiding unnecessary handling of sharps,and potential needle stick injuries to staff,volunteers,and participants.Programs should follow the universal precaution
guidelines established by the CDC and OSHA. SSPs may need to adapt those precautions to accommodate the circumstances of their work(e.g.,mobile and
outreach settings). Programs should also anticipate the potential of needlestick injury and have a"post-exposure-prophylaxis"protocol included in this document.
Exhibit A,Statement of Work Page 5 of 11 Contract Number CLH3 2053-Amendment 13
Page 10 of 27
j. All staff and volunteers working directly with participants/clients must complete CPR certification within the first 3 months after contract start date(if not
already complete).
5. Syringe Services Program,Harm Reduction Care Navigation Requirements
a. Includes all requirements for Syringe Service Program operations(see above)
b. Attend Harm Reduction Care Navigation training provided by DOH.
c. Support participant transportation(e.g.,through the provision of bus passes,cab vouchers,or direct transportation).
d. Accompany participants to appointments or provide"warm hand-offs."
e. Full-time care navigators(1.0 FTE) shall not exceed a case load greater than 25 individuals.
f. Submit monthly outcome data in accordance with DOH standards.
6. Syringe Services Program,Clinical Services Requirements
a. Includes all requirements for Syringe Service Program operations(see above)
b. Must have clinical staff licensed to practice in the state of Washington to provide clinical services(e.g.,RN, PA,ARNP,LCSW).
c. If providing advanced level clinical services(e.g., PA,ARNP,CNM),programs must have appropriate clinical oversight.
Note: Clinical services can be provided through sub-contractor arrangement or MOU with a Federally Qualified Health Center or other clinical
partner if there is a justification the relationship will support efforts to reach people who use drugs and provide onsite and/or mobile clinical services.
Clinical services can also be provided using telemedicine services with appropriate description of why in-person services cannot be provided and who
the telemedicine partner(s)will be.
NOTE: Funds from this contract may not be used to purchase basic safer injection supplies(listed below)—Instead,DOH will provide Contractors with supplies.
Below is the list of required supplies for SSP to be provided to Contractors by DOH:
a. Syringes(1 cc 27 gauge 1/2",28 gauge 1/2",and 29 gauge 1/2"; 1 cc 30 gauge 5/16";3 cc 25G 1"and 1.5")
b. Alcohol pads
c. Non-latex tourniquets
d. Sterile water
e. Sterile saline
f. Cookers
g. Cottons and/or cellulose filters
h. Bandages/gauze
i. Sharps containers(1 quart and 2 gallon for distribution, 8 gallon for program use)
j. Naloxone
k. Amber bags
The exceptions to these supplies are vendor or manufacturer supply shortages. If a program expects to run out of one of these items,please contact DOH immediately.
7. Performance Objectives&Work Plan:
a. Funded Syndemic Prevention Services agencies are required to submit Performance Objectives and Work Plan that provides both a high-level overview of the
period of performance and a detailed description of the first year of the contract period.The work plan should incorporate related program strategies and
activities.Applicants should propose specific,measurable,achievable,realistic,and time-based(SMART)process and/or outcome objectives for each activity
aligned with performance outcomes. The work plan should include training,capacity building,and TA needs to support the implementation of the funded
services.Proposed work plan activities may be adjusted in collaboration with OID staff to better address the overarching goals of the funded services. OID will
provide a template that must be used in developing the work plan.
b. The applicant should address the following outline in their work plan:
Exhibit A, Statement of Work Page 6 of 11 Contract Number CLH32053-Amendment 13
Page 11 of 27
i. Contract Year 2 Detailed Work Plan(For each funded service category)
ii. Program strategies and activities
iii. Outcomes aligned with program strategies and activities
iv. SMART objectives aligned with performance targets
v. Activities aligned with program outcomes
vi. Timeline for implementation(including staffing of the proposed program,training,etc.)
vii. Anticipated capacity building or technical assistance needs.
c. Performance Objectives&Work Plans should be submitted by December 31,2025.
d. OID staff are available to support in developing Performance Objectives&Work Plans in collaboration with funded agencies.
e. Performance Objectives&Work Plans will be reviewed between OID staff and funded agencies at least quarterly.Performance Objectives& Work Plans can be
adjusted throughout the period of performance.
8. Participation in program evaluation activities—The Contractor is expected to participate in program evaluation activities,including evaluation planning,and collecting
and reporting qualitative and quantitative program data,as deemed necessary by OID staff.
9. Participation in Capacity Building and Technical Assistance Activities designed to increase efficacy of Syndemic Services
a. Opportunities for capacity building and technical assistance for contractor will be offered throughout the contract year by WA DOH and other regional or
national capacity building organizations.
b. Contractors will be expected to meet with WA DOH OID staff on an annual basis to discuss training and will work with DOH to track shared completion of
Capacity Building Needs
c. All contracted staff will be required to complete training in respect to their role. DOH staff and contracted staff will work together to track completion of required
trainings.
10. CLAS Standards—The CONTRACTOR will comply with the National Standards for Culturally and Linguistically Appropriate Services(CLAS)standards(1,5-9).
National Standards for Culturally and Linguistically Appropriate Services(CLAS) in Health and Health Care(allianceforclas.org)
11. Participation in Program Monitoring Activities—
a. DOH will conduct semi-annual or annual performance site visits in the following areas:
i. Integrated testing
ii. Syndemic service navigation
iii. PrEP Housing
iv. Syringe Service Programs
v. Mail-order naloxone distribution program
vi. Fiscal Monitoring—To be scheduled by the DOH Fiscal Monitoring Unit
b. Corrective Action Plans—DOH may exercise the following options if the CONTRACTOR does not come into compliance or resolution with programmatic
and/or fiscal monitoring corrective action plan by the due date(s)identified in the CAP.i. §200.339 Remedies for noncompliance.
If a non-Federal entity fails to comply with the U.S.Constitution,Federal statutes,regulations or the terms and conditions of a Federal award,the Federal
awarding agency or pass-through entity may impose additional conditions,as described in§200.208.If the Federal awarding agency or pass-through entity
determines that noncompliance cannot be remedied by imposing additional conditions,the Federal awarding agency or pass-through entity may take one or more
of the following actions,as appropriate in the circumstances:
Exhibit A,Statement of Work Page 7 of 11 Contract Number CLH32053-Amendment 13
Page 12 of 27
a)Temporarily withhold cash payments pending correction of the deficiency by the non-Federal entity or more severe enforcement action by the Federal
awarding agency or pass-through entity.
b)Disallow(that is,deny both use of funds and any applicable matching credit for)all or part of the cost of the activity or action not in compliance.
c)Wholly or partly suspend or terminate the Federal award.
d)Initiate suspension or debarment proceedings as authorized under 2 CFR part 180 and Federal awarding agency regulations(or in the case of a pass-through
entity,recommend such a proceeding be initiated by a Federal awarding agency).
e)Withhold further Federal awards for the project or program.
f)Take other remedies that may be legally available
12. Contract Management—
a. Fiscal Guidance
i. Indirect-If charging indirect costs,the CONTRACTOR must have a current federally negotiated rate or De Minimis certification of file with DOH.
DOH is not able to reimburse indirect costs without an approved indirect cost rate or De Minimis certification of file.
ii. Advance Payments Prohibited—DOH funds are"cost reimbursement"funds. DOH will not make payment in advance or in anticipation of services
or supplies provided.This includes payments of"one-twelfth"of the current fiscal year's funding.
iii. Duplication of EIP Services—The CONTRACTOR shall not use contract funds to provide a parallel medication service to EIP. CONTRACTOR's
providing case management services shall make every effort to enroll clients in EIP.
iv. Payment of Cash or Checks to Clients Not Allowed—Where direct provision of service is not possible or effective,vouchers or similar programs,
which may only be exchanged for a specific service(e.g.,transportation),shall be used to meet the need for such services. CONTRACTOR shall
administer gift cards voucher programs to assure that recipients cannot readily convert vouchers into cash.
1. Store gift cards that can be redeemed at one merchant or an affiliated group of merchants for specific goods or services are allowable as
incentives for eligible program participants.
2. General-use prepaid cards are considered"cash equivalent"and are therefore unallowable. Such cards generally bear the logo of a payment
network,such as Visa,MasterCard,or American Express,and are accepted by any merchant that accepts those credit or debit cards as payment.
Gift cards that are cobranded with the logo of a payment network and the logo of a merchant or affiliated group of merchants are general-use
prepaid cards,not store gift cards,and therefore are unallowable.
3. The CONTRACTOR must ensure that a policy for managing gift cards with strong internal controls is in place.
v. Funds for Needle Exchange Programs Not Allowed with Federal Funding—CONTRACTOR shall not expend contract federal funds to support
needle exchange programs using funds from HIV Community Services Tasks.
vi. Travel—Out of staff travel requires prior approval from DOH and must follow GSA guidelines and reimbursement rates.
vii. Supervision,under DOH Community Programs contracts,will be understood as the delivery of a set of interrelated functions encompassing
administrative,educational and supportive roles that work collectively to ensure clinical staff(i.e.case managers,navigators,coordinators,assistants,
coaches)are equipped with the skills necessary to deliver competent and ethical services to clients that adhere to best practices within applicable
fields as well as all relevant Statewide Standards. Supervisors must meet the criteria set forth within the WA State HIV Case Management Standards
and provide the level of interaction and review detailed in that document.
It is the understanding of DOH that Supervision funded under the direct program portion of this contract include at minimum the provision of at least
two of the three functions detailed here:administrative,educational or supportive supervision.Supervision that encompasses only administrative
Exhibit A,Statement of Work Page 8 of 11 Contract Number CLH32053-Amendment 13
Page 13 of 27
functions will not be considered billable under Direct Program.To that end,it is the expectation of DOH that those personnel identified as Supervisors
have no more than one degree of separation from direct client care.Exceptions to this rule can be presented and considered to and by DOH Contract
Management.It will fall to the requesting organization to satisfactorily demonstrate that any Supervisory positions falling within the scope of Direct
Program are meeting the expectation of provision of educational or supportive supervision with the aim of directly impacting client experiences,
quality of services,and adherence to best practices and Statewide Standards.
viii. Small and Attractive items—Each Contractor shall perform a risk assessment(both financial and operational)on the agency's assets to identify
those assets that are particularly at risk or vulnerable to loss. Operational risks include risks associated with data security on mobile or portable
computing devices that store or have access to state data.Assets so identified that fall below the state's capitalization policy are considered small and
attractive assets.The Contractor shall develop written internal policies for managing small and attractive assets. Internal policies should take into
consideration the WaTech IT Security Standard SEC-04,which includes SEC-04-06-S Mobile Device Security Standard and SEC-04-01-G Media
Handling and Data Disposal Best Practices-https://watech.wa.gov/policies.
The Contractor shall implement specific measures to control small and attractive assets in order to minimize identified risks. Periodically,the
Contractor should perform a follow up risk assessment to determine if the additional controls implemented are effective in managing the identified
risks.
Contractor must include,at a minimum,the following assets with unit costs of$300 or more:
1. Laptops and Notebook Computers
2. Tablets and Smart Phones
Agencies must also include the following assets with unit costs of$1,000 or more:
1. Optical Devices,Binoculars,Telescopes,Infrared Viewers,and Rangefinders
2. Cameras and Photographic Projection Equipment
3. Desktop Computers(PCs)
4. Television Sets,DVD Players,Blu-ray Players,and Video Cameras(home type)
ix. Food and Refreshments—Food and refreshments are not allowable direct costs,unless provided in conjunction with allowable meetings,whose
primary purpose is the dissemination of technical information. Pre-approval is required when food and refreshments are purchased for these
meetings.A sign in sheet with the clients' ID number from the DOH approved data system as well as an agenda is required to receive reimbursement
for these charges.
1. The CONTRACTOR shall follow Healthy Nutrition Guidelines for Meetings and Events[Washington State Department of Health
when purchasing food and refreshments for approved meetings.
2. Food for staff meetings/training is unallowable.
PLEASE NOTE: If meals/refreshments are purchased for allowable meetings,food can only be
purchased for clients at the per diem rate. Any expenses over per diem will be denied. U.S. General Services Administration Per Diem
Look Up
x. Reimbursement of disallowed costs—The CONTRACTOR agrees to reimburse DOH for expenditures billed to the DOH for costs that are later
determined through audit or monitoring to be disallowed under the requirements of 2 CFR Part 200—Uniform Administrative Requirements,Cost
Principles,and Audit Requirements for Federal Audits.
Exhibit A,Statement of Work Page 9 of 11 Contract Number CLH32053-Amendment 13
Page 14 of 27
b. Contract Modifications
i. Notice of Change in Services—The CONTRACTOR shall notify DOH program staff,within 45 days,if any situations arise that may impede
implementation of the services contained in the statement of work.DOH and the CONTRACTOR will agree to strategies for resolving any shortfalls.
DOH retains the right to withhold funds in the event of substantial noncompliance.
ii. Contract Amendments—Effective Date—The CONTRACTOR shall not begin providing services authorized by a contract amendment until the
CONTRACTOR has received a signed and fully executed copy of the contract amendment from DOH.
1. Local Health Jurisdiction(LHJ)Contractors—Request for contract amendments must be received no less than 60 days prior to the Draft Due
Date identified by the CON CON SOW Schedule on the CON CON Dashboard.
2. Non-LHJ Contractors—Request for contract amendments must be received no later than 60 days prior to the end of the Federal Fiscal Year
FFY)and 90 days prior to end of the State Fiscal Year(SFY).
a. Amendments must be signed prior to the end of the FFY or SFY end date.
EX.FFY end date is 12/31,contract amendment request due to contract manager by 11/1
13. Youth and Peer Outreach Workers
All programs,including CONTRACTORS,using youth(either paid or volunteer)in program activities will use caution and judgment in the venues/situations where
youth workers are placed. Agencies will give careful consideration to the age appropriateness of the activity or venue.Agencies will also ensure that organizational staff
and youth comply with all relevant laws and regulations regarding entrance into adult establishments and environments.Agencies will also maintain and implement
appropriate safety protocols that include clear explanation of the appropriate laws and curfews and clearly delineate safe and appropriate participation of youth in program
outreach activities.
14. Whistleblower
a. Whistleblower statue,41 U.S.C.&4712,applies to all employees working for CONTRACTOR,subcontractors,and subgrantees on federal grants and contracts.
The statue(41 U.S.C.&4712)states that an"employee of a CONTRACTOR,subcontractor,grantee,or subgrantee,may not be discharged,demoted,or
otherwise discriminated against as a reprisal for"whistleblowing."In addition,whistleblower protections cannot be waived by an agreement,policy, form,or
condition of employment.
b. The National Defense Authorization Act(NDAA)for Fiscal Year 2013 (Pub. L. 112-239,enacted January 2,2013)mandates a pilot program entitled"Pilot
Program for Enhancement of Contractor Employee Whistleblower Protections."This program requires all grantees,their subgrantees,and subcontractors to:
i. Inform their employees working on any federal award they are subject to the whistleblower rights and remedies of the pilot program
ii. Inform their employees in writing of employee whistleblower protections under 41 U.S.C. &4712 in the predominant native language of the
workforce;and,
iii. CONTRACTOR and grantees will include such requirements in any agreement made with a subcontractor or subgrantee.
15. Allowable Costs
All expenditures incurred and reimbursements made for performance under this statement of work shall be based on actual allowable costs.Costs can include direct labor,
direct material,and other direct costs specific to the performance of activities or achievement of deliverables under this statement of work.
For information in determining allowable costs,please reference OMB Circulars:
2 CFR200(State,Local and Indian Tribal governments)at:https://www.federalregister.gov/documents/2013/12/26/2013-30465/uniform-administrative-
requ irements-cost-principles-and-audit-requirements-for-federal-awards.
Disclosure of information is governed by the Washington Administrative Code(WAC)246-101-120,520 and 635,and the Revised Code of Washington(RCW)
70.24.080,70.24.084,and 70.24.105 regarding the exchange of medical information among health care providers related to HIV/AIDS or STI diagnosis and treatment.
Exhibit A,Statement of Work Page 10 of 11 Contract Number CLH32053-Amendment 13
Page 15 of 27
Please note that CONTRACTORs fit under the definition of"health care providers"and"individuals with knowledge of a person with a reportable disease or condition"
in the WAC and RCW.
DOH statutory authority to have access to the confidential information or limited Dataset(s)identified in this agreement to the Information Recipient: RCW 43.70.050
Information Recipient's statutory authority to receive the confidential information or limited Dataset(s) identified in this Agreement: RCW 70.02.220(7)
Exhibit A, Statement of Work Page 11 of 11 Contract Number CLH32053-Amendment 13
Page 16 of 27
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: Maternal&Child Health Block Grant— Local Health Jurisdiction Name: Jefferson County Public Health
Effective January 1,2025
Contract Number: CLH32053
SOW Type: Revision Revision#(for this SOW) 5 Funding Source Federal Compliance Type of Payment
Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: January 1,2025 through September 30,2026
State FFATA(Transparency Act) Fixed Price
Other Research&Development
Statement of Work Purpose: The purpose of this statement of work(SOW)is to support local interventions that impact the target population of the Maternal and Child Health
Block Grant.
Revision Purpose: The purpose of this revision is to add additional FFY26 MCHBG LHJ CONTRACTS HRSA YR l funding.
Master Assistance BARS Allocation
LHJ Funding Period ChangeIndexListingRevenueCurrentTotal
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
FFY25 HRSA MCHBG LHJ CONTRACTS 78101251 93.994 333.93.99 01/01/25 09/30/25 27,525 0 27,525
FFY26 MCHBG LHJ CONTRACTS HRSA YR1 78101261 93.994 333.93.99 10/01/25 09/30/26 8,857 7,646 16,503
FFY25 MCHBG SPECIAL PR HRSA 2 7810125A 93.994 333.93.99 10/01/25 09/30/26 3,376 0 3,376
0 0 0
0 0 0
0 0 0
TOTALS 39,758 7,646 47,404
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
Maternal and Child Health Block Grant(MCHBG)Administration
la Report actual expenditures for the six-month period Submit actual expenditures using the MCHBG May 16,2025 Reimbursement for actual
from October 1,2024 through March 31,2025. Budget Workbook to DOH Community costs,not to exceed total
Consultant.funding consideration.
lb Develop 2025-2026 MCHBG Budget Workbook for Submit MCHBG Budget Workbook to DOH September 5,2025 Monthly Reports must only
October 1,2025 through September 30,2026 using Community Consultant. reflect activities paid for
DOH-provided template. with funds provided in this
lc Participate in DOH-sponsored annual MCHBG meeting. LHJ Contract Lead or designee will attend September 30,2025 statement of work for the
meeting. specified funding period.
Exhibit A, Statement of Work Page 1 of 5 Contract Number CLH32053-Amendment 13
Page 17 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
Id Report actual expenditures for October 1,2024 through Submit actual expenditures using the MCHBG December 5,2025
September 30,2025. Budget Workbook to DOH Community See Program Specific
Consultant.Requirements and Special
1 e Report actual expenditures for the six-month period Submit actual expenditures using the MCHBG May 15,2026 Billing Requirements.
from October 1,2025 through March 31,2026. Budget Workbook to DOH Community
Consultant.
l f Report annual FTE billed to MCHBG.Submit FTE information on DOH-provided July 1,2026
template.
lg Develop 2026-2027 MCHBG Budget Workbook for Submit MCHBG Budget Workbook to DOH September 4,2026
October 1,2026 through September 30,2027 using Community Consultant.
DOH-provided template.
lh Participate in DOH-sponsored MCHBG fall regional LHJ Contract Lead or designee will attend September 30,2026
meeting. regional meeting.
Implementation
2a Report 2024-25 MCHBG-funded activities and Submit monthly reports to DOH Community January 15,2025 Reimbursement for actual
outcomes using DOH-provided reporting template. As a Consultant.Describe in your updates within February 15,2025 costs,not to exceed total
foundation of your MCHBG work determine how each activity of the monthly report how you March 15,2025 funding consideration.
processes and programs can close gaps in health are intentionally focused on closing gaps in April 15,2025 Monthly Reports must only
outcomes.health outcomes. May 15,2025 reflect activities paid for
June 15,2025 with funds provided in this
July 15,2025 statement of work for the
August 15,2025 specified funding period.
September 15,2025
2b Develop 2025-26 MCHBG reporting document for Submit MCHBG reporting document to DOH Draft-August 15,2025 See Program Specific
October 1,2025 through September 30,2026 using Community Consultant. Final-September 12,2025 Requirements and Special
DOH-provided template. Billing Requirements.
2c Report 2025-26 MCHBG-funded activities and Submit monthly reports to DOH Community September report due
outcomes using DOH-provided reporting template. As a Consultant.Describe in your updates within October 15,2025
foundation of your MCHBG work determine how each activity of the monthly report how you November 15, 2025
processes and programs can close gaps in health are intentionally focused on closing gaps in December 15,2025
outcomes.health outcomes. January 15,2026
February 15,2026
March 15,2026
April 15,2026
May 15,2026
June 15,2026
July 15,2026
August 15,2026
September 15,2026
Exhibit A,Statement of Work Page 2 of 5 Contract Number CLH32053-Amendment 13
Page 18 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
2d Develop 2026-27 MCHBG Monthly Reporting Submit MCHBG reporting document to DOH Draft—August 14,2026
Template for October 1,2026 through September 30, Community Consultant. Final—September 11,2026
2027 using DOH-provided template.
Children and Youth with Special Health Care Needs(CYSHCN)
3a Complete intake and renewal,per reporting guidance Submit data to DOH per CYSHCN Program January 15,2025 Reimbursement for actual
supplied by DOH,on all infants and children served by guidance. April 15,2025 costs,not to exceed total
the CYSHCN Program as referenced in CYSHCN July 15,2025 funding consideration.
Program guidance. If no CYSHCN care coordination Monthly Reports must only
enabling service)is provided in a given quarter,email reflect activities paid for
the CHIF administrator at DOH-CHIF@doh.wa.gov and with funds provided in this
indicate that zero clients were served during the quarter. statement of work for the
No spreadsheet is necessary when zero clients are specified funding period.
served.
3b Identify unmet needs for CYSHCN on Medicaid and Submit completed Health Services 30 days after forms are See Program Specific
refer to DOH CYSHCN Program for approval to access Authorization forms and Central Treatment completed. Requirements and Special
Diagnostic and Treatment funds as needed. Fund requests directly to the CYSHCN Through September 30, Billing Requirements.
Program as needed. 2025
3c Review your program's entry on ParentHelp123.org Document in the Administrative box on your September 30,2025
annually for accuracy. MCHBG report that you have updated
information on your local CYSHCN program
with WithinReach/Help Me Grow.
3d Support improvements to the local system of care Submit updates as part of monthly reporting January 15,2025
public health services and systems/policy,systems,and document. February 15,2025
environment)for CYSHCN.Refer to the Focus of Work March 15,2025
document for example activities and priority areas. April 15,2025
May 15,2025
June 15,2025
July 15,2025
August 15,2025
September 15,2025
3 e Complete intake and renewal,per reporting guidance Submit data to DOH per CYSHCN Program October 15,2025
supplied by DOH,on all infants and children served by guidance. January 15,2026
the CYSHCN Program as referenced in CYSHCN April 15,2026
Program guidance.If no CYSHCN care coordination July 15,2026
enabling service)is provided in a given quarter,email
the CHIF administrator at DOH-CH1F@,doh.wa.gov and
indicate that zero clients were served during the quarter.
No spreadsheet is necessary when zero clients are
served.
3f Review your program's entry on Help Me Grow's Document in the Administrative box on your September 30,2026
ParentHelp123 Resource Finder annually for accuracy. MCHBG report that you have updated
Exhibit A,Statement of Work Page 3 of 5 Contract Number CLH32053-Amendment 13
Page 19 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
information on your local CYSHCN program
with WithinReach/Help Me Grow.
3g Support improvements to the local system of care Submit updates as part of monthly reporting September report due
public health services and systems/policy,systems,and document. October 15,2025
environment)for CYSHCN.Refer to the Focus of Work November 15,2025
document for example activities and priority areas. December 15,2025
January 15,2026
February 15,2026
March 15,2026
April 15,2026
May 15,2026
June 15,2026
July 15,2026
August 15,2026
September 15,2026
MCHBG Assessment and Evaluation
4a As part of the ongoing 5-year MCHBG Needs Submit documentation as requested by DOH. September 30,2025 Reimbursement for actual
Assessment,participate in activities developed and costs,not to exceed total
coordinated by DOH using DOH-provided reporting funding consideration.
template. Monthly Reports must only
4b Provide summary of outcomes of MCHBG-funded work Submit documentation as requested by DOH. November 21,2025 reflect activities paid for
completed from October 1,2024 through September 30, with funds provided in this
2025 using DOH-provided reporting template. statement of work for the
4c As part of the ongoing 5-year MCHBG Needs Submit documentation as requested by DOH. September 30,2026 specified funding period.
Assessment,participate in activities developed and
coordinated by DOH using DOH-provided reporting See Program Specific
template. Requirements and Special
Billing Requirements.
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to finance(a,doh.wa.gov.
Federal Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Exhibit A,Statement of Work Page 4 of 5 Contract Number CLH32053-Amendment 13
Page 20 of 27
Program Specific Requirements
Special Requirements:
All training costs and all travel expenses for such training(for example:per diem,hotel,registration fees)must be pre-approved,unless identified in pre-approved Budget
Workbook. Submit a paragraph to your Community Consultant explaining why the training is necessary to implement a strategy in the approved work plan. Details should also
include total cost of the training and a link to or brochure of the training. Retain a copy of the Community Consultant's approval in your records.
Program Manual,Handbook,Policy References:
CYSHCN Information and Resources:
Children and Youth with Special Health Care Needs Website(wa.gov)
Restrictions on Funds(i.e.,disallowed expenses or activities,indirect costs,etc.):
1. At least 30%of federal Title V funds must be used for preventive and primary care services for children and at least 30%must be used for services for children with
special health care needs. [Social Security Law,Sec.505(a)(3)].
2. Funds may not be used for:
a. Inpatient services,other than inpatient services for children with special health care needs or high-risk pregnant women and infants,and other patient services approved by
Health Resources and Services Administration(HRSA).
b. Cash payments to intended recipients of health services.
c. The purchase or improvement of land,the purchase,construction,or permanent improvement of any building or other facility,or the purchase of major medical
equipment.
d. Meeting other federal matching funds requirements.
e. Providing funds for research or training to any entity other than a public or nonprofit private entity.
f. Payment for any services furnished by a provider or entity who has been excluded under Title XVIII(Medicare),Title XIX(Medicaid),or Title XX(social services block
grant).[Social Security Law,Sec 504(b)].
3. If any charges are imposed for the provision of health services using Title V(MCH Block Grant)funds, such charges will be pursuant to a public schedule of charges;will not
be imposed with respect to services provided to low-income mothers or children;and will be adjusted to reflect the income,resources,and family size of the individual
provided the services. [Social Security Law, Sec. 505(1)(D)].
Monitoring Visits(i.e.,frequency,type,etc.):
Check-ins with DOH Community Consultant as needed.
Billing Requirements:
Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable A19-lA invoice voucher.Payment to completely expend the"Total Consideration"for
a specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices must be submitted monthly by the 30th of each month following
the month in which the expenditures were incurred and must be based on actual allowable program costs.Billing for services on a monthly fraction of the"Total Consideration"
will not be accepted or approved.
Special Instructions:
Contact DOH Community Consultant for approval of expenses not reflected in pre-approved Budget Workbook.
Exhibit A,Statement of Work Page 5 of 5 Contract Number CLH32053-Amendment 13
Page 21 of 27
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: WIC Nutrition Program -Effective January 1,2025 Local Health Jurisdiction Name: Jefferson County Public Health
Contract Number: CLH32053
SOW Type: Revision Revision#(for this SOW) 7 Funding Source Federal Compliance Type of Payment
Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: January 1,2025 through December 31,2027
El State FFATA(Transparency Act) El Fixed Price
Other Research&Development
Statement of Work Purpose: To provide Women, Infants,and Children(WIC)Nutrition Program services by following WIC federal regulations, WIC state office policies and
procedures,WIC directives,and other rules. Refer to the Program Specific Requirements section of this document.
Revision Purpose: To add funds to FFY26 WIC CLIENT SVS CONTRACTS USDA and update caseload.
Master Assistance BARS Allocation
LHJ Funding Period ChangeIndexListingRevenueCurrentg Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
FFY25 USDA WIC CLIENT SVS CONTRACTS 76101251 10.557 333.10.55 01/01/25 09/30/25 144,669 0 144,669
FFY24 BRSTFDG PEER CN PR MGMT USDA 7621424A 10.557 333.10.55 01/01/25 09/30/26 4,067 0 4,067
FFY25 BRSTFDG PEER CN PR MGMT USDA 76214250 10.557 333.10.55 01/01/25 09/30/27 23,449 0 23,449
FFY25 FARM MKT NTR PROG MGMT USDA 76540251 10.572 333.10.57 01/01/25 09/30/25 637 0 637
FFY26 WIC CLIENT SVS CONTRACTS USDA 76101261 10.557 333.10.55 10/01/25 09/30/26 50,800 62,893 113,693
0 0 0
TOTALS 223,622 62,893 ,286,515
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
See"Billing1WICNutritionProgram
Requirements" below.
1.1 Maintain authorized participating caseload at 100%based on Outcomes based on monthly participation Authorized participating
quarterly average as determined from monthly caseload data from state WIC caseload caseload for March 2025
management reports generated at state WIC office. management reports. through September 2026=
The Department of Health(Department)State WIC Nutrition 280
Program has the option of reducing authorized participating
caseload and corresponding funding when:Authorized participating
1. Unanticipated funding situations occur. caseload for March 2025
2. Reallocations are necessary to redistribute caseload through September 2026=
statewide. 300
3. Caseload declines.
Exhibit A, Statement of Work Page 1 of 7 Contract Number CLH32053-Amendment 13
Page 22 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
Authorized participating
caseload for October 2025
through September 2026 =
350
1.2 Submit the annual Nutrition Services Plan for each year of the Nutrition Services Plan First year due 9/30/25 Payment withheld if not
contract. Second year due 9/30/26 received by due date.
Third year due 9/30/27
1.3 Submit the annual Nutrition Services Expenditure Report for Nutrition Services Expenditure Report 11/30/25 Payment withheld if not
each year of the contract. 11/30/26 received by due date.
11/30/27
1.4 Tell participants about other health services in the agency. If Documentation must be available for Biennial WIC Monitor
needed,develop written agreements with other health care review by WIC monitor staff.
agencies and refer participants to these services.
1.5 Provide nutrition education services to participants and Documentation must be available for Biennial WIC Monitor
caregivers in accordance with federal and state requirements. review by WIC monitor staff.
1.6 Issue WIC benefits while assuring adequate WIC card security Documentation must be available for Biennial WIC Monitor
and reconciliation.review by WIC monitor staff.
1.7 Collect data,maintain records,and submit reports to effectively Documentation must be available for Biennial WIC Monitor
enforce the non-discrimination laws(Refer to Civil Rights review by WIC monitor staff.
Assurances below).
1.8a Submit entire WIC and Breastfeeding Peer Counseling Budget Budget Workbook First year due 9/30/25
Workbook for each year of the contract Second year due 9/30/26
Third year due 9/30/27
1.8b Submit Rev-Exp Report spreadsheet from the WIC Budget Revenue and Expense Report and A-19 First year due monthly
Workbook monthly with A-19 through September 30,2025
Second year due monthly
through September 30,2026
Third year due monthly
through September 30,2027
See"Billing2BreastfeedingPromotion
Requirements" below.
2.1 Provide breastfeeding promotion activities in accordance with Status report of chosen activities in First year due 11/30/25
federal and state requirements. Nutrition Services Plan.Second year due 11/30/26
Third year due 11/30/27
Documentation must be available for
review by WIC monitor staff. Biennial WIC Monitor
Exhibit A,Statement of Work Page 2 of 7 I, Contract Number CLH32053-Amendment 13
Page 23 of 27
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
2.2 Work with community partners to improve practices that affect Status report of chosen activities in First year due 8/30/25
breastfeeding. Choose one or more of the following projects: Nutrition Services Plan.Second year due 8/30/26
Provide staff,health care providers and community partners Third year due 8/30/27
virtual breastfeeding training resources. Documentation must be available for
Work with employers who likely employ low-income review by WIC monitor staff. Biennial WIC Monitor
people to create worksite environments that support
breastfeeding.
Work with birthing hospitals to improve maternity care
practices that affect WIC participant breastfeeding rates.
Provide participants access to lactation consultants.
Other projects will need pre-approval from the State WIC Office
3 Breastfeeding Peer Counseling Program(BFPC) See"Billing
Requirements" below.
3.1 Provide Breastfeeding Peer Counseling Program activities in Breastfeeding Peer Counseling Annual First year due 12/31/25
accordance with federal and state requirements.The WIC Report and expenditures from the Second year due 12/31/26
Breastfeeding Peer Counseling Program is meant to enhance, previous federal fiscal year. Third year due 12/31/27
not replace,WIC Breastfeeding promotion and support
activities. Documentation must be available for Biennial WIC Monitor
review by WIC monitor staff.
3.2 Track Breastfeeding Peer Counseling Program expenditures and Documentation must be available for Biennial WIC Monitor
bill separately from the WIC grant. review by WIC monitor staff.
4 Farmers Market Nutrition Program(FMNP) See"Billing
Requirements" below.
4.1 Issue FMNP benefits to eligible WIC participants by September Document in a Family Alert that FMNP Biennial WIC Monitor
30 of the current year. benefits were issued. Set the end date to
Participants have until October 31 of the current year to use October 31 of the current year for the
FMNP benefits at authorized farmers markets and farm stores. alert to dismiss at the end of the season.
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to finance( doh.wa.gov.
Federal Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Exhibit A, Statement of Work Page 3 of 7 Contract Number CLH32053-Amendment 13
Page 24 of 27
Program Specific Requirements
Program Manual,Handbook,Policy References:
The local agency shall be responsible for providing services according to rules,regulations and other information contained in the following:
WIC Federal Regulations, USDA,and FNS 7CFR Part 246.
Washington State WIC Nutrition Program Policy and Procedure Manual
Office of Management and Budget, Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards,2 CFR 200
Farmers Market Nutrition Program Federal Regulations,USDA, FNS 7CFR Part 248
Other directives issued during the term of the contract
Staffing Requirements:
The local agency shall:
Use Competent Professional Authority staff,as defined by WIC policy,to determine participant eligibility,prescribe an appropriate food package and offer nutrition
education based on the participants' needs.
Use a Registered Dietitian(RD)or other qualified nutritionist to provide nutrition services to high-risk participants,to include development of a high-risk care plan. The
RD is also responsible for quality assurance of WIC nutrition services. See WIC Policy for qualifications for a Registered Dietitian and other qualified nutritionist.
Assign a qualified person to be the Breastfeeding Coordinator to organize and direct local agency efforts to meet federal and state policies regarding breastfeeding
promotion and support. The Breastfeeding Coordinator must be an International Board-Certified Lactation Consultant or attend an intensive lactation management
course,or other state approved training.
Restrictions on Funds(i.e.,disallowed expenses or activities,indirect costs,etc.):
The local agency shall follow the instructions found in the Policy and Procedure Manual under WIC Allowable Costs and 2 CFR Part 200 Uniform Administrative Requirements,
Cost Principles,and Audit Requirements for Federal Awards.
Special References(i.e.,RCWs,WACs,etc.):
What is the WIC program?
1. The WIC program in the state of Washington is administered by the Department of Health.
2. The WIC program is a federally funded program established in 1972 by an amendment to the Child Nutrition Act of 1966. The purpose of the program is to provide nutrition
and health assessment;nutrition education;nutritious food;breastfeeding counseling; and referral services to pregnant,breastfeeding,and postpartum women,infants,and
young children in specific risk categories.
3. Federal regulations governing the WIC program(7 CFR Part 246)require implementation of standards and procedures to guide the state's administration of the WIC program.
These regulations define the rights,responsibilities, and legal procedures of WIC employees,participants,persons acting on behalf of a participant,and retailers. They are
designed to promote:
a. High quality nutrition services;
b. Consistent application of policies and procedures for eligibility determination;
c. Consistent application of policies and procedures for food benefit issuance and delivery;and
d. WIC program compliance.
4. The WIC program implements policies and procedures stated in program manuals,handbooks,contracts, forms,and other program documents approved by the USDA Food
and Nutrition Service.
5. The WIC program may impose sanctions against WIC participants for not following WIC program rules stated on the WIC rights and responsibilities.
6. The WIC program may impose monetary penalties against persons who misuse WIC benefits or WIC food but who are not WIC participants.
Monitoring Visits(i.e.,frequency,type,etc.):
Program and fiscal monitoring are done on a biennial(every two years)basis and are conducted onsite.
The local agency must maintain on file and have available for review,audit and evaluation:
Exhibit A,Statement of Work Page 4 of 7 Contract Number CLH32053-Amendment 13
Page 25 of 27
All criteria used for certification,including information on income,nutrition risk eligibility and referrals
Program requirements
Nutrition education
All financial records
Assurances/Certifications:
1. Computer Equipment Loaned by the Department of Health WIC Nutrition Program
In order to perform WIC program activities,the Department requires computer equipment,such as computers,signature pads,document scanners,card readers and printers to
be in local WIC clinics or to be transported to mobile clinics. This equipment("Loaned Equipment")is owned by the Department and loaned to the local agency(Contractor).
The Loaned Equipment is supported by the Department. This equipment shall be used for WIC business only or according to WIC Policy and Procedures.
An inventory of Loaned Equipment is kept by the Department. Each time Loaned Equipment is changed,the parties shall complete the Equipment Transfer Form and the
Department updates the inventory. A copy of the Transfer Form will be provided to the contractor. Copies of the updated inventory list may be requested at any time.
The local agency agrees to:
a. Defend,protect and hold harmless the Department or any of its employees from any claims,suits or actions arising from the use of this Loaned Equipment.
b. Assume responsibility for any loss or damage from abnormal wear or use,or from inappropriate storage or transportation. The Department may enforce this by:
1) Requiring reimbursement from the local agency of the value of the Loaned Equipment at the time of the loss or damage.
2) Requiring the local agency to replace the Loaned Equipment with equipment of the same type,manufacturer,and capabilities(as pre-approved by the Department),or
3) Assertion of a lien against the Contractor's property.
c. Notify the Department immediately of any damage to Loaned Equipment.
d. Notify the Department prior to moving or replacing any Loaned Equipment.
The Department recommends Contractors carry insurance against possible loss or theft.
2. Civil Rights Assurance
a. The local agency shall perform all services and duties necessary to comply with federal law in accordance with the following Civil Rights Assurance.
b. "The Program applicant hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964(42 U.S.C.2000d et seq.),Title IX of the Education Amendments
of 1972(20 U.S.C. 1681 et seq.),Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794),Age Discrimination Act of 1975 (42 U.S.C.6101 et seq.);all provisions
required by the implementing regulations of the Department of Agriculture;Department of Justice Enforcement Guidelines,28 CFR 50.3 and 42;and FNS directives and
guidelines,to the effect that,no person shall,on the ground of race,color,national origin, sex,age or handicap,be excluded from participation in,be denied benefits of,or
otherwise be subject to discrimination under any program or activity for which the Program applicant receives Federal financial assistance from FNS;and hereby gives
assurance that it will immediately take measures necessary to effectuate this agreement.
c. "By accepting this assurance,the Program applicant agrees to compile data,maintain records and submit reports as required, to permit effective enforcement of the
nondiscrimination laws and permit authorized USDA personnel during normal working hours to review such records,books and accounts as needed to ascertain
compliance with the nondiscrimination laws.If there are any violations of this assurance,the Department of Agriculture,Food and Nutrition Service,shall have the right
to seek judicial enforcement of this assurance.This assurance is binding on the Program applicant,its successors,transferees,and assignees,as long as it receives
assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear on the contract are authorized to sign this
assurance on behalf of the Program applicant."
3. 2CFR 200
The local agency shall comply with all the fiscal and operations requirements prescribed by the state agency as directed by Federal WIC Regulations(7CFR part 246.6),2CFR
part 200,the debarment and suspension requirements of 2CFR part 200.213,if applicable,the lobbying restrictions of 2CFR part 200.245,and FNS guidelines and instructions
and shall provide on a timely basis to the state agency all required information regarding fiscal and program information.
Exhibit A,Statement of Work Page 5 of 7 Contract Number CLH32053-Amendment 13
Page 26 of 27
Billing Requirements:
1. Definitions
Contract Period: January 1,2025—December 31,2027
Contract Budget Periods: The time periods for which the funding is budgeted.
There are four federal budget periods
January 1,2025,through September 30,2025
October 1,2025,through September 30,2026
October 1,2026,through September 30,2027
October 1,2027,through December 31,2027
2. Billing Information:
a. Billings are submitted on an A19-IA invoice. These invoices are provided by the Department in the WIC Budget Workbook and include accounting codes for different
budget categories.
b. Al 9s are submitted monthly and must be received by the Department within 30 days following the close of each calendar month.Additional A19s may be submitted at
any time but must be received within 45 days of the close of the federal budget period.
c. Funds are allocated by budget categories and by federal budget periods(refer to the budget spreadsheet).
d. Funds are encumbered or spent only during the budget period;no carry forward from previous time periods or borrowing from future time periods is allowed.
e. Payments are limited to the amounts allocated for the budget period for each budget category.
f. Billings are based on actual costs for completed activities. Advance payments are not allowed. Back-up documentation must be retained by the local agency and available
for inspection by the Department or other appropriate authorities.
g. Payments will be made only for WIC approved expenditures.Refer to the Washington State WIC Nutrition Program Policy and Procedure Manual Volume 2,Chapter 4—
Allowable Costs and 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards.
h. If billing for indirect costs,a Cost Allocation Plan or Federal Indirect Cost Agreement must be submitted prior to payment.
Special Instructions:
The local agency shall:
1. Maintain complete,accurate,and current accounting of all local,state,and federal program funds received and expended.
2. Provide,as necessary,a single audit in accordance with the provisions of 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for
Federal Awards. This circular requires all recipients and sub-recipients of federal funds to have a single audit performed should they spend$750,000 or more of federal grants
or awards from all sources. Contractors spending less than$750,000 in federal grants or awards may also be subject to audit.
3. Use Breastfeeding Peer Counseling(BFPC)Program funds only to support the peer counseling program. Once the program is established and peer counselors are trained,the
majority of the salary costs must be paid to peer counselors to provide direct services to WIC participants. For a list of allowable costs see Volume 2,Chapter 4—Allowable
Costs. The priority use of BFPC funds is to hire and train peer counselors to provide breastfeeding peer counseling services to WIC participants.
SPECIAL REQUIREMENTS
Contract Budget Period Time Period special requirement Amount Special Requirement Description
funds are available
January 1,2025—September 30,January 2025—September 2025 2,500 For general training funds.This funding is for all WIC staff to participate in
2025 WIC-related training.Added in the USDA WIC Client Services Contracts
category to cover training registrations,travel expenses, staff time to
participate in training(salary/benefits for part time or contractor),and other
approved training expenses.
Exhibit A,Statement of Work Page 6 of 7 Contract Number CLH32053-Amendment 13
Page 27 of 27
Other:
Any program requirements that are not followed may be subject to corrective action and may result in monetary fines or repayment of funds.
I
Exhibit A,Statement of Work Page 7 of 7 Contract Number CLH32053-Amendment 13
Page 1 of 21
JEFFERSON COUNTY PUBLIC HEALTH
2025-2027 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH32053 AMENDMENT NUMBER: 12
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
DOH", and JEFFERSON COUNTY PUBLIC HEALTH, a Local Health Jurisdiction, hereinafter referred to as"LHJ",
pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract and any
subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work,which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
tittps:,;siate«kka.charepoiutsprR sites!t oh-tifsfundinaresourecx'sit naPeeh/tr.me,amx? c1 944688cia2d9-1d3gatitl ic7fbc32e ld7c
Adds Statements of Work for the following programs:
BEACH Program - Effective March 1,2026
Amends Statements of Work for the following programs:
Maternal&Child Health Block Grant—Effective January I, 2025
Office of Drinking Water Group A Program -Effective January 1,2025
WIC Nutrition Program - Effective January 1, 2025
Deletes Statements of Work for the following programs:
2. Exhibit B-12 Allocations,attached and incorporated by this reference,amends and replaces Exhibit B-11 Allocations
as follows:
Increase of S40,140 for a revised maximum consideration of$6,179,07$.
Decrease of for a revised maximum consideration of
No change in the maximum consideration of .
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C Federal Grant Awards Index, incorporated by this reference, and located in the ConCon,Funding&BARS
library at the URL provided above.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof
JEFFERSON COUNTY WASHINGTON STATE OF WASHINGTON
BOARD OF OUNTY COMMISSIONERS DEPARTMENT OF HEALTH
Lb catibUk.03/11/2026
Greg rotherton,Chair Dale
V
Date
AP, @V,ED S TO FORM ONLY APPROVED AS TO FORM ONLY
Jeremiah B.Luther,DPA Assistant Attorney General
02/27/2026
hi p'C. H isucker, Date Page 1 of l
ief Civ' eputy Prosecuting Attorney
CC 25-OO1•Al:
EXHIBIT B-12 Page 2 of 21
lefferson County Public Health ALLOCATIONS Contract Number: CLH32053
Contract Term:2025-2027 Date: February 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 11 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 1,994 23,449 27,516
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 9 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 722)
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 8 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 6,061)
FFY25 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 4,8 10.557 333.10.55 01/01/25 09/30/27 10/01/24 09/30/27 28,238
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 11 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 1,994) 4,067
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 8 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 6,061
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 4 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 ($28,238) 0
FFY24 Brstfdg Peer Cn Pr Mgmt USDA 7WA700WA1 Amd 2 10.557 333.10.55 01/01/25 09/30/26 10/01/23 09/30/26 28,238
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 8 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 3,448) $144,669 144,669
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 4 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 3,975
FFY25 USDA WIC Client Svs Contracts 7WA700WA7 Amd 2 10.557 333.10.55 01/01/25 09/30/25 10/01/24 09/30/25 $144,142
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 kind 12 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 25,400 50,800 50,800
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 11 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 10,837
FFY26 WIC Client Svs Contracts USDA 7WA700WA7 Amd 9 10.557 333.10.55 10/01/25 09/30/26 10/01/25 09/30/26 14,563
FFY25 Farm Mkt Ntr Prog Mgmt USDA 7WA810WA7 Amd 4 10.572 333.10.57 01/01/25 09/30/25 10/01/24 09/30/25 637 637 637
FFY26 Swimming Beach Act IAR(ECY) 03J18701 Amd 12 66.472 333.66.47 03/01/26 10/31/26 07/01/25 11/30/26 8,000 8,000 21,500
FFY25 SWIMMING BEACH ACT IAR(ECY)01J74301 Amd 2 66.472 333.66.47 03/01/25 10/31/25 01/01/25 11/30/25 13,500 13,500
FFY25 PHEP BP2-CDC-LHJ Partners NU90TU000055 Amd 9 93.069 333.93.06 07/01/25 06/30/26 07/01/25 06/30/26 14,857 34,384 48,138
FFY25 PHEP BP2-CDC-LHJ Partners NU90TU000055 Amd 7 93.069 333.93.06 07/01/25 06/30/26 07/01/25 06/30/26 19,527
FFY24 PHEP BP1-CDC-LHJ Partners NU90TU000055 Amd 1 93.069 333.93.06 01/01/25 06/30/25 07/01/24 06/30/25 13,754 13,754
FFY25 OD2A OID CDC Prevent NU17CE010218 Amd 10 93.136 333.93.13 09/01/25 06/30/26 09/01/25 08/31/26 98,000 98,000 217,677
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 10 93.136 333.93.13 07/01/25 08/31/25 09/01/24 08/31/25 21,788 38,121
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 6 93.136 333.93.13 07/01/25 08/31/25 09/01/24 08/31/25 16,333
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 2 93.136 333.93.13 01/01/25 06/30/25 09/01/24 08/31/25 32,556 81,556
FFY24 OD2A OID CDC Prevent NU17CE010218 Amd 1 93.136 333.93.13 01/01/25 06/30/25 09/01/24 08/31/25 49,000
FFY25 FPHPA Title X Family Plan FPHPA006560 Amd 9 93.217 333.93.21 04/01/25 03/31/26 04/01/25 03/31/26 21,049 38,072 55,038
FFY25 FPHPA Title X Family Plan FPHPA006560 Amd 5 93.217 333.93.21 04/01/25 03/31/26 04/01/25 03/31/26 17,023
FFY24 FPHPA Title X Family Plan FPHPA006560 Amd 3 93.217 333.93.21 01/01/25 03/31/25 04/01/24 03/31/25 8,345 16,966
FFY24 FPHPA Title X Family Plan FPHPA006560 Amd 21 93.217 333.93.21 01/01/25 03/31/25 04/01/24 03/31/25 8,621
FFY24 CDC PPHF Ops NH23IP922619 Amd 1 93.268 333.93.26 01/01/25 06/30/25 07/01/23 06/30/25 10,000 10,000 10,000
FFY20 ELC EDE LHJs CDC NU50CK000515 Amd 1,7 93.323 333.93.32 01/01/25 12/31/25 01/15/21 07/31/26 15,580 15,580 15,580
FFY19 ELC ED Immunizations CDC NU50CK000515 Amd 9 93.323 333.93.32 07/01/25 06/30/26 07/01/25 07/30/26 10,000 10,000 10,000
FFY21 CDC COVID-19 PHWFD-LHJ NU90TP922181 Amd 3 93.354 333.93.35 01/01/25 06/30/25 07/01/23 06/30/25 51,330 51,330 51,330
Page 1 of 3
EXHIBIT B-12
Page 3 of 21
Jefferson County Public Health ALLOCATIONS Contract Number: CLH32053
Contract Term:2025-2027 Date: February 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
PH Infrastructure Comp A1-LHJ NE110E000053 Amd 9 93.967 333.93.96 01/01/25 11/30/27 12/01/22 11/30/27 $200,000 350.300 350,300
PH Infrastructure Comp Al-LHJ NE110E000053 Amd 3 93.967 333.93.96 01/01/25 11/30/27 12/01/22 11/30/27 $150,300
FFY25 HRSA MCHBG LHJ Contracts B04MC54583 Amd 1 93.994 333.93.99 01/01/25 09/30/25 10/01/24 09/30/25 27,525 27,525 27,525
FFY25 MCHBG Special Pr HRSA 2 B04MC54583 Amd 9 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 3,376 3.376 3,376
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 12 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 2,140 8,857 S8,85'
FFY26 MCHBG LI-U Contracts HRSA YR1 B04MC55473 Amd 11 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 6,717
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 9 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 ($36,700) 0
FFY26 MCHBG LHJ Contracts HRSA YR1 B04MC55473 Amd 7 93.994 333.93.99 10/01/25 09/30/26 10/01/25 09/30/26 36,700
SFY25 SBHC Proviso Amd 1 N/A 334.04.90 01/01/25 06/30/25 07/01/24 06/30/25 59,000 59,000 59,000
SFY26 Sch Based Hlth Cent 1225 Proviso Amd 7 N/A 334.04.90 07/01/25 06/30/26 07/01/25 06/30/26 $140,000 140,000 140,000
SFY25 DUH Naloxone DDO HCA IAR Amd 4 N/A 334.04.91 03/01/25 06/30/25 12/10/24 06/30/25 15,000 15,000 15,000
SFY26 Drug User Health Program Amd 6 N/A 334.04.91 07/01/25 06/30/26 07/01/25 06/30/26 80,500 80,500 120,750
SFY25 Drug User Health Program Amd 1 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 40,250 40,250
SFY26 Sexual&Rep Hlth Cost Share Amd 9 N/A 334.04.91 01/01/26 06/30/26 07/01/25 06/30/26 41,664 41,664 137,061
SFY26 Sexual&Rep Hlth Cost Share Amd 7 N/A 334.04.91 07/01/25 12/31/25 07/01/25 06/30/26 47,404 47,404
SFY25 Sexual&Rep Hlth Cost Share Amd 1 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 47,993 47,993
SFY25 SSPS Opiod Harm Red Proviso Amd 2 N/A 334.04.91 01/01/25 06/30/25 07/01/24 06/30/25 8,000 8,000 8,000
SFY25 LHJ Opioid Campaign Proviso Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 24,500 56,000 56,000
SFY25 LHJ Opioid Campaign Proviso Amd 1 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 31,500
Rec Shellfish/Biotoxin Amd 6 N/A 334.04.93 07/01/25 06/30/26 07/01/25 06/30/26 7,500 7,500 11,200
Rec Shellfish/Biotoxin Amd 1 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 3,700 3,700
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 07/01/26 06/30/27 07/01/25 06/30/27 6,571 6,571 68,200
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 07/01/25 06/30/26 07/01/25 06/30/27 36,611 36,611
Small Onsite Management(ALEA) Amd 8 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 8,763)25,018
Small Onsite Management(ALEA) Amd 4 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 1,363
Small Onsite Management(ALEA) Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/23 06/30/25 32,418
SFY27 Wastewater Management-GFS Amd 8 N/A 334.04.93 07/01/26 06/30/27 07/01/26 06/30/27 31,822 31,822 49,824
SFY25 Wastewater Management-GFS Amd 8 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 8,763 18,002
SFY25 Wastewater Management-GFS Amd 4 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 1,363)
SFY25 Wastewater Management-GFS Amd 3 N/A 334.04.93 01/01/25 06/30/25 07/01/24 06/30/25 10,602
Page 2 of 3
EXHIBIT B-12 Page 4 of 21
Jefferson County Public Health ALLOCATIONS Contract Number: CLH32053
Contract Term:2025-2027 Date: February 1,2026
Indirect Rate January 1,2025 through December 31,2025:27.38%Public Health
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend#List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
SFY26 FPHS-LHJ Funds-GFS Amd 9 N/A 336.04.25 07/01/25 06/30/26 07/01/25 06/30/26 ($75,000) $2,128,000 4,461,000
SFY26 FPHS-LHJ Funds-GFS Amd 7 N/A 336.04.25 07/01/25 06/30/26 07/01/25 06/30/26 $2,203,000
SFY25 FPHS-LHJ Funds-GFS Amd 1 N/A 336.04.25 01/01/25 06/30/25 07/01/24 06/30/25 $2,333,000 $2,333,000
YR 1 Stimulus- Local Asst(10%of 15%)SS Amd 12 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 1,800 3,850 3.8511
YR1 Stimulus-Local Asst(10%of 15%)SS Amd 11 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 250
YR1 Stimulus-Local Asst(10%of 15%)SS Amd 6 N/A 346.26.64 01/01/25 12/31/27 07/01/23 06/30/28 1,800
YR 28 SRF-Local Asst(15%)SS Amd 11 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 200 200 200
YR 28 SRF-Local Asst(15%)SS Amd 6 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 2,200)
YR 28 SRF-Local Asst(15%)SS Amd 4 N/A 346.26.64 01/01/25 12/31/27 07/01/24 06/30/29 2,200
YR 27 SRF-Local Asst(15%)SS Amd 4 N/A 346.26.64 01/01/25 06/30/25 07/01/23 06/30/25 2,200) 0
YR 27 SRF-Local Asst(15%)SS Amd 1 N/A 346.26.64 01/01/25 06/30/25 07/01/23 06/30/25 2,200
Sanitary Survey Fees SS-State Amd 12 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 1,800 4,050 4,050
Sanitary Survey Fees SS-State Amd 11 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 450
Sanitary Survey Fees SS-State Amd 6 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 400)
Sanitary Survey Fees SS-State Amd 1,6 N/A 346.26.65 01/01/25 12/31/27 07/01/23 12/31/27 2,200
YR 1 Stimulus- Local Asst(10%of 15%)TA Amd 12 N/A 346.26.66 01/01/25 12/31/27 07/0I/23 06/30/28 1,000 2,000 2,000
YR1 Stimulus-Local Asst(10%of 15%)TA Amd 6 N/A 346.26.66 01/01/25 12/31/27 07/01/23 06/30/28 1,000
YR 28 SRF-Local Asst(15%)TA Amd 6 N/A 346.26.66 01/01/25 12/31/27 07/01/24 06/30/29 1,000) 0 0
YR 28 SRF-Local Asst(15%)TA Amd 4 N/A 346.26.66 01/01/25 12/31/27 07/01/24 06/30/29 1,000
YR 27 SRF-Local Asst(15%)TA Amd 4 N/A 346.26.66 01/01/25 06/30/25 07/01/23 06/30/25 1,000) 0
YR 27 SRF-Local Asst(15%)TA Amd 1 N/A 346.26.66 01/01/25 06/30/25 07/01/23 06/30/25 1,000
TOTAL 6,179,078 $6,179,078
Total consideration: 6,138,938 GRAND TOTAL S6,179,078
40,140
GRAND TOTAL 6,179,078 Total Fed 1,042,943
Total State 5,136,135
Assistance Listing Number fka Catalog of Federal Domestic Assistance
Federal revenue codes begin with"333". State revenue codes begin with"334".
Page 3 of 3
Page 5 of 21
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: BEACH Program-Effective March 1,2026 Local Health Jurisdiction Name: Jefferson County Public Health
Contract Number: CLH32053
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: March 1,2026 through October 31,2026
State FFATA(Transparency Act) Fixed Price
Other Research&Development
Statement of Work Purpose: The Beach Environmental Assessment,Communication,and Health(BEACH)Program works with LHJ to monitor water at marine swimming
beaches for bacteria and provide public notification when levels are unsafe.This work is funded by an interagency agreement issued by Department of Ecology(ECY) for
administration by DOH. Reference DOH Contract#GVS32430.
Revision Purpose: N/A
Master Assistance BARS Allocation
LHJ Funding Period ChangeIndexListingRevenueCurrentg Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
FFY26 SWIMMING BEACH GRANT IAR(ECY) 26505926 66.472 333.66.47 03/01/26 10/31/26 0 8,000 8,000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
TOTALS 0 8,000 8,000
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
1 BEACH Program Administration and Annual Meeting: Time Summarize time spent on administrative Annual meeting held in Reimbursement for actual
spent on administrative duties related to the BEACH duties in annual report. March 2026. Annual report costs up to$8,000 for
Program and the 2026 Annual meeting. due October 31,2026. tasks 1-3. Sub-recipient
2 Bacteria Monitoring&Public Notification 1. Enter data into Department of Ecology's 1. Enter data results into may use their discretion in
Collect samples and field observations in BEACH Program Database. database by Friday each prioritizing which task(s)
accordance with BEACH Program Quality week of sample collection. to pay with this award.
Assurance Project Plan(QAPP).Notify BEACH 2. Email copies of laboratory analytical
Program Coordinator in advance if samples cannot reports to BEACH Program Coordinator.2. Email copies of reports
be collected. Coordinate deviations from the QAPP upon receipt.
and/or schedule with the BEACH Program 3. Include a list of swimming advisories in
Coordinator.annual report. 3. Annual report due
Post and/or remove swimming advisory signs as October 31,2026.
needed. Provide public education about beach water
Exhibit A, Statement of Work Page 1 of 2 Contract Number CLH32053-Amendment 12
Page 6 of 21
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
quality.Notify BEACH Program Coordinator of
swimming advisories as soon as possible.
3 Illness Pollution Investigations 1. Provide notification via telephone to 1. Within fourteen(14)
Notify BEACH Program Coordinator of any illness reports BEACH Program Coordinator. business days.
related to recreational swimming beaches.Conduct illness
investigations as needed. 2. Summarize illness investigation in annual 2. Annual report due
report.October 31,2026.
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to finance@doh.\}a.t_o\.
Federal Funding Accountability and Transparency Act(FFATAI(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Program Specific Requirements
The funds for this project are being provided by an Environmental Protection Agency grant,Agreement Number CU-03J 18701-0,Catalog of Federal Domestic Assistance Number
66.472—Beach Monitoring and Notification Program Implementation Grants.
Program Manual,Handbook,Policy References:
Quality Assurance Project Plan https://apps.ecology.wa.gov/publications/SummaryPages/1903119.html
Exhibit A, Statement of Work Page 2 of 2 Contract Number CLH32053-Amendment 12
Page 7 of 21
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: Maternal&Child Health Block Grant— Local Health Jurisdiction Name: Jefferson County Public Health
Effective January 1, 2025
Contract Number: CLH32053
SOW Type: Revision Revision#(for this SOW) 4 Funding Source Federal Compliance Type of Payment
Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: January 1,2025 through September 30, 2026
State FFATA(Transparency Act) El Fixed Price
Other Research&Development
Statement of Work Purpose: The purpose of this statement of work(SOW)is to support local interventions that impact the target population of the Maternal and Child Health
Block Grant.
Revision Purpose: The purpose of this revision is to add additional FFY26 MCHBG LHJ CONTRACTS HRSA YR1 funding.
Master Assistance BARS Allocation
Index Listing Revenue
LHJ Funding Period
Current Change Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
FFY25 HRSA MCHBG LHJ CONTRACTS 78101251 93.994 333.93.99 01/01/25 09/30/25 27,525 0 27,525
FFY26 MCHBG LHJ CONTRACTS HRSA YR1 78101261 93.994 333.93.99 10/01/25 09/30/26 6,717 2,140 8,857
FFY25 MCHBG SPECIAL PR HRSA 2 7810125A 93.994 333.93.99 10/01/25 09/30/26 3,376 0 3,376
0 0 0
0 0 0
0 0 0
TOTALS 37,618 2,140 39,758
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
Maternal and Child Health Block Grant(MCHBG)Administration
1 a Report actual expenditures for the six-month period Submit actual expenditures using the MCHBG May 16,2025 Reimbursement for actual
from October 1,2024 through March 31,2025. Budget Workbook to DOH Community costs,not to exceed total
Consultant.funding consideration.
lb Develop 2025-2026 MCHBG Budget Workbook for Submit MCHBG Budget Workbook to DOH September 5,2025 Monthly Reports must only
October 1,2025 through September 30,2026 using Community Consultant. reflect activities paid for
DOH-provided template. with funds provided in this
lc Participate in DOH-sponsored annual MCHBG meeting. LHJ Contract Lead or designee will attend September 30,2025 statement of work for the
meeting. specified funding period.
Exhibit A,Statement of Work Page 1 of 5 Contract Number CLH32053-Amendment 12
Page 8 of 21
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
id Report actual expenditures for October 1,2024 through Submit actual expenditures using the MCHBG December 5,2025
September 30,2025. Budget Workbook to DOH Community See Program Specific
Consultant.Requirements and Special
1 e Report actual expenditures for the six-month period Submit actual expenditures using the MCHBG May 15,2026 Billing Requirements.
from October 1,2025 through March 31,2026. Budget Workbook to DOH Community
Consultant.
1 f Report annual FTE billed to MCHBG.Submit FTE information on DOH-provided July 1,2026
template.
I g Develop 2026-2027 MCHBG Budget Workbook for Submit MCHBG Budget Workbook to DOH September 4,2026
October 1,2026 through September 30,2027 using Community Consultant.
DOH-provided template.
lh Participate in DOH-sponsored MCHBG fall regional LHJ Contract Lead or designee will attend September 30,2026
meeting. regional meeting.
Implementation
2a Report 2024-25 MCHBG-funded activities and Submit monthly reports to DOH Community January 15,2025 Reimbursement for actual
outcomes using DOH-provided reporting template. As a Consultant.Describe in your updates within February 15,2025 costs,not to exceed total
foundation of your MCHBG work determine how each activity of the monthly report how you March 15,2025 funding consideration.
processes and programs can close gaps in health are intentionally focused on closing gaps in April 15,2025 Monthly Reports must only
outcomes.health outcomes. May 15,2025 reflect activities paid for
June 15,2025 with funds provided in this
July 15,2025 statement of work for the
August 15,2025 specified funding period.
September 15,2025
2b Develop 2025-26 MCHBG reporting document for Submit MCHBG reporting document to DOH Draft-August 15,2025 See Program Specific
October 1,2025 through September 30,2026 using Community Consultant. Final-September 12,2025 Requirements and Special
DOH-provided template. Billing Requirements.
2c Report 2025-26 MCHBG-funded activities and Submit monthly reports to DOH Community September report due
outcomes using DOH-provided reporting template. As a Consultant.Describe in your updates within October 15,2025
foundation of your MCHBG work determine how each activity of the monthly report how you November 15,2025
processes and programs can close gaps in health are intentionally focused on closing gaps in December 15,2025
outcomes.health outcomes. January 15,2026
February 15,2026
March 15,2026
April 15,2026
May 15,2026
June 15,2026
July 15,2026
August 15,2026
September 15,2026
Exhibit A, Statement of Work Page 2 of 5 Contract Number CLH32053-Amendment 12
Page 9 of 21
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
2d Develop 2026-27 MCHBG Monthly Reporting Submit MCHBG reporting document to DOH Draft—August 14,2026
Template for October 1,2026 through September 30, Community Consultant. Final—September 11,2026
2027 using DOH-provided template.
Children and Youth with Special Health Care Needs(CYSHCN)
3a Complete intake and renewal,per reporting guidance Submit data to DOH per CYSHCN Program January 15,2025 Reimbursement for actual
supplied by DOH,on all infants and children served by guidance. April 15,2025 costs,not to exceed total
the CYSHCN Program as referenced in CYSHCN July 15,2025 funding consideration.
Program guidance. If no CYSHCN care coordination Monthly Reports must only
enabling service)is provided in a given quarter,email reflect activities paid for
the CHIF administrator at DOH-CHIFadoh.wa.gov and with funds provided in this
indicate that zero clients were served during the quarter. statement of work for the
No spreadsheet is necessary when zero clients are specified funding period.
served.
3b Identify unmet needs for CYSHCN on Medicaid and Submit completed Health Services 30 days after forms are See Program Specific
refer to DOH CYSHCN Program for approval to access Authorization forms and Central Treatment completed. Requirements and Special
Diagnostic and Treatment funds as needed. Fund requests directly to the CYSHCN Through September 30, Billing Requirements.
Program as needed. 2025
3c Review your program's entry on ParentHelpl23.org Document in the Administrative box on your September 30,2025
annually for accuracy. MCHBG report that you have updated
information on your local CYSHCN program
with WithinReach/Help Me Grow.
3d Support improvements to the local system of care Submit updates as part of monthly reporting January 15,2025
public health services and systems/policy,systems,and document. February 15,2025
environment)for CYSHCN.Refer to the Focus of Work March 15,2025
document for example activities and priority areas. April 15,2025
May 15,2025
June 15,2025
July 15,2025
August 15,2025
September 15,2025
3e Complete intake and renewal,per reporting guidance Submit data to DOH per CYSHCN Program October 15,2025
supplied by DOH,on all infants and children served by guidance. January 15,2026
the CYSHCN Program as referenced in CYSHCN April 15,2026
Program guidance. If no CYSHCN care coordination July 15,2026
enabling service)is provided in a given quarter,email
the CHIF administrator at DOH-CHIF( doh.wa.gov and
indicate that zero clients were served during the quarter.
No spreadsheet is necessary when zero clients are
served.
3f Review your program's entry on Help Me Grow's Document in the Administrative box on your September 30,2026
ParentHelp123 Resource Finder annually for accuracy. MCHBG report that you have updated
Exhibit A,Statement of Work Page 3 of 5 Contract Number CLH32053-Amendment 12
Page 10 of 21
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
information on your local CYSHCN program
with WithinReach/Help Me Grow.
3g Support improvements to the local system of care Submit updates as part of monthly reporting September report due
public health services and systems/policy,systems,and document. October 15,2025
environment)for CYSHCN.Refer to the Focus of Work November 15,2025
document for example activities and priority areas. December 15,2025
January 15,2026
February 15,2026
March 15,2026
April 15,2026
May 15,2026
June 15,2026
July 15,2026
August 15,2026
September 15,2026
MCHBG Assessment and Evaluation
4a As part of the ongoing 5-year MCHBG Needs Submit documentation as requested by DOH. September 30,2025 Reimbursement for actual
Assessment,participate in activities developed and costs,not to exceed total
coordinated by DOH using DOH-provided reporting funding consideration.
template. Monthly Reports must only
4b Provide summary of outcomes of MCHBG-funded work Submit documentation as requested by DOH. November 21,2025 reflect activities paid for
completed from October 1,2024 through September 30, with funds provided in this
2025 using DOH-provided reporting template. statement of work for the
4c As part of the ongoing 5-year MCHBG Needs Submit documentation as requested by DOH. September 30,2026 specified funding period.
Assessment,participate in activities developed and
coordinated by DOH using DOH-provided reporting See Program Specific
template. Requirements and Special
Billing Requirements.
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to finance(a,doh.wa.gov.
Federal Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Exhibit A,Statement of Work Page 4 of 5 Contract Number CLH32053-Amendment 12
Page 11 of 21
Program Specific Requirements
Special Requirements:
All training costs and all travel expenses for such training(for example:per diem,hotel,registration fees)must be pre-approved,unless identified in pre-approved Budget
Workbook. Submit a paragraph to your Community Consultant explaining why the training is necessary to implement a strategy in the approved work plan.Details should also
include total cost of the training and a link to or brochure of the training.Retain a copy of the Community Consultant's approval in your records.
Program Manual,Handbook,Policy References:
CYSHCN Information and Resources:
Children and Youth with Special Health Care Needs Website(wa.gov)
Restrictions on Funds(i.e.,disallowed expenses or activities,indirect costs,etc.):
1. At least 30%of federal Title V funds must be used for preventive and primary care services for children and at least 30%must be used for services for children with
special health care needs. [Social Security Law, Sec. 505(a)(3)].
2. Funds may not be used for:
a. Inpatient services,other than inpatient services for children with special health care needs or high-risk pregnant women and infants,and other patient services approved by
Health Resources and Services Administration(HRSA).
b. Cash payments to intended recipients of health services.
c. The purchase or improvement of land,the purchase,construction,or permanent improvement of any building or other facility, or the purchase of major medical
equipment.
d. Meeting other federal matching funds requirements.
e. Providing funds for research or training to any entity other than a public or nonprofit private entity.
f. Payment for any services furnished by a provider or entity who has been excluded under Title XVIII(Medicare),Title XIX(Medicaid),or Title XX(social services block
grant).[Social Security Law,Sec 504(b)].
3. If any charges are imposed for the provision of health services using Title V(MCH Block Grant)funds,such charges will be pursuant to a public schedule of charges;will not
be imposed with respect to services provided to low-income mothers or children;and will be adjusted to reflect the income,resources,and family size of the individual
provided the services. [Social Security Law,Sec. 505 (1)(D)].
Monitoring Visits(i.e.,frequency,type,etc.):
Check-ins with DOH Community Consultant as needed.
Billing Requirements:
Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable A19-1A invoice voucher. Payment to completely expend the"Total Consideration"for
a specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices must be submitted monthly by the 30th of each month following
the month in which the expenditures were incurred and must be based on actual allowable program costs. Billing for services on a monthly fraction of the"Total Consideration"
will not be accepted or approved.
Special Instructions:
Contact DOH Community Consultant for approval of expenses not reflected in pre-approved Budget Workbook.
Exhibit A,Statement of Work Page 5 of 5 Contract Number CLH32053-Amendment 12
Page 12 of 21
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: Office of Drinking Water Group A Program - Local Health Jurisdiction Name: Jefferson County Public Health
Effective January 1,2025
Contract Number: CLH32053
SOW Type: Revision Revision#(for this SOW) 4 Funding Source Federal Compliance Type of Payment
Federal Contractor (check if applicable) Reimbursement
Period of Performance: January 1,2025 through December 31,2027
State FFATA(Transparency Act) ® Fixed Price
Other Research&Development
Statement of Work Purpose: The purpose of this statement of work is to provide funding to the LHJ for conducting sanitary surveys and providing technical assistance to small
community and non-community Group A water systems
Revision Purpose: Correct total allocation column to reflect cumulative funding amount for SS and TA 2025 and 2026.
Master Assistance BARS Allocation
LHJ Funding Period ChangeIndexListingRevenueCurrentg Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
SANITARY SURVEY FEES SS-STATE 24112522 N/A 346.26.65 01/01/25 12/31/27 2,250 1,800 4,050
YR 27 SRF-LOCAL ASST(15%)SS 24119227 N/A 346.26.64 01/01/25 12/31/25 0 0 0
YR 27 SRF-LOCAL ASST(15%)TA 24119227 N/A 346.26.66 01/01/25 12/31/25 0 0 0
YR 28 SRF-LOCAL ASST(15%)SS 24119228 N/A 346.26.64 01/01/25 12/31/27 200 0 200
YR1 STIMULUS -LOCAL ASST(10%OF 15%)SS 24144240 N/A 346.26.64 01/01/25 12/31/27 2,050 1,800 3,850
YR 28 SRF-LOCAL ASST(15%)TA 24119228 N/A 346.26.66 01/01/25 12/31/27 0 0 0
YR1 STIMULUS -LOCAL ASST(10%OF 15%)TA 24144240 N/A 346.26.66 01/01/25 12/31/27 1,000 1,000 2,000
0 0 0
0 0 0
TOTALS 5,500 4,600 10,100
Task
Activity Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount
1 Trained LHJ staff will conduct sanitary surveys of Provide Final* Sanitary Survey Reports Final Sanitary Survey Upon ODW acceptance of the Final
small community and non-community Group A to ODW Regional Office. Complete Reports must be Sanitary Survey Report,the LHJ shall be
water systems identified by the DOH Office of Sanitary Survey Reports shall include: received by the ODW paid$1,000 for each sanitary survey of a
Drinking Water(ODW)Regional Office. 1. Cover letter identifying significant Regional Office within Transient Non-Community(TNC)system.
deficiencies, significant findings, 30 calendar days of
See Special Instructions for task activity. observations,recommendations,and conducting the sanitary Upon ODW acceptance of the Final
referrals for further ODW follow- survey. Sanitary Survey Report,the LHJ shall be
The purpose of this statement of work is to provide up. paid$1,500 for each sanitary survey of a
funding to the LHJ for conducting sanitary surveys 2. Completed Small Water System non-Transient Non-Community(NTNC)
and providing technical assistance to small checklist.
Exhibit A, Statement of Work Page 1 of 4 Contract Number CLH32053-Amendment 12
Page 13 of 21
Task
Activity Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount
community and non-community Group A water 3. Updated Water Facilities Inventory and Community systems with 499 and less
systems. WFI). connections.
4. Photos of water system with text
identifying features Payment is inclusive of all associated costs
5. Any other supporting documents. such as travel,lodging,per diem.
Final Reports reviewed and accepted by Payment is authorized upon receipt and
the ODW Regional Office. acceptance of the Final Sanitary Survey
Report within the 30-day deadline.
Late or incomplete reports may not be
accepted for payment.
2 Trained LHJ staff will conduct Special Purpose Provide completed SPI Report and any Completed SPI Reports Upon acceptance of the completed SPI
Investigations(SPI)of small community and non- supporting documents and photos to must be received by the Report,the LHJ shall be paid$750 for each
community Group A water systems identified by ODW Regional Office.ODW Regional Office SPI on Transient Non-Community(TNC)
the ODW Regional Office. within 2 working days system.
of the service request.
See Special Instructions for task activity. Payment is inclusive of all associated costs
such as travel,lodging,per diem.
Payment is authorized upon receipt and
acceptance of completed SPI Report within
the 2-working day deadline.
Late or incomplete reports may not be
accepted for payment.
3 Trained LHJ staff will provide direct technical Provide completed TA Report and any Completed TA Report Upon acceptance of the completed TA
assistance(TA)to small community and non- supporting documents and photos to must be received by the Report,the LHJ shall be paid$250 per hour
community Group A water systems identified by ODW Regional Office.ODW Regional Office for each technical assistance activity.
the ODW Regional Office. within 30 calendar
days of providing Payment is authorized upon receipt and
See Special Instructions for task activity. technical assistance. acceptance of completed TA Report within
the 30-day deadline.
Late or incomplete reports may not be
accepted for payment.
4 LHJ staff performing the activities under tasks 1,2 For training attended in person,prior to Annually For training attended in person,LHJ shall
and 3 attend periodic required survey training as attending the training,submit an be paid mileage,per diem,lodging,and
directed by DOH. Authorization for Travel(Non- registration costs as approved on the pre-
Employee)"DOH Form 710-013 to the authorization form in accordance with the
See Special Instructions for task activity. ODW Program Contact for approval(to current rates listed on the OFM Website
ensure enough funds are available). http://www.ofm.wa.gov/resources/travel.asp
Exhibit A,Statement of Work Page 2 of 4 Contract Number CLH32053-Amendment 12
Page 14 of 21
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DC)H Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to finance@doh.wa.gov.
Federal Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Program Specific Requirements
Data Sharing
The Office of Drinking Water will share water system information and files with the local health jurisdiction to support the work identified in this statement of work. To request
water system data please contact the regional office with the name of the water system,water system ID#,specific information being requested and any timeline requirements.If
allowable,please give administrative staff 3 to 5 business days to provide records.
Program Manual, Handbook,Policy References: Field Guide(DOH Publication 331-486).
Special References:
Chapter 246-290 WAC is the set of rules that regulate Group A water systems. By this statement of work,ODW contracts with the LHJ to conduct sanitary surveys(and SPIs and
provide technical assistance)for small community and non-community water systems with groundwater sources. ODW retains responsibility for conducting sanitary surveys(and
SPIs and provide technical assistance)for small community and non-community water systems with surface water sources, large water systems,and systems with complex
treatment.
LHJ staff assigned to perform activities under tasks 1,2,and 3 must be trained and approved by ODW prior to performing work. See special instructions under Task 4,below.
Special Billing Requirements
The LW shall submit monthly invoices within 30 days following the end of the month in which work was completed,noting on the invoice the month and year being billed for.
Payment cannot exceed a maximum accumulative fee of$4300$8,100 for Task 1,and S000$2,000 for Task 2,Task 3 and Task 4 combined during the contracting period,to
be paid at the rates specified in the Payment Method/Amount section above. When invoicing for sanitary surveys,bill half to BARS Revenue Code 346.26.64 and half to BARS
Revenue Code 346.26.65.
When invoicing for Task 1, submit the list of WS Name,ID#,Amount Billed,Survey Date and Letter Date for which you are requesting payment.
When invoicing for Task 2-3,submit the list of WS Name,ID#,TA Date and description of TA work performed,and Amount Billed.
When invoicing for Task 4,submit receipts and the signed pre-authorization form for non-employee travel to the ODW Program Contact below and a signed A 19-I A Invoice
Voucher to DOH Grants Management,billing to BARS Revenue Code 346.26.66 under Technical Assistance(TA).
Special Instructions
Task 1
Trained LHJ staff will evaluate the water system for physical and operational deficiencies and prepare a Final Sanitary Survey Report which has been accepted by ODW. Detailed
guidance is provided in the Field Guide for Sanitary Surveys, Special Purpose Investigations and Technical Assistance(Field Guide). The sanitary survey will include an
evaluation of the following eight elements: source;treatment;distribution system;finished water storage;pumps,pump facilities and controls;monitoring,reporting and data
verification;system management and operation;and certified operator compliance. If a system is more complex than anticipated or other significant issues arise,the LHJ may
request ODW assistance.
Exhibit A,Statement of Work Page 3 of 4 Contract Number CLH32053-Amendment 12
Page 15 of 21
No more than 3 surveys of non-community systems with three or fewer connections be completed between January 1,2025, and December 31,2025.
No more than 3 surveys of non-community systems with four or more connections and all community systems to be completed between January 1, 2025,and
December 31,2025.
No more than 3 surveys of Transient Non-Community(TNC)systems to be completed between January 1,2026,and December 31,2026.
No more than 1 surveys of Non-Transient Non-Community(NTNC)and Community systems with 499 and less connections to be completed between January 1,
2026,and December 31,2026.
The process for assignment of surveys to the LHJ,notification of the water system,and ODW follow-up with unresponsive water systems;and other roles and responsibilities of
the LHJ are described in the Field Guide.
Task 2
Trained LHJ staff will perform Special Purpose Investigations(SPIs)as assigned by ODW. SPIs are inspections to determine the cause of positive coliform samples or the cause of
other emergency conditions. SPIs may also include sanitary surveys of newly discovered Group A water systems. Additional detail about conducting SPIs is described in the Field
Guide. The ODW Regional Office must authorize in advance any SPI conducted by LHJ staff.
Task 3
Trained LHJ staff will conduct Technical Assistance as assigned by ODW.Technical Assistance includes assisting water system personnel in completing work or verifying work
has been addressed as required,requested, or advised by the ODW to meet applicable drinking water regulations. Examples of technical assistance activities are described in the
Field Guide. The ODW Regional Office must authorize in advance any technical assistance provided by the LHJ to a water system.
Task 4
LHJ staff assigned to perform activities under tasks 1,2,and 3 must be trained and approved by ODW prior to performing work.
If required trainings,workshops or meetings are not available,not scheduled,or if the LW staff person is unable to attend these activities prior to conducting assigned tasks,the
LHJ staff person may,with ODW approval, substitute other training activities to be determined by ODW. Such substitute activities may include one-on-one training with ODW
staff,co-surveys with ODW staff,or other activities as arranged and pre-approved by ODW.LHJ staff may not perform the activities under tasks 1,2,and 3 without completing
the training that has been arranged and approved by ODW.
Exhibit A, Statement of Work Page 4 of 4 Contract Number CLH32053-Amendment 12
Page 16 of 21
Exhibit A
Statement of Work
Contract Term: 2025-2027
DOH Program Name or Title: WIC Nutrition Program -Effective January 1,2025 Local Health Jurisdiction Name: Jefferson County Public Health
Contract Number: CLH32053
SOW Type: Revision Revision#(for this SOW) 6 Funding Source Federal Compliance Type of Payment
Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: January 1,2025 through December 31, 2027
State FFATA(Transparency Act) Fixed Price
Other Research&Development
Statement of Work Purpose: To provide Women, Infants,and Children(WIC)Nutrition Program services by following WIC federal regulations,WIC state office policies and
procedures, WIC directives,and other rules. Refer to the Program Specific Requirements section of this document.
Revision Purpose: To add funds to FFY26 WIC CLIENT SVS CONTRACTS USDA.
Master Assistance BARS Allocation
LHJ Funding Period ChangeIndexListingRevenueCurrentg Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
FFY25 USDA WIC CLIENT SVS CONTRACTS 76101251 10.557 333.10.55 01/01/25 09/30/25 144,669 0 144,669
FFY24 BRSTFDG PEER CN PR MGMT USDA 7621424A 10.557 333.10.55 01/01/25 09/30/26 4,067 0 4,067
FFY25 BRSTFDG PEER CN PR MGMT USDA 76214250 10.557 333.10.55 01/01/25 09/30/27 23,449 0 23,449
FFY25 FARM MKT NTR PROG MGMT USDA 76540251 10.572 333.10.57 01/01/25 09/30/25 637 0 637
FFY26 WIC CLIENT SVS CONTRACTS USDA 76101261 10.557 333.10.55 10/01/25 09/30/26 25,400 25,400 50,800
0 0 0
TOTALS 198,222 25,400 223,622
Task Payment Information
Activity Deliverables/Outcomes Due Date/Time Frame
and/or Amount
1 WIC Nutrition Program See"Billing
Requirements below.
1.1 Maintain authorized participating caseload at 100%based on Outcomes based on monthly participation Authorized participating
quarterly average as determined from monthly caseload data from state WIC caseload caseload for March 2025
management reports generated at state WIC office. management reports. through September 2026=
The Department of Health(Department) State WIC Nutrition 280
Program has the option of reducing authorized participating
caseload and corresponding funding when:Authorized participating
1. Unanticipated funding situations occur. caseload for March 2025
2. Reallocations are necessary to redistribute caseload through September 2026=
statewide. 300
3. Caseload declines.
Exhibit A, Statement of Work Page 1 of 6 Contract Number CLH32053-Amendment 12
Page 17 of 21
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
1.2 Submit the annual Nutrition Services Plan for each year of the Nutrition Services Plan First year due 9/30/25 Payment withheld if not
contract. Second year due 9/30/26 received by due date.
Third year due 9/30/27
1.3 Submit the annual Nutrition Services Expenditure Report for Nutrition Services Expenditure Report 11/30/25 Payment withheld if not
each year of the contract. 11/30/26 received by due date.
11/30/27
1.4 Tell participants about other health services in the agency. If Documentation must be available for Biennial WIC Monitor
needed,develop written agreements with other health care review by WIC monitor staff
agencies and refer participants to these services.
1.5 Provide nutrition education services to participants and Documentation must be available for Biennial WIC Monitor
caregivers in accordance with federal and state requirements. review by WIC monitor staff
1.6 Issue WIC benefits while assuring adequate WIC card security Documentation must be available for Biennial WIC Monitor
and reconciliation.review by WIC monitor staff.
1.7 Collect data,maintain records,and submit reports to effectively Documentation must be available for Biennial WIC Monitor
enforce the non-discrimination laws(Refer to Civil Rights review by WIC monitor staff
Assurances below).
I.8a Submit entire WIC and Breastfeeding Peer Counseling Budget Budget Workbook First year due 9/30/25
Workbook for each year of the contract Second year due 9/30/26
Third year due 9/30/27
1.8b Submit Rev-Exp Report spreadsheet from the WIC Budget Revenue and Expense Report and A-19 First year due monthly
Workbook monthly with A-19 through September 30,2025
Second year due monthly
through September 30,2026
Third year due monthly
through September 30,2027
2 Breastfeeding Promotion
See"Billing
Requiremente below.
2.1 Provide breastfeeding promotion activities in accordance with Status report of chosen activities in First year due 11/30/25
federal and state requirements. Nutrition Services Plan.Second year due 11/30/26
Third year due 11/30/27
Documentation must be available for
review by WIC monitor staff. Biennial WIC Monitor
2.2 Work with community partners to improve practices that affect Status report of chosen activities in First year due 8/30/25
breastfeeding. Choose one or more of the following projects: Nutrition Services Plan.Second year due 8/30/26
Provide staff,health care providers and community partners Third year due 8/30/27
virtual breastfeeding training resources. Documentation must be available for
Work with employers who likely employ low-income review by WIC monitor staff. Biennial WIC Monitor
people to create worksite environments that support
breastfeeding.
Exhibit A,Statement of Work Page 2 of 6 Contract Number CLH32053-Amendment 12
Page 18 of 21
Task
Activity Deliverables/Outcomes Due Date/Time Frame
Payment Information
and/or Amount
Work with birthing hospitals to improve maternity care
practices that affect WIC participant breastfeeding rates.
Provide participants access to lactation consultants.
Other projects will need pre-approval from the State WIC Office
3 Breastfeeding Peer Counseling Program(BFPC) See"Billing
Requirements" below.
3.1 Provide Breastfeeding Peer Counseling Program activities in Breastfeeding Peer Counseling Annual First year due 12/31/25
accordance with federal and state requirements.The WIC Report and expenditures from the Second year due 12/31/26
Breastfeeding Peer Counseling Program is meant to enhance, previous federal fiscal year. Third year due 12/31/27
not replace,WIC Breastfeeding promotion and support
activities. Documentation must be available for Biennial WIC Monitor
review by WIC monitor staff.
3.2 Track Breastfeeding Peer Counseling Program expenditures and Documentation must be available for Biennial WIC Monitor
bill separately from the WIC grant. review by WIC monitor staff.
4 Farmers Market Nutrition Program (FMNP) See"Billing
Requirements" below.
4.1 Issue FMNP benefits to eligible WIC participants by September Document in a Family Alert that FMNP Biennial WIC Monitor
30 of the current year. benefits were issued. Set the end date to
Participants have until October 31 of the current year to use October 31 of the current year for the
FMNP benefits at authorized farmers markets and farm stores. alert to dismiss at the end of the season.
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW,or any other
finance-related inquiry,may be sent to tinance@doh.wa.gov.
Federal Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Program Specific Requirements
Program Manual, Handbook,Policy References:
The local agency shall be responsible for providing services according to rules,regulations and other information contained in the following:
WIC Federal Regulations,USDA, and FNS 7CFR Part 246.
Washington State WIC Nutrition Program Policy and Procedure Manual
Exhibit A, Statement of Work Page 3 of 6 Contract Number CLH32053-Amendment 12
Page 19 of 21
Office of Management and Budget, Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards, 2 CFR 200
Farmers Market Nutrition Program Federal Regulations,USDA, FNS 7CFR Part 248
Other directives issued during the term of the contract
Staffing Requirements:
The local agency shall:
Use Competent Professional Authority staff,as defined by WIC policy,to determine participant eligibility,prescribe an appropriate food package and offer nutrition
education based on the participants'needs.
Use a Registered Dietitian(RD)or other qualified nutritionist to provide nutrition services to high-risk participants,to include development of a high-risk care plan. The
RD is also responsible for quality assurance of WIC nutrition services. See WIC Policy for qualifications for a Registered Dietitian and other qualified nutritionist.
Assign a qualified person to be the Breastfeeding Coordinator to organize and direct local agency efforts to meet federal and state policies regarding breastfeeding
promotion and support. The Breastfeeding Coordinator must be an International Board-Certified Lactation Consultant or attend an intensive lactation management
course,or other state approved training.
Restrictions on Funds(i.e.,disallowed expenses or activities,indirect costs,etc.):
The local agency shall follow the instructions found in the Policy and Procedure Manual under WIC Allowable Costs and 2 CFR Part 200 Uniform Administrative Requirements,
Cost Principles,and Audit Requirements for Federal Awards.
Special References(i.e.,RCWs,WACs,etc.):
What is the WIC program?
1. The WIC program in the state of Washington is administered by the Department of Health.
2. The WIC program is a federally funded program established in 1972 by an amendment to the Child Nutrition Act of 1966.The purpose of the program is to provide nutrition
and health assessment;nutrition education;nutritious food;breastfeeding counseling; and referral services to pregnant,breastfeeding,and postpartum women,infants,and
young children in specific risk categories.
3. Federal regulations governing the WIC program(7 CFR Part 246)require implementation of standards and procedures to guide the state's administration of the WIC program.
These regulations define the rights,responsibilities,and legal procedures of WIC employees,participants,persons acting on behalf of a participant,and retailers.They are
designed to promote:
a. High quality nutrition services;
b. Consistent application of policies and procedures for eligibility determination;
c. Consistent application of policies and procedures for food benefit issuance and delivery;and
d. WIC program compliance.
4. The WIC program implements policies and procedures stated in program manuals,handbooks,contracts, forms,and other program documents approved by the USDA Food
and Nutrition Service.
5. The WIC program may impose sanctions against WIC participants for not following WIC program rules stated on the WIC rights and responsibilities.
6. The WIC program may impose monetary penalties against persons who misuse WIC benefits or WIC food but who are not WIC participants.
Monitoring Visits(i.e.,frequency,type,etc.):
Program and fiscal monitoring are done on a biennial(every two years)basis and are conducted onsite.
The local agency must maintain on file and have available for review,audit and evaluation:
All criteria used for certification,including information on income,nutrition risk eligibility and referrals
Program requirements
Nutrition education
All financial records
Exhibit A,Statement of Work Page 4 of 6 Contract Number CLH32053-Amendment 12
Page 20 of 21
Assurances/Certifications:
1. Computer Equipment Loaned by the Department of Health WIC Nutrition Program
In order to perform WIC program activities,the Department requires computer equipment,such as computers,signature pads,document scanners,card readers and printers to
be in local WIC clinics or to be transported to mobile clinics. This equipment("Loaned Equipment")is owned by the Department and loaned to the local agency(Contractor).
The Loaned Equipment is supported by the Department. This equipment shall be used for WIC business only or according to WIC Policy and Procedures.
An inventory of Loaned Equipment is kept by the Department. Each time Loaned Equipment is changed,the parties shall complete the Equipment Transfer Form and the
Department updates the inventory. A copy of the Transfer Form will be provided to the contractor. Copies of the updated inventory list may be requested at any time.
The local agency agrees to:
a. Defend,protect and hold harmless the Department or any of its employees from any claims, suits or actions arising from the use of this Loaned Equipment.
b. Assume responsibility for any loss or damage from abnormal wear or use,or from inappropriate storage or transportation. The Department may enforce this by:
1) Requiring reimbursement from the local agency of the value of the Loaned Equipment at the time of the loss or damage.
2) Requiring the local agency to replace the Loaned Equipment with equipment of the same type,manufacturer,and capabilities(as pre-approved by the Department),or
3) Assertion of a lien against the Contractor's property.
c. Notify the Department immediately of any damage to Loaned Equipment.
d. Notify the Department prior to moving or replacing any Loaned Equipment.
The Department recommends Contractors carry insurance against possible loss or theft.
2. Civil Rights Assurance
a. The local agency shall perform all services and duties necessary to comply with federal law in accordance with the following Civil Rights Assurance.
b. "The Program applicant hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964(42 U.S.C.2000d et seq.),Title IX of the Education Amendments
of 1972(20 U.S.C. 1681 et seq.),Section 504 of the Rehabilitation Act of 1973 (29 U.S.C.794),Age Discrimination Act of 1975 (42 U.S.C.6101 et seq.);all provisions
required by the implementing regulations of the Department of Agriculture;Department of Justice Enforcement Guidelines,28 CFR 50.3 and 42;and FNS directives and
guidelines,to the effect that,no person shall, on the ground of race,color,national origin,sex,age or handicap,be excluded from participation in,be denied benefits of,or
otherwise be subject to discrimination under any program or activity for which the Program applicant receives Federal financial assistance from FNS;and hereby gives
assurance that it will immediately take measures necessary to effectuate this agreement.
c. "By accepting this assurance,the Program applicant agrees to compile data,maintain records and submit reports as required, to permit effective enforcement of the
nondiscrimination laws and permit authorized USDA personnel during normal working hours to review such records,books and accounts as needed to ascertain
compliance with the nondiscrimination laws. If there are any violations of this assurance,the Department of Agriculture,Food and Nutrition Service,shall have the right
to seek judicial enforcement of this assurance.This assurance is binding on the Program applicant,its successors,transferees,and assignees,as long as it receives
assistance or retains possession of any assistance from the Department.The person or persons whose signatures appear on the contract are authorized to sign this
assurance on behalf of the Program applicant."
3. 2CFR 200
The local agency shall comply with all the fiscal and operations requirements prescribed by the state agency as directed by Federal WIC Regulations(7CFR part 246.6),2CFR
part 200,the debarment and suspension requirements of 2CFR part 200.213,if applicable,the lobbying restrictions of 2CFR part 200.245,and FNS guidelines and instructions
and shall provide on a timely basis to the state agency all required information regarding fiscal and program information.
Billing Requirements:
1. Definitions
Contract Period: January 1,2025—December 31,2027
Contract Budget Periods:The time periods for which the funding is budgeted.
There are four federal budget periods
January 1,2025,through September 30,2025
Exhibit A, Statement of Work Page 5 of 6 Contract Number CLH32053-Amendment 12
Page 21 of 21
October 1,2025,through September 30,2026
October 1,2026,through September 30,2027
October 1,2027,through December 31,2027
2. Billing Information:
a. Billings are submitted on an Al 9-lA invoice. These invoices are provided by the Department in the WIC Budget Workbook and include accounting codes for different
budget categories.
b. A19s are submitted monthly and must be received by the Department within 30 days following the close of each calendar month. Additional Al 9s may be submitted at
any time but must be received within 45 days of the close of the federal budget period.
c. Funds are allocated by budget categories and by federal budget periods(refer to the budget spreadsheet).
d. Funds are encumbered or spent only during the budget period;no carry forward from previous time periods or borrowing from future time periods is allowed.
e. Payments are limited to the amounts allocated for the budget period for each budget category.
f. Billings are based on actual costs for completed activities. Advance payments are not allowed. Back-up documentation must be retained by the local agency and available
for inspection by the Department or other appropriate authorities.
g. Payments will be made only for WIC approved expenditures. Refer to the Washington State WIC Nutrition Program Policy and Procedure Manual Volume 2,Chapter 4—
Allowable Costs and 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards.
h. If billing for indirect costs,a Cost Allocation Plan or Federal Indirect Cost Agreement must be submitted prior to payment.
Special Instructions:
The local agency shall:
1. Maintain complete,accurate,and current accounting of all local,state,and federal program funds received and expended.
2. Provide,as necessary,a single audit in accordance with the provisions of 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for
Federal Awards. This circular requires all recipients and sub-recipients of federal funds to have a single audit performed should they spend$750,000 or more of federal grants
or awards from all sources. Contractors spending less than$750,000 in federal grants or awards may also be subject to audit.
3. Use Breastfeeding Peer Counseling(BFPC)Program funds only to support the peer counseling program. Once the program is established and peer counselors are trained,the
majority of the salary costs must be paid to peer counselors to provide direct services to WIC participants. For a list of allowable costs see Volume 2,Chapter 4—Allowable
Costs. The priority use of BFPC funds is to hire and train peer counselors to provide breastfeeding peer counseling services to WIC participants.
SPECIAL REQUIREMENTS
Contract Budget Period Time Period special requirement Amount Special Requirement Description
funds are available
January 1,2025—September 30,January 2025—September 2025 $2,500 For general training funds.This funding is for all WIC staff to participate in
2025 WIC-related training.Added in the USDA WIC Client Services Contracts
category to cover training registrations,travel expenses,staff time to
participate in training(salary/benefits for part time or contractor),and other
approved training expenses.
Other:
Any program requirements that are not followed may be subject to corrective action and may result in monetary fines or repayment of funds.
Exhibit A, Statement of Work Page 6 of 6 Contract Number CLH32053-Amendment 12
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO:Board of County Commissioners
Josh Peters, County Administrator
FROM: Sheriff Andy Pernsteiner
DATE:
6/ Celia 67 .
SUBJECT: Warrant and record clerk contract with Pencom911
STATEMENT OF ISSUE: JCSO has had a MOU with Jeffcom911 for several years which will expire in
June of 2026. JCSO wants to sign a contract with Pencom911 for this function.
ANALYSIS: JCSO needs a record clerk to enter warrants and orders, since Jefcom911 is no longer capable
of providing this service, we need to contract with Pencom911. JCSO will pay Pencom911 for the entry of
orders and warrants for both JCSO and PTPD and in turn Jefferson County will invoice PTPD as part of the
public services contract already in existence.
FISCAL IMPACT:
Partnering with Pencom911 will be a cost savings of$28,000 for the service that they will provide to JCSO
and PTPD.
RECOMMENDATION: Recommend to approve the contract.
REVIEWED BY:
1-
Josh Peters, County Administrator Date
CONTRACT REVIEW FORM Clear Form
INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: City of Port Angeles Contract No: Pencom911
Contract For: Warrant Clerk Term: 5 years
COUNTY DEPARTMENT: Jefferson County Sheriff
Contact Person: Andy Pernsteiner
Contact Phone: 360)344-9760
Contact email: apemsteiner@co.jefferson.wa.us
AMOUNT: $100,000 PROCESS: _ Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: too,000($40,000 billed to PTPD Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s)of Matching Funds Vendor List Bid
Fund# RFPorRFQ
Munis Org/Obj i/ Other: ILA
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIANCE W H JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: p N/A:0 ea.(
Ignature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: n N/A:J !_
Signature Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 5/15/2026.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 5/14/2026.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
INTERLOCAL AGREEMENT
BY AND BETWEEN
JEFFERSON COUNTY AND THE CITY OF PORT ANGELES
THIS INTERLOCAL AGREEEMENT("ILA") is by and between Jefferson County, a
Washington political subdivision of the State of Washington (the "County"), on behalf of the
Jefferson County Sheriff's Office ("JCSO") and the City of Port Angeles, a Washington
municipality ("COPA") for the provision of certain services by COPA to JCSO through Pencom
911, a department of COPA. The County and COPA are each referred to as a "Party" and
together as "the Parties."
WHEREAS, the County Board of Commissioners wishes to approve an agreement
between JSCO and the COPA establishing the terms and conditions whereby Pencom 911 will
provide the County with warrant and protection order data entry and data management
services as described further below (the "Services");
WHEREAS, the Services include provision of services to the County on behalf of the City
of Port Townsend, which the County shall separately charge the City of Port Townsend via an
amendment to the County's existing Law and Justice ILA with the City of Port Townsend or
another agreement;
WHEREAS, the COPA City Council wishes to approve an agreement between JSCO and
the County establishing the terms and conditions whereby Pencom 911 will provide the County
with the Services;
WHEREAS, the Parties are authorized to enter into this MOU in accordance with the
Interlocal Cooperation Act as codified at Chapter 39.34 RCW, as this arrangement will allow
local governmental units to make the most efficient use of their powers by enabling them to
cooperate with other localities on a basis of mutual advantage and thereby to providing
services and facilities in a manner and pursuant to forms of governmental organization that will
accord best with geographic, economic, population and other factors influencing the needs and
development of local communities;
WHEREAS, Pencom 911 already has the power and authority to, and provides similar
services to other agencies within Clallam County, and the provision of these services is within
its law enforcement functions and purposes;
NOW, THEREFORE, In consideration of the mutual covenants herein contained, and
good and adequate consideration, the Parties agree as follows:
1. Data Entry Services. Pencom 911 will provide JCSO warrant and protection order data
entry services in a timely fashion, including but not limited to entering, clearing,
canceling and modifying computer records in regional, state and national law
Page 1 of 5
ILA between JCSO and COPA for Warrant Entry Services
enforcement databases; filing and verifying for accuracy of such records of the criminal
justice agencies of the City of Port Townsend and JCSO; and maintaining confidentiality
of all information. Examples of work performed include, and are not limited to:
Enter arrest warrants in the state database and the in-house records management
system and quash warrants in both systems;
Enter, modify, and cancel protection orders;
Enter data into the computer from source documents using a computer terminal
source documents include arrest warrants, protection orders, and other similar
law enforcement records);
Maintain orderly and accurate files of source documents;
Validate entry records monthly and quarterly for accuracy and currency of
information;
Ensure adequate training and supervision of all Pencom 911 staff performing data
entry services; and
Maintain working contacts within the courts and law enforcement agencies.
2. Financial Consideration. The annual rate for these services shall be $100,000, with the year
2026 prorated for the months during which Pencom 911 provides these services. The Parties
agree that this charge shall increase 3% per year starting in 2027. Pencom 911 shall invoice
JCSO quarterly, with payment to be remitted no later than thirty (30) days from date of
invoice. If this ILA is terminated early, the final invoice and payment will cover the last
quarter of service and shall be prorated for any period less than a full quarter.
3. Services related to criminal justice agencies of the City of Port Townsend. The City of
Port Townsend shall not be billed for services related to its warrant and protection order
data entry being provided to JCSO under this ILA. The County enters into this ILA having
received a representation from the City of Port Townsend that it will compensate the
County by a separate agreement for the services provided by Pencom 911 related to the
City of Port Townsend's warrant and protection order data entry. For the avoidance of
doubt, the Parties agree that failure of the City of Port Townsend to compensate the
County pursuant to its representation or otherwise for the City of Port Townsend's
warrant and protection order data entry services provided by Pencom 911 shall not
affect the validity of this ILA. However, COPA agrees it will not enter into any agreement
with the City of Port Townsend to provide warrant and protection order data entry
services directly to the City of Port Townsend during the term of this ILA. The Parties
agree that COPA and its Pencom 911 department shall have no obligation to provide
warrant and protection order data entry services directly to the City of Port Townsend
Page 2 of 5
ILA between JCSO and COPA for Warrant Entry Services
during the term of this ILA.
4. Term. This ILA shall be effective from the date of the last Party's signature through
December 31, 2031. Pencom 911 will begin providing the Services under this agreement
on July 1, 2026. Either Party to this ILA may request termination of this ILA for any reason
upon not less than one-hundred-and-eighty (180) days written notice to the other Party.
If neither Party invokes their right to terminate this ILA as set forth herein prior to the
end of each term, then this ILA shall automatically renew annually on January 1st. There
is no limit to the number of automatic renewals.
5. Contract Administrators. This ILA shall be administered for the County by the
Jefferson County Sheriff, and for Pencom 911 by the Deputy Director of the Port
Angeles Police Department.
6. No real or personal property. The Parties do not intend to and shall not utilize this ILA
for the purchase or sale of any personal or real property.
7. Liabilities. Except for liability that is subject to immunity as provided in Chapter 38.52
RCW, each Party shall indemnify, defend and hold harmless the other Party, their
officers, agents, employees, and volunteers, from and against any and all claims,
demands, damages, judgments, losses, liability and expense (including attorney's fees
and costs) including but not limited to those for personal injury, death or property
damage suffered or incurred by any person, by reason of or in the course of performing
this agreement which is or alleged to be caused by or may directly or indirectly arise out
of any act or omission of the Party, its officers, employees, agents and volunteers.
Except as provided above, in the event more than one Party is responsible or negligent,
each Party shall be responsible in proportion to its negligence. It is understood and
agreed that nothing contained in this ILA shall be considered as in any way constituting
or creating a partnership, joint venture or principal and agent relationship between the
County and the COPA or Pencom 911.
8. Amendments. This ILA and its terms may be amended at any time by mutual written
agreement duly executed by both Parties.
9. Severability. If any provision of this ILA is found to be void or invalid, the remaining
provisions shall remain in full force and effect.
Page 3 of 5
ILA between JCSO and COPA for Warrant Entry Services
IN WITNESS WHEREOF, the Parties execute this
Agreement.
JEFFERSON COUNTY,WASHINGTON
BOARD OF COUNTY COMMISSIONERS
Approved as to form only:
gBthert0nreg ro DATE
hair C <
VV May 14,2026
Philip C. Hunsucker DATE
Heidi Eisenhour, DATE Chief Civil Deputy Prosecuting Attorney
Commissioner
Heather Dudley-Nollette, DATE
SHERIFF
An ernsteiner, DATE
Jefferson County Sheriff
SEAL:
ATTEST:
Carolyn Galloway, CMC DATE
Clerk of the Board
Page 4 of 5
ILA between JCSO and COPA for Warrant Entry Services
THE CITY OF PORT ANGELES:
Name:
Title:
Date:
APPROVED AS TO FORM:
Sheida Sahandy, City Attorney
Page 5 of 5
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO:Board of County Commissioners
Josh Peters, County Administrator
FROM: Sheriff Andy Pernsteiner
DATE: j J(,/ ,
SUBJECT: Mutual aid agreement with Clallam Fire district 3 for tactical EMS
STATEMENT OF ISSUE: JCSO works with other Olympic Peninsula agencies as part of a CRT (Crisis
Response Team), Clallam County Fire District 3 provided tactical EMS services as part of the CRT team
within Clallam County.
ANALYSIS: JCSO needs to have a mutual aid agreement with Clallam County Fire District 3 to have them
perform tactical EMS within Jefferson County. JCSO has already had discussions with Jefferson County
Fire and they are unable to provide this service at this time.
FISCAL IMPACT:
Partnering with Clallam County Fire District 3 has no fiscal impact.
RECOMMENDATION: Recommend to approve the mutual aid agreement.
REVIEWED BY:
WJosh eters, County Administrator Date
CONTRACT REVIEW FORM Clear Form
INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Clallam County Fire District 3 Contract No: TEMS
Contract For: Tactical EMS services Term: non expiring
COUNTY DEPARTMENT: Jefferson County Sheriff
Contact Person: Andy Pemsteiner
Contact Phone: 360)344-9760
Contact email: apemsteiner@co.jefferson.wa.us
AMOUNT: o
PROCESS: ^ Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: o Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s)of Matching Funds Vendor List Bid
Fund# RFP or RFQ
Munis Org/Obj Other: Mutual Aid Agreement
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIANC TH JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: N/A:171
Signature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: a N/A: Ei ij .i.. "' est C
Signature Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 5/15/2026.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 5/14/2026.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
INTERLOCAL MUTUAL AID TEMS SERVICES AGREEMENT
PENINSULA CRISIS RESPONSE TEAM
THIS INTERLOCAL MUTUAL AID TEMS SERVICES AGREEMENT FOR TEMS SERVICES
Agreement") is between the Clallam County Fire District #3, ("Fire/Medical Agency") and
Jefferson County, on behalf of the Jefferson County Sheriff's Office ("JCSO"), all shall be
collectively referred to as the "Parties" and individually as a "Party".
RECITALS
WHEREAS, the Interlocal Cooperation Act, chapter 39.34 RCW, allows public agencies to enter
into agreements for joint and cooperative action more efficiently within their jurisdictions.
WHEREAS, the Fire Agencies and JCSO each have unique expertise which are beneficial to the
public and each other in the event of a Law Enforcement Critical Incident.
WHEREAS, this Agreement will improve the life safety of the public and emergency responders
during high threat incidents that may involve multiple causalities through the coordination of law
enforcement activities, provided by the Jefferson County Sheriffs Office, and emergency medical
services, provided by Fire Agencies, operating under the Incident Management System.
WHEREAS, the Parties desire to execute this Agreement to multiply and combine their
personnel, equipment, expertise and other resources when responding to emergencies, subject to
the terms and conditions of this Agreement.
AGREEMENT
NOW, THEREFORE, in consideration of the foregoing recitals, which are incorporated herein by
reference, and the mutual promises and covenants, the parties agree as follows:
1. DEFINITIONS. The following definitions shall apply unless otherwise provided in the Agreement.
A. Fire Chief means the Chief of the Clallam County Fire District#3.
B. JCSO means the Jefferson County Sheriffs Office.
C. CRT Executive Board Each Signatory will appoint someone to serve as its Executive Board
member(typically its chief law enforcement officer) and shall appoint an alternate for its
seat on the Executive Board. A representative of a Signatory may attend an Executive
Board meeting and express opinions, but does not have a vote.
D. TEMS Providers means medically trained staff assigned by a Fire Agency to participate in
TEMS activities within the Fire Agency service areas subject to the terms and conditions of
this Agreement. TEMS Providers shall not operate in any law enforcement capacity. TEMS
may handle and manipulate firearms during team trainings in the presence of a qualified
firearms and range instructor.
E. JeffCom 9-1-1 and Pencom are the agencies that provides public safety emergency
communication services for Jefferson and Clallam Counties, respectively.
F. Law Enforcement Critical Incidents means those involving high threat dynamic incidents such
as: "active shooter"; explosions in public forums/events; random or intentional killing of
ILA TEMS Services 1
multiple civilians in public and private assemblies;warrant service; CRT activations;fugitive
tracking; and similar acutely violent circumstances.
G. Lead Fire Agency means the Fire Agency selected by the Jefferson or Clallam County Fire Chiefs
Association.
H. Sheriff means the Jefferson County Sheriff or designee.
I. CRT means Peninsula Crisis Response Team.
J. CRT Commander means the CRT commander that provides the tactical command on
scene. The CRT Commander will take over tactical command from the officer in charge.
K. TEMS means Tactical Emergency Medical Support team which has a Fire Agency
Component and law enforcement agency component. Each component is responsible for
its own training (initial and ongoing), materials, service, equipment, actions, and policy as
they relate to the delivery of emergency medical support or law enforcement services to be
provided.
L. TEMS Standards means the Tactical Response and Operation Standards for law
enforcement agencies adopted by the National Tactical Officers Association, as amended.
2. PURPOSE. The purpose of this Agreement is to provide for the joint and cooperative undertaking
of the parties to collaborate and combine their personnel, equipment, expertise and technical
resources to provide a rapid response by CRT and TEMS Providers to Law Enforcement Critical
Incidents.within Jefferson and Clallam Counties; identify persons responsible for administering
the services; and define the responsibilities of the Parties as contemplated in RCW 39.34.030.
3. ORGANIZATION. No separate legal or administrative entity is created by this Agreement nor do
the parties intend to create through this Agreement a separate legal or administrative entity
subject to suit.
4. ADMINISTRATOR. The Jefferson County Sheriff, and the Fire Chief of the Fire/Medical
Agency will administer this Agreement for each Party and will meet as needed for the purpose
of reviewing this agreement and the recommendations of the Executive Board for adoption.
Neither Party is intending to assume responsibility or liability for the actions, or failures to act,
of another Party and/or their respective employees.
5. BOARD DUTIES. The Board will have no authority to alter this agreement or implement
policies, but will be responsible for proposing recommendations to the Jefferson County Sheriff
and the ClaIlam County Fire District#3 TEMS Team Leader and Chief or designee on the
following subjects:
A. Meeting as needed to implement and comply with the terms of this Agreement.
B. Creating operational policies as needed to carry out the terms of this Agreement.
C. Developing and updating the TEMS Provider Job Description.
D. Developing policies and procedures consistent with the mission and goals of this Agreement.
ILA TEMS Services 2
F. Establishing (and disbanding) committees, as it deems appropriate, and provide any other
guidance to the Parties as reasonably required to implement and comply with the terms of this
Agreement.
G. Other duties and responsibilities deemed appropriate by the Board.
6. EFFECTIVE DATE/DURATION. This Agreement shall be effective from the date first executed by
two parties and shall remain in effect unless terminated or extended. Should fewer than all named
Parties execute this Agreement, the Agreement when filed as provided herein will be effective as
between the County and the Parties that have executed the Agreement to the same extent as if
no other Party had been named.
7. FILING. Prior to entry into force, this Agreement will be filed with the Jefferson County
Auditor's Office or, alternatively, listed by subject on a public agency's web site or other
electronically retrievable public source in compliance with RCW 39.34.040.
8. ADDITIONAL PARTIES. Additional governmental entities may to be added as a party to this
Agreement in the future, with the approval of the Sheriff and the Clallam County Fire
District #3, by executing an amendment this Agreement executed by the party requesting to
begin participation and all current Parties to this Agreement. The Amendment must be filed with
the Jefferson County Auditor's Office in compliance with RCW 39.34.040.
9. TERMINATION. Any Party may terminate their participation in this Agreement with 60- days prior
notice to the other Parties. Termination by one Party does not terminate the Agreement as to the
remaining Parties. A terminated Party assumes no responsibility for the acts or omissions
occurring after the termination effective date but will remain liable for acts or omissions occurring
prior to the termination effective date.
10. PROPERTY
A. The parties do not anticipate the acquisition of property for the performance of this Agreement
and any property acquired by a Party during this Agreement shall be held by and remain the
property of the acquiring Party.
B. All durable and consumable goods purchased and provided by a Fire Agency shall be returned
to the Fire Agency if the TEMS Provider leaves the team or the Fire Agency
terminates involvement with this Agreement.
11. COMPENSATION. No Party shall seek or be entitled to compensation for services rendered under
this Agreement from any other Party to this Agreement. Nothing shall prohibit a Fire Agency from
obtaining reimbursement from a third-party as provided in 44 CFR Part 151 (REIMBURSEMENT
FOR COSTS OF FIREFIGHTING ON FEDERAL PROPERTY) or from other agencies not a party
to this Agreement.
12. INSURANCE. Maintain insurance or membership in a risk pool that provides to the Signatory
entity self-insurance or financial coverage for third-party liability in amount of not less than Ten
Million Dollars ($10,000,000.00). Proof of active membership in a Ch. 48.62 RCW"Risk Pool"
through providing the Sheriff with both a"Certificate of Coverage" (or similarly titled document)
and a copy of the Memorandum of Liability Coverage (or similarly titled document) containing the
text of the relevant Risk Pool's coverage document shall satisfy this requirement.
13. INDEMNIFICATION. To the extent of its comparative liability, each Party agrees to indemnify,
defend, and hold harmless the other Party, and the other Party's elected and appointed officials,
employees, agents, and volunteers (and their marital communities) from and against any and all
claims, damages, losses, and expenses, including but not limited to court costs, attorneys fees,
ILA TEMS Services 3
and alternative dispute resolution costs, for violation of any law applicable to a Party, any
violation of those policies and procedures adopted by the Parties to accomplish the
purposes of this Agreement, any personal injury, or any bodily injury, sick disease, or death,
and for any damage to or destruction of any property (including the loss of uses therefrom)
which are alleged or proven to be caused by an act or omission, negligent or otherwise, of
the Party, its elected and appointed officials, employees, agents, or volunteers (and their
marital communities).
B. Participation in Defense, No Waiver.A Party reserves the right, but shall have no obligation, to
participate in the defense of any claim, damages, losses or expenses and such participation
shall not constitute a waiver of the Party's indemnity obligations under this Agreement.
C. Survival of Indemnity Obligations. All indemnity obligations shall survive the completion,
expiration or termination of this Agreement.
14. INDEPENDENT CAPACITY
A. Each Party and its respective employees or agents will act as an independent contractor and
continue to be the employees or agents of that Party, which will be solely and exclusively
responsible for their employees and agents. Employees and agents of one party will not be
considered for any purpose whatsoever under this Agreement to be employees or agents of
another Party to this Agreement. No Party will have the authority to bind another Party, absent
a written agreement of the parties, nor the authority to control the employees, agents, or
contractors of another Party to this Agreement. All rights, duties and obligations of the
employer will remain with the employing Party. Each Party agrees to indemnify, defend, and
hold harmless the other Parties in any action arising from or related to the negligence of its
own employees, including all costs of defense and attorney's fees.
B. Each Party shall be solely and exclusively responsible for the compensation, benefits, training
expenses, and all other costs and expenses for its employees. Each Party will be responsible
for ensuring compliance with all applicable laws, collective bargaining agreements, and civil
service rules and regulations regarding its own employees.
C. Personnel assigned as TEMS members shall conform to rules and procedures of their
employing agency, as well as Peninsula CRT policies and procedures. It is the
responsibility of the TEMS participants to inform the CRT Commander of any policy
conflicts. All disciplinary matters shall be the responsibility of the TEMS member's employer.
D. Fire Agencies may, in their discretion, refuse to commit and/or recall personnel, equipment,
or both, to a position and/or task as deemed appropriate by Fire Agency's command.
15. NOTICE. All notices will be delivered in writing to the Fire Chiefs or Sheriff. Notice mailed by
regular post (including first class) shall be deemed to have been given on the second business
day following the date of mailing, if properly mailed and addressed. Notices sent by certified or
registered mail shall be deemed to have been given on the day next following the date of mailing,
if properly mailed and addressed. For all types of mail, the postmark affixed by the United States
Postal Service shall be conclusive evidence of the date of mailing.
16. NONDISCRIMINATION. No Party will discriminate against any person on the basis of race, color,
creed, religion, national origin, age, sex, marital status, sexual orientation, veteran status,
disability, or other circumstance prohibited by federal, state, or local law, and shall comply with
Title VI of the Civil Rights Act of 1964, P.L. 88-354 and Americans with Disabilities Act of 1990 in
the performance of this Agreement.
17. GOVERNING LAW, VENUE, FEES. The Agreement will be governed in all respects by the laws
ILA TEMS Services 4
of the State of Washington, both as to interpretation and performance, without regard to conflicts
of law or choice of law provisions. Any action arising out of or in connection with the
Agreement may be instituted and maintained only in a court of competent jurisdiction in
Jefferson County, Washington or as provided by RCW 36.01.050. Should any Party bring
any legal action, each Party in such action shall bear the cost of its own attorney's fees and
court costs.
18. COMPLIANCE WITH LAWS. The parties shall comply with all applicable laws, rules and
regulations pertaining to them in connection with the Services provided and matters covered in
the Agreement, including but not limited to applicable regulations of the Washington Department
of Labor and Industries, including WA-DOSH Safety Regulations, bargaining agreements, and all
relevant state and federal workplace safety requirements and.
19. DISPUTE RESOLUTION. In the event of a dispute between the Parties regarding the terms and
condition, or performance, of this Agreement, the Parties shall use their best efforts to resolve
those difference on an informal basis.
20. NO JOINT VENTURE. Nothing contained in this Agreement shall be construed as creating any
type or manner of partnership,joint venture, or other joint enterprise between the Parties.
21. IMPLIED CONTRACT TERMS. Each provision of law and any terms required by law to be in the
Agreement are made a part of the Agreement as if fully stated in it.
22. PRESS AND RELEASE OF INFORMATION. Press releases and/or the release of information to
the media will be made by the agency that has the jurisdiction where the event occurred in
accordance with the releasing agency's established media release policy. No press releases will
be made by another agency regarding the incident without the prior approval of the agency(s)
having jurisdiction, and the Clallam County Fire District#3 Chief. No Party will release the tactics,
intelligence or other information, the nondisclosure of which is essential to effective law
enforcement. RCW 42.56.240.
23. PUBLIC RECORDS ACT. Notwithstanding any 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 be amended), each Party agrees to maintain all records constituting public
records and to produce or assist the other Party in producing such records,within the time frames
and parameters set forth in state law.
24. SEVERABILITY. The provisions of this Agreement are severable. Any term or condition of this
Agreement or application thereof deemed to be illegal, invalid or unenforceable, in whole or in
part, shall not affect any other terms or conditions of the Agreement and the parties' rights and
obligations will be construed and enforced as if the Agreement did not contain the particular
provision.
25. SURVIVAL. Those provisions of the Agreement that by their sense and purpose should survive
expiration or termination of the Agreement shall so survive. Those provisions include, without
limitation, the respective responsibilities of each Party, compensation, and indemnification.
26. HEADINGS. Headings of this Agreement are for convenience only and shall not affect the
interpretation of this Agreement.
27. ENTIRE AGREEMENT. This Agreement contains all terms and conditions agreed upon by the
Parties, except necessary operational agreements, and supersedes any other agreement or
understanding of the Parties relating to the subject matter of this Agreement.
No other understanding, oral or otherwise, regarding the subject matter of this Agreement shall
ILA TEMS Services 5
be deemed to exist or to bind the Parties.
28. AMENDMENT. This Agreement may be amended from time to time as deemed appropriate by
the parties, provided, any such amendment will not become effective unless written and signed
by all parties to this Agreement with the same formality as this Agreement.
29. DISCLAIMER. Nothing in this Agreement will be construed in any manner that would limit a
Parry's authority or powers under law.
30. NO THIRD-PARTY RIGHTS. This Agreement is intended to be solely between the parties. No
part of this Agreement shall be construed to add, supplement, or amend existing rights,
benefits, or privileges of any third-party. Nothing in this Agreement will be construed as giving any
benefits, rights, remedies, or claims to any other person, firm, corporation, or other entity
including, without limitation, the public or any member thereof, or to authorize anyone not a party
to this Agreement to maintain a suit for breach of contract, personal injuries, property damage, or
any other relief in law or equity in connection with this Agreement.
31. ASSIGNMENT. The rights or obligations under this Agreement, and any claims arising
thereunder, are not assignable or delegable by any Party.
32. NO WAIVER. A failure by any Party to exercise its rights under this Agreement shall not preclude
that Party from subsequent exercise of such rights and shall not constitute a waiver of any
other rights under this Agreement unless stated to be such in a writing signed by an
authorized representative of the Party.
33. COUNTERPARTS, ELECTRONIC SIGNATURE. The Agreement may be executed in several
counterparts, each of which will be deemed an original, but all of which together will constitute
one and the same agreement. A facsimile, email, or other electronically delivered signatures of
the parties shall be deemed to constitute original signatures and deemed to constitute duplicate
originals.
34. AUTHORIZATION. Any authorizations, actions required or permitted to be taken, and any
document required or permitted to be executed under this Agreement will be taken or executed
only by a duly authorized representative of the Party. Each Party warrants and represents to the
other that the person signing below has been properly authorized and empowered to execute this
Agreement on behalf of the Party for whom they sign.
ILA TEMS Services 6
IN WITNESS WHEREOF, the Parties execute this
Agreement.
JEFFERSON COUNTY, WASHINGTON
BOARD OF COUNTY COMMISSIONERS
B: Approved as to form only:
Greg Brotherton, DATE
Chair cam'- - May 14,2026
B Philip C. Hunsucker DATE
Heidi Eisenhour, DATE Chief Civil Deputy Prosecuting Attorney
Commissioner
B
Heather Dudley-Nollette, DATE
SHERIFF
B
Andy Pernsteiner, DATE
Jefferson County Sheriff
SEAL:
ATTEST:
Carolyn Galloway, CMC DATE
Clerk of the Board
7
CLALLAM COUNTY FIRE DISTRICT#3
DATED ir ADOPTER.thisc9n- day of 2025.
Jt in/ rider, Fir hief
I
DATED or ADOPTED this' day of 6 i<.,rn,,f,- . , 2025.
CLALLAM COUNTY FIRE DISTRICT#3 BOARD OF COMMISSIONERS
J icholas, Commissioner- Chair
ATTEST:
9r 1) ter ek-
ILA TEMS Services 8
Cf
r•-"I
H1
SIIING\
Payroll Expense Report
05/20/2026
PAYROLL DATE
260520
PAYROLL WARRANT#
Payroll Checks: $0.00
Check#'s: N/A
Payroll Direct Deposit: $64,133.83
Advice #'s: 10101804-10101867
Benefits Paid: $11,966.10
AP Warrant#'s: Elect. Pymnts
Total: $76,099.93
Payment of Jefferson County Payroll Warrants Dated May 20, 2026 Totaling $76,099.93 (Records of all claims
submitted for payment along with A/P Warrants approved by the Payroll Services Manager are retained in the Jefferson County
Auditor's Office.)
BoCC Chair
Jefferson County
Board of Commissioners
Consent Agenda Request
To: Board of Commissioners
Josh Peters, County Administrator
From: Eric Kuzma
Public Works Direct
Agenda Date: May 26, 2026
Subject: Engineering Support for Solid Waste Capital Projects
Statement of Issue: Modifications to the transfer station necessary for the replacement of the customer
scales and knuckle boom crane require structural and civil engineering support.
Analysis/Strategic Goals/Pro's& Con's: The transfer station customer scales were purchased used
when installed in 1994 and are too short to measure truck and trailer combinations. They are beyond their
service life and need to be replaced with properly sized scales that can be mobilized to the new transfer
station when operations begin at a new site.
The knuckle boom crane used to load and compact solid waste in containers at the transfer station is not
cost-effective,requiring frequent repairs which cause operational delays.An engineering study has
determined that it could be replaced by an excavator operated from outside the tipping floor building.
This requires structural modifications to the building and the construction of a retaining wall and
excavator pad.
Fiscal Impact/Cost Benefit Analysis:
Costs for engineering services needed for both capital projects are$145,955.00. Expenditure is from the
Equipment Reserve(Capital) side of the Solid Waste Enterprise Fund with revenue generated from the
15 per ton Capital Surcharge adopted into the tipping fee schedule by the BoCC in 2025.
Recommendation: Execute the attached Professional Services Agreement with Sargent Engineers, Inc.
Department Contact:
Al Cairns, Solid Waste Manager x213
Reviewed By:
Ili C/a°. /4H
Jos i 'eters,County Administrator Date
CONTRACT REVIEW FORM Clear Form
INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Sargent Engineers, Inc. Contract No: PW 2026-072
Contract For: Engineering Services Term: 36 Months
COUNTY DEPARTMENT: Public Works
Contact Person: Al Cairns
Contact Phone: X213
Contact email: acaims@co.jeflerson.wa us
AMOUNT: $145,955.00 PROCESS: —
Exempt from Bid Process
Revenue: 401000010.34370.00.000 Cooperative Purchase
Expenditure: 594370/59437.41 Competitive Sealed Bid
Matching Funds Required: N/A
r Small Works Roster
Sources(s)of Matching Funds N/A Vendor List Bid
Fund # RFP or RFQ
Munis Org/Obj Other: MRSC Consultant Roster
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: RI I N/A:1 1 r4 /z
Signature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: N/A: S' A 44.
Signature Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 5/14/2026.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 5/13/2026.
Pre-approved K form appears in order. Needs risk analysis.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
PROFESSIONAL SERVICES AGREEMENT FOR
Engineering Support for Transfer Station Tipping Floor Structure
Modifications
THIS PROFESSIONAL SERVICES AGREEMENT("this Agreement")is entered into between
the County of Jefferson, a municipal corporation ("the County"), and
Sargent Engineers, Inc. the Consultant"), in consideration of the
mutual benefits, terms, and conditions specified below.
Project Designation. The Consultant is retained by the County to provide design,
specifications, and an estimate for customer scale replacement and modifications to the
transfer station tipping floor building and foundation.
I.Scope of Services. Consultant agrees to perform the services, identified on Exhibit"A"
attached hereto, including the provision of all labor.
2.Time for Performance. Work under this Agreement shall commence upon the giving of
written notice by the County to the Consultant to proceed. The Consultant receipt of a
Purchase Order shall constitute said notice. Consultant shall perform all services and
provide all work product required pursuant to this Agreement on the dates listed on
Exhibit"A". Time is of the essence in the performance of this Agreement.
3.Payment. The Consultant 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 Consultant shall be made as provided on
Exhibit"B" attached hereto,provided that the total amount of payment to
Consultant shall not exceed $ 145,955.00 without express written modification
of this Agreement signed by the County.
b.The Consultant may submit invoices to the County once per month during the
progress of the work for partial payment for project completed to date. Such
vouchers will be checked by the County, and upon approval thereof, payment will
be made to the Consultant in the amount approved. Payment of Consultant
invoices shall be within 30 days of receipt by the County for any services not in
dispute based on the terms of this Agreement.
c.Final payment of any balance due the Consultant of the total contract price earned
will be made promptly upon its ascertainment and verification by the County after
the completion of the work under this Agreement and its acceptance by the
County.
d.Payment as provided in this section shall be full compensation for work
performed, services rendered and for all materials, supplies, equipment and
incidentals necessary to complete the work.
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 1 of 10
e.The Consultant'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
three(3) years after final payments. Copies shall be made available upon request.
4.Ownership and Use of Documents. All documents, drawings, specifications, and other
materials produced by the Consultant 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 Consultant shall be permitted to retain copies, including
reproducible copies, of drawings and specifications for information,reference and use in
connection with Consultant's endeavors.
5.Compliance with laws. Consultant 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.
6.Indemnification. The Consultant shall defend, indemnify and hold the County, its
officers, officials, employees, agents and volunteers (and their marital communities)
harmless from any and all claims, injuries, damages, losses or suits including attorney
fees, arising out of or resulting from the acts, errors or omissions of the Consultant 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 that this
Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising
out of bodily injury to persons or damages to property caused by or resulting from the
concurrent negligence of the Consultant and the County, its officers, officials, employees,
agents and volunteers (and their marital communities) the Consultant's liability,
including the duty and cost to defend, hereunder shall be only to the extent of the
Consultant's negligence. It is further specifically and expressly understood that the
indemnification provided herein constitutes the Consultant'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. The provisions of this section shall
survive the expiration or termination of this Agreement.
7.Insurance. Prior to commencing work, the Consultant 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.
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
Consultant's performance of his Agreement. This insurance shall indicate on the
certificate of insurance the following coverage: (a) Owned automobiles; (b) Hired
automobiles; and, (3) Non-owned automobiles.
Commercial General Liability Insurance in an amount not less than a single limit of
500,000 per occurrence and an aggregate of not less than two (2)times the occurrence
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 2 of 10
amount($1,000,000.00 minimum) for bodily injury, including death and property
damage, unless a greater amount is specified in the contract specifications.
The commercial general liability insurance coverage shall contain no limitations on the
scope of the protection provided and include the following minimum coverage:
a.Broad Form Property Damage, with no employee exclusion;
b.Personal Injury Liability, including extended bodily injury;
c.Broad Form Contractual/Commercial Liability—including coverage for products
and completed operations;
d.Premises—Operations Liability(M&C);
e.Independent Contractors and subcontractors;
f.Blanket Contractual Liability.
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, and shall include a provision prohibiting cancellation of said policy except
upon thirty (30) days prior written notice to the County.
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.
The Consultant 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 Risk
Management, P.O. Box 1220, 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 Consultant 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 Consultant 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.
Failure of the Consultant to take out or maintain any required insurance shall not relieve
the Consultant from any liability under this Agreement, nor shall the insurance
requirements be construed to conflict with or otherwise limit the obligations concerning
indemnification of the County.
The Consultant'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 all the parties and shall be primary coverage for all
losses covered by the above described insurance.
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 3 of 10
Insurance companies issuing the Consultant'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.
All deductibles in the Consultant's insurance policies shall be assumed by and be at the
sole risk of the Consultant.
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 Consultant
shall procure a bond guaranteeing payment of losses and related investigations, claim
administration and defense expenses.
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 Consultant until the Consultant shall furnish additional security
covering such judgment as may be determined by the County.
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
insurance policy the Consultant shall provide to comply with this Agreement.
The County may, upon the Consultant's failure to comply with all provisions of this
Agreement relating to insurance, withhold payment or compensation that would
otherwise be due to the Consultant.
The Consultant shall provide a copy of all insurance policies specified in this Agreement.
Written notice of cancellation or change in the Consultant's insurance required by this
Agreement shall reference the project name and agreement number and shall be mailed to
the County at the following address: Jefferson County Risk Management, P.O. Box
1220, Port Townsend, WA 98368.
The Consultant'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.
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.
The Consultant'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.
The Consultant shall include all subconsultants as insured under its insurance policies or
shall furnish separate certificates and endorsements for each subconsultants. All
insurance coverage for subconsultants shall be subject to all the requirements stated in
this Agreement.
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 4 of 10
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.
The Consultant 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 County Risk Manager by registered mail,return receipt requested.
The Consultant 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.
The County reserves the right to request additional insurance on an individual basis for
extra hazardous contracts and specific service agreements.
8.Worker's Compensation(Industrial Insurance).
If and only if the Consultant 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 Consultant, the Consultant 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 Risk
Management, upon request.
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.
This coverage shall extend to any subconsultant that does not have their own worker's
compensation and employer's liability insurance.
The Consultant 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.
If the County incurs any costs to enforce the provisions of this subsection, all cost and
fees shall be recoverable from the Consultant.
9.Independent Contractor. The Consultant and the County agree that the Consultant is an
independent contractor with respect to the services provided pursuant to this Agreement.
The Consultant specifically has the right to direct and control Consultant's own activities,
and the activities of its subconsultants, employees, agents, and representatives, in
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 5 of 10
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 Consultant nor any employee of
Consultant 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 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 Consultant, or any
employee of Consultant.
10. Subcontracting Requirements. The Consultant 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 subconsultant to perform is no defense
to a breach of this Agreement. The Consultant assumes responsibility for and all liability
for the actions and quality of services performed by any subconsultant.
Every subconsultant must agree in writing to follow every term of this Agreement. The
Consultant must provide every subconsultant's written agreement to follow every term of
this Agreement before the subconsultant can perform any services under this Agreement.
The County Engineer or their designee must approve any proposed subconsultants in
writing.
Any dispute arising between the Consultant and any subconsultants or between
subconsultants must be resolved without involvement of any kind on the part of the
County and without detrimental impact on the Consultant's performance required by this
Agreement.
11. Covenant Against Contingent Fees. The Consultant warrants that he has not employed or
retained any company or person, other than a bona fide employee working solely for the
Consultant, 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
Consultant, 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 Agreement price or
consideration, or otherwise recover, the full amount of such fee, commission, percentage,
brokerage fee, gift, or contingent fee.
12. Discrimination Prohibited. The Consultant, 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, sex, or the presence of any physical or sensory handicap in the
selection and retention of employees or procurement of materials or supplies.
13. No Assignment. The Consultant shall not sublet or assign any of the services covered by
this Agreement without the express written consent of the County. Assignment does not
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 6 of 10
include printing or other customary reimbursable expenses that may be provided in an
agreement.
14. 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.
15. Termination.
a.The County reserves the right to terminate this Agreement at any time by giving
ten(10) days written notice to the Consultant.
b.In the event of the death of a member,partner, or officer of the Consultant, or any
of its supervisory personnel assigned to the project, the surviving members of the
Consultant hereby agree to complete the work under the terms of this Agreement,
if requested to do so by the County. This section shall not be a bar to
renegotiations of this Agreement between surviving members of the Consultant
and the County, if the County so chooses.
16. 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 Works
623 Sheridan Street
Port Townsend, WA 98368
Notices to Consultant shall be sent to the following address:
Erik Martin SE, PE
Sargent Engineers, Inc.
320 Ronlee Lane NW, Olympia, WA 98502
17. Integrated Agreement. This Agreement together with attachments or addenda, represents
the entire and integrated Agreement between the County and the Consultant 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 Consultant ratifies and adopts all statements, representations,
warranties, covenants, and agreements contained in its proposal, and the supporting
material submitted by the Consultant, accepts this Agreement and agrees to all of the
terms and conditions of this Agreement.
18. Modification of this Agreement. This Agreement may be amended only by written
instrument signed by both County and Consultant.
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 7 of 10
19. 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 Director of Public Works or County Engineer, 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 Consultant
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.
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 Consultant 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.
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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 Consultant 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
Consultant further agrees that upon receipt of any written public record request,
Consultant shall, within two business days, notify the County by providing a copy of the
request per the notice provisions of this Agreement.
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 9 of 10
DATED this day of 20
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Sargent Engineers, Inc.
Name of Consultant Heather Dudley-Nollette, District 1
Erik C. Martin
Consultant Representative(Please print) Heidi Eisenhour, District 2
ignature) Greg Brotherton, District 3
Principal
Title
05/18/2026
Date
Approved as to form only:
PRE-APPR VED CONTRACT FORM
Philip . H sucker Date
Chief vil eputy Prosecuting Attorney
Eric Kuzm Date
Public Work Director/County Engineer
Professional Services Agreement, Contract A, Version 3, Risk Legal Review 6/17/2020 Page 10 of 10
Exhibit "A"
Scope of Work
Task 1: Solid Waste Transfer Station Scale Replacement
Develop scale foundation and scale house design and drawings based on information provided
by the scale expert subconsultant. Structural design will be completed per the requirements of the
2024 International Building Code. Soil bearing pressures will be limited to 2000 pounds per
square foot as noted in the structural drawings for the existing transfer station (1994 drawings).
Project coordination with County staff and the civil engineering subconsultant including
assistance with possible trucking bypass route reviews and construction phasing options.
Develop specifications for the project based on WSDOT Standard Specifications.
Provide an updated cost estimate for the structural elements noted above.
Time for completion of cost estimate for funding request is July 1, 2026
Time for completion of bid ready documents is August 31, 2026
Task 2: Solid Waste Transfer Station Facility Modifications
Final design of the PEMB modifications needed to open the west wall, and final design of the
retaining wall for building up the excavator roadway adjacent to the new opening. Design per the
2024 International Building Code. Soil bearing pressures will be limited to 2000 pounds per
square foot as noted in the structural drawings for the existing transfer station (1994 drawings).
Develop stamped drawings of the PEMB modified west wall and the retaining wall. The
retaining wall layout will be developed based on the 1994 drawings.
Develop conceptual level layout plan to 30% design for feasibility check.
Develop stamped drawings for the trench drain modifications.
Develop stamped drawings for the new southwest scale canopy. This work will likely be
phased.
Develop specifications for the project based on WSDOT Standard Specifications.
Provide an updated cost estimate for the structural elements noted above.
Time for completion of cost estimate for funding request is July 1, 2026
Time for completion of bid ready documents is August 31, 2026
Exhibit "B"
Consultant Fees
Task 1:
Jefferson County Solid Waste Scale Replacement
Structural Engineering Services Proposal
Senior
Project Project Design
Principal Engineer Engineer Engineer Task Cost
Rate $275 00 $205 00 $175 00 $135 00
Scale Replacement Construction Documents
1. Coordination and 2 Site Visits 16 12 6,500
2. Scale Foundation Design............_.._._........ 1 4 12 3,195
3 Scale House Design 1 12 24 6,935
4 Scale Foundation Drawings 1 6 12 3,605
5 Scale House Drawings 1 12 24 6,935
10 Estimate 1 4 8 2,495
11 Specifications 1 4 12 3,195
Subtotal 22 42 104 0 32,860
Total Labor Cost 6,050 8,610 $18,200 0 32,860
Direct Costs
Civil Subconsultant(plus 10%markup) 48,950 00 48.950
Geotechnical Subconsultant(plus 10%markup) $5.500 00 5.500
Scale Expert Subconsultant(plus 10%markup) $5.775 00 5.775
Mileage(2 trip @ 180 mi) 270 00 270
60,495
Maximum Fee 93,355
Exhibit "B"
Consultant Fees
Task 2:
Jefferson County Solid Waste Transfer Station Modification
Structural Engineering Services Proposal
Senior
Project Project Design
Principal Engineer Engineer Engineer Task Cost
Rate. $275.00 $205 00 $175 00 $135 00
Transfer Station Modification Construction Documents
1. Coordination and 2 Site Visits 12 12 5,400
2. PEMB Wall Opening Design 1 8 16 4,715
3. West Foundation Wall Design _._....._.._.. _._ 1 8 16 4,715
4. Trench Drain Repair Design 0 5 4 8 2,358
5. Rear Scale Canopy Design 1 8 16 4,715
6. PEMB Wall Opening Drawings 1 12 24 6,935
7. West Foundation Wall Drawings 1 12 24 6,935
8. Trench Drain Repair Drawings 0.5 4 8 2,358
9. Rear Scale Canopy Drawing 1 8 16 4,715
10. Estimate 1 4 8 2,495
11 Specifications 2 8 16 4,990
Subtotal 22 76 164 0 50,330
Direct Costs
Mileage (2 trip @ 180 mi) 270 00 270
270
Maximum Fee 50,600
Regular Agenda
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of Commissioners
Josh Peters, County Administrator
FROM: Shawn Frederick, Central Services Director
DATE: May 25,2026
RE: Follow up to Workshop on Artificial Intelligence Policy—Proposed Revised
AI Policy
STATEMENT OF ISSUE:
Jefferson County needs an artificial intelligence policy both to facilitate AI use and to protect
the County from known problems with AI use. The Board of County Commissioners held a
workshop on a draft Al Policy on May 18, 2026 that might fulfill this need. The draft AI
Policy presented for the workshop was the result of nearly two years of effort by staff. Based
on comments from the Commissioners and the public, Staff has revised the proposed AI Policy
presented during and after the May 18, 2026 workshop. A redlined document with proposed
changes is attached.Also attached is Appendix C, the list of"other statutes"containing
exemptions incorporated in the Public Records Act by RCW 42.56.070.
ANALYSIS:
Useful comments from the Commissioners and members of the public were received at the
May 18, 2026 workshop.
ChatGPT Analysis
An analysis was provided used ChatGPT to review the draft AI Policy. This ChatGPT
analysis provided an overall assessment of the AI Policy and said:
The policy does several things well:
Recognizes AI as both an operational tool and a governance risk.
Integrates Washington Public Records Act considerations directly into the
policy.
1
Regular Agenda
Requires human review and verification of AI outputs.
Addresses hallucinations, bias,procurement transparency, and auditability.
Attempts to create centralized governance and approval processes.
Restricts entry of protected data into AI systems.
Includes training and accountability mechanisms.
Acknowledges accessibility and equity obligations.
For a county government,this is unusually mature.
These points were all goals of developing the AI Policy.
The Chat GPT analysis provides some comments as a result of a misunderstanding that the
document at the end of the Agenda Request for the May 18, 2026 Al Policy Workshop titled
Artificial Intelligence System Policy for Jefferson County"is not part of the proposed AI
Polity. The Agenda Request for the May 18, 2026 Workshop said: "The proposed Al Policy
relies for completeness on the Darwin Al Organizational Policy(also attached),which was
developed by adding inputs to the Darwin GovernTM Al Policy Wizard (https://
www.darwingov.com/ai-policy-wizard)." Staff apologizes for the confusion. That document
the proposed policy created using only generative AI, using the Darwin GovernTM Al Policy
Wizard.
Staff analyzed the Chat GPT output and believes the agenda request caused confusion which
led to comments. Staff believes both the proposed AI Policy,the adopting resolution, and the
policy generated by the Darwin GovernTM Al Policy Wizard were fed into Chat GPT
together.
To be sure, the ChatGPT analysis finds errors. Staff noted in the comments to the revised AI
Policy (attached)errors found in the ChatGPT analysis. This AI capability demonstrates the
promise of AI—humans create the type of errors AI can find and fix easily.
But the ChatGPT analysis also shows why human oversight of AI use is necessary. For
example, the ChatGPT analysis recommend that the county needs"Specific Washington PRA
handling procedures." Section 6 of the Chat GPT analysis further states:
6. Public Records Act treatment is underdeveloped
The policy correctly recognizes AI outputs as public records.
But it does not adequately address:
prompt retention,
2
Regular Agenda
metadata preservation,
audit logs,
draft retention,
transient chats,
records classification,
retention schedules,
discoverability,
or third-party hosted data.
This is one of the largest real-world government AI risks.
But the county already has a detailed public records policy,Jefferson County Public
Records Act Compliance Policy(Resolution No. 10-22,February 28,2022),and it is
referenced in the proposed AI Policy in section 6.
The county needs to implement an Al Policy now,to unleash its potential to increase
productivity. The county purchased Darwin AI in 2025 to minimize the risks of use of AI.
Staff strongly recommends adopting the revised AI policy attached to this Agenda Request as
soon as possible.
FISCAL IMPACT:
Adoption of an AI Policy now, even if imperfect, allow the county to almost immediately
implement Darwin AI, which the county bought in 2025. We expect Darwin AI to help
minimize the risks of use of AI and increase the safety in using AI. AI has the proven promise
of increasing productivity, making it possible for the county to do more with less resources.
RECOMMENDATION:
Adopt review and adopt as quickly as possible an AI Policy. Staff believes the revised
attached AI Policy should be adopted as is or as modified by the BoCC.
DEPARTMENT CONTACT:
Shawn Frederick, Central Services Director
REVIEWED BY:
9(1)07 D f
Josh D. Peters, County Administrator Date
3
STATE OF WASHINGTON
County of Jefferson
In the Matter of Adopting the Jefferson
County Artificial Intelligence Acceptable RESOLUTION NO.
Development and Use Policy
WHEREAS, generative artificial intelligence (AI)represents a significant leap forward in
technology,by generating novel text, images, and other content, which has the capacity to
transform the way Jefferson County conducts business and serves the public; and,
WHEREAS, generative AI can enhance human potential and creativity but must be
deployed and regulated carefully to mitigate and guard against a new generation of risks, harms,
and perpetuation of existing inequities; and,
WHEREAS, Jefferson County is committed to accuracy, reliability, and ethical outcomes
when adopting generative AI technology, and serving all of those who reside, work, and do
business in Jefferson County in a transparent, engaged, and equitable way; and,
WHEREAS, Jefferson County seeks to realize the potential benefits of generative AI
through the deployment of generative AI tools that improve the equitable and timely delivery of
services, while balancing the benefits and risks of these new technologies; and,
WHEREAS,a generative AI policy is necessary to govern the development, deployment,
management and use of generative AI use in Jefferson County government affairs in a thoughtful
manner that upholds the public trust, ensures safety and security, and promotes ethical standards;
NOW, THEREFORE, THE BOARD OF COUNTY COMMISSIONERS OF
JEFFERSON COUNTY,WASHINGTON, HEREBY RESOLVE AS FOLLOWS:
Section 1. Whereas Clauses are Findings of Fact. The Jefferson County Board of Commissioners
hereby adopts the above "Whereas" clauses as Findings of Fact.
Section 2. Purpose. The purpose of this resolution is to adopt the Jefferson County Artificial
Intelligence Acceptable Development and Use Policy(AI Policy).
Section 3. Adoption of the Jefferson County Artificial Intelligence Acceptable Development and
Use Policy. The AI Policy in Appendix A is hereby adopted.
Section 4. Repealing and Replacing Any Inconsistent Policy that Addresses the Topic of
this Policy. This Policy controls over any ordinance, other resolution or policy on the same
topic.
Section 5. Severability. If any section,subsection, sentence,clause,phrase or section of this Policy
or its application to any person or circumstance is held invalid, the remainder of this Policy or its
application to other persons or circumstances shall be fully valid and shall not be affected.
1
Section 7. Effective Date. The Policy becomes effective upon the date of adoption.
Section 8. SEPA Categorical Exemption. This policy is categorically exempt from the State
Environmental Policy Act under WAC 197-11-800 (19).
SIGNATURES FOLLOW ON THE NEXT PAGE)
2
APPROVED and ADOPTED this _ day of 2026.
JEFFERSON COUNTY BOARD OF
COMMISSIONERS
Greg Brotherton, Chair
SEAL: Heidi Eisenhour, Member
Heather Dudley-Nollette, Member
ATTEST:
Carolyn Gallaway, CMC Date
Clerk of the Board
Approved as to form only:
Philip C. Hunsucker Date
Chief Civil Deputy Prosecuting Attorney
3
RED L NE VERSION
REDLINED
VERSION OF
PROPOSED Al POLICY
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REDLINEVERSION
RED LINE VERSION
Document Code No.:
Title: Jefferson County Artificial Intelligence Acceptable Development and Use Policy
Page ii of ii
TABLE OF CONTENTS
TABLE OF CONTENTS ii
1) INTRODUCTION 1
2) PURPOSES 1
3) GUIDING PRINCIPLES AND VALUES 2
4) DEFINITIONS 3
5) APPLICABILITY OF THIS AI POLICY 8
6) Compliance with Existing Laws and Policies 8
7) Prohibited uses of an Al System 9
8) PUBLIC RECORDS ACT COMPLIANCE 12
9) architectural and technical STANDARDS 12
10) ROLES AND RESPONSIBILITIES 12
11) AI SYSTEM AND USE AND CASE APPROVAL PROCESS 15
12) PROCEDURES 17
13) CONSEQUENCES FOR NONCOMPLIANCE 20
14) LIMITATIONS OF THIS AI POLICY 20
APPENDIX A:REFERENCES 22
APPENDIX B:RELEVANT COMPLIANCE REQUIREMENTS 24
APPENDLX C- 25
RECORDS PROTECTED FROM DISCLOSURE BY AN"OTHER STATUTE"THAT ARE
NOT TO BE USED IN AN AI SYSTEM 25
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Document Code No:
Title: Jefferson County Artificial Intelligence Acceptable Development and Use Policy
Page 1 of 25
JEFFERSON COUNTY ARTIFICIAL INTELLIGENCE
ACCEPTABLE DEVELOPMENT AND USE POLICY
1)INTRODUCTION
Artificial Intelligence (AI)technology is increasingly becoming an integral part of local
government operations, offering opportunities to enhance the efficiency and effectiveness
of public services. At the same time, the use of AI also presents ethical, legal, and social
challenges that require responsible management.This AI Policy provides a framework for
the effective and responsible use of AI systems within the County, to maximize the benefits
of these innovative tools while minimizing their potential risks to both the County and the
public.
2)PURPOSES
The purposes of this AI Policy are to:
A. Ensure ethical and responsible development, deployment, and use of Al technology in the
County, ensuring they are in alignment with the principles of transparency, fairness,
accountability, and public trust
B. Enable effective use of AI technology by providing clear guidance to the County personnel,
vendors, and other partners who work with AI systems.
C. Inform community members and other stakeholders about how the County is utilizing AI
technology and what measures it is taking to protect the public from potential adverse
consequences of these systems.
D. Promote responsible and ethical use of AI technology by defining the principles and values
that govern the application of this technology within the County.
E. Ensure the compliance of AI systems with all applicable federal, state, and local laws and
regulations as well as existing the County policies.
F. Assign roles and responsibilities related to the County's use of AI systems.
G. Establish processes that encourage effective and responsible use of AI systems.
H_ Define prohibited uses of AI systems_
I. Specify measures which may be taken in the event of failure to comply with these policies.
This AI Policy may be updated from time to time to account for changes in Al technology, laws
and regulations: uses of AI systems within the County, and other considerations.
In addition,the Central Services Director may publish an AI User Guide to provide more detailed
guidance on how the requirements of this AI Policy is to be implemented.Unless otherwise stated,
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Document Code No:
Title Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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any such additional guidance should be considered an extension of this AI Policy and carry the
same requirements for compliance.
PAO
3)`GUIDING PRINCIPLES AND VALUES] The ChatOPT anah-ti said.
The County s AI devel ent: loyment, and use of artificial intelli ence systems %hall be aS. i provisions are a3piratiooal rather than
g a1orceabk
guided by the following guiding principles and values:
The policy repeatedly uses phrases hke.
a) We expect to retain appropriate human agency and oversight, allowing for r-We expect_ -
should..."
intervention to prevent harm. I.-to the create:erect tc,ssible
This weakens enfarceabihr_..
b) We expect to use internal and external security testing of systems before Example
public release for high-risk artificial intelligence systems.
We expect AI decisions to be understandable..
c) We expect to protect data privacy and security. What constitutes compliance"
d) We expect to promote appropriate transparency for consumers when they
xer®mmeaaation
interact with artificial intelligence systems or products created by artificial Distinguish:
intelligence. mandatory requirements('shai r..
from goals principles(`should").
e) We expect to ensure accountability, considering oversight, impact Fight now the document mire:them heavily.
assessment,auditablllty,and due diligence mechanisms.
Response: Staff does not agree. All the provisions in
this section(3)were aspirationaL Mandatoryf) We expect to make AI accessible to all residents, including those with requirements below do use-shall.'The BoCC
disabilities or limited access_ considered section(3)at the workshop and decided it
was satisfactory.except for subsection iki,which
g) We expect to govern the deployment and maintenance of Al systems with re used to address his concern.
human oversight ensuring adherence to relevant laws and regulations and by
defining roles and responsibilities.
h) We expect to implement measures to detect and mitigate biases in order to prevent
harm.
i) We expect to continuously monitor and enhance AI systems based on feedback and
technological advancements.
j) We expect proper management,quality,and stewardship of data used by AI systems.
k) We will-expect the county will be one source of p etedigital literacy among
residents to help them understand and engage with Al systems.
1) We expect AI systems to be reliable, meet their objectives, and deliver
precise and dependable outcomes in their deployment contexts;
m) We expect AI decisions to be understandable to those affected_
n) We expect AI systems to prevent discrimination and bias,ensuring fair treatment for
all residents.
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Title: Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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o) We expect AI systems should be developed and deployed with a human-
centered approach that evaluates their impact on the public.
p) We expect technological innovation to be embraced responsibly while minimizing
environmental impacts_
q) We expect Al systems to comply with all relevant laws and regulations_
r) We expect privacy concerning personal data to be protected, while satisfying the
requirements of the Washington Public Records Act, chapter 42.56 RCW.
s) We expect AI systems to comply with data protection laws.
t) We expect AI systems not to cause harm and to prioritize the safety of
residents_
u) We expect Al systems to be secure against unauthorized access and ensure consistent
performance_
v) We expect the use of Al systems to be proactively communicated to the
public, ensuring that AI systems, their data sources, operational models, and
governing policies are understandable and documented.
w) We expect Staff to be empowered to use AI in their roles through education, training,
and collaborations that promote participation and opportunity.
These guiding principles and values are the inspiration for this AI Policy,and AI users are expected
to incorporate these same motivations in the implementation of this Al Policy. While the ideal
course of action may not be obvious or practical in every circumstance,this AI Policy is designed
to offer guidance to help AI users responsively navigate the use of AI systems.
4)DEFINITIONS
a) `Artificial Intelligence" (or "AI")l means a machine-based system that can,
for a given set of human-defined objectives, make predictions,
recommendations or decisions influencing real or virtual environments_
Artificial intelligence systems use machine and human-based inputs to:
i) Perceive real and virtual environments;
ii) Abstract such perceptions into models through analysis in an automated
manner; and,
iii) Use a model to formulate options for information or action_
Slightly modi ie3. ti:_ is the definition from the National ttifcial Intelligence Initiative Act of 2020, 15 U.S.0
section 9461.
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Title.Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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b) "AI best practices"means the best practices described in National Cyber
Security Centre,Best Practices for Securing Data Used to Train&Operate
AI systems,Ver. 1.0(May 2025).
c) "AI model"means a set of programmed instructions that processes data to
perform tasks,make decisions,or solve problems within an AI system.
d) "Al Policy"means this Jefferson County Artificial Intelligence Acceptable
Development and Use Policy.
PAO
e) "Al System means any machine-based system that, for any explicit or The ChatGPT analys said:
implicit objective, infers from the inputs the system receives how to
The definition of"AI system"is escessireiv
generate outputs, including content, decisions, predictions, or broad
recommendations,that can influence physical or virtual environments and
includes any tool, software,process,workflow, or other system which is The policy defines AI system broadly enough to
poteatally include;based on AI or which uses an AI tool.
spell check.
f) "AI Tool"means a piece of software which provides AI functionality and search ranlan_,
predictive filters.
can be applied to a specific use case.automated workflows.
document categorization_
g) "AI Use Case"means specific task or purpose for which an AI tool is used s camerar-
arsd embedded software features.
or under consideration_
although exclusions exit,the scope remain
h) "AI User" means any person is—using, developing, purchasing, eszemeiy expansive.
configuring,or maintaining any AI used by or for the County on its behalf
Response: Staff does not agree. The definition is
including contractors,consultants,elected officials,employees,and volunteers. relied upon Colorado's Al Act Corn.Rev Slat. a
1=01(Lexis Advance throueh Chapter 22 of the 2026
i) "AI User Guide"means a document which supplements an AI Policy with Regular Session;effective as of March 2d..2026)and
the Darwin GovernTAl Al Policy Wizard and is
more detailed guidance on how to implement this AI Policy. hmited by section 5(d)and section'(a).
j) `Bias"means systematic tendencies that can exist within AI systems,often
stemming from flawed data,algorithms,or design processes,that may lead
to discriminatory or inaccurate outcomes affecting certain groups or
persons.
k) "Central Services"means the County Central Services Department.
1) "Central Services Director"means the person holding the title of Director
of Central Services or a delegee that has been delegated in writing.
m) "Chatbot"means a computer program that simulates human conversation
through text or voice interactions.
For erecter precision,this definition was modified,using Colorado's Al Act Colo.Rev.Stat. $6-1-1701(Lexis
Advance through Chapter 22 of the 2026 Regular Session,effective as of March 26,2026).
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n) "Consequential decision"3 means a decision that has a material legal or
similarly significant effect on,or the cost of:
i) Hiring or retention of a contractor,employee,vendor or volunteer;
ii) Any budget decision;
iii) The provision of any essential government service;
iv) Health care(as defined in this AI Policy);
v). Risk management,including but not limited to obtaining coverage for
any risks by an insurance company or a self-insurance program;or,
vi) The provision of legal services.
o) "County"means the County,Washington_
p) "County Approved Al system"means an Al system approved for use by
AI users as specified in section 7.a.
PAO
f)4(q) "County Information Systems"means all county information systems, Added definition to rase in Limita ton:on AI used in
including but not limited to computers or servers owned or operated by the 5e ion:.
County.
q)(r) "Data" means any digital representation of information; knowledge,
facts, concepts, data programs or instructions that are being prepared or
have been prepared in a formalized manner and are intended for use in a
data network,data program,data services,or data system.
r L"Health care provider"' means a person who is licensed, certified;
registered,or otherwise authorized by the law of this state to provide health
care in the ordinary course of business or practice of a profession.
Es-Al)"Health care"5 means any care, service, or procedure provided by a
health care provider:
i) To diagnose,treat, or maintain a patient's physical or mental condition;
or,
ii)That affects the structure or any function of the human body.
Adapted from the Colorado AI Act,Colo.Rev.Stat.§6-1-1701(2026).
DeSnition from RCW 70.02.010(19).
DeSnition from RCW 70.02.010(15)-
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Title: Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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Health care information" means all information about health care that
is protected from disclosure by the Health Insurance Portability and
Accountability Act of 1996(HIPAA)Privacy Rule, 45 C.F.R.Parts 160 and
164, Chapter 70.02 RCW (Medical Records—Health Care Information
Access and Disclosure) or RCW 42.56.360 (Health care exemption from
disclosure of records under the Washington Public Records Act).
v) "High-risk AI system" means any AI system that, when deployed,
makes, or is a substantial factor in making, a consequential decision_
High-risk AI system" does not include an AI system if
i) The AI system is intended to:
A) Perform a narrow procedural task;
B) Detect decision-making patterns or deviations from prior
decision-making patterns and is not intended to replace or
influence a previously completed human assessment without
sufficient human review;
ii) The AI system uses the following technologies, unless the
technologies, when deployed, make, or are a substantial factor in
making, a consequential decision:
A) Anti-fraud technology that does not use facial recognition
technology;
B) Anti-malware;
C) Anti-virus:
D) AI-enabled video games;
E) Calculators;
F) Cybersecurity;
G) Databases;
II) Data storage;
I) Firewall;
J) Internet domain registration;.
Adapted from the Colorado AI Act,Colo.Rev.Staff§6-1-1701(2026).
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Title: Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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K) Internet website loading;
L) Networking;
M) Spam- filtering;
N) Robocall-filtering;
0) Spell-checking;
P) Spreadsheets;
Q) Web caching;
R) Web hosting or any similar technology; or,
S) Technology that communicates with consumers in natural language for the
purpose of providing users with information, making referrals or
recommendations, and answering questions and is subject to County policy
that prohibits generating content that is discriminatory or harmful.
IT" means the Jefferson County Information Technologies
Department, a division of Central Services.
w)(x) "Public Record"has the same meaning as in RCW 42.56.010(3).'
Risk management" means coordinated activities to direct and control
an organization with regard to risk.
v)fz) "Section" means a section of this AI Policy, unless there is clear
language in this AI Policy that a section of this AI Policy does not apply.
L"Substantial factor's means a factor that:
A) Assists in making a consequential decision;
Public record' includes any niiting containing information relating to the conduct of government or the
performance of any governmental or proprietary function prepared, owned, used, or retained by any state or local
agency regardless of physical form or characteristics.For the office of the secretary of the senate and the office of the
chief clerk of the house of representatives;public records means legislative records as defined in RCW 40.14.100 and
also means the following:All budget and financial records;personnel leave,travel. and payroll records;records of
legislative sessions;reports submitted to the legislature;and any other record designated a public record by any official
action of the senate or the house of representatives.This definition does not include records that are not otherwise
required to be retained Irf the agency and are held by volunteers who:
a)Do not serve in an administrative capacity;
b)Have not been appointed by the agency to an agency board,commission,or internship;and
a)Do not have a supervisory role or delegated agency authority."RCW 42.56.010(3).
Adapted from the Colorado AI Act,Colo.Rev.Stat. 6-1-1701(2026).
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Document Code No.:
Title: Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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B) Is capable of altering the outcome of a consequential decision;and,
C) Is generated by an AI system.
Substantial factor' includes any use of an AI system to generate any content
decision,prediction:or recommendation concerning consequential decision.
aa)(bb)"Writing"has the same meaning as in RCW 42.56.010(4).9
5)APPLICABILITY OF THIS AI POLICY
42) PAO
a)R'hisE AI Policy governs the development, procurement or use of any Al systems(as Clarifies that the concern is inputting AI System
defined in this AI Policy)for input of results of the use of an Al System into tryvergn results into a county informaton system-
behalf-eft e County Information Systems.
b)All County boards, commissions, committees, departments; and task forces
shall comply with this AI Policy.
0PAO
Clarifies that the concern is inputting Al SystemC)This Al Policy applies to:
runts into a county information system. Also
addresses Mr.Thiersch's comment.which says:
i) Agents, contractors, elected officials, employees. officers. vendors and
volunteers of the County who lase or input data into County Information The proposed AI policy makes it perfectly clear that
the policy will apply to all"Al users",whichSystemsand- definition includes volunteers such as myself
ii) All Al users(as defined in this AI Policy). Pare 10::Al User"means any person is using,
developing,purchasing.:-onbgtumz.or mamt'inino
any AI used tiv or for the County,includingd)This AI Policy does not apply to any Al system which: contactors,consultant,elected official..
employees,-and volunteers.
i) Has been evaluated and determined in writing by the Central Services
Director to be safe for unrestricted usage; so,yes,the acrornm D, does not appear in the
policy-.what is present in the policy is an NDA-litre
obligation that would be imposed on me should the
ii) Has AI features included in applications maintained by Central Services, policy be adopted as-written,and with which I will
which are not part of the AI feature's core functionality or involve the use not comply.
of sensitive data;and,May 20.2026 2:41 PM email!tons Toni Thier_ch to
the soCC-
iii)s not use or
input data into the-County re= Information Systems,
g
PAO
Clarifies that the concern is inputting AI System
6)COMPLIANCE WITH EXISTING LAWS AND POLICIES re itc etc a coin-informations stem
Writing' means handwriting, typewriting, printing, photostating, photographing, and every other means of
recording any form of communication or representation including,but not limited to,letters,words,pictures,sounds,
or symbols,or combination thereof,and all papers,maps;magnetic or paper taper,photographic films and prints,
motion picture,film and video recordings,magnetic or punched cards,discs,drums,diskettes,sound recordings,and
other documents including existing data compilations from which information may be obtained or translated."RC1 I'
42.t6.010(3).
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Tale:Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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Development and use of AI systems shall comply with:
a)All applicable federal,state,and local laws and regulations;and,
b)All County policies,including but not limited to:
i) Jefferson County Social Media Policy(Resolution No. 14-20,March 16,
2020). PAO
Revision make to address comment in ChatGPT
ii)Jefferson County Public Records Act Compliance Policy(Resolution No.10-22, analysis.
February 28,2022).
iii)Open Public Meeting Act Guidelines for Jefferson County Boards,Pao
The ChatOPT analysis said:Commissions&Committees(Resolution No. 50-22,October 24,2022).
S."Only Microsoft Copilot'is likely
iv)Jefferson County Personnel Administration Manual (Resolution No. 19-0407- unsustainable
R April 7,2025).
The policy authorizes only Microsoft Copilot fox
7)PROHIBITED USES OF AN AI SYSTEM
generative AI.
This aeates multiple problems:
a)The following AI systems are approved for use by the persons subject to this /Vendor lock-in
AI Policy listed in sections 5 and 6, subject to the limitations in this section 7:
The county becomes dependent on one ecosystem.
i) Microsoft's Enterprise AI system called Co-Pilot Kwhich is part of the Microsoft
360365 suite of programs)is the only AI system to be used for generative AI that l°°0ya hoe freeze
is approved for use by Al users(as defined in this policy). Departments cannot pilot emereeine tools without
a a approval.
ii) The Central Services Director shall maintain a list of any other approved
AI systems and shall publish the list on the County's web site.
Procurement rigidity
Farce competitive tools may be superior or
This space was intentionally left blank to allow the comments show fully.] cheaper.
Employee circumvention
Users may seaetly use personal account on
ezternal a stem..
Recommendation
Instead of nemi•tg a single tool:
establish security and compliance criteria.
then maintain an approved-tool registry
separately.
Policies should avoid hardcoding vendor products
whenever possible.
Response: Staff does not agree This analysis
ignores section 5(d)(i)and section-(aXii)both of
which authorize other approved Al systems.
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Title:Jefferson County Artificial Intelligence Acceptable Development and Use Policy
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PAO
b)Use of an AI system on a County-owned computer,server or system that is'net Addresses Air.Thietsck s comment,which says:
on the list of AI systems approved and made available on the County's web site
I'll point out a couple of other problems in the
is prohibited_ policy which stand out as berm impractical and or
unenforceable.
b)(c) Use of an AI system on a County-owned computer,server or system that
is on the list of AI Page 15:Use of an Al system on a County-systems systems being tested for possible authorized use pursuant owned computer.sewer or system that is not
to section(11)is authorized until testing is complete Once testing is complete, approved pursuant to this AI Policy is prohibited.
the Central Services Director shall determine whether such system shall be
faddedtoeitherthelistofAIsystemsthatareapprovedorthelistofAIsystems
Uses of
which
county-ocos be
haveactingn way o
knowing which Al.AI systems might on their
that are not approved. behalf as they access websrtes outride the county-3
puriew_A simple example is any use of Facebook
where malevolent AI's(almost certainly not on theThisspacewasintentionallyleftblanktoallowthecommentsshowfdlyllappeased"list) Dozens of coast staff are
empowered and'or required as part of their jobs to
monitor and post on Facebook_Is the count-nine
to take disciplinary action against them when they
access a rite that uses unapproved AI"
May 20.2025_:41 PM email hom Tom Thiersch to
the DoCC
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f€f d) Use of any high-risk Al system (as defined in this Al Policy) Is 1 PAO
pfehibited*equires enhanced review and specific written approval before it can Revision make to addiesa comment in ChatOPT
be added to the list of dppx oved AI Systems in section 7(aXi).anal`:5a5.Wh:ch Said:
Recommendanon
4)(e) Use of an AI system on a County-owned computer,server or system to Replace blanket prohibition teida-
create any deepfake,which is an image created by using machine learning to High-risk.Al systems require enhanced review
and Written approval.'capture and encode unique biometric characteristics of targets to combine the
Othmwise the policy is ioeically inconsistent
subject's unique characteristics with the acquired knowledge of general human
expression in order to then synthesize the target's facial features, voice,
mannerisms,etc. is prohibited.
f j(f) Entry any of the following data into an AI system is prohibited:
i) Personal financial information for any individual.This includes credit card
number, bank account number, PIN numbers, and any other financial
information.
ii) Authentication information.Inputting any passwords,login credentials,or
other authentication information into an AI system is prohibited.
iii) Personally Identifying Information. Inputting any personally identifying
information into an AI system is prohibited_ Personally identifying
information includes name,address,phone number, email address, social
security number,passport number,driver's license number,and any other
information that can reasonably be used to identify an person_
iv) Health care information(as defined in this AI Policy).
v) Sensitive or confidential information. This includes any information that
could be used or disclosed to harm the County or its employees or
volunteers, or residents such as information about political affiliations,
religious beliefs, membership in a protected class, criminal history, or
information related to the County information system.
vi) Any information exempted from disclosure by the Public Records Act,
chapter 42.56 RCW or some other federal or state statute, including but
not limited to:
A) Attorney-client privileged records relating to representation of the
County by its attorneys. The attorney-client privileged records are
protect communications and advice between an attorney and their
client. RCW 5.60.060(2)(a) constitutes an "other statute' exemption
under RCW 42.56.070(1)
B) Attorney work product records. Attorney work product records are:
Records that are relevant to a controversy to which an agency is a
party but which records would not be available to another party under
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the rules of pretrial discovery for causes pending in the superior courts
are exempt from disclosure under [the Public Records Act]." RCW
42.56.290.
C) Autopsy records. Autopsy and post mortem reports and records are
confidential and exempt from examination by the public. RCW
68.50.105(1).
D) Records related to juvenile offenses. RCW 13.50.050(1), (3).
E) Records of a person confined in jail. RCW 70.48.100(2)_
F) Personal information in files maintained for County employees,
appointees, or elected officials of any public agency to the extent that
disclosure would violate their right to privacy. RCW 42.56.230(3).
G) Specific intelligence information. Secret information, information
about an enemy, or conclusions drawn from such information or that
would disclose particular methods or procedures for gathering or
evaluating intelligence information_ RCW 42.56.240(1).
H) Specific investigative records. Information on active ongoing law
enforcement investigations. RCW 42.56.240(1).
I) Records protected by an "other statute which exempts or prohibits
disclosure of specific information or records." RC\A" 42.56.070(1)_
A list of"other statutes"is attached as Appendix D.
8)PUBLIC RECORDS ACT COMPLIANCE
Any product created by any AI system necessarily will be a"public record," as defined in ROC
42.56.010(3). All public records shill be managed in compliance with chapter 40.14 RCW
Preservation And Destruction of Public Records), chapter 42.56 RCW(Public Records Act), and
the County's most recent version of the Jefferson County Public Records Act Compliance Policy.
9)ARCHITECTURAL AND TECHNICAL STANDARDS
The architectural and technical standards associated with the enterprise use of AI systems ehall be
maintained by IT.
10) ROLES AND RESPONSIBILITIES
The following persons and groups are responsible for the duties involved in implementing this
AI Policy, as described below:
a)Central Services Director.
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The Central Services Director shall be responsible for:
i) Providing a public report at least annually to the Board of Count_.Commissioners on
County AI usage_
ii) Developing this AI Policy and additional guidance.
iii) Coordinating AI initiatives across departments and teams.
iv) Overseeing compliance with laws, regulations and County policies_
v) Providing guidance to AI users across the organization.
vi) Convening and overseeing the AI Wor-ki —GfetipReview Committee.
vii) Leading the AI review process.
viii)Directing technology resources, policies, projects, and services.
ix) Apprev-ing-Reviewing AlAI Review Committee
recommendations on oversight and guidance on AI initiatives within the
County_
x) Facilitating collaboration between teams and departments for successful
implementation of this AI Policy_
xi) Overseeing enterprise Security infrastructure and cybersecurity
operations.
xii) Maintaining security policies, procedures, standards, and guidelines.
xiii)Monitoring compliance with security policies and related requirements.
xiv)Ensuring accurate data sensitivity classification and protections.
xv) Advising on compliance on AI usage_
xvi)Identifying legal issues and risks related to AI usage.
xvii) Investigating alleged violations of this Al Policy and recommend
corrective actions.
b)AI Review Committee
The Board of County Commissioners shall establish an AI Review Committee with
department representatives which shall be make recommendations to the Central Services
Director on oversight and guidance on Al initiatives within the County.
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The Al Review Committee shall review and consider updates to this Al Policy, along with
the Central Services Director, at least annually to reflect technological advancements and
evolving community needs.
The Al Review Committee shall be responsible for making recommendations to the Central
Services Director on the following topics:
i) Al systems being considered for use by the County.
ii) Ethical concerns and conflicts.
iii) Policy and guidance updates.
c)County Administrator
The County Administrator shall be responsible for:
i) Approving proposed changes to this Al Policy.
ii) Making a final determination whether to allow Al use cases which involve
substantial risks of harm or other negative consequences.
iii) Enforcing corrective action for violations of this Al Policy.
d)Electeds and Department Heads
Electeds and department heads or a delegee shall be responsible for:
i) Ensuring employee, contractor and vendor compliance with this Al
Policy.
ii) Integrating Al systems into department operations that comply with this
AI Policy.
iii) Facilitating training for staff on this Al P o lic and Al best practices (as defined in
this Al Policy).
Unless otherwise specified,the specific officials listed above may delegate to one or more
persons to act on their behalf with respect to this Al Policy, and in such cases those
designees are understood to inherit the same authorities and obligations as the named
officials_
e)AI Users
i) All Al users are responsible for complying with the requirements of this Al
Policy.
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ii) All AI users have the responsibility to verify the accuracy of any
information acquired through the use of AI systems before using that
information in any final,published, or production documents.
11) AI SYSTEM AND USE AND CASE APPROVAL PROCESS
a) AI Systems Review Process
The Central Services Director shall establish a process under which all AI systems and AI
Use Cases are subject to a-thorough review-testing to determine their compliance with this AI
Policy prior to their implementation.The reviewtesting process shall:
i) Confirm compli mre with the specific requirements and prohibitions established
under this AI Policy;
ii) Consider the relative benefits and risks of each system or use case and determine
whether or not approval is reasonable and aligned with the values and principles in
this AI Policy;
iii) Specify the intended use cases of those systems and whether or not other use
cases require additional review;
iv) Document the results of each review using a standard template,which results
shall be retained for either the full lifespan of the AI system or use case or the
retention period required under law for similar documents (whichever is
longer).
b)Determination of High Risk Potential Negative Impacts
i) The Central Services Director shall create a standard for determining whether
or not a particular AI system or Al use case has a high risk of potential negative
impacts to any relevant person,group,or organization.
ii) A high-risk determination,that AI system or use case shall be presented to the
full AI Review Committee for approval.
iii) Lower-risk AI systems and use cases may be approved by the Central Services
Director at their discretion.
iv) The Central Services Director shall revisit all previously-approved AI systems
and use cases at least annually, or sooner in the event of substantial
modifications (such as a major software upgrade or change in scope), and
confirm in writing to the County Administrator the continued compliance and
reasonableness of the AI system or use case.
c)Monitoring,Evaluation, and Accountability
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i) The Central Services Director shall be responsible for implementing AI
systems to monitor AI system performance, effectiveness, and policy
compliance. The data collected from these AI systems shall be periodically
reviewed to evaluate the effectiveness of AI systems and their impacts on the
community.
ii) The Central Services Director shall establish procedures and protocols for
responding to failures of AI systems and violations of this AI Policy, including
corrective actions with regard to both the AI systems themselves and the
persons and organizations involved.
iii) Upon the recommendation of the Central Services Director, Central Services
Director, anor County Administrator, independent audits shall be conducted
to review AI systems for compliance with policies and ethical standards.
Findings from audits and evaluations shall be used to refine AI policies, improve
AI system functionalities,and determine any additional training or accountability
requirements.
d)Data Management,Privacy, and Retention
All AI systems shall comply with applicable data protection laws, regulations, and
policies to safeguard data protected by this AI Policy.
e)Mitigation of Bias and Human Oversight
All AI users shall be responsible for taking steps to mitigate potential biases(including but
not limited to biases related to protected characteristics such as race, gender, sexual
orientation, national origin, disability, or language) in AI systems they interact with, in
accordance with training and recommendations provided by the Central Services
Director.
f) Transparency and Explainability
Upon the consideration or introduction of a new AI system which is likely to have
major public impact,the Central Services Director shall ensure that key information
is provided to affected groups and other stakeholders in a timely manner. Such
information shall be provided in multiple formats or languages if necessary,consistent
with the County's practice in communicating
To the greatest extent possible,AI systems should provide clear and understandable
explanations for their decisions and outputs,particularly in cases where erroneous
results may create a risk of substantial negative impacts.
g)Training
i) All users shall be provided with regular training on AI technologies,
ethical considerations: and compliance requirements to ensure
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knowledgeable and responsible use of AI systems, as recommended by the
Central Services Director.
ii) The Central Services Director shall develop specific training requirements and
content for users granted access to high-risk AI systems and associated data,
focusing on compliance with this AI Policy and other associated laws,
regulations, policies, and AI best practices.
iii) These trainings shall be updated on a regular basis to ensure their accuracy and
relevance, and users' continued access to high-risk AI systems and data shall
be contingent upon completion of additional required trainings determined by
the Central Services Director.
h)Vendors and Third Parties
i) All vendors and other third parties who provide or interact with AI systems shall
be required to comply with this and all other applicable policies, and this
compliance shall be explicitly included in all relevant contracts and similar
agreements.
ii) All technology vendors shall be required to disclose whether and how AI is used
in their products and services, and what mechanisms they provide to allow for
auditing these AI systems. These disclosures shall be provided using a standard
form developed and maintained by the Central Services Director and required in
all technology procurements.
iii) Vendors shall be evaluated based on their commitment to responsible AI
development and their history of adherence to ethical standards,and preference
in procurement decisions shall be given to vendors which can effectively
provide transparency into their AI systems and practices to both the County
and the public.
i) Labeling of Al-generated Content
All content generated by AI systems and presented to the public shall be clearly labeled as
such. This shall include all text, audio, image, and video content, as well as interactive AI
systems such as chatbots and automated decision-making tools.
All persons involved in disseminating content generated by an AI system on behalf of the
County shall be responsible for ensuring the accuracy of such content and its appropriate
labeling.
The Central Services Director or designee Shall establish standard mechanisms for the County
personnel and members of the public to report violations of this labeling requirement.
12) PROCEDURES
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a)Attribution
i) The use of AI systems and the resulting product(s) shall be attributed,
referenced, and cited in any electronic or paper material produced and
published by anyone subject to this AI Policy.
ii) Attribution should include a description of the source application, how it
was used, how the material was edited, by whom, and the date. For
example:
Microsoft Co-Pilot was used to generate the charts and data referenced above. The
content was reviewed and edited before being published by Sam Smith, Jefferson
County Public Works Department, on 04 15/2026."
b)Intellectual Property
Content produced by AI systems may implicate intellectual property rights and likely will
include copynghted material_ AI systems shall be "trained"using Data(text, images, etc.)
that has been sourced from the interne without regard for copyright or licensing terms. It
is extremely difficult to determine what content was used to train an AI system, and
difficult to verify whether Al-generated content is wholly original or only a slight
stylization of existing copyrighted material_Nevertheless, County AI users are required to
perform due diligence to ensure that no copyrighted material is published by the County
without proper attribution or without obtaining proper rights_
c)Validation Required
i) Complex algorithms of AI systems exponentially increase risk when
incomplete or inaccurate data is involved. AI systems shall be validated
and regularly assessed to ensure completeness and accuracy. Results from
decisions, code, or research supported by AI systems should consistently
align with those of a human subject matter expert.
ii) AI users shall verify the accuracy of any information acquired through the
use of AI systems before using that information in any final, published, or
production documents_ If AI users are uncertain about the accuracy of the
obtained information, they should consult their supervisor or seek advice
from a IT.
iii) AI users shall independently verify any quotes or references generated by
AI systems. AI users shall not assume that a quote or reference is accurate,
or real.AI systems rarely act as if they are uncertain,making false answers
difficult to spot. AI systems can generate:
A) Fabricated content, sometimes called "hallucinations_' This is a
phenomenon where an AI system, particularly those using large
language models, generates false, inaccurate, or illogical
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information while presenting it in a confident, authoritative, and
convincing manner. Fabricated content occurs when an AI system
creates synthetic data, fabricates facts, or invents nonexistent
sources. An AI system may invent fake academic papers, legal
cases, scientific studies, or personal facts.
B) Factual Errors: Stating incorrect facts, such as "Einstein won two
Nobel Prizes."
C) Image Distortions: AI systems can create anatomically incorrect
figures (e.g., too many fingers).
Verification ehall include cross-referencing sources included in the AI output_ or
independently verifying dates, names and events in peer reviewed or authoritative
published literature on the internet or printed material.
d)Decision Making
County departments shall utilize AI systems to enhance efficiency and effectiveness. AI
systems can be used for idea generation and as one source of information when researching
a topic.AI systems products shall be human reviewed and edited before usage in any final,
published, or production documents. This is particularly important when the content is
public facing. AI users shall be responsible for their use of AI systems and the application
of any content or product in work tacks generated by AI systems.
e)Equity and Inclusion
While Al systems can reduce workloads, support capacity, and increase accessibility,the
generated content reflects the cultural_ economic,and social biases of the source materials
used for training. The algorithms applied can be a source of bias as well. Applying
principles from the equity and empowerment lens,AI users should thoroughly review any
content generated by AI systems to ensure that any instances of bias; or potentially
offensive or harmful material is changed or removed.
When it comes to the adoption of AI systems, the County's goal is to eliminate digital
disparities and ensure that persons who belong to a protected class and those impacted by
language or other accessibility barriers have equal access to and benefit from the County
programs,activities,benefits,and services.To uphold this commitment,the County applies
the equity and empowerment lens to address race,color,national origin,disability,religion,
age, gender, sexual orientation, gender identity and expression, marital status, veteran
status, source of income,or any other basis prohibited by federal, state, or local law.
f) Final Requirements
Under no circumstances is a County employee authorized to engage in any activity that is
illegal under local, state, federal, or local law while utilizing County-owned resources;
including County-Information Systems_
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Document Code No:
Title:Jefferson County Artificial Intelligence Acceptable Development and Use Policy
Pale 20of25
k1i users County emploveesj shall comply with all applicable County policies and are PAO
required to read and understand them.Responsibilities for protecting County information Addresses Mt'.T iersch's comment,ivhicla soya
do not end at the termination of employment. These responsibilities continue until the
Page 24:AI users shall comply with all applicable
information is reclassified to be public. County policies and are required to read and
understand them.Responsibilities for protecting
13) CONSEQUENCES FOR NONCOMPLIANCE County information do not end at the termination of
employment.These responsibilities continue until
a)DepartmentsDepartment heads shall ensure compliance with this Al Policy
the info rnation i reclassr5ed to be pnblic.
and are accountable for any AI systems deployed by their department. Pratecim2 county information"is not my job.In
my-volunteer role as chair of the counts-s Ferry
a)(b7 Violations of this Al Policy shall be grounds for disciplinary action advisory Committee(FAC),I create a largenumberofpublicrecords(county information)_
under the current version of the County's standards of conduct policy in pritnan1y in the form of arn,ily Because the county
Appendix C of to the Jefferson County Personnel Administration Manual,up doe=not provide FAC members with county email
to and including termination of employment and enforcement action which addresses,we must rely on=mail or other 3rd par-3
mail systems.While I am very careful to use the
shall include civil or criminal penalties. mail address that I have set up exclusively for
FAC purposes,I cannot be held responsible if
14) LLIIITATIONS OF THIS AI POLICY1e Gootle loses an email.
May 20.2026 2:41 PM email Sam Tom Thiersch to
a) Nothing in this AI Policy restricts the County or any other person's ability the Bade.
to:
i) Comply with federal, state, or municipal laws, ordinances, or
regulations_
ii) Comply with a civil, criminal: or regulatory inquiry, investigation,
subpoena, or summons by a federal, a state, a municipal, or other
governmental authority;
iii) Cooperate with a law enforcement agency concerning conduct or
activity that the developer,deployer,or other person reasonably and in
good faith believes may violate federal, state, or municipal laws,
ordinances,or regulations;
iv) Investigate; establish,exercise,prepare for,or defend legal claims;
v) Take immediate steps to protect an interest that is essential for the life
or physical safety of a consumer or another person;
vi) By any means other than the use of facial recognition technology,
prevent, detect, protect against, or respond to security incidents,
identity theft, fraud,harassment,malicious or deceptive activities, or
illegal activity; investigate, report, or prosecute the persons
responsible for any such action;or preserve the integrity or security of
AI systems;or,
Adapted from the Colorado AI Act,Colo.Rev.Star&6-1-1705(2026).
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vii) Assist any other person with any of the obligations imposed under this
Al Policy.
b) Nothing in this Al Policy restricts the Central Services Department from
conducting research, testing, and development activities regarding an Al
system or Al model,other than testinu conducted under real-world conditions
before an AI system or AI model is deployed or put into service by the County:
Nothing in this AI Policy imposes any obligation on any person that
adversely affects their rights or freedoms, including the rights to freedom of
speech or freedom of the press that are guaranteed in:
i) The first amendment to the United States constitution; or,
ii) Section Article I, Section 5 of the Washington constitution.
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APPENDIX A: REFERENCES
1+1
Reference 11.11Wen1111111 Citation
Federal Law
National Artificial Intelligence Initiative Shaping AI 15 U.S_C. section
Act of 2020(P.L. 116-283) development and use in 9401 et seq.
the United States
Health Insurance Portability and Protection of heath 45 C_F_R Parts 160
Accountability Act of 1996(HIP AA)information and 164.
Priva Rule
Washington Law
Protection of the Right to Privacy Protection of privacy Chapter 9.73 RCW
Preservation and Destruction of Public Rules for preservation Chapter 40.14 RCW
Records and destruction of
public records
Washington Public Records Act Promote open Chapter 42.56
government RCW
Health care exemption from disclosure of Protection of heath RCW 42.563f
records under the Washington Public information
Records Act
Medical Records— Health Care Protection of heath Chapter 70.02 RCW.
Information Access and Disclosure Law information
SHB 1205(2025) Reenacts and amends See the URL in the
RCW 9A60.010 and footnote below)1
9A60.045 and makes it
a crime to knowingly
distribute a forged
digital likeness of
another person to
defraud,harass,
threaten,or intimidate
another,or for an
unlawful . ..se
Other References and Standards
National Cyber Security Centre, Best Best Practices for See the URL in the
Practices for Securing Data Used to development and use of footnote below.':
Train&Operate AI systems,(Ver. 1.0 AI systems
May 2025)
httas://12wfilesext_les.wa.e-ov;bienniuni 2025-26IPdf7Bi11s&Session%20LawsIHousei 1205-S.SL.Ddf Accessed
April 11,2026.
littps://media_defense.gov/2025/Mavi22,2003720601.-1 -1..(I CSI AI DATA SECUR TYPDF. Accessed April
12,2026.
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Reference Topic Citation
National Institute of Standards and Standards for use of AI See the URL in the
Technology,Artificial Intelligence Risk systems foonote telow.1=
Management Framework(AI RMF 1.0
2023)
Washington State Artificial Intelligence ESSB 5838(2024) See the URL in the
Task Force's Interim Report(December established the footnote below.''
1,2025) Washington State
Artificial Intelligence
Task Force to evaluate
AI development use
and risks
Mark H.Francis and Ashwini Jarrala Washington State See the URL in the
Legal Practitioner's Guide to AI& Artificial Intelligence footnote below.15
Hallucinations(February 16,2026) Task Force companion
report
Colorado's AI Act(March 26, 2026) Regulation of Al Colo.Rev. Stat §6-
1-1701 et. seq. See
the URL in the
footnote below."
httvsifdoi.ore110.602&NISTAL100-1,Accessed April 11,2026.
hitps:lagporbl-s3bockets3_us-west-
2.amazonaws_com'AJ%20Task°1620ForceIVITA%20AI%20Task%20Force%20-
20Literature%20Review%20of/.20A1%20Risksf.20and%200pportunities_pdf.VersionId=2lmmRG ns5c1ZgxE
tRetYunrtg7eC9q,Accessed April 1,2026.
Mops:`Fnationalcenterforstatecourts.app.box.comfvlegal-practitioner-gaide-AL Accessed April 1,2026.
Mhis://practicalcompliance.thomsomeuters.com Brow ssiiomejurisdictionslUnitedStatesiGolorado.Colarado5tatu
tes°gnjd=NBB934F3017CE 11EF9141 A 71 BA98479C6&orizinationContext—documenttoc&transitionType=Default
contextData=(sc.Defink)&firstPage=t ue,Accessed April 15,2026.
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APPENDLX B: RELEVANT COMPLIANCE REQUIREMENTS
This appendix provides references to applicable key regulations and standards.This appendix does
not replace the authoritative source and is only a reference to assist with further research. Please
use the Compliance Standard and Section No. to further research the entirety, of the regulation,
framework or standard from the authoritative source.
Compliance
Location Description
Standard
HIPAA 45 CE'R 164,Subpart C Security Standards for the Protection
of Electronic Protected Health
Information.
45 C1"lt 164.316 Policies and procedures and
documentation requirements.
PCI DSS v3.2 12.2 at page 295 Acceptable Uses of the Technology.
Jun. 2024)
NIST CSF 2.0 Information Protection Processes and
Procedures.
Feb. 2024)
NIST 800-536, AI system Use Notification.
Revision 5
AC-8 at page 40
Sep.2020)
Various sections Policies and Procedures.
PL-4 at page 197 Rules of Behavior.
PS-6 at page 226 Access Agreements.
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APPENDIX C:
RECORDS PROTECTED FROM DISCLOSURE BY AN `OTHER
STATUTE' THAT ARE NOT TO BE USED IN AN AI SYSTEM
PAO
taliki-c-hact-hefel I[ATTACHED' Re•:ision make to address comment in ChatOPT
analyna.which said: `'add chart here-left in final
appendix.- The chart will be added in the final
version of the AI Policy.
CLEAN
VERSION OF PROPOSED
Al POLICY
JEFFERSON
COUNTY
ARTIFICIAL
INTELLIGENCE
Version: May 22,
2026
ACCEPTABLE
DEVELOPMENT
AND USE POLICY
This AI Policy governs all uses of artificial
intelligence by or on behalf of Jefferson County,
Washington.
Document Code No.:
Title: Jefferson County Artificial Intelligence Acceptable Development and Use Policy
Page ii of ii
TABLE OF CONTENTS
TABLE OF CONTENTS
1) INTRODUCTION 1
2) PURPOSES 1
3) GUIDING PRINCIPLES AND VALUES 2
4) DEFINITIONS 3
5) APPLICABILITY OF THIS AI POLICY 8
6) Compliance with Existing Laws and Policies 8
7) Prohibited uses of an AI System 9
8) PUBLIC RECORDS ACT COMPLIANCE I I
9) architectural and technical STANDARDS 1 1
10) ROLES AND RESPONSIBILITIES 1 1
11) AI SYSTEM AND USE AND CASE APPROVAL PROCESS 13
12) PROCEDURES I6
13) CONSEQUENCES FOR NONCOMPLIANCE 18
14) LIMITATIONS OF THIS AI POLICY I9
APPENDIX A: REFERENCES 21
APPENDIX B: RELEVANT COMPLIANCE REQUIREMENTS 23
APPENDIX C: RECORDS PROTECTED FROM DISCLOSURE BY AN"OTHER
STATUTE"THAT ARE NOT TO BE USED IN AN AI SYSTEM 24
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JEFFERSON COUNTY ARTIFICIAL INTELLIGENCE
ACCEPTABLE DEVELOPMENT AND USE POLICY
1)INTRODUCTION
Artificial Intelligence (AI) technology is increasingly becoming an integral part of local
government operations,offering opportunities to enhance the efficiency and effectiveness
of public services. At the same time, the use of AI also presents ethical, legal, and social
challenges that require responsible management.This AI Policy provides a framework for
the effective and responsible use of AI systems within the County, to maximize the benefits
of these innovative tools while minimizing their potential risks to both the County and the
public.
2)PURPOSES
The purposes of this AI Policy are to:
A. Ensure ethical and responsible development, deployment, and use of AI technology in the
County, ensuring they are in alignment with the principles of transparency, fairness,
accountability, and public trust.
B. Enable effective use of AI technology by providing clear guidance to the County personnel,
vendors, and other partners who work with AI systems.
C. Inform community members and other stakeholders about how the County is utilizing AI
technology and what measures it is taking to protect the public from potential adverse
consequences of these systems.
D. Promote responsible and ethical use of AI technology by defining the principles and values
that govern the application of this technology within the County.
E. Ensure the compliance of AI systems with all applicable federal, state, and local laws and
regulations as well as existing the County policies.
F. Assign roles and responsibilities related to the County's use of AI systems.
G. Establish processes that encourage effective and responsible use of AI systems.
H. Define prohibited uses of AI systems.
I. Specify measures which may be taken in the event of failure to comply with these policies.
This AI Policy may be updated from time to time to account for changes in AI technology, laws
and regulations, uses of AI systems within the County, and other considerations.
In addition,the Central Services Director may publish an AI User Guide to provide more detailed
guidance on how the requirements of this AI Policy is to be implemented.Unless otherwise stated,
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any such additional guidance should be considered an extension of this AI Policy and carry the
same requirements for compliance.
3)GUIDING PRINCIPLES AND VALUES
The County's AI development, deployment, and use of artificial intelligence systems shall be
guided by the following guiding principles and values:
a) We expect to retain appropriate human agency and oversight, allowing for
intervention to prevent harm.
b) We expect to use internal and external security testing of systems before
public release for high-risk artificial intelligence systems.
c) We expect to protect data privacy and security.
d) We expect to promote appropriate transparency for consumers when they
interact with artificial intelligence systems or products created by artificial
intelligence.
e) We expect to ensure accountability, considering oversight, impact
assessment, auditability, and due diligence mechanisms.
f) We expect to make AI accessible to all residents, including those with
disabilities or limited access.
g) We expect to govern the deployment and maintenance of AI systems with
human oversight ensuring adherence to relevant laws and regulations and by
defining roles and responsibilities.
h) We expect to implement measures to detect and mitigate biases in order to prevent
harm.
i) We expect to continuously monitor and enhance AI systems based on feedback and
technological advancements.
j) We expect proper management,quality,and stewardship of data used by AI systems.
k) We expect the county will be one source of digital literacy among residents to
help them understand and engage with AI systems.
1) We expect AI systems to be reliable, meet their objectives, and deliver
precise and dependable outcomes in their deployment contexts;
m) We expect AI decisions to be understandable to those affected.
n) We expect AI systems to prevent discrimination and bias, ensuring fair treatment for
all residents.
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o) We expect AI systems should be developed and deployed with a human-
centered approach that evaluates their impact on the public.
p) We expect technological innovation to be embraced responsibly while minimizing
environmental impacts.
q) We expect AI systems to comply with all relevant laws and regulations.
r) We expect privacy concerning personal data to be protected, while satisfying the
requirements of the Washington Public Records Act, chapter 42.56 RCW.
s) We expect AI systems to comply with data protection laws.
t) We expect AI systems not to cause harm and to prioritize the safety of
residents.
u) We expect AI systems to be secure against unauthorized access and ensure consistent
performance.
v) We expect the use of AI systems to be proactively communicated to the
public, ensuring that AI systems, their data sources, operational models, and
governing policies are understandable and documented.
w) We expect Staff to be empowered to use AI in their roles through education, training,
and collaborations that promote participation and opportunity.
These guiding principles and values are the inspiration for this AI Policy,and AI users are expected
to incorporate these same motivations in the implementation of this AI Policy. While the ideal
course of action may not be obvious or practical in every circumstance, this AI Policy is designed
to offer guidance to help AI users responsively navigate the use of AI systems.
4)DEFINITIONS
a)"Artificial Intelligence" (or "AI")1 means a machine-based system that can,
for a given set of human-defined objectives, make predictions,
recommendations or decisions influencing real or virtual environments.
Artificial intelligence systems use machine and human-based inputs to:
i) Perceive real and virtual environments;
ii) Abstract such perceptions into models through analysis in an automated
manner; and,
iii) Use a model to formulate options for information or action.
Slightly modified, this is the definition from the National Artificial Intelligence Initiative Act of 2020, 15 U.S.0
section 9401.
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b) "AI best practices" means the best practices described in National Cyber
Security Centre, Best Practices for Securing Data Used to Train & Operate
AI systems, Ver. 1.0 (May 2025).
c) "AI model" means a set of programmed instructions that processes data to
perform tasks, make decisions, or solve problems within an Al system.
d) "AI Policy" means this Jefferson County Artificial Intelligence
Acceptable Development and Use Policy.
e) "AI System"2 means any machine-based system that, for any explicit or
implicit objective, infers from the inputs the system receives how to
generate outputs, including content, decisions, predictions, or
recommendations, that can influence physical or virtual environments and
includes any tool, software, process, workflow, or other system which is
based on Al or which uses an AI tool.
f) "AI Tool" means a piece of software which provides AI functionality and
can be applied to a specific use case.
g) "AI Use Case" means specific task or purpose for which an AI tool is used
or under consideration.
h) "Al User" means any person using, developing, purchasing, configuring,
or maintaining any AI used by or for the County on its behalf, including
contractors, consultants, elected officials, employees, and volunteers.
i) "AI User Guide"means a document which supplements an Al Policy with
more detailed guidance on how to implement this AI Policy.
j) "Bias"means systematic tendencies that can exist within AI systems, often
stemming from flawed data, algorithms, or design processes,that may lead
to discriminatory or inaccurate outcomes affecting certain groups or
persons.
k) "Central Services" means the County Central Services Department.
1) "Central Services Director" means the person holding the title of Director
of Central Services or a delegee that has been delegated in writing.
m) "Chatbot" means a computer program that simulates human conversation
through text or voice interactions.
2 For greater precision,this definition was modified, using Colorado's AI Act, Colo. Rev. Stat. § 6-1-1701 (Lexis
Advance through Chapter 22 of the 2026 Regular Session,effective as of March 26,2026).
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n) "Consequential decision"' means a decision that has a material legal or
similarly significant effect on, or the cost of:
i) Hiring or retention of a contractor, employee, vendor or volunteer;
ii) Any budget decision;
iii) The provision of any essential government service;
iv) Health care (as defined in this AI Policy);
v) Risk management, including but not limited to obtaining coverage for
any risks by an insurance company or a self-insurance program; or,
vi) The provision of legal services.
o) "County" means the County, Washington.
p) "County Approved AI system" means an AI system approved for use by
AI users as specified in section 7.a.
q) "County Information Systems" means all county information systems,
including but not limited to computers or servers owned or operated by the
County.
r) "Data" means any digital representation of information, knowledge, facts,
concepts, data programs or instructions that are being prepared or have
been prepared in a formalized manner and are intended for use in a data
network, data program, data services, or data system.
s) "Health care provider"
4
means a person who is licensed, certified,
registered,or otherwise authorized by the law of this state to provide health
care in the ordinary course of business or practice of a profession.
t) "Health care"5 means any care, service, or procedure provided by a health
care provider:
i) To diagnose, treat, or maintain a patient's physical or mental condition;
or,
ii)That affects the structure or any function of the human body.
u)"Health care information" means all information about health care that is
protected from disclosure by the Health Insurance Portability and
Adapted from the Colorado AI Act,Colo.Rev.Stat.§6-1-1701 (2026).
Definition from RCW 70.02.010(19).
Definition from RCW 70.02.010(15).
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Accountability Act of 1996(HIPAA)Privacy Rule,45 C.F.R. Parts 160 and
164, Chapter 70.02 RCW (Medical Records—Health Care Information
Access and Disclosure) or RCW 42.56.360 (Health care exemption from
disclosure of records under the Washington Public Records Act).
v) "High-risk AI system"6 means any AI system that, when deployed, makes,
or is a substantial factor in making, a consequential decision. "High-risk
AI system" does not include an AI system if:
i) The AI system is intended to:
A) Perform a narrow procedural task;
B) Detect decision-making patterns or deviations from prior
decision-making patterns and is not intended to replace or
influence a previously completed human assessment without
sufficient human review;
ii) The AI system uses the following technologies, unless the
technologies, when deployed, make, or are a substantial factor in
making, a consequential decision:
A) Anti-fraud technology that does not use facial recognition
technology;
B) Anti-malware;
C) Anti-virus;
D) AI-enabled video games;
E) Calculators;
F) Cybersecurity;
G) Databases;
H) Data storage;
I) Firewall;
J) Internet domain registration;
K) Internet website loading;
Adapted from the Colorado Al Act,Colo.Rev.Stat.§6-1-1701 (2026).
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L) Networking;
M) Spam- filtering;
N) Robocall-filtering;
0) Spell-checking;
P) Spreadsheets;
Q) Web caching;
R) Web hosting or any similar technology; or,
S) Technology that communicates with consumers in natural language for the
purpose of providing users with information, making referrals or
recommendations,and answering questions and is subject to County policy
that prohibits generating content that is discriminatory or harmful.
w)IT" means the Jefferson County Information Technologies
Department, a division of Central Services.
x) "Public Record" has the same meaning as in RCW 42.56.010(3).7
y) "Risk management" means coordinated activities to direct and control an
organization with regard to risk.
z) "Section" means a section of this AI Policy, unless there is clear language in
this Al Policy that a section of this AI Policy does not apply.
aa) "Substantial factor"8 means a factor that:
A) Assists in making a consequential decision;
B) Is capable of altering the outcome of a consequential decision; and,
Public record' includes any writing containing information relating to the conduct of government or the
performance of any governmental or proprietary function prepared, owned, used, or retained by any state or local
agency regardless of physical form or characteristics.For the office of the secretary of the senate and the office of the
chief clerk of the house of representatives,public records means legislative records as defined in RCW 40.14.100 and
also means the following: All budget and financial records; personnel leave, travel, and payroll records; records of
legislative sessions;reports submitted to the legislature;and any other record designated a public record by any official
action of the senate or the house of representatives. This definition does not include records that are not otherwise
required to be retained by the agency and are held by volunteers who:
a)Do not serve in an administrative capacity;
b)Have not been appointed by the agency to an agency board,commission,or internship;and
c)Do not have a supervisory role or delegated agency authority."RCW 42.56.010(3).
Adapted from the Colorado AI Act,Colo.Rev.Stat. §6-1-1701 (2026).
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C) Is generated by an AI system.
Substantial factor" includes any use of an AI system to generate any content,
decision, prediction, or recommendation concerning consequential decision.
bb) "Writing" has the same meaning as in RCW 42.56.010(4).9
5)APPLICABILITY OF THIS AI POLICY
a) This AI Policy governs the development, procurement or use of any AI systems (as
defined in this AI Policy) for input of results of the use of an AI System into County
Information Systems.
b) All County boards, commissions, committees, departments, and task forces
shall comply with this AI Policy.
c) This AI Policy applies to:
i) Agents, contractors, elected officials, employees, officers, vendors and
volunteers of the County who use or input data into County Information
Systems; and,
ii) All AI users (as defined in this AI Policy).
d)This AI Policy does not apply to any AI system which:
i) Has been evaluated and determined in writing by the Central Services
Director to be safe for unrestricted usage;
ii) Has AI features included in applications maintained by Central Services,
which are not part of the AI feature's core functionality or involve the use
of sensitive data; and,
iii) That does not use or input data into County Information Systems.
6)COMPLIANCE WITH EXISTING LAWS AND POLICIES
Development and use of AI systems shall comply with:
a) All applicable federal, state,and local laws and regulations; and,
9 "'Writing' means handwriting, typewriting, printing, photostating, photographing, and every other means of
recording any form of communication or representation including,but not limited to,letters,words,pictures,sounds,
or symbols, or combination thereof, and all papers, maps, magnetic or paper tapes, photographic films and prints,
motion picture,film and video recordings,magnetic or punched cards,discs,drums,diskettes,sound recordings,and
other documents including existing data compilations from which information may be obtained or translated."RCW
42.56.010(3).
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b) All County policies, including but not limited to:
i) Jefferson County Social Media Policy (Resolution No. 14-20, March 16,
2020).
ii) Jefferson County Public Records Act Compliance Policy (Resolution No. 10-22,
February 28,2022).
iii)Open Public Meeting Act Guidelines for Jefferson County Boards,
Commissions & Committees (Resolution No. 50-22, October 24, 2022).
iv)Jefferson County Personnel Administration Manual (Resolution No. 19-0407-
25R, April 7, 2025).
7)PROHIBITED USES OF AN AI SYSTEM
a)The following AI systems are approved for use by the persons subject to this
AI Policy listed in sections 5 and 6, subject to the limitations in this section 7:
i) Microsoft's Enterprise AI system called Co-Pilot(which is part of the Microsoft
365 suite of programs) is the only AI system to be used for generative AI that is
approved for use by AI users (as defined in this policy).
ii) The Central Services Director shall maintain a list of any other approved
AI systems and shall publish the list on the County's web site.
b)Use of an AI system on a County-owned computer, server or system that is on
the list of AI systems approved and made available on the County's web site
is prohibited.
c)Use of an AI system on a County-owned computer, server or system that is on
the list of AI systems being tested for possible authorized use pursuant to
section (11) is authorized until testing is complete. Once testing is complete,
the Central Services Director shall determine whether such system shall be
added to either the list of AI systems that are approved or the list of AI systems
that are not approved.
d)Use of any high-risk AI system (as defined in this AI Policy)requires enhanced
review and specific written approval before it can be added to the list of
approved AI Systems in section 7(a)(i).
e)Use of an AI system on a County-owned computer, server or system to create
any deepfake, which is an image created by using machine learning to capture
and encode unique biometric characteristics of targets to combine the subject's
unique characteristics with the acquired knowledge of general human
expression in order to then synthesize the target's facial features, voice,
mannerisms, etc. is prohibited.
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f) Entry any of the following data into an Al system is prohibited:
i) Personal financial information for any individual. This includes credit card
number, bank account number, PIN numbers, and any other financial
information.
ii) Authentication information. Inputting any passwords, login credentials, or
other authentication information into an AI system is prohibited.
iii) Personally Identifying Information. Inputting any personally identifying
information into an AI system is prohibited. Personally identifying
information includes name, address, phone number, email address, social
security number, passport number, driver's license number, and any other
information that can reasonably be used to identify an person.
iv) Health care information (as defined in this AI Policy).
v) Sensitive or confidential information. This includes any information that
could be used or disclosed to harm the County or its employees or
volunteers, or residents such as information about political affiliations,
religious beliefs, membership in a protected class, criminal history, or
information related to the County information system.
vi) Any information exempted from disclosure by the Public Records Act,
chapter 42.56 RCW or some other federal or state statute, including but
not limited to:
A) Attorney-client privileged records relating to representation of the
County by its attorneys. The attorney-client privileged records are
protect communications and advice between an attorney and their
client. RCW 5.60.060(2)(a) constitutes an "other statute' exemption
under RCW 42.56.070(1)
B) Attorney work product records. Attorney work product records are:
Records that are relevant to a controversy to which an agency is a
party but which records would not be available to another party under
the rules of pretrial discovery for causes pending in the superior courts
are exempt from disclosure under [the Public Records Act]." RCW
42.56.290.
C) Autopsy records. Autopsy and post mortem reports and records are
confidential and exempt from examination by the public. RCW
68.50.105(1).
D) Records related to juvenile offenses. RCW 13.50.050(1), (3).
E) Records of a person confined in jail. RCW 70.48.100(2).
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F) Personal information in files maintained for County employees,
appointees, or elected officials of any public agency to the extent that
disclosure would violate their right to privacy. RCW 42.56.230(3).
G) Specific intelligence information. Secret information, information
about an enemy, or conclusions drawn from such information or that
would disclose particular methods or procedures for gathering or
evaluating intelligence information. RCW 42.56.240(1).
H) Specific investigative records. Information on active ongoing law
enforcement investigations. RCW 42.56.240(1).
I) Records protected by an "other statute which exempts or prohibits
disclosure of specific information or records." RCW 42.56.070(1).
A list of"other statutes" is attached as Appendix D.
8)PUBLIC RECORDS ACT COMPLIANCE
Any product created by any AI system necessarily will be a "public record," as defined in RCW
42.56.010(3). All public records shall be managed in compliance with chapter 40.14 RCW
Preservation And Destruction of Public Records), chapter 42.56 RCW(Public Records Act), and
the County's most recent version of the Jefferson County Public Records Act Compliance Policy.
9)ARCHITECTURAL AND TECHNICAL STANDARDS
The architectural and technical standards associated with the enterprise use of AI systems shall be
maintained by IT.
10) ROLES AND RESPONSIBILITIES
The following persons and groups are responsible for the duties involved in implementing this
AI Policy, as described below:
a)Central Services Director.
The Central Services Director shall be responsible for:
i) Providing a public report at least annually to the Board of County Commissioners on
County AI usage.
ii) Developing this AI Policy and additional guidance.
iii) Coordinating AI initiatives across departments and teams.
iv) Overseeing compliance with laws, regulations and County policies.
v) Providing guidance to AI users across the organization.
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vi) Convening and overseeing the AI Review Committee.
vii) Leading the AI review process.
viii)Directing technology resources, policies, projects, and services.
ix) Reviewing the AI Review Committee recommendations on oversight and
guidance on AI initiatives within the County.
x) Facilitating collaboration between teams and departments for successful
implementation of this AI Policy.
xi) Overseeing enterprise security infrastructure and cybersecurity
operations.
xii) Maintaining security policies, procedures, standards, and guidelines.
xiii)Monitoring compliance with security policies and related requirements.
xiv)Ensuring accurate data sensitivity classification and protections.
xv) Advising on compliance on AI usage.
xvi)Identifying legal issues and risks related to AI usage.
xvii) Investigating alleged violations of this AI Policy and recommend
corrective actions.
b)AI Review Committee
The Board of County Commissioners shall establish an AI Review Committee with
department representatives which shall be make recommendations to the Central Services
Director on oversight and guidance on AI initiatives within the County.
The AI Review Committee shall review and consider updates to this AI Policy, along with
the Central Services Director, at least annually to reflect technological advancements and
evolving community needs.
The AI Review Committee shall be responsible for making recommendations to the Central
Services Director on the following topics:
i) AI systems being considered for use by the County.
ii) Ethical concerns and conflicts.
iii) Policy and guidance updates.
c)County Administrator
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The County Administrator shall be responsible for:
i) Approving proposed changes to this AI Policy.
ii) Making a final determination whether to allow AI use cases which involve
substantial risks of harm or other negative consequences.
iii) Enforcing corrective action for violations of this AI Policy.
d)Electeds and Department Heads
Electeds and department heads or a delegee shall be responsible for:
i) Ensuring employee, contractor and vendor compliance with this AI
Policy.
ii) Integrating AI systems into department operations that comply with this
AI Policy.
iii) Facilitating training for staff on this AI Policy and AI best practices(as defined in
this AI Policy).
Unless otherwise specified,the specific officials listed above may delegate to one or more
persons to act on their behalf with respect to this AI Policy, and in such cases those
designees are understood to inherit the same authorities and obligations as the named
officials.
e)AI Users
i) All AI users are responsible for complying with the requirements of this AI
Policy.
ii) All AI users have the responsibility to verify the accuracy of any
information acquired through the use of AI systems before using that
information in any final, published, or production documents.
11) AI SYSTEM AND USE AND CASE APPROVAL PROCESS
a) AI Systems Review Process
The Central Services Director shall establish a process under which all AI systems and AI
Use Cases are subject to thorough testing to determine their compliance with this AI Policy
prior to their implementation. The testing process shall:
i) Confirm compliance with the specific requirements and prohibitions established
under this AI Policy;
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ii) Consider the relative benefits and risks of each system or use case and determine
whether or not approval is reasonable and aligned with the values and principles in
this AI Policy;
iii) Specify the intended use cases of those systems and whether or not other use
cases require additional review;
iv) Document the results of each review using a standard template,which results
shall be retained for either the full lifespan of the AI system or use case or the
retention period required under law for similar documents (whichever is
longer).
b)Determination of High Risk Potential Negative Impacts
i) The Central Services Director shall create a standard for determining whether
or not a particular AI system or AI use case has a high risk of potential negative
impacts to any relevant person,group,or organization.
ii) A high-risk determination,that AI system or use case shall be presented to the
full AI Review Committee for approval.
iii) Lower-risk AI systems and use cases may be approved by the Central Services
Director at their discretion.
iv) The Central Services Director shall revisit all previously-approved AI systems
and use cases at least annually, or sooner in the event of substantial
modifications (such as a major software upgrade or change in scope), and
confirm in writing to the County Administrator the continued compliance and
reasonableness of the AI system or use case.
c)Monitoring, Evaluation, and Accountability
i) The Central Services Director shall be responsible for implementing AI
systems to monitor AI system performance, effectiveness, and policy
compliance. The data collected from these AI systems shall be periodically
reviewed to evaluate the effectiveness of AI systems and their impacts on the
community.
ii) The Central Services Director shall establish procedures and protocols for
responding to failures of AI systems and violations of this AI Policy,including
corrective actions with regard to both the AI systems themselves and the
persons and organizations involved.
iii) Upon the recommendation of the Central Services Director, , or County
Administrator, independent audits shall be conducted to review AI systems for
compliance with policies and ethical standards. Findings from audits and
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evaluations shall be used to refine AI policies,improve AI system functionalities,
and determine any additional training or accountability requirements.
d)Data Management, Privacy, and Retention
All AI systems shall comply with applicable data protection laws, regulations, and
policies to safeguard data protected by this AI Policy.
e)Mitigation of Bias and Human Oversight
All AI users shall be responsible for taking steps to mitigate potential biases (including but
not limited to biases related to protected characteristics such as race, gender, sexual
orientation, national origin, disability, or language) in AI systems they interact with, in
accordance with training and recommendations provided by the Central Services
Director.
f) Transparency and Explainability
Upon the consideration or introduction of a new AI system which is likely to have
major public impact, the Central Services Director shall ensure that key information
is provided to affected groups and other stakeholders in a timely manner. Such
information shall be provided in multiple formats or languages if necessary,consistent
with the County's practice in communicating
To the greatest extent possible,AI systems should provide clear and understandable
explanations for their decisions and outputs, particularly in cases where erroneous
results may create a risk of substantial negative impacts.
g)Training
i) All users shall be provided with regular training on AI technologies,
ethical considerations, and compliance requirements to ensure
knowledgeable and responsible use of AI systems, as recommended by the
Central Services Director.
ii) The Central Services Director shall develop specific training requirements and
content for users granted access to high-risk AI systems and associated data,
focusing on compliance with this AI Policy and other associated laws,
regulations, policies, and AI best practices.
iii) These trainings shall be updated on a regular basis to ensure their accuracy and
relevance, and users' continued access to high-risk Al systems and data shall
be contingent upon completion of additional required trainings determined by
the Central Services Director.
h)Vendors and Third Parties
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i) All vendors and other third parties who provide or interact with Al systems shall
be required to comply with this and all other applicable policies, and this
compliance shall be explicitly included in all relevant contracts and similar
agreements.
ii) All technology vendors shall be required to disclose whether and how AI is used
in their products and services, and what mechanisms they provide to allow for
auditing these AI systems. These disclosures shall be provided using a standard
form developed and maintained by the Central Services Director and required in
all technology procurements.
iii) Vendors shall be evaluated based on their commitment to responsible Al
development and their history of adherence to ethical standards,and preference
in procurement decisions shall be given to vendors which can effectively
provide transparency into their AI systems and practices to both the County
and the public.
i) Labeling of AI-generated Content
All content generated by AI systems and presented to the public shall be clearly labeled as
such. This shall include all text, audio, image, and video content, as well as interactive AI
systems such as chatbots and automated decision-making tools.
All persons involved in disseminating content generated by an AI system on behalf of the
County shall be responsible for ensuring the accuracy of such content and its appropriate
labeling.
The Central Services Director or designee shall establish standard mechanisms for the County
personnel and members of the public to report violations of this labeling requirement.
12) PROCEDURES
a)Attribution
i) The use of AI systems and the resulting product(s) shall be attributed,
referenced, and cited in any electronic or paper material produced and
published by anyone subject to this AI Policy.
ii) Attribution should include a description of the source application, how it
was used, how the material was edited, by whom, and the date. For
example:
Microsoft Co-Pilot was used to generate the charts and data referenced above. The
content was reviewed and edited before being published by Sam Smith, Jefferson
County Public Works Department, on 04/15/2026."
b)Intellectual Property
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Content produced by AI systems may implicate intellectual property rights and likely will
include copyrighted material. AI systems shall be"trained" using Data(text, images, etc.)
that has been sourced from the internet without regard for copyright or licensing terms. It
is extremely difficult to determine what content was used to train an Al system, and
difficult to verify whether AI-generated content is wholly original or only a slight
stylization of existing copyrighted material.Nevertheless, County Al users are required to
perform due diligence to ensure that no copyrighted material is published by the County
without proper attribution or without obtaining proper rights.
c)Validation Required
i) Complex algorithms of AI systems exponentially increase risk when
incomplete or inaccurate data is involved. AI systems shall be validated
and regularly assessed to ensure completeness and accuracy. Results from
decisions, code, or research supported by AI systems should consistently
align with those of a human subject matter expert.
ii) AI users shall verify the accuracy of any information acquired through the
use of AI systems before using that information in any final, published, or
production documents. If AI users are uncertain about the accuracy of the
obtained information, they should consult their supervisor or seek advice
from a IT.
iii) AI users shall independently verify any quotes or references generated by
AI systems. AI users shall not assume that a quote or reference is accurate,
or real. AI systems rarely act as if they are uncertain, making false answers
difficult to spot. AI systems can generate:
A) Fabricated content, sometimes called "hallucinations." This is a
phenomenon where an AI system, particularly those using large
language models, generates false, inaccurate, or illogical
information while presenting it in a confident, authoritative, and
convincing manner. Fabricated content occurs when an AI system
creates synthetic data, fabricates facts, or invents nonexistent
sources. An AI system may invent fake academic papers, legal
cases, scientific studies, or personal facts.
B) Factual Errors: Stating incorrect facts, such as "Einstein won two
Nobel Prizes."
C) Image Distortions: AI systems can create anatomically incorrect
figures (e.g., too many fingers).
Verification shall include cross-referencing sources included in the AI output, or
independently verifying dates, names and events in peer reviewed or authoritative
published literature on the internet or printed material.
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d)Decision Making
County departments shall utilize AI systems to enhance efficiency and effectiveness. AI
systems can be used for idea generation and as one source of information when researching
a topic.AI systems products shall be human reviewed and edited before usage in any final,
published, or production documents. This is particularly important when the content is
public facing.AI users shall be responsible for their use of AI systems and the application
of any content or product in work tasks generated by AI systems.
e)Equity and Inclusion
While AI systems can reduce workloads, support capacity, and increase accessibility, the
generated content reflects the cultural, economic, and social biases of the source materials
used for training. The algorithms applied can be a source of bias as well. Applying
principles from the equity and empowerment lens, AI users should thoroughly review any
content generated by AI systems to ensure that any instances of bias, or potentially
offensive or harmful material, is changed or removed.
When it comes to the adoption of AI systems, the County's goal is to eliminate digital
disparities and ensure that persons who belong to a protected class and those impacted by
language or other accessibility barriers have equal access to and benefit from the County
programs,activities,benefits,and services.To uphold this commitment,the County applies
the equity and empowerment lens to address race,color,national origin,disability,religion,
age, gender, sexual orientation, gender identity and expression, marital status, veteran
status, source of income, or any other basis prohibited by federal, state, or local law.
f) Final Requirements
Under no circumstances is a County employee authorized to engage in any activity that is
illegal under local, state, federal, or local law while utilizing County-owned resources,
including County Information Systems.
County employees shall comply with all applicable County policies and are required to
read and understand them. Responsibilities for protecting County information do not end
at the termination of employment. These responsibilities continue until the information is
reclassified to be public.
13) CONSEQUENCES FOR NONCOMPLIANCE
a)Department heads shall ensure compliance with this AI Policy and are
accountable for any AI systems deployed by their department.
b)Violations of this Al Policy shall be grounds for disciplinary action under the
current version of the County's standards of conduct policy in Appendix C of
to the Jefferson County Personnel Administration Manual, up to and including
termination of employment; and enforcement action which shall include civil
or criminal penalties.
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14) LIMITATIONS OF THIS AI POLICY")
a) Nothing in this AI Policy restricts the County or any other person's ability
to:
i) Comply with federal, state, or municipal laws, ordinances, or
regulations;
ii) Comply with a civil, criminal, or regulatory inquiry, investigation,
subpoena, or summons by a federal, a state, a municipal, or other
governmental authority;
iii) Cooperate with a law enforcement agency concerning conduct or
activity that the developer, deployer, or other person reasonably and in
good faith believes may violate federal, state, or municipal laws,
ordinances, or regulations;
iv) Investigate, establish, exercise, prepare for, or defend legal claims;
v) Take immediate steps to protect an interest that is essential for the life
or physical safety of a consumer or another person;
vi) By any means other than the use of facial recognition technology,
prevent, detect, protect against, or respond to security incidents,
identity theft, fraud, harassment, malicious or deceptive activities, or
illegal activity; investigate, report, or prosecute the persons
responsible for any such action; or preserve the integrity or security of
AI systems; or,
vii) Assist any other person with any of the obligations imposed under this
AI Policy.
b) Nothing in this AI Policy restricts the Central Services Department from
conducting research, testing, and development activities regarding an AI
system or AI model, other than testing conducted under real-world conditions,
before an AI system or AI model is deployed or put into service by the
County;
c)Nothing in this AI Policy imposes any obligation on any person that adversely
affects their rights or freedoms, including the rights to freedom of speech or
freedom of the press that are guaranteed in:
i) The first amendment to the United States constitution; or,
10 Adapted from the Colorado AI Act,Colo.Rev.Stat. $6-1-1705(2026).
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ii) Section Article I, Section 5 of the Washington constitution.
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APPENDIX A: REFERENCES
Reference I_oh k_ Citation
Federal LaNA
National Artificial Intelligence Initiative Shaping AI 15 U.S.C. section
Act of 2020(P.L. 116-283) development and use in 9401 et. seq.
the United States
Health Insurance Portability and Protection of heath 45 C.F.R. Parts 160
Accountability Act of 1996 (HIPAA)information and 164.
Privac Rule
Washington Law
Protection of the Right to Privacy Protection of privacy Chapter 9.73 RCW
Preservation and Destruction of Public Rules for preservation Chapter 40.14 RCW
Records and destruction of
public records
Washington Public Records Act Promote open Chapter 42.56
government RCW
Health care exemption from disclosure of Protection of heath RCW 42.56.360.
records under the Washington Public information
Records Act
Medical Records—Health Care Protection of heath Chapter 70.02 RCW.
Information Access and Disclosure Law information
SHB 1205 (2025) Reenacts and amends See the URL in the
RCW 9A.60.010 and footnote below)'
9A.60.045 and makes it
a crime to knowingly
distribute a forged
digital likeness of
another person to
defraud, harass,
threaten, or intimidate
another, or for an
unla tul -)ur r e
Other References and Standards
National Cyber Security Centre, Best Best Practices for See the URL in the
Practices for Securing Data Used to development and use of footnote below. 12
Train&Operate AI systems, (Ver. 1.0 AI systems
May 2025)
https://lawfilesext.leg.wa.gov/biennium/2025-26/PdfBills/Session%20Laws/House/1205-S.SL.pdf, Accessed
April 11,2026.
12 https://media.defense.gov/2025/May/22/2003720601/-I/-1/0/CSI AI DATA SECURITY.PDF, Accessed April
12,2026.
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Reference Topic Citation
National Institute of Standards and Standards for use of AI See the URL in the
Technology, Artificial Intelligence Risk systems footnote below.l3
Management Framework(AI RMF 1.0
2023)
Washington State Artificial Intelligence ESSB 5838 (2024) See the URL in the
Task Force's Interim Report(December established the footnote below.to
1, 2025) Washington State
Artificial Intelligence
Task Force to evaluate
AI development,use
and risks
Mark H. Francis and Ashwini Jarrala,Washington State See the URL in the
Legal Practitioner's Guide to AI& Artificial Intelligence footnote below.15
Hallucinations(February 16, 2026) Task Force companion
report
Colorado's AI Act(March 26, 2026) Regulation of AI Colo. Rev. Stat. § 6-
1-1701 et. seq. See
the URL in the
footnote below.16
13 https://doi.org/10.6028/NIST.AI.100-1,Accessed April 11,2026.
4https://agportal-s3 bucket.s3.us-west-
2.amazonaws.com/AI%20Task%20Force/W A%20AI%20Task%20Force%20-
20Literature%20Review%20of%20Al%20Risks%20and%200pportunities.pdf?Versionld=21mmRG ns5cIZgxE
tRgJtYuwta7eC9q,Accessed April 1,2026.
15 https://nationalcenterforstatecourts.app.box.com/v/Legal-practitioner-guide-AI,Accessed April 1,2026.
16https://practi calcompliance.thomsonreuters.com/Browse/Home/Jurisdictions/United States/Colorado/ColoradoStatu
tes?guid=NBB934F3017CE 11 EF9141 A71 BA98479C6&originationContext=documenttoc&transitionTvpe=Default
contextData=(sc.Default)&firstPage=true,Accessed April 15,2026.
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APPENDIX B: RELEVANT COMPLIANCE REQUIREMENTS
This appendix provides references to applicable key regulations and standards.This appendix does
not replace the authoritative source and is only a reference to assist with further research. Please
use the Compliance Standard and Section No. to further research the entirety of the regulation,
framework or standard from the authoritative source.
Compliance
Location Description
Standard
HIPAA 45 CFR 164, Subpart C Security Standards for the Protection
of Electronic Protected Health
Information.
45 CFR 164.316 Policies and procedures and
documentation requirements.
PCI DSS v3.2 12.2 at page 295 Acceptable Uses of the Technology.
Jun.2024)
NIST CSF 2.0 Information Protection Processes and
Procedures.
Feb. 2024)
NIST 800-536, AI system Use Notification.
Revision 5
AC-8 at page 40
Sep.2020)
Various sections Policies and Procedures.
PL-4 at page 197 Rules of Behavior.
PS-6 at page 226
i
Access Agreements.
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APPENDIX C:
RECORDS PROTECTED FROM DISCLOSURE BY AN "OTHER
STATUTE" THAT ARE NOT TO BE USED IN AN AI SYSTEM
ATTACHED]
APPENDIX C
Page 25 of 29
List of Other Statutes Exempting Disclosure under the
Washington Public Records Act (Chapter 42.56 RCW)
RCW 42.56.070(2)requires an agency to:
publish and maintain a current list containing every law,other than those listed in the
PRA,that the agency believes exempts or prohibits disclosure of specific information or
records of the agency.An agency's failure to list an exemption shall not affect the
efficacy of any exemption.
Washington State Statutes
RCW 2.64.111 Judicial conduct commission investigations of judges and initial
proceedings
RCW 4.24.550 Information on sex offenders
RCW 4.24.601 and.611
Trade secrets and confidential research,development or
commercial information re products or business methods
RCW 5.60.060 Privileged communications
RCW 5.60.070;RC W
7.07.070
Mediation records
RCW 7.68.140 Victims' compensation claims
RCW 7.69A.030(4) Name,address and photograph of child victim or child witness
RCW 7.69A.050
Child victims and witnesses of certain crimes—protection of
address
RCW 7.75.050 Records of Dispute Resolution Centers
RCW 9.02.100 Reproductive privacy
RCW 9.41.097(2)Mental health information re persons buying pistols or applying
for CPLs
RCW 9.41.129 Concealed pistol license applications
RCW 9.73.230
Name of confidential informants in written report on wire
tapping
RCW 9.51.050 Disclosing transaction of grand jury
RCW 9.51.060 Disclosure of grand jury deposition
RCW 9.73.090(1)(c)
Prohibition on disclosure of law enforcement dash cam videos
until final disposition of litigation
RCW 9A.44.138 Offender registration information given to high school or
institution of higher education re an employee or student
RCW 9A.82.170 Financial institution records re criminal profiteering act
RCW 10.27.090 Grand jury testimony/evidence
RCW 10.27.160 Grand jury reports—release to public only by judicial order
RCW 10.52.100 Records identifying child victims of sexual assault
Information re victims, next of kin,or witnesses requesting notice
RCW 10.77.205 of release of person found not guilty of a sex,violent,or felony
harassment offense by reason of criminal insanity and the notice
itself
Page 26 of 29
RCW 10.77.210 Records of persons committed for criminal insanity
RCW 10.97.040 Criminal history information released must include disposition,
with some exceptions
RCW 10.97.050 Conviction and criminal history information
RCW 10.97.060 Deletion of certain criminal history record information,
conditions
RCW 10.97.070 Disclosure of identity of suspect to victim
RCW 10.97.080 Inspection of criminal record by subject
RCW 10.97.130 Information about victims of sexual assault under age eighteen
RCW 10.101.020(3) Information given by an accused regarding determination for
indigent defense
RCW 13.34.115 Court dependency proceedings
RCW 13.40.217 Juveniles adjudicated of sex offenses—release of information
RCW 13.50.010 Maintenance of and access to juvenile records
RCW 13.50.050 Juvenile offender records
RCW 13.50.100 Juvenile/children records not relating to offenses
RCW 13.60.020 Missing children or endangered person information
RCW 18.04.405 Confidentiality of information gained by CPA
RCW 18.19.060 Notification to clients by counselors
RCW 18.19.180 Confidential communications with counselors
RCW 19.215.020 Destruction of personal health and financial information
RCW 19.34.240(3) Private digital signature keys
RCW 19.215.030 Compliance with federal rules
RCW 26.04.175
Name and address of domestic violence victim in marriage
records
RCW 26.12.170 Reports of child abuse/neglect with courts
RCW 26.23.050 Child support orders
RCW 26.23.120 Child support records
RCW 26.26.041 Uniform Parentage Act— protection of participants
RCW 26.26.450 Confidentiality of genetic testing
RCW 26.33.330 Sealed court adoption records
RCW 26.33.340 Agency adoption records
RCW 26.33.343 Access to adoption records by confidential intermediary
RCW 26.33.380 Adoption—identity of birth parents confidential
RCW 26.44.010 Privacy of reports on child abuse and neglect
RCW 26.44.031 Information related to reports of child abuse or neglect
RCW 26.44.125 Reports,reviews and hearings related to a review of abuse finding
RCW 27.53.070 Records identifying the location of archaeological sites
RCW 29A.08.720
Voter registration records—place of registration and any decision
not to register to vote confidential
RCW 29A.08.710 Voter registration records—certain information exempt
RCW 35.102.145
Municipal business and occupation tax—local ordinance can
protect return or tax information
Page 27 of 29
RCW 36.28A.060(8) Tactical and intelligence information provided to WASPC
Alternative public works-trade secrets or other proprietary
information submitted by bidder in connection with an
RCW 39.10.470(2) alternative public works transaction if data identified and reasons
stated in writing
RCW 39.10.470(3)
Alternative public works—proposals submitted by design-build
finalists until notification of highest scoring finalist is made
RCW 42.23.070(4)
Municipal officer disclosure of confidential information
prohibited
RCW 42.41.030(7) Identity of local government whistleblower
RCW 42.41.045 Non-disclosure of protected information (whistleblower)
RCW 43.43.762 Contents of statewide criminal street gang database
RC W 46.12.635 Vehicle registration
RCW 46.52.065 State toxicologist records relating to analyses of blood samples
RCW 46.52.080 Traffic accident reports—confidentiality
RCW 46.52.083 Traffic accident reports—available to interested parties
RCW 46.52.120
Traffic crimes and infractions—confidential use by police and
courts
RCW 46.52.130(2) Abstract of driving record—limited disclosure
RCW 48.62.101 Local government insurance/risk management liability reserve
funds established to settle claims
RC W 50.13.060 Access to employment security records by local government
agencies
RCW 50.13.100 Disclosure of confidential employment security records allowed if
identifying information deleted or with consent
RCW 51.28.070 Worker's compensation records confidential—limited disclosure
RCW 51.36.060 Physician information on injured workers
RCW 60.70.040 No duty to disclose record of common law lien
RCW 68.50.105 Autopsy reports—confidential—limited disclosure
RCW 68.50.320
Dental identification records—available to law enforcement
agencies
Ch.70.02 RCW
Medical records—access and disclosure—entire chapter
information from HC providers)
RCW 70.05.170 Child mortality reviews by local health departments
RCW 70.24.022 Public health agency information regarding sexually transmitted
disease investigations-confidential
RCW 70.24.024 Transcripts and records of hearings regarding sexually
transmitted diseases
RCW 70.28.020 Local health department TB records—confidential
RCW 70.41.200 Hospital quality improvement committee records and
accreditation reports
RCW 70.48.100 Jail records and booking photos
RCW 70.58.055 Birth certificates—certain information confidential
RCW 70.58.104 Vital records,research confidentiality safeguards
Page 28 of 29
RCW 70.94.205 Washington Clean Air Act—confidentiality of data.
RCW 70.96A.150 Registration and other records of alcohol and drug abuse
treatment programs
RCW 70.123.075 Client records of domestic violence programs
RCW 70.125.065 Records of community sexual assault program and underserved
populations provider in discovery
RCW 71.05.425 Notice of release or transfer of committed person after offense
dismissal
RCW 71.05.445 Release of mental health information to Dept. of Corrections
RCW 71.05.620
Access to court records related to mental health cases under
chapter 71.05 RC W
RCW 71.24.035(5)(g)
Mental health information system—state, county and regional
support networks—confidentiality of client records
RCW 71.34.335 Mental health treatment of minors—records confidential
RCW 71A.14.070 Records regarding developmental disability—confidentiality
RCW 72.09.345
Notice to public about sex offenders—department of corrections
access to information
RCW 72.09.585 Disclosure of inmate records to local agencies—confidentiality
RCW 73.04.030 Veterans discharge papers exemption(see related RCW
42.56.440)
RCW 74.04.060 Applicants and recipients of public assistance
RCW 74.04.520 Food stamp program confidentiality
RCW 74.13.075(5) Juvenile's status as a sexually aggressive youth and related info
RCW 74.13.280 Children in out-of-home placements - confidentiality
RCW 74.20.280
Child support enforcement—local agency cooperation,
information
RCW 74.34.095 Abuse of vulnerable adults-confidentiality of investigations and
reports
RCW 82.32.330 Disclosure of tax information
RCW 84.36.389 Confidential income data in property tax records held by assessor
RCW 84.40.020 Confidential income data supplied to assessor regarding real
property
Page 29 of 29
Selected Federal Confidentiality Statutes and Rules
18 USC§2721 -2725 Driver and License Plate Information
20 USC§1232g Family Education Rights and Privacy Act
23 USC§409 Evidence ofcertain accident reports
42 USC 290dd-2 Confidentiality of Substance Abuse Records
42 USC§405(c)(2)(C)(viii)(I) Limits on Use and Disclosure of Social Security Numbers.
42 USC 654(26) State Plans for Child Support
42 USC 671(a)(8) State Plans for Foster Care and Adoption Assistance
42 USC 1396a(7) State Plans for Medical Assistance
7 CFR272.1(c) Food Stamp Applicants and Recipients
34 CFR 361.38 State Vocational Rehabilitation Services Programs
42 CFR Part 2(2.1-2.67) Confidentiality of Alcohol and Drug Abuse Patient Records
42 CFR431.300-307 Safeguarding Information on Applicants and Recipients of
Medical Assistance
42 CFR 483.420
Client Protections for Intermediate Care Facilities for the
Mentally Retarded
42 CFR 5106a
Grants to States for Child Abuse and Neglect Prevention and
Treatment Programs
45 CFR 160-164 HIPPA Privacy Rule
46 CFR 40.321 USCG regulations regarding confidentiality
28 USC§534(b) Information from the FBI
5 USC§552(a)SSN#& Passport#
26 USC§6103(a) Taxpayer information
42 USC§ 121 1 2(d)(3) Employee ADA accommodations
17 USC§102, 301, and 106(1) Federal Copyright Act
JEFFERSON COUNTY
ARTIFICIAL INTELLIGENCE TOOLS LIST May 22, 2026
Name Description Al Type Vertical Classification
Adobe An Al-integrated design and content creation tool that ai_integrated Media &Creative Sandbox
Express enables users to build social media graphics. videos.
flyers. and branded assets using templates and
generative Al powered by Adobe Firefly.
Ahrefs An AI-integrated SEO and marketing analytics platform ai_integrated Marketing&Content Sandbox
that provides keyword research. backlink analysis. rank
tracking. content optimization. and AI-powered brand
visibility monitoring across search and Al platforms.
AiSDR An Al sales development representative (SDR) platform pure_ai Sales &CRM Sandbox
that automates outbound and inbound sales
prospecting. personalized email and Linkedln outreach.
lead research. and meeting booking using real-time
buyer signals.
Amazon Q A generative Al assistant that answers questions. ai_integrated Productivity& Sandbox
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data and enterprise systems. with specialized
capabilities for software development. business
intelligence. and contact center use cases.
Apollo An AI-powered sales intelligence and engagement pure_ai Sales &CRM Sandbox
platform that enables B2B prospecting. lead generation.
and outreach automation using a database of 210M+
contacts and AI-driven sequencing tools.
ArcGIS A comprehensive geographic information system (GIS) ai_integrated Government& Public Authorized
platform that enables users to create. analyze. and Sector
share maps and spatial data. supporting location
intelligence and geospatial decision-making across
desktop. web. and mobile.
Atlassian A team collaboration and project management platform ai_integrated Productivity& Sandbox
featuring Jira. Confluence. and Trello. with built-in Workplace
Atlassian Intelligence Al for summarization. writing
assistance. and workflow automation.
Barracuda An AI-integrated cybersecurity platform that provides ai_integrated Security& Authorized
Networks email protection. network security. application Compliance
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protection. and data backup with Al-powered threat
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Box Al An Al-integrated assistant built into the Box content ai_integrated Productivity& Sandbox
management platform that enables document Workplace
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Calendly Al A scheduling automation platform that uses Al to ai_integrated Productivity& Sandbox
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Calm A mental wellness app that offers guided meditations.ai_integrated Healthcare/ Life Sandbox
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Canva Al An Al-integrated suite of creative tools built into Canva's ai_integrated Media &Creative Sandbox
design platform that generates images. video. text. and
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Canvas LMS A cloud-based learning management system that ai_integrated Education &Sandbox
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CapCut An Al-integrated video editing platform that enables ai_integrated Media &Creative Unauthorized
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Cellebrite An Al-powered digital forensics platform that enables ai_integrated Government & Public Sandbox
data extraction. analysis. and evidence management Sector
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ChatGPT An Al-powered conversational assistant that generates pure_ai General Purpose Al Sandbox
text. images. audio. and code in response to user
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prompts. supporting tasks from research and writing to
data analysis and coding.
Chatbase An AI-powered chatbot and agent platform that lets pure_ai Customer Service Sandbox
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and automated actions.
Claude A conversational Al assistant that handles writing. pure_ai General Purpose Al Sandbox
analysis. coding. research. and complex reasoning
tasks through natural language dialogue. supporting
text. image. and document inputs.
ClickUp Al An AI-integrated productivity platform that assists with ai_integrated Productivity& Sandbox
content generation. task summarization. automation. Workplace
and intelligent search across projects. docs. and
workflows within the ClickUp workspace.
Coda Al An Al assistant integrated into the Coda document ai_integrated Productivity& Sandbox
platform that helps teams write. summarize. analyze Workplace
data. automate workflows. and extract insights within
docs.
Copilot Studio A low-code platform for building. customizing. and pure_ai Productivity& Sandbox
deploying Al agents and copilots. enabling organizations Workplace
to automate workflows and extend Microsoft 365 Copilot
across multiple channels.
CrowdStrike A cloud-native AI-powered cybersecurity platform that pure_ai Security& Sandbox
Falcon provides endpoint protection. threat detection. identity Compliance
security. and automated response across endpoints.
workloads. and cloud environments.
Cursor An AI-powered code editor and IDE that provides pure_ai Software Sandbox
intelligent code completion. multi-file editing.Development
codebase-aware chat. and agentic coding capabilities.
built as a fork of Visual Studio Code.
CustomGPT A no-code Al platform that enables businesses to build pure_ai Productivity& Sandbox
and deploy custom chatbots and Al agents trained on Workplace
their own content. supporting customer support.
internal knowledge search. and workflow automation.
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ARTIFICIAL INTELLIGENCE TOOLS LIST May 22, 2026
DeepSeek An Al platform that develops and offers large language pure_ai General Purpose Al Unauthorized
models for conversational assistance. coding.
reasoning. and data analysis. accessible via web.
mobile app. and API.
Descript An AI-powered video and podcast editing platform that pure_ai Media &Creative Sandbox
enables text-based editing of audio and video. with
features including transcription. voice cloning. filler
word removal. and AI-assisted content generation.
DocuSign An AI-integrated electronic signature and agreement ai_integrated Productivity& Sandbox
management platform that enables users to create. sign.Workplace
and manage agreements. with Al features for contract
analysis. clause detection. and workflow automation.
Doodle AG An AI-enhanced scheduling platform that enables group ai_integrated Productivity& Sandbox
polling. 1:1 meeting booking. and calendar integration Workplace
to help individuals and teams find and book optimal
meeting times.
Drift An AI-powered conversational marketing and sales pure_ai Sales & CRM Sandbox
platform that engages website visitors through chatbots
and live chat. qualifies leads in real time. and routes
buyers to sales teams.
ElevenLabs An Al voice and audio platform that generates lifelike pure_ai Media &Creative Sandbox
speech. clones voices. and deploys conversational
voice agents across 70+ languages via text-to-speech.
speech-to-text. and sound effect APIs.
Evernote A note-taking and knowledge management platform that ai_integrated Productivity& Sandbox
captures. organizes. and searches notes and Workplace
documents. with Al features including summarization.
writing assistance. and intelligent search.
Figma Al An AI-integrated suite of features within Figma's ai_integrated Design & UX Sandbox
collaborative design platform that generates layouts and
prototypes from prompts. automates repetitive design
tasks. and accelerates the design-to-code workflow.
Fireflies.ai An AI-powered meeting assistant that automatically pure_ai Productivity& Sandbox
records. transcribes. summarizes. and analyzes voice Workplace
JEFFERSON COUNTY
ARTIFICIAL INTELLIGENCE TOOLS LIST May 22, 2026
conversations. with searchable transcripts. action
items. and integrations across major video conferencing
platforms.
Freshservice An AI-integrated IT service management platform that ai_integrated Productivity& Sandbox
handles ticketing. incident management. asset tracking.Workplace
and automated workflows. with Freddy Al providing
intelligent triage and self-service capabilities.
Google A multimodal Al assistant that generates text. images.pure_ai General Purpose Al Sandbox
Gemini and video. performs deep research. and automates
tasks across web. mobile. and Google Workspace apps.
Gptzero An AI-powered text detection platform that analyzes pure_ai Security& Sandbox
written content to determine whether it was generated by Compliance
Al or written by a human. with sentence-level and
document-level analysis.
Grammarly An AI-powered writing assistant that checks grammar.pure_ai Productivity& Sandbox
spelling. tone. and clarity. while offering generative Al Workplace
features for drafting. rewriting. and content suggestions
across apps and websites.
Grok An Al chatbot and assistant that provides conversational pure_ai General Purpose Al Sandbox
responses. real-time web and X search. image and
video generation. coding help. and advanced reasoning
capabilities.
Harvey A generative Al platform purpose-built for legal pure_ai Legal Sandbox
professionals that assists with legal research. document
drafting. contract analysis. and workflow automation
using domain-specific large language models.
Highspot An AI-integrated sales enablement platform that ai_integrated Sales &CRM Sandbox
manages sales content. training. and coaching for go-
to-market teams. using AI to surface deal guidance.
identify skill gaps. and automate rep workflows.
HubSpot Al An AI-integrated suite of tools embedded within ai_integrated Sales &CRM Sandbox
HubSpot's CRM platform that automates content
creation. sales prospecting. customer service. and data
analysis using AI agents and an Al assistant.
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ARTIFICIAL INTELLIGENCE TOOLS LIST May 22, 2026
Jotform An Al-integrated online form builder and workflow ai_integrated Productivity& Sandbox
automation platform that enables drag-and-drop form Workplace
creation. Al-powered form generation. data collection.
and workflow automation with 150+ integrations.
Julius Al An Al-powered data analyst that enables users to pure_ai Data &Analytics Sandbox
analyze. visualize. and forecast data through natural
language conversation. supporting spreadsheets. CSV
files. and database connections without coding.
KnowBe4 An Al-integrated security awareness training platform ai_integrated Security& Authorized
that delivers simulated phishing attacks. compliance Compliance
training. and behavioral risk scoring to reduce
organizational vulnerability to social engineering threats. _
LivePerson Al A conversational Al platform that enables businesses to pure_ai Customer Service Sandbox
deploy Al-powered chatbots and messaging across
digital channels. combining automated bots with human
agent assistance and analytics.
Lucidchart An Al-integrated collaborative diagramming platform that ai_integrated Productivity& Sandbox
enables users to create flowcharts. org charts. UML Workplace
diagrams. and other visual diagrams. with Al features for
text-to-diagram generation. auto-layout. and data-
driven visualization.
Make A no-code visual workflow automation platform that pure_ai Productivity& Sandbox
connects apps and services to build. scale. and Workplace
automate multi-step workflows and Al-powered
scenarios without coding.
Manus Al An autonomous Al agent platform that independently pure_ai General Purpose Al Sandbox
plans. executes. and delivers complex multi-step tasks
including data analysis. research. content creation. and
coding without continuous human supervision.
Microsoft 365 An Al-integrated productivity assistant that provides ai_integrated Productivity& Authorized
Copilot Cloud chat. content creation. data analysis. and search Workplace
capabilities within Microsoft 365 apps including Word.
Excel. PowerPoint. Outlook. and Teams.
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ARTIFICIAL INTELLIGENCE TOOLS LIST May 22, 2026
Microsoft An AI-powered conversational assistant that provides pure_ai Productivity& Sandbox
Copilot information. content generation. and answers to Workplace
questions across text. images. and web-grounded
topics. integrated across Microsoft products and
available as a standalone chat interface.
Microsoft An AI-powered graphic design tool that generates pure_ai Media &Creative Sandbox
Designer images. creates visual content. and edits photos using
generative Al. supporting social posts. invitations.
banners. and custom designs.
Miro An AI-integrated visual collaboration platform that ai_integrated Productivity& Sandbox
enables teams to brainstorm. plan. and create on a Workplace
shared digital canvas. with Al features for content
generation. diagramming. and workflow automation.
Monday An AI-integrated work management platform that helps ai_integrated Productivity& Sandbox
teams plan. track. and automate projects and Workplace
workflows. with Al agents. automation. and cross-
functional collaboration tools-built in.
Muse Hub A music software marketplace and desktop platform that ai_integrated Media &Creative Sandbox
distributes plugins. sounds. sample libraries. and apps"
including AI-powered tools"for music production and
composition.
Notion Al An AI-integrated assistant built into the Notion ai_integrated Productivity& Sandbox
workspace that helps users write. summarize. search. Workplace
automate tasks. and take meeting notes across pages.
docs. databases. and connected apps.
OpenAl API An Al developer platform and API that provides pure_ai General Purpose Al Sandbox
programmatic access to OpenAl's large language models
for text generation. reasoning. image creation. voice.
and agentic capabilities.
OpenClaw A free. open-source autonomous Al agent that runs pure_ai Productivity& Unauthorized
locally on a user's device. connecting to external LLMs to Workplace
execute tasks such as managing email. calendar. files.
and web browsing via messaging platforms like
WhatsApp. Telegram. and Discord.
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ARTIFICIAL INTELLIGENCE TOOLS LIST May 22, 2026
Otter.ai An Al-powered meeting assistant that automatically pure_ai Productivity& Sandbox
records. transcribes. and summarizes meetings. Workplace
capturing action items. speaker identification. and
searchable transcripts across Zoom. Teams. and
Google Meet.
Paperpile A generative Al writing assistant that helps researchers pure_ai Education &Sandbox
Copilot and academics create titles. outlines. abstracts. and Research
paraphrased text. built on proprietary Al models trained
on scholarly data.
Perplexity Al An Al-powered answer engine that responds to user pure_ai General Purpose Al Sandbox
queries with real-time web search results. synthesizing
cited answers from multiple sources.
Picsart Al An Al-powered content generator that creates written pure_ai Media &Creative Sandbox
content copy for social media. blogs. marketing. and other
generator formats from user prompts. with support for text
expansion. summarization. and rewriting.
Playground An Al-powered graphic design and image generation pure_ai Media &Creative Sandbox
platform that creates logos. social media graphics. and
custom designs from text prompts. with editing and
template tools.
Poe An Al chatbot aggregator platform that provides access pure_ai General Purpose Al Sandbox
to multiple large language models including GPT.
Claude. and Gemini in a single interface. with tools to
create and share custom bots.
Qualtrics An Al-integrated experience management platform that ai_integrated Data &Analytics Sandbox
collects and analyzes customer and employee feedback
across channels. using Al-powered sentiment detection.
text analytics. and automated insights.
QuillBot An Al-powered writing platform that paraphrases. pure_ai Marketing&Content Sandbox
rewrites. and checks grammar across text. offering tools
for summarizing. tone analysis. plagiarism detection.
and citation generation.
Riverside An Al-integrated platform for remote podcast and video ai_integrated Media &Creative Unauthorized
recording. editing. and publishing that locally captures
JEFFERSON COUNTY
ARTIFICIAL INTELLIGENCE TOOLS LIST May 22, 2026
studio-quality audio and video. with AI-powered tools for
transcription. clip generation. and content editing.
Salesforce An AI-integrated suite of predictive and generative Al ai_integrated Sales&CRM Sandbox
Einstein capabilities built natively into the Salesforce platform.
enabling automation. personalization. and intelligent
insights across sales. service. marketing. and
commerce workflows.
Seismic An AI-integrated knowledge management tool that ai_integrated Sales&CRM Sandbox
Knowledge surfaces verified answers. FAQs. and guides within the
flow of work. enabling sales and service teams to access
just-in-time information across connected knowledge
sources.
Slack GPT An AI-integrated feature set within Slack that summarizes ai_integrated Productivity& Sandbox
conversations. answers search queries. takes meeting Workplace
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using large language models.
Smartsheet A cloud-based work management platform that enables ai_integrated Productivity& Sandbox
teams to plan. track. automate. and report on projects Workplace
and workflows. with integrated Al features for formula
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Tableau Al An AI-integrated analytics and data visualization platform ai_integrated Data &Analytics Sandbox
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exploration across cloud and on-premises deployments.
Typefully A social media scheduling and content creation platform ai_integrated Marketing&Content Sandbox
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powered writing assistance and analytics.
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JEFFERSON COUNTY
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automated publishing to YouTube Shorts.
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scale multi-step workflows and Al agents without code.
Zendesk Al An Al-integrated customer service platform that provides ai_integrated Customer Service Sandbox
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assistance. intelligent triage. and intent and sentiment
detection across support channels.
Zia An Al assistant integrated across the Zoho ecosystem ai_integrated Productivity& Sandbox
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supports conversational queries. data analysis. and
content generation within Zoho applications.
Zoom Al An Al-integrated workplace assistant that provides ai_integrated Productivity& Authorized
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jam.dev An Al-integrated bug reporting platform that captures ai_integrated Software Sandbox
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Al to auto-generate actionable ticket details.
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
CONSENT AGENDA REQUEST
TO: Board of County Commissioners
Josh Peters, County Administrator
FROM: Jeremy Williammee, DCD Director
DATE: May 26, 2026
RE: Board Approval to Notice a Public Hearing to Deliberate and Adopt by Ordinance
Amendments to JCC 8.75 to Ban Fireworks in Jefferson County
STATEMENT OF ISSUE:
The Department of Community Development(DCD)/Office of the Fire Marshal requests Board
of County Commissioners(BoCC)approval to notice a hearing to receive public comment and
act regarding a new ordinance regarding fireworks regulations in Jefferson County.
ANALYSIS:
As instructed by the BoCC during an April 20, 2026 workshop, DCD and the Fire Marshal have
coordinated with the Sheriff and Prosecuting Attorney's Office (PAO)to draft amendments to
Jefferson County Code (JCC) 8.75. The draft ordinance will ban fireworks in unincorporated
Jefferson and update the fine structure for fireworks-related violations. The ordinance continues
to provide a pathway for licensed public display subject to federal and state law and local special
event review requirements.
The Jefferson County Fire Chiefs Association has been provided with opportunities to comment
and support the drafting of these regulation revisions.
The PAO has provided ongoing guidance and has confirmed compliance with state requirements
and best practices for this ordinance.
FISCAL IMPACT:
There are no direct fiscal impacts associated with this ordinance.
RECOMMENDATION:
Staff recommend that the Board hold the requested hearing and take appropriate action.
REVIEWED BY:
0-621 /1/3 5-4°/9'4)-
Jo0D. Peters, County Administrator Date
Please publish 2 times: June 3 and 8, 2026
Contact Person: Chelsea Pronovost
Bill to: Department of Community Development
621 Sheridan St
Port Townsend, WA 98368
NOTICE OF PUBLIC HEARING
Public hearing for a new ordinance banning fireworks in Jefferson County.
NOTICE IS HEREBY GIVEN that a public hearing is scheduled by the Jefferson County Board of
Commissioners for MONDAY, June 15, 2026 at 3:00 p.m. in the Commissioners' Chambers,
County Courthouse, 1820 Jefferson Street, Port Townsend, WA 98368 (HYBRID). Notice of said
hearing is to be published in the official newspaper of Jefferson County.
This hearing consists of changes to Jefferson County Code Chapter 8.75 regarding Fireworks
regulations in the County.
A portion of the draft ordinance consists of the authority to set a burn restriction level and seasonal
burn restriction effective dates outside of the set annual restriction season period.
The information is available for viewing on the County website by visiting: www.cojefferson.wa.us
and follow this pathway—Services—Laserfiche Web Portal(username and password is: public)-Board of
Commissioners—BOCC Agenda Packets—2026 Weekly Agenda Items— 15 JUNE 2026—061526—Hearing
re Fireworks Ban
You are welcome to participate in this hearing. You will need to join the meeting by 3:00 p.m. using
the following methods: VIRTUALLY: Via the following Zoom, link:
https://zoom.us/j/93777841705, PHONE: Dial 1-253-215-8782 and enter access code: 937-7784-
1705# and press *9 to "raise your hand"to be called upon. Access for the hearing impaired can be
accommodated using Washington Relay Service at 1-800-833-6384, or IN-PERSON
In addition, written testimony is also invited beginning on May 26, 2026 and ending on June 15,2026 at
the end of the Public Hearing, unless extended by the Board of County Commissioners. Written public
testimony may be submitted by Email to:jeffbocc@cojefferson.wa.us You may view documents and
testimony received by visiting: www.co.jefferson.wa.us and following this pathway—Services—
Laserfiche Web Portal (username and password is public)—Board of Commissioners—BOCC
Agenda Packets—2026 Weekly Agenda Items— 15 June 2026—061526
You can also Mail your testimony to: Jefferson County Commissioners' Office; P.O. Box 1220, Port
Townsend, WA 98368. Written testimony must be received by the Board of County Commissioners by
the end of the hearing testimony period.
Signed this 26 day of May 2026.
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
S/Greg Brotherton, Chair
STATE OF WASHINGTON
County of Jefferson
An Ordinance Amending Chapter 8.75
Fireworks and Sky Lanterns)of the Jefferson ORDINANCE NO.
County Code
WHEREAS, Article XI, section 11 of the Washington Constitution, confers upon county
legislative authorities the police power to adopt such local police, sanitary and other regulations
as are not in conflict with general laws; and,
WHEREAS, Article XI, section 11 of the Washington Constitution is a direct delegation
of the police power to cities and counties, and the power delegated is as extensive within their
sphere as that possessed by the legislature; and,
WHEREAS,RCW 36.32.120(7)provides that the county legislative authorities shall make
and enforce, by appropriate resolutions or ordinances, all such police and sanitary regulations as
are not in conflict with state law; and,
WHEREAS, police power is that inherent and plenary power which enables prohibition
of all things hurtful to the comfort, safety and welfare of society;and,
WHEREAS, the scope of police power is broad, encompassing all those measures which
bear a reasonable and substantial relation to promotion of the general welfare of the people;and,
WHEREAS, RCW 36.32.120(10) provides that county legislative bodies have the power
to declare by ordinance what shall be deemed a nuisance within the county; to abate a nuisance at
the expense of the parties creating, causing, or committing the nuisance; and to levy a special
assessment on the land or premises on which the nuisance is situated to defray the cost, or to
reimburse the county for the cost of abating it; and,
WHERAS, RCW 70.77.250(4) provides that a county may adopt fireworks regulations
that are more restrictive than state law, provided the local regulations must have an effective date
no sooner than one year after their adoption; and,
WHEREAS, the Jefferson County Board of County Commissioners (Board) has held a
hearing and has received public comment on the draft ordinance proposed by staff; and,
WHEREAS, the Board amended chapter 8.75 JCC on March 24, 2022, when it adopted
Ordinance No. 3-0314-22; and,
WHEREAS, increasing wildfire risk associated with changing climate patterns and
shifting atmospheric conditions has resulted in longer periods of drought, elevated temperatures,
and heightened fire danger, thereby necessitating more responsive and precautionary local
regulation of fireworks to protect public health, safety, and property; and,
WHEREAS, the Board recognizes the danger to public health, safety, and the
environment; that noise created by fireworks is disruptive to many people and animals; and
discourages their unsafe use; and,
WHEREAS, in response to the public comment and testimony, additional improvements
to the draft ordinance have been made, and,
NOW, THEREFORE,be it ordained by the Board as follows:
Section 1. Amending Chapter 8.75 JCC. The Board amends chapter 8.75 JCC as shown in
Appendix A. A clean version of the amended chapter 8.75 JCC is in Appendix B.
Section 2. Findings. The Board adopts the above recitals (the "WHEREAS" statements) as its
findings of fact in support of this ordinance.
Section 3. Severability. The provisions of this ordinance are declared separate and severable. If
any provision of this ordinance or its application to any person or circumstances is held invalid,
then the remainder of this ordinance or application of its provisions to other persons or
circumstances shall remain valid and unaffected.
Section 4. SEPA Compliance. This ordinance is categorically exempt from the State
Environmental Policy Act under WAC 197-11-800(19).
Section 5. Effective Date. This ordinance shall be in full force and effect one year after the date
of adoption.
SIGNATURES FOLLOW ON NEXT PAGES)
ADOPTED this day of 2026, at_•• —• a.m.
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
Greg Brotherton, Chair
Heidi Eisenhour, Member
ATTEST:
Heather Dudley-Nollette, Member
APPROVED AS TO FORM:
Carolyn Gallaway,Date Philip C. Hunsucker, Date
Clerk of the Board Chief Civil Deputy Prosecuting Attorney
RED LINE VERSION
APPENDIX A—REPLACEMENT FOR CHAPTER 8.75 JCC
Title 8 - HEALTH AND SAFETY
Chapter 8.75 — FIREWORKS AND SKY LANTERNS BANNEDPROHIBITED
Sections:
8.75.010 Purpose and Construction.
1) This chapter supplements Chapter 70.77 RCW, and shall be construed in connection with that
law and any regulations or rules issued pursuant that law.
2) It is expressly the purpose of this chapter to provide for and promote the health, safety and
welfare of the general public, and not to create or otherwise establish or designate any particular
class or group of persons who will or should be specially protected or benefited by the terms of
this chapter.
3) This chapter shall be liberally construed to carry out its broad purposes, allowing the local fire
official to determine permissible consumer fireworks within their region of responsibility within
Jefferson County.
4) Reference to the Revised Code of Washington(RCW) in this chapter is to the provision of the
RCW as currently adopted or as may be amended in the future.
8.75.020 Definitions.
In construing provisions of this chapter, except where otherwise plainly declared or clearly
apparent from the context, words used in this chapter shall be given their common and ordinary
meaning and in addition,the following definitions shall apply:
1) "Agricultural and wildlife fireworks"has the same meaning as in RCW 70.77.141.
2) "Consumer fireworks"has the same meaning as in RCW 70.77.136.
3) "County fire marshal" means the person designated by the Board of County Commissioners
pursuant to RCW 43.44.050(1)(b) with the police power to investigate the origin, cause,
circumstances, and extent of loss of all fires within unincorporated areas of Jefferson County.
3) "Declaration of high fire hazard" means a declaration by the county fire marshal or their
designee, or a local fire official or their designee, that a high fire hazard exists within their region
of responsibility.
4) "Display fireworks"as in RCW 70.77.131.
5) "Fire hazard" means the accumulation of combustible materials in such a condition as to be
readily ignited and in such a quantity as to create a hazard from fire to nearby structures, forest
areas, life and property.
RED LINE VERS pN
6)"Fireworks"has the same meaning as in RCW 70.77.126.
7) "Fireworks waste"means any waste remaining after the discharge, manufacture, sale, storage,
or transportation of fireworks, including,but not limited to, ashes, garbage, and rubbish.
8) "High fire hazard" means a period of hot, dry weather accompanied by low fuel moistures,
where fires start quickly, spread furiously, and burn intensely and are difficult to control unless
they are successfully attacked when the fires are small. It is during this period that wildland fires
can be expected, and fire growth will be accelerated.
9) "Local fire official" means a fire chief of a fire district wholly or partially within Jefferson
County or their designee.
10) "Public display of fireworks"has the same meaning as in RCW 70.77.160.
11)"Region of responsibility"means the fire district wholly or partially within Jefferson County
for a local fire official, or the county as a whole for the county fire marshal.
12) "Sky lantern"has the same meaning as in RCW 76.04.005(19).
13) "Special effects"has the same meaning as in RCW 70.77.136.
14) "Vehicle" means every device capable of being moved upon a highway and in, upon, or by
which any person or property is or may be transported or drawn upon a highway. "Vehicle" shall
include but shall not be limited to automobiles,motorcycles,trucks,buses, motorized recreational
vehicles, campers, travel trailers, and boat trailers. "Vehicle" does not include devices moved by
human or animal power, or used exclusively upon stationary rails or tracks.
15)"Vessel"means every species of watercraft or other mobile artificial contrivance,powered or
unpowered, intended to be used for transporting people or goods on water or for floating marine
construction or repair and which does not exceed two hundred feet in length.
16) "Wildland fire" means any non-structure fire that occurs in vegetation or natural fuels and
includes fires originating from an unplanned ignition and unauthorized and accidental human
caused fires.
8.75.030 Sky lanterns prohibited.
It is unlawful for any person to ignite, light or launch any sky lantern within unincorporated
Jefferson County.
8.75.035 Publication of Declaration of High Fire Hazard.
The county fire marshal and each local fire official shall publish the declaration of high fire hazard
on their website. in local media outlets for public review.
RED LINE VERSION
8.75.040 - Prohibited acts—Exceptions.
1) Limits on Dates and Times Consumer Fireworks May Be Sold or Discharged. The county
adopts the dates and times consumer fireworks may be sold or discharged under RCW 70.77.395.
discharge of consumer fireworks is below:
Sal„ofConsum r Fireworks idea in R W 7n 77 2>>
Date From To
June 28 each year Neon 11:00 p.m.
June 29 each year 9:00 a.m. 11:00 p.m.
Jule I each year 9:00 a.m. 11:00 p.m.
July ,ach year 9:00 a.m. 11:00 p.m.
lulu ,:ach year 9:00 a.m. 11:00 p.m.
July 4 each year 9:00 a.m. 11:00 p.m.
December 27 each year Noon 11:00 p.m.
December 28 each year Nee* 11:00 p.m.
December 29 each year Nee* 11:00 p.m.
December 30 each year Neen 11:00 p.m.
December 31 each year Neen 11:00 p.m.
Dote From To
June 28 each year Neon 11:00 p.m.
June 29 each year 9:00 a.m. 11:00 p.m.
July 1 each year 9:00 a.m. 11:00 p.m.
July 2 each year 9:00 a.m. 11:00 p.m.
July 3 each year 9:00 a.m. 11:00 p.m.
July 4 each year 00 a.m.Mt,
cember 31 each year Nero
January I each year M 1:00 p.m.
The above chart shall be updated to be consistent with the requirements of RCW 70.77.395. if
that section is amended.
12) Discharge, Manufacture, Possession, Sale,Storage,
Transportation, or Use of Fireworks Is Prohibited During ^ Declaration of High Fire H za,.a
Except as permitted in this chapter, the discharge, manufacture, possession, sale, storage, or
transportation of fireworks is prohibited during a aeclaratio,, of high fire hazard declared in a
region of responsibility in unincorporated Jefferson County; provided, however, that this
restriction shall not apply:
a) To the storage or transportation of consumer fireworks;
ha) To the use by railroads or other transportation agencies for signal or illumination purposes;
e )To the use of agricultural and wildlife fireworks;
dc) To the use of devices for vegetation management or wildfire firefighting tactics;
RED LINE VERSION
ed) To the use of flares or fuses in connection with the operation of vehicles or vessels for signal
purposes, or use by others for emergency signal purposes, or illumination of for use in forest
protection activities, or for those other uses described in RCW 70.77.311.
t) To the use of special effects when used as an integral part of a theatrical production;
ge) To the transportation of fireworks through the county as part of interstate commerce; or,
hf)To the public display of display fireworks by persons with the appropriate state licenses.
8.75.045 Fa°e-to Cleanup Fireworks Waste Required.
Failure to clean up fireworks waste After any discharge of fireworks, cleanup of any fireworks
waste is requiredis „rohibited u nf'er this chapter
8.75.050—Public Display of Fireworks in the County.
1) Public display of fireworks in unincorporated Jefferson County is prohibited, unless an
application has been approved for any permit required under JCC 8.20.030 (entertainment,
amusement or assemblies permit), JCC 18.20.380 (temporary outdoor use permit) or JCC
18.20.390 (temporary festival conditional use), after a consultation with local fire officials
consistent with RCW 770. 6070.77.260 prior to approval on an application form approved by
the fire marshal.
2) A public display of fireworks shall be of such character, and so located, discharged or fired in
a manner that is not hazardous to property or injurious to any person, as determined by either the
fire marshal or a local fire official.
3) Every operator of a public display of fireworks shall first obtain a state license pursuant to
RCW 70.77.355.
8.75.060—Seizure of Fireworks
Pursuant to RCW 70.77.435, any fireworks which are illegally sold, offered for sale, used,
discharged, possessed, or transported in violation of the provisions of this chapter or the rules or
regulations of the chief of the Washington state patrol,through the director of fire protection, are
subject to seizure by the chief of the Washington state patrol, through the director of fire
protection, or his or her deputy, or by state agencies or local governments having general law
enforcement authority.
8.75.070 - Violations and penalties.
Pursuant to RCW 36.32.120(7), this chapter declares certain acts to be civil violations and
establishes civil enforcement procedures and penalties, and also declares certain acts to be
misdemeanors.
1) Misdemeanor. Any person, firm, corporation or association violating or failing to comply
with any of the provisions of this chapter during a period of high tire danger shall be deemed guilty
RED LINE VERSION
of a misdemeanor and upon conviction thereof shall be punished by a fine in a sum not exceeding
one thousand dollars ($1,000.00) dollars or by imprisonment in the jail for a period not to exceed
ninety (90) days or by both such fine and jail.
2) Civil Infraction.
a) Any person who violates any provision of this chapter may be issued a notice of infraction.
The penalty for an infraction issued to a person who violates any provision of this chapter shall be
one-two hundred and fifty dollars ($250) dollars for first offense; five hundred ($500) for second
offense;and one thousand cl‘ail, '-1 no, i
2,000.00)for any subsequent violation of this chapter. For each violation of a continuing nature,
each day shall constitute a separate infraction, subject to a daily penalty.
b) It shall be unlawful for any property owner or their—designeeany other person who has
control of all or a portion of a property(licensees,holders of easements,etc.)to allow the discharge
of fireworks e€on anv kind on their property. Any volition of this
subsection io ates the evisions ofthis chapter may be issued a notice of infraction.
b)(cLA notice of infraction represents a determination that a violation has been committed. The
determination will be final unless contested as provided in this chapter.
e (d) The Infraction Rules for Courts of Limited Jurisdiction(IRLJ)as they exist now or may be
amended in the future, apply to the processing and adjudication of civil infractions under this
chapter.
8.75.080—Enforcement
1) Particularly with the discharge of consumer fireworks in violation of this chapter, public
awareness and voluntary compliance efforts should be used prior to enforcement under this
chapter.
2) The county sheriff or their designee has the discretion to enforce this chapter. This chapter
does not create a duty on the part of the county,the county sheriff,the county fire marshal,or local
fire officials to enforce violations of this chapter. Decisions about whether and how to enforce
this chapter shall be made in conjunction with the county prosecuting attorney or their designee.
3) The county sheriff or their designee may consult with the county fire marshal or a local fire
official in enforcement of this chapter. The county sheriff or their designee are authorized to:
a) Issue citations to or arrest without warrant persons violating the provisions of this chapter;
b) Serve and execute all warrants, citations and other process issued by the courts;
c) Send by certified mail any warrant, citation or other process to the last known place of
residence of the person alleged to have violated of this chapter,which shall be deemed as personal
service upon the person alleged to have violated this chapter.
RED LINE VERSION
4) This chapter as well as permits or decisions issued under it may be enforced through the
provisions of Title 19 JCC, Code Compliance. The county sheriff is the "director" for purposes
of JCC 19.10.015(19). The county sheriff shall coordinate with the code compliance coordinator
on decisions to enforce this chapter under Title 19 JCC.
5)Enforcement through this chapter is not exclusive and additional enforcement mechanisms may
exist, which may include filing civil actions in courts of competent jurisdiction under other
applicable laws.
6)The county prosecuting attorney may at any time bring such additional injunctive,declaratory,
criminal, or other actions as are necessary to enforce the provisions of this chapter.
7)Nothing in this title shall be interpreted to mean that civil and criminal remedies for the same
violations may not be brought simultaneously.
8.75.090 - Severability.
If any provision of this chapter is declared unconstitutional or the applicability thereof to any
person or circumstance is held invalid, the constitutionality of the remainder of the ordinance
codified in this chapter and the applicability thereof to other persons and circumstance shall not be
affected thereby.
8.75.100 - Effective date.
That the ordinance codified in this chapter and the rules, regulations, provisions, requirements,
orders and matters established and adopted pursuant to the ordinance codified in this chapter shall
take effect and be in full force and effect one year after the date of adoption.
8.75.110 Disclaimer of liability.
Nothing contained in this chapter is intended to be nor shall be construed to create or form the
basis for any liability on the part of the county, its officers, employees or agents, or any local fire
official, for any injury or damage resulting from the failure of anyone to comply with the
provisions of this chapter, or by reason or in consequence of the implementation or enforcement
pursuant to this chapter, or by reason of any action or inaction on the part of the county related in
any manner to the enforcement of this chapter by its officers, employees or agents.
ANNEX B—SUPPLEMENTAL CODE CHANGES
8.72.010 Purpose and construction.
4) This chapter shall be liberally construed to carry out its broad purposes_, allowing the loc"l
8.72.040 Fire danger risk level burn restrictions.
RED LINE VERSION
5) Fire Danger Risk Levels.
c) Stage 3 High Fire Hazard.
i) Use of charcoal briquettes is prohibited, except for commercially made listed
and labeled barbeque devices located and used at a residence.
ii) Target shooting outside of gun ranges, and use of exploding targets or
incendiary ammunition is prohibited. Hunting is allowed in open areas.
Chapter 8.75 JCC.
APPENDIX B—REPLACEMENT FOR CHAPTER 8.75 JCC (CLEAN)
Title 8-HEALTH AND SAFETY
Chapter 8.75—FIREWORKS AND SKY LANTERNS PROHIBITED
Sections:
8.75.010 Purpose and Construction.
1) This chapter supplements Chapter 70.77 RCW, and shall be construed in connection with that
law and any regulations or rules issued pursuant that law.
2) It is expressly the purpose of this chapter to provide for and promote the health, safety and
welfare of the general public, and not to create or otherwise establish or designate any particular
class or group of persons who will or should be specially protected or benefited by the terms of
this chapter.
3) This chapter shall be liberally construed to carry out its broad purposes, allowing the local fire
official to determine permissible consumer fireworks within their region of responsibility within
Jefferson County.
4) Reference to the Revised Code of Washington(RCW) in this chapter is to the provision of the
RCW as currently adopted or as may be amended in the future.
8.75.020 Definitions.
In construing provisions of this chapter, except where otherwise plainly declared or clearly
apparent from the context, words used in this chapter shall be given their common and ordinary
meaning and in addition,the following definitions shall apply:
1)"Agricultural and wildlife fireworks"has the same meaning as in RCW 70.77.141.
2)"Consumer fireworks"has the same meaning as in RCW 70.77.136.
3) "County fire marshal" means the person designated by the Board of County Commissioners
pursuant to RCW 43.44.050(1)(b) with the police power to investigate the origin, cause,
circumstances, and extent of loss of all fires within unincorporated areas of Jefferson County.
3) "Declaration of high fire hazard" means a declaration by the county fire marshal or their
designee, or a local fire official or their designee, that a high fire hazard exists within their region
of responsibility.
4) "Display fireworks" as in RCW 70.77.131.
5) "Fire hazard" means the accumulation of combustible materials in such a condition as to be
readily ignited and in such a quantity as to create a hazard from fire to nearby structures, forest
areas, life and property.
6) "Fireworks"has the same meaning as in RCW 70.77.126.
7) "Fireworks waste"means any waste remaining after the discharge, manufacture, sale, storage,
or transportation of fireworks, including, but not limited to, ashes, garbage, and rubbish.
8) "High fire hazard" means a period of hot, dry weather accompanied by low fuel moistures,
where fires start quickly, spread furiously, and burn intensely and are difficult to control unless
they are successfully attacked when the fires are small. It is during this period that wildland fires
can be expected, and fire growth will be accelerated.
9) "Local fire official" means a fire chief of a fire district wholly or partially within Jefferson
County or their designee.
10) "Public display of fireworks"has the same meaning as in RCW 70.77.160.
11) "Region of responsibility"means the fire district wholly or partially within Jefferson County
for a local fire official, or the county as a whole for the county fire marshal.
12) "Sky lantern"has the same meaning as in RCW 76.04.005(19).
13) "Special effects"has the same meaning as in RCW 70.77.136.
14) "Vehicle" means every device capable of being moved upon a highway and in, upon, or by
which any person or property is or may be transported or drawn upon a highway. "Vehicle" shall
include but shall not be limited to automobiles,motorcycles,trucks,buses, motorized recreational
vehicles, campers, travel trailers, and boat trailers. "Vehicle" does not include devices moved by
human or animal power, or used exclusively upon stationary rails or tracks.
15)"Vessel"means every species of watercraft or other mobile artificial contrivance,powered or
unpowered, intended to be used for transporting people or goods on water or for floating marine
construction or repair and which does not exceed two hundred feet in length.
16) "Wildland fire" means any non-structure fire that occurs in vegetation or natural fuels and
includes fires originating from an unplanned ignition and unauthorized and accidental human
caused fires.
8.75.030 Sky lanterns prohibited.
It is unlawful for any person to ignite, light or launch any sky lantern within unincorporated
Jefferson County.
8.75.035 Publication of Declaration of High Fire Hazard.
The county fire marshal and each local fire official shall publish the declaration of high fire hazard
on their website.
8.75.040 - Prohibited acts—Exceptions.
1) Discharge, Manufacture, Possession, Sale, Storage, Transportation, or Use of Fireworks Is
Prohibited. Except as permitted in this chapter, the discharge, manufacture, possession, sale,
storage,or transportation of fireworks is prohibited in unincorporated Jefferson County;provided,
however,that this restriction shall not apply:
a) To the use by railroads or other transportation agencies for signal or illumination purposes;
b) To the use of agricultural and wildlife fireworks;
c) To the use of devices for vegetation management or wildfire firefighting tactics;
d) To the use of flares or fuses in connection with the operation of vehicles or vessels for signal
purposes, or use by others for emergency signal purposes, or illumination of for use in forest
protection activities, or for those other uses described in RCW 70.77.311.
e) To the transportation of fireworks through the county as part of interstate commerce; or,
f)To the public display of display fireworks by persons with the appropriate state licenses.
8.75.045 Cleanup of Fireworks Waste Required.
After any discharge of fireworks, cleanup of any fireworks waste is required.
8.75.050—Public Display of Fireworks in the County.
1) Public display of fireworks in unincorporated Jefferson County is prohibited, unless an
application has been approved for any permit required under JCC 8.20.030 (entertainment,
amusement or assemblies permit), JCC 18.20.380 (temporary outdoor use permit) or JCC
18.20.390 (temporary festival conditional use), after a consultation with local fire officials
consistent with RCW 70.77.260 prior to approval on an application form approved by the fire
marshal.
2) A public display of fireworks shall be of such character, and so located, discharged or fired in
a manner that is not hazardous to property or injurious to any person, as determined by either the
fire marshal or a local fire official.
3) Every operator of a public display of fireworks shall first obtain a state license pursuant to
RCW 70.77.355.
8.75.060—Seizure of Fireworks
Pursuant to RCW 70.77.435, any fireworks which are illegally sold, offered for sale, used,
discharged, possessed, or transported in violation of the provisions of this chapter or the rules or
regulations of the chief of the Washington state patrol,through the director of fire protection, are
subject to seizure by the chief of the Washington state patrol, through the director of fire
protection, or his or her deputy, or by state agencies or local governments having general law
enforcement authority.
8.75.070-Violations and penalties.
Pursuant to RCW 36.32.120(7), this chapter declares certain acts to be civil violations and
establishes civil enforcement procedures and penalties, and also declares certain acts to be
misdemeanors.
1) Misdemeanor. Any person, firm, corporation or association violating or failing to comply
with any of the provisions of this chapter during a period of high fire danger shall be deemed guilty
of a misdemeanor and upon conviction thereof shall be punished by a fine in a sum not exceeding
one thousand dollars ($1,000.00) dollars or by imprisonment in the jail for a period not to exceed
ninety (90)days or by both such fine and jail.
2) Civil Infraction.
a) Any person who violates any provision of this chapter may be issued a notice of infraction.
The penalty for an infraction issued to a person who violates any provision of this chapter shall be
two hundred and fifty dollars ($250) dollars for first offense; five hundred ($500) for second
offense; and one thousand dollars($1,000) for any subsequent violation of this chapter. For each
violation of a continuing nature, each day shall constitute a separate infraction, subject to a daily
penalty.
b) It shall be unlawful for any property owner or any other person who has control of all or a
portion of a property(licensees, holders of easements,etc.)to allow the discharge of fireworks on
any property. any volition of this subsection may be issued a notice of infraction.
c) A notice of infraction represents a determination that a violation has been committed. The
determination will be final unless contested as provided in this chapter.
d) The Infraction Rules for Courts of Limited Jurisdiction(IRLJ)as they exist now or may be
amended in the future, apply to the processing and adjudication of civil infractions under this
chapter.
8.75.080—Enforcement
1) Particularly with the discharge of consumer fireworks in violation of this chapter, public
awareness and voluntary compliance efforts should be used prior to enforcement under this
chapter.
2) The county sheriff or their designee has the discretion to enforce this chapter. This chapter
does not create a duty on the part of the county,the county sheriff,the county fire marshal,or local
fire officials to enforce violations of this chapter. Decisions about whether and how to enforce
this chapter shall be made in conjunction with the county prosecuting attorney or their designee.
3) The county sheriff or their designee may consult with the county fire marshal or a local fire
official in enforcement of this chapter. The county sheriff or their designee are authorized to:
a) Issue citations to or arrest without warrant persons violating the provisions of this chapter;
b) Serve and execute all warrants, citations and other process issued by the courts;
c) Send by certified mail any warrant, citation or other process to the last known place of
residence of the person alleged to have violated of this chapter,which shall be deemed as personal
service upon the person alleged to have violated this chapter.
4) This chapter as well as permits or decisions issued under it may be enforced through the
provisions of Title 19 JCC, Code Compliance. The county sheriff is the "director" for purposes
of JCC 19.10.015(19). The county sheriff shall coordinate with the code compliance coordinator
on decisions to enforce this chapter under Title 19 JCC.
5)Enforcement through this chapter is not exclusive and additional enforcement mechanisms may
exist, which may include filing civil actions in courts of competent jurisdiction under other
applicable laws.
6)The county prosecuting attorney may at any time bring such additional injunctive, declaratory,
criminal, or other actions as are necessary to enforce the provisions of this chapter.
7)Nothing in this title shall be interpreted to mean that civil and criminal remedies for the same
violations may not be brought simultaneously.
8.75.090 -Severability.
If any provision of this chapter is declared unconstitutional or the applicability thereof to any
person or circumstance is held invalid, the constitutionality of the remainder of the ordinance
codified in this chapter and the applicability thereof to other persons and circumstance shall not be
affected thereby.
8.75.100 - Effective date.
That the ordinance codified in this chapter and the rules, regulations, provisions, requirements,
orders and matters established and adopted pursuant to the ordinance codified in this chapter shall
take effect and be in full force and effect one year after the date of adoption.
8.75.110 Disclaimer of liability.
Nothing contained in this chapter is intended to be nor shall be construed to create or form the
basis for any liability on the part of the county, its officers, employees or agents, or any local fire
official, for any injury or damage resulting from the failure of anyone to comply with the
provisions of this chapter, or by reason or in consequence of the implementation or enforcement
pursuant to this chapter, or by reason of any action or inaction on the part of the county related in
any manner to the enforcement of this chapter by its officers, employees or agents.
SUPPLEMENTAL CODE CHANGES (CLEAN)
8.72.010 Purpose and construction.
4) This chapter shall be liberally construed to carry out its broad purposes.
8.72.040 Fire danger risk level burn restrictions.
5) Fire Danger Risk Levels.
c) Stage 3 High Fire Hazard.
i)Use of charcoal briquettes is prohibited, except for commercially made listed
and labeled barbeque devices located and used at a residence.
ii) Target shooting outside of gun ranges, and use of exploding targets or
incendiary ammunition is prohibited. Hunting is allowed in open areas.
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
CONSENT AGENDA REQUEST
TO:Board of County Commissioners
FROM: Heidi Eisenhour, Commissioner District 2
DATE: May 26,2026
RE:LETTER OF SUPPORT: Jamestown S'Klallam Tribe Land Transfer Act of 2026
STATEMENT OF ISSUE:
The Jamestown S'Klallam Tribe Land Transfer Act of 2026 is a proposed piece of federal
legislation aimed at transferring the Dungeness National Wildlife Refuge and Protection Island
National Wildlife Refuge into trust for the Jamestown S'Klallam Tribe.
Because both refuge areas hold such extraordinary ecological significance, it is a source of
significant regional pride for both the Tribe and the broader Jefferson County community. We
have been hearing from constituents who are both supportive of this transfer and who oppose it.
Those who oppose the transfer are especially concerned the tribe will emphasize aquacultural
activities in these refuge areas.
The Tribe has asked us to send a letter of support to Senators Murray and Cantwell as well as
Representative Randall as they maintain profound historical and cultural ties to the island and the
surrounding waters. The proposed land transfer legislation recognizes the Tribe's longstanding
connections and represents an important step toward restoring ancestral connections and
honoring the Tribe's sovereign relationship with Protection Island. They have also been involved
in managing the Dungeness Spit Wildlife Refuge through an agreement inked in the late 1980's,
and through the Tribe's 2024 self-governance agreement with the U.S. Fish and Wildlife Service
have been managing both the Dungeness Spit and Protection Island Wildlife Refuges for the past
couple of years.
FISCAL IMPACT:
There is no fiscal impact.
RECOMMENDATION: Discuss what we've been here, consider signing—and potentially
updating -the draft letter of support and send an original to Representative Emily Randall and
Senators Patty Murray and Maria Cantwell.
REVIEWED BY:
e'; /'0-06f&O 5/go 7-•)-
J•_ Peters, County Administrator Date
oi CoN ssr Board of County Commissioners
4w s co gt 1820 Jefferson Street
m ti PO Box 1220
Port Townsend, WA 98368
O Heather Dudley-Nollette,District 1 Heidi Eisenhour,District 2 Greg Brotherton,District 3S1/ING't
May 26,2026
Representative Emily Randall
1531 Longworth House Bldg
Washington, D.C. 20515
RE: Support for The Jamestown S'Klallam Tribe Land Transfer Act of 2026
Dear Representative Randall:
On behalf of Jefferson County, Washington, we write to express the County's support for"The
Jamestown S'Klallam Tribe Land Transfer Act of 2026," legislation that would transfer former
National Wildlife Refuge lands, comprising the Dungeness and Protection Island National Wildlife
Refuges, to the Bureau of Indian Affairs to be held in trust for the Jamestown S'Klallam Tribe.
The Tribe is a highly collaborative and well-respected partner to Jefferson County, and we recognize
the deep historical and cultural connections that the Tribe maintains with the lands and waters
impacted by this legislation. These sites are not only central to the Tribe's heritage but are also integral
to the ecological health and quality of life for our entire region. Protection Island, located within
Jefferson County, is of particular importance to our constituents. The island provides critical nesting
habitat for tufted puffins, rhinoceros auklets, glaucous-winged gulls and many other species of
seabirds and raptors. The waters surrounding Protection Island also provide essential grounds for a
variety of marine mammals, and the island's shorelines support a WA Department of Natural
Resources designated marine aquatic reserve .
Because Protection Island holds such extraordinary ecological significance, it is a source of significant
regional pride for both the Tribe and the broader Jefferson County community. The Tribe maintains
profound historical and cultural ties to the island and the surrounding waters. The land transfer
legislation recognizes the Tribe's longstanding connections and represents an important step toward
restoring ancestral connections and honoring the Tribe's sovereign relationship with Protection Island.
Through the Tribe's 2024 self-governance agreement with the U.S. Fish and Wildlife Service and its
expenditure of its own supplemental funds, the Tribe has demonstrated a strong financial commitment
to improving Protection Island for the benefit of researchers and the greater Jefferson County area
alike. Since assuming management of the island, the Tribe has already revitalized habitat research
studies, rebuilt the access road, and initiated vegetative management to support island prairie habitat.
Wage
We are confident that upon transfer into trust status,the Tribe will continue to manage both former
Refuges to a standard that will meet or exceed federal requirements. Jefferson County has familiarity
with the Tribe's ability to manage lands through the Tamanowas Rock Sanctuary and trail network,
which are open to the public and well monitored by the Tribe. Jamestown S'Klallam Tribe and
Jefferson County Land Trust partnered on the acquisition of Tamanowas Rock sanctuary lands from
2009—2012 and the area showcases the Tribe's ability to steward lands for cultural purposes,
conservation and public access.
The County further notes that Protection Island is not currently subject to local property taxation as
federal public land and if the island is transferred into trust status on behalf of the Tribe, it will not
result in any loss of property tax revenue to the County. However, the Tribe has agreed to assume
through the legislation the U.S. Fish and Wildlife Service's existing obligations to Jefferson County for
payment in lieu of taxes and refuge revenue sharing, at a prorated rate tied to the federal statutory
payment rate, to ensure that the County will continue to receive these valuable payments following
transfer. This is a key consideration in the Board of County Commissioner's decision to support the
legislation, and the County is pleased that the land transfer is structured to protect Jefferson County
from any potential negative fiscal impact.
For these reasons,Jefferson County respectfully urges the delegation to support and advance "The
Jamestown Land Transfer Act of 2026."We appreciate your consideration of this legislation and your
ongoing commitment to constructive and locally-driven solutions that will benefit Tribal Nations and
all residents within the State of Washington.
Sincerely,
Heather Dudley-Nollette, Dist. 1 Heidi Eisenhour, Dist. 2 Greg Brotherton,Dist. 3-Chair
2IPage
Jamestown S'Klallam Tribe
1
ko04 ISLAND REFDungeness & 0 Gce.
z L rn
Protection Island i
li i .
in1IildlifeaNato
ishr ,../ N
4
fy-
J f U2- /..... .. . , .Refuges FY2425
On Aug. 16, 2024,the Jamestown S'Klallam Tribe and U.S. Fish&Wildlife jp.a ® .es
Service entered into a historic co-stewardship agreement for the Dungeness
and Protection Island National Wildlife Refuges (NWRs).Over the past year,
S+ •,
1
the Tribe has worked diligently to fulfill objectives outlined in that agreement
and with the National Wildlife Refuge System, including:wildlife monitoring; gym_.
habitat restoration; community engagement;and cultural resource protection. ,
7"-&
MAJOR ACCOMPLISHMENTS
Advanced habitat restoration across Dungeness NWR (including the
Dawley Unit),and Protection Island NWR,improving more than six acres of ems'r.wetland,forest,prairie,and bluff habitats through invasive vegetation map-
ping,manual removal,and targeted pesticide application.
Sustained prairie restoration on Protection Island, maintaining existing
treated areas and supporting long-term recovery of culturally important and
wildlife dependent plant communities.
Conducted critical wildlife monitoring, including bird surveys, marine
mammal observations,and deployed autonomous wildlife monitoring
equipment.
Executed intensive European green crab trapping,capturing over 1,650
crabs and informing regional management strategies.a j
Delivered public use,outreach,and education programs,strengthen-
t
ing community awareness of cultural values,wildlife protection,and refuge r ,
stewardship.
Expanded the volunteer program, recruiting new volunteers,complet-
ing orientations,and supporting hundreds of hours of on-the-ground work 111410111111
in restoration, public engagement,and refuge operations.
Completed key facilities and maintenance projects, including:
Deferred maintenance repairs on the Protection Island NWR access road iitt -_
Concrete installation for the Dungeness NWR pit toilets
Repairs to the Protection Island NWR marina dock
Strengthened partnerships and co-management,deepening coordi-
nation between Tribal refuge staff and conservation partners to support t
restoration,monitoring,and community outreach.
z
Pun ner r Z . Prot ction Irlind
National Wildlife Refuges FY24-25
HABITAT RESTORATION WILDLIFE SCIENCE AND INVASIVE SPECIES PUBLIC USE AND
AND STEWARDSHIP RESEARCH MANAGEMENT: EDUCATION
Across the Dungeness NWR Wildlife monitoring remained EUROPEAN GREEN CRAB The Tribe expanded the
and Protection Island NWR, a central component of the The Tribe began monitor- refuge's public outreach
the Jamestown S'Klallam Refuge Management Pro-ing and controlling inva-and education initiatives
Tribe's Refuge Management gram's stewardship respon- sive European green crab to strengthen community
Program focused on inva- sibilities.Monitoring efforts ("EGC")at Dungeness NWR connections and promote
sive species control,habitat focused on documenting pop- in 2025,expanding upon stewardship of the refug-
restoration and small-scale ulation trends,habitat use, USFWS efforts to protect the es'cultural and ecological
enhancement of wetland, and species presence across bay's ecological unction and resources.These initiatives
forest,grassland,and prairie the Dungeness and Protection native species.Tribal and re- play an key role in support-
habitats. Island NWRs. gional EGC catch data high- ing refuge protection,foster-
acres of habitat enhanced
2 0 game cameras installed on lighted a need for expanded ing community engagement,2 0+ or being actively restored Protection Island NWR efforts at Dungeness for the and uplifting the Tribe's
lbs.of creosote •Conducted seasonal surveys of pri-
3 0 2025 field season.leadership in conservation.0 0 0+ logs removed ority wildlife,including:Pacific Flyway
Shorebird,Wintering Waterfowl,Brant,
1 64 3 EGC captured between 2 4 6 4 people reached at
1 7 species of native seed used Surface-nesting seabird and Deer Count April-September various hosted events
in restoration projects surveys; Christmas Bird Count;and
acres of refuge surveyed for
invasive vegetation
Purple Martin Breeding Success Survey
increase from Education,presentation,and
200 on Protection Island
148 6% 2024 trapping 2.7 outreach events
Conducted comprehensive invasive •
Conducted and assisted with monthly •Implemented intensive EGC trapping 75 00 n Visitors hosted at
Coastal Observation and Seabird Sur- and monitoring program across three J Dungeness NWR
vegetation mapping.
veyTeam(Dungeness Spit)and pigeon keysites on Dungeness Spit Developed electronic a
Held multiple work parties to manually
g p ) g P P payment en
guillemot(Dungeness NWR)surveys •Conducted targeted high-effort trap- trance fee available at Dungeness NWR
remove priority invasive vegetation.
Deployed automated recordingunits pingsessionsPartneredwithWashingtonConser-during peak activity,as (through recreation.gov)
vation Corps on invasive vegetation (
ARU)to record avian and nocturnal well as late fall and winter EGC trap- •Improved visitor services(enhanced
and debris removal across all sites.
wildlife presence and improve detec- ping once per month(October-March) safety messaging)and increased staff
tion rates across both refuges. by boat.presence during high-use periods.
VOLUNTEER PROGRAM FACILITIES AND GENERAL REFUGE
Volunteers continued to play MAINTENANCE OPERATIONS
a vital role in refuge opera- The Refuge Management Throughout the year,Tribal
tions,providing meaningful Program maintained essen- staff provided consistent
support to stewardship, tial infrastructure and facili- on-the-ground presence,
restoration,and public en- ties across Dungeness NWR coordinated field activities,
gagement efforts. The Tribe and Protection Island NWR maintained facilities and
integrated longtime Refuge to ensure safe operations, equipment,and ensured
volunteers with newly re-support habitat and wildlife compliance with refuge
cruited,and volunteers of the management,and provide regulations.These core
Dungeness River Nature Cen- access (public and private). functions supported every
ter,creating the well-designed Maintenance focused on major program area,from
Dungeness Nature Alliance. routine upkeep,safety restoration and wildlife
40 new volunteers added from improvements,and targeted monitoring to public use,
two recruitment events repairs that support both volunteer coordination,and
200
registered volunteers with
Dungeness Nature Alliance
staff and visitor needs. invasive species control—
Completed deferred maintenance ensuring safe,efficient,and
4,800 total volunteer hours repairs of the Protection Island NWR uninterrupted operation at
contributed access road,improving access and safety.
Hosted eight volunteer training Completed concrete installation for the
both refuges.
courses in interpretation,safety,cul- pit toilets at Dungeness NWR enhancing
tural resources,European green crab sanitation infrastructure for visitors.
trapping,kiosk hosting Completed needed repairs to the
Hosted monthly volunteer socials and Protection Island NWR marina dock
five"idea-sharing"events Clean-up of Dawley Tract to remove
Provided on-site mentoring and skill debris,deteriorating well house and
development for volunteers storage shed,chain link fencing.
p ,0NM/Wssj Board of County Commissionerssc
4w OOP 1820 Jefferson Street
tel PO Box 1220
Port Townsend, WA 98368
co- Heather Dudley-Nollette,District 1 Heidi Eisenhour,District 2 Greg Brotherton,District 3SNING''
May 26,2026
Senator Maria Cantwell
717 Senate Hart Bldg
Washington, D.C. 20510
RE: Support for The Jamestown S'Klallam Tribe Land Transfer Act of 2026
Dear Senator Cantwell:
On behalf of Jefferson County, Washington, we write to express the County's support for"The
Jamestown S'Klallam Tribe Land Transfer Act of 2026,"legislation that would transfer former
National Wildlife Refuge lands, comprising the Dungeness and Protection Island National Wildlife
Refuges, to the Bureau of Indian Affairs to be held in trust for the Jamestown S'Klallam Tribe.
The Tribe is a highly collaborative and well-respected partner to Jefferson County, and we recognize
the deep historical and cultural connections that the Tribe maintains with the lands and waters
impacted by this legislation. These sites are not only central to the Tribe's heritage but are also integral
to the ecological health and quality of life for our entire region. Protection Island, located within
Jefferson County, is of particular importance to our constituents. The island provides critical nesting
habitat for tufted puffins, rhinoceros auklets, glaucous-winged gulls and many other species of
seabirds and raptors. The waters surrounding Protection Island also provide essential grounds for a
variety of marine mammals, and the island's shorelines support a WA Department of Natural
Resources designated marine aquatic reserve .
Because Protection Island holds such extraordinary ecological significance, it is a source of significant
regional pride for both the Tribe and the broader Jefferson County community. The Tribe maintains
profound historical and cultural ties to the island and the surrounding waters. The land transfer
legislation recognizes the Tribe's longstanding connections and represents an important step toward
restoring ancestral connections and honoring the Tribe's sovereign relationship with Protection Island.
Through the Tribe's 2024 self-governance agreement with the U.S. Fish and Wildlife Service and its
expenditure of its own supplemental funds,the Tribe has demonstrated a strong financial commitment
to improving Protection Island for the benefit of researchers and the greater Jefferson County area
alike. Since assuming management of the island, the Tribe has already revitalized habitat research
studies, rebuilt the access road, and initiated vegetative management to support island prairie habitat.
11Page
We are confident that upon transfer into trust status, the Tribe will continue to manage both former
Refuges to a standard that will meet or exceed federal requirements. Jefferson County has familiarity
with the Tribe's ability to manage lands through the Tamanowas Rock Sanctuary and trail network,
which are open to the public and well monitored by the Tribe. Jamestown S'Klallam Tribe and
Jefferson County Land Trust partnered on the acquisition of Tamanowas Rock sanctuary lands from
2009—2012 and the area showcases the Tribe's ability to steward lands for cultural purposes,
conservation and public access.
The County further notes that Protection Island is not currently subject to local property taxation as
federal public land and if the island is transferred into trust status on behalf of the Tribe, it will not
result in any loss of property tax revenue to the County. However,the Tribe has agreed to assume
through the legislation the U.S. Fish and Wildlife Service's existing obligations to Jefferson County for
payment in lieu of taxes and refuge revenue sharing, at a prorated rate tied to the federal statutory
payment rate,to ensure that the County will continue to receive these valuable payments following
transfer. This is a key consideration in the Board of County Commissioner's decision to support the
legislation, and the County is pleased that the land transfer is structured to protect Jefferson County
from any potential negative fiscal impact.
For these reasons, Jefferson County respectfully urges the delegation to support and advance"The
Jamestown Land Transfer Act of 2026."We appreciate your consideration of this legislation and your
ongoing commitment to constructive and locally-driven solutions that will benefit Tribal Nations and
all residents within the State of Washington.
Sincerely,
Heather Dudley-Nollette, Dist. 1 Heidi Eisenhour, Dist. 2 Greg Brotherton, Dist. 3-Chair
Wage
Jamestown S'Klallam Tribe r
NV, T°-
1\O ISLgfy0 kDungenesso F
rF
2
i n IslandProtecto
NationalWildhte
Refuges FY24- 25
1.
On Aug. 16, 2024,the Jamestown S'Klallam Tribe and U.S. Fish &Wildlife Aiwa
Service entered into a historic co-stewardship agreement for the Dungeness
and Protection Island National Wildlife Refuges (NWRs).Over the past years •,,
the Tribe has worked diligently to fulfill objectives outlined in that agreement
and with the National Wildlife Refuge System,including:wildlife monitoring;
habitat restoration; community engagement; and cultural resource protection. 4,
AMAJORACCOMPLISHMENTSss
Advanced habitat restoration across Dungeness NWR (including the 4. f .
Dawley Unit),and Protection Island NWR,improving more than six acres of f -
wetland,forest,prairie,and bluff habitats through invasive vegetation map- fir» •..,r`•
ping,manual removal,and targeted pesticide application.
Sustained prairie restoration on Protection Island,maintaining existing
treated areas and supporting long-term recovery of culturally important and 4
wildlife dependent plant communities.
Conducted critical wildlife monitoring, including bird surveys, marine
mammal observations,and deployed autonomous wildlife monitoring e, '
equipment.
Executed intensive European green crab trapping,capturing over 1,650
lir
crabs and informing regional management strategies. j
Delivered public use,outreach,and education programs,strengthen-
ing community awareness of cultural values,wildlife protection,and refuge
stewardship.
Expanded the volunteer program, recruiting new volunteers, complet-4 ` `
ing orientations,and supporting hundreds of hours of on-the-ground work
in restoration,public engagement, and refuge operations.
s
Completed key facilities and maintenance projects,including:
Deferred maintenance repairs on the Protection Island NWR access road
Concrete installation for the Dungeness NWR pit toilets t.-
Repairs to the Protection Island NWR marina dock
Strengthened partnerships and co-management,deepening coordi-
nation between Tribal refuge staff and conservation partners to support
restoration,monitoring,and community outreach. i
Dung ness & Prot ction Island
National Wildlife Refuges FY24-25
HABITAT RESTORATION WILDLIFE SCIENCE AND INVASIVE SPECIES PUBLIC USE AND
AND STEWARDSHIP RESEARCH MANAGEMENT: EDUCATION
Across the Dungeness NWR Wildlife monitoring remained EUROPEAN GREEN CRAB The Tribe expanded the
and Protection Island NWR, a central component of the The Tribe began monitor- refuge's public outreach
the Jamestown S'Klallam Refuge Management Pro-ing and controlling inva-and education initiatives
Tribe's Refuge Management gram's stewardship respon- sive European green crab to strengthen community
Program focused on inva- sibilities.Monitoring efforts ("EGC")at Dungeness NWR connections and promote
sive species control,habitat focused on documenting pop- in 2025,expanding upon stewardship of the refug-
restoration and small-scale ulation trends,habitat use, USFWS efforts to protect the es'cultural and ecological
enhancement of wetland, and species presence across bay's ecological unction and resources.These initiatives
forest,grassland,and prairie the Dungeness and Protection native species.Tribal and re- play an key role in support-
habitats. Island NWRs. gional EGC catch data high- ing refuge protection,foster-
acres of habitat enhanced game cameras installed on lighted a need for expanded ing community engagement,
2 0+ or being actively restored 2 0 Protection Island NWR efforts at Dungeness for the and uplifting the Tribe's
3 0,0 0 0
Conducted seasonal surveys of pri- 2025 field season.leadershipIbs.ofcreosotein conservation.
logs removed ority wildlife,including:Pacific Flyway
Shorebird,Wintering Waterfowl,Brant,
1/6 4 3 EGC captured between 2 4644 people reached at
7 species of native seed used Surface-nestingseabird and Deer Count April-September various hosted events
1 / + in restoration projects surveys; Christmas Bird Count;and
Education,presentation,and
Purple Martin BreedingSuccess Surveyincrease from 2 9
200
acres of refuge surveyed for 4 8 6% 2024 trapping outreach events
invasive vegetation on Protection Island
Conducted and assisted with monthly •Implemented intensive EGC trapping
J
7[ 0 O n Visitors hosted at
Conducted comprehensive invasive Coastal Observation and Seabird Sur- and monitoring program across three / Dungeness NWR
vegetation mapping. vey Team(Dungeness Spit)and pigeon key sites on Dungeness Spit Developed electronic payment en-
Held multiple work parties to manually guillemot(Dungeness NWR)surveys •Conducted targeted high-effort trap- trance fee available at Dungeness NWR
remove priority invasive vegetation.
Partnered with Washington Conser=
Deployed automated recording units ping sessions during peak activity,as (through recreation.gov)
ARU)to record avian and nocturnal well as late fall and winter EGC trap- •Improved visitor services(enhanced
vation Corps on invasive vegetation
wildlife presence and improve detec- ping once per month(October-March) safety messaging)and increased staff
and debris removal across all sites.
tion rates across both refuges. by boat. presence during high-use periods.
VOLUNTEER PROGRAM FACILITIES AND GENERAL REFUGE
Volunteers continued to play MAINTENANCE OPERATIONS
a vital role in refuge opera- The Refuge Management Throughout the year,Tribal
tions,providing meaningful Program maintained essen- staff provided consistent
support to stewardship, tial infrastructure and facili- on-the-ground presence,
restoration,and public en- ties across Dungeness NWR coordinated field activities,
gagement efforts. The Tribe and Protection Island NWR maintained facilities and
integrated longtime Refuge to ensure safe operations, equipment,and ensured
volunteers with newly re-support habitat and wildlife compliance with refuge
cruited,and volunteers of the management,and provide regulations.These core
Dungeness River Nature Cen- access (public and private). functions supported every
ter,creating the well-designed Maintenance focused on major program area,from
Dungeness Nature Alliance. routine upkeep,safety restoration and wildlife
new volunteers added from improvements,and targeted monitoring to public use,40 two recruitment events repairs that support both volunteer coordination,and
20 0
registered volunteers with staff and visitor needs. invasive species control—
Dungeness Nature Alliance ensuringsafe,efficient,andCompleteddeferredmaintenance
4,800
total volunteer hours
repairs of the Protection Island NWR uninterrupted operation at
contributed access road,improving access and safety.
Hosted eight volunteer training Completed concrete installation for the
both refuges.
courses in interpretation,safety,cul- pit toilets at Dungeness NWR enhancing
tural resources,European green crab sanitation infrastructure for visitors.
trapping,kiosk hosting Completed needed repairs to the
Hosted monthly volunteer socials and Protection Island NWR marina dock
five"idea-sharing"events Clean-up of Dawley Tract to remove
Provided on-site mentoring and skill debris,deteriorating well house and
development for volunteers storage shed,chain link fencing.
CoofNMssrBoardofCountyCommissioners
4w¢
S c°
U o,1820 Jefferson Street
o ti PO Box 1220
Port Townsend, WA 98368
y O Heather Dudley-Nollette,District 1 Heidi Eisenhour,District 2 Greg Brotherton,District 3NINGS
May 26,2026
Senator Patty Murray
2988 Jackson Federal Building 915
2nd Ave, Seattle,WA 98174
RE: Support for The Jamestown S'Klallam Tribe Land Transfer Act of 2026
Dear Senator Cantwell and Representative Randall:
On behalf of Jefferson County, Washington, we write to express the County's support for"The
Jamestown S'Klallam Tribe Land Transfer Act of 2026,"legislation that would transfer former
National Wildlife Refuge lands, comprising the Dungeness and Protection Island National Wildlife
Refuges, to the Bureau of Indian Affairs to be held in trust for the Jamestown S'Klallam Tribe.
The Tribe is a highly collaborative and well-respected partner to Jefferson County,and we recognize
the deep historical and cultural connections that the Tribe maintains with the lands and waters
impacted by this legislation. These sites are not only central to the Tribe's heritage but are also integral
to the ecological health and quality of life for our entire region. Protection Island, located within
Jefferson County, is of particular importance to our constituents. The island provides critical nesting
habitat for tufted puffins, rhinoceros auklets, glaucous-winged gulls and many other species of
seabirds and raptors. The waters surrounding Protection Island also provide essential grounds for a
variety of marine mammals, and the island's shorelines support a WA Department of Natural
Resources designated marine aquatic reserve .
Because Protection Island holds such extraordinary ecological significance, it is a source of significant
regional pride for both the Tribe and the broader Jefferson County community. The Tribe maintains
profound historical and cultural ties to the island and the surrounding waters. The land transfer
legislation recognizes the Tribe's longstanding connections and represents an important step toward
restoring ancestral connections and honoring the Tribe's sovereign relationship with Protection Island.
Through the Tribe's 2024 self-governance agreement with the U.S. Fish and Wildlife Service and its
expenditure of its own supplemental funds, the Tribe has demonstrated a strong financial commitment
to improving Protection Island for the benefit of researchers and the greater Jefferson County area
alike. Since assuming management of the island, the Tribe has already revitalized habitat research
studies, rebuilt the access road, and initiated vegetative management to support island prairie habitat.
Wage
We are confident that upon transfer into trust status,the Tribe will continue to manage both former
Refuges to a standard that will meet or exceed federal requirements. Jefferson County has familiarity
with the Tribe's ability to manage lands through the Tamanowas Rock Sanctuary and trail network,
which are open to the public and well monitored by the Tribe. Jamestown S'Klallam Tribe and
Jefferson County Land Trust partnered on the acquisition of Tamanowas Rock sanctuary lands from
2009—2012 and the area showcases the Tribe's ability to steward lands for cultural purposes,
conservation and public access.
The County further notes that Protection Island is not currently subject to local property taxation as
federal public land and if the island is transferred into trust status on behalf of the Tribe, it will not
result in any loss of property tax revenue to the County. However, the Tribe has agreed to assume
through the legislation the U.S. Fish and Wildlife Service's existing obligations to Jefferson County for
payment in lieu of taxes and refuge revenue sharing, at a prorated rate tied to the federal statutory
payment rate, to ensure that the County will continue to receive these valuable payments following
transfer. This is a key consideration in the Board of County Commissioner's decision to support the
legislation, and the County is pleased that the land transfer is structured to protect Jefferson County
from any potential negative fiscal impact.
For these reasons,Jefferson County respectfully urges the delegation to support and advance"The
Jamestown Land Transfer Act of 2026."We appreciate your consideration of this legislation and your
ongoing commitment to constructive and locally-driven solutions that will benefit Tribal Nations and
all residents within the State of Washington.
Sincerely,
Heather Dudley-Nollette, Dist. 1 Heidi Eisenhour, Dist.2 Greg Brotherton, Dist. 3-Chair
21Page
itJamestownS'Klallam Tribe GS' °
n ISLANp irEFDungeness f
h
Protection Island lei
i n 1 %VildlifeNatoa w 5._
t :
1Y24-25
Itiv,11014 .R f seuse
On Aug. 16, 2024,the Jamestown S'Klallam Tribe and U.S. Fish &Wildlife airj . . .Service entered into a historic co-stewardship agreement for the Dungeness
and Protection Island National Wildlife Refuges (NWRs).Over the past year;
f
4
the Tribe has worked diligently to fulfill objectives outlined in that agreement
and with the National Wildlife Refuge System, including:wildlife monitoring;
habitat restoration; community engagement;and cultural resource protection. „
1/4.
14, .,4r4,44;
4t- ',.,44-
4,.
7.0,44. it.4.144.,":7,444.,„L;i i -:04.-.4„,.„:
MAJOR ACCOMPLISHMENTS
x
Advanced habitat restoration across Dungeness NWR (including the
Dawley Unit),and Protection Island NWR,improving more than six acres of
wetland,forest,prairie,and bluff habitats through invasive vegetation map-
ping,manual removal,and targeted pesticide application.
Sustained prairie restoration on Protection Island, maintaining existing
treated areas and supporting long-term recovery of culturally important and
wildlife dependent plant communities.
Conducted critical wildlife monitoring, including bird surveys, marine
mammal observations,and deployed autonomous wildlife monitoring
equipment.
Executed intensive European green crab trapping,capturing over 1,650
crabs and informing regional management strategies.
AP
Delivered public use,outreach,and education programs,strengthen
ing community awareness of cultural values,wildlife protection,and refuge
stewardship.
Expanded the volunteer program, recruiting new volunteers, complet
ing orientations, and supporting hundreds of hours of on-the-ground work i
in restoration, public engagement, and refuge operations. t
Completed key facilities and maintenance projects,including:
Deferred maintenance repairs on the Protection Island NWR access road
t"'-- '" .:.,, ,.sk
Concrete installation for the Dungeness NWR pit toilets if
Repairs to the Protection Island NWR marina dock
Strengthened partnerships and co-management,deepening coordi-
nation between Tribal refuge staff and conservation partners to support
restoration,monitoring,and community outreach.
Dung ner : k. Prot coon I: lind
National Wildlife Refuges FY24-25
HABITAT RESTORATION WILDLIFE SCIENCE AND INVASIVE SPECIES PUBLIC USE AND
AND STEWARDSHIP RESEARCH MANAGEMENT: EDUCATION
Across the Dungeness NWR Wildlife monitoring remained EUROPEAN GREEN CRAB The Tribe expanded the
and Protection Island NWR, a central component of the The Tribe began monitor- refuge's public outreach
the Jamestown S'Klallam Refuge Management Pro-ing and controlling inva-and education initiatives
Tribe's Refuge Management gram's stewardship respon- sive European green crab to strengthen community
Program focused on inva- sibilities.Monitoring efforts ("EGC")at Dungeness NWR connections and promote
sive species control,habitat focused on documenting pop- in 2025,expanding upon stewardship of the refug-
restoration and small-scale ulation trends,habitat use, USFWS efforts to protect the es'cultural and ecological
enhancement of wetland, and species presence across bay's ecological unction and resources.These initiatives
forest,grassland,and prairie the Dungeness and Protection native species.Tribal and re- play an key role in support-
habitats. Island NWRs. gional EGC catch data high- ing refuge protection,foster-
2 0
acres of habitat enhanced
20 game cameras installed on lighted a need for expanded ing community engagement,
or being actively restored Protection Island NWR efforts at Dungeness for the and uplifting the Tribe's
Conducted seasonal surveys of pri- 202 S field season.leadershiplbs.of creosote in conservation.3 0 0 0 0+ logs removed ority wildlife,including:Pacific Flyway
Shorebird,Wintering Waterfowl,Brant,
1 6433 EGC captured between 2 4 6 4 people reached at
species of native seed used Surface-nesting seabird and Deer Count ) April-September various hosted events17+ in restoration projects surveys; Christmas Bird Count;and
acres of refuge surveyed for Purple Martin Breeding Success Survey 1 4 8 6 ,o,
increase from Education,presentation,and
invasive vegetation on Protection Island
2024 trapping 2 9
200 outreach events
Conducted comprehensive invasive •
Conducted and assisted with monthly •Implemented intensive EGC trapping 7[
J O O n Visitors hosted at
Coastal Observation and Seabird Sur- and monitoring program across three / V Dungeness NWR
vegetation mapping. veyTeam(Dungeness Spit)and pigeon keysites on Dungeness Spit Developed electronic a
Held multiple work parties to manually
g p ) p g g p D p payment en
guillemot(Dungeness NWR)surveys •Conducted targeted high-effort trap- trance fee available at Dungeness NWR
remove priority invasive vegetation.
Deployed automated recording units ping sessions during peak activity,as (through recreation.gov)
Partnered with Washington Conser- (
ARU)to record avian and nocturnal well as late fall and winter EGC trap- •Improved visitor services(enhanced
vation Corps on invasive vegetation
wildlife presence and improve detec- ping once per month(October-March) safety messaging)and increased staffanddebrisremovalacrossallsites.
tion rates across both refuges. by boat.presence during high-use periods.
VOLUNTEER PROGRAM FACILITIES AND GENERAL REFUGE
Volunteers continued to play MAINTENANCE OPERATIONS
a vital role in refuge opera- The Refuge Management Throughout the year,Tribal
tions,providing meaningful Program maintained essen- staff provided consistent
support to stewardship, tial infrastructure and facili- on-the-ground presence,
restoration,and public en- ties across Dungeness NWR coordinated field activities,
gagement efforts. The Tribe and Protection Island NWR maintained facilities and
integrated longtime Refuge to ensure safe operations, equipment,and ensured
volunteers with newly re-support habitat and wildlife compliance with refuge
cruited,and volunteers of the management,and provide regulations.These core
Dungeness River Nature Cen- access (public and private). functions supported every
ter,creating the well-designed Maintenance focused on major program area,from
Dungeness Nature Alliance. routine upkeep,safety restoration and wildlife
new volunteers added from improvements,and targeted monitoring to public use,4 0 two recruitment events repairs that support both volunteer coordination,and
200 registered volunteers with
Dungeness Nature Alliance
staff and visitor needs. invasive species control—
Completed deferred maintenance ensuring safe,efficient,and
4,800 total volunteer hours repairs of the Protection Island NWR uninterrupted operation at
contributed access road,improving access and safety.
Hosted eight volunteer training Completed concrete installation for the
both refuges.
courses in interpretation,safety,cul- pit toilets at Dungeness NWR enhancing
tural resources,European green crab sanitation infrastructure for visitors.
trapping,kiosk hosting Completed needed repairs to the
Hosted monthly volunteer socials and Protection Island NWR marina dock
five"idea-sharing"events Clean-up of Dawley Tract to remove
Provided on-site mentoring and skill debris,deteriorating well house and
development for volunteers storage shed,chain link fencing.