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f~C~~ JEFFERSON COUNTY PUBLIC HEALTH
..~-;::-,,, 615 Sheridan Street. Port Townsend' Washington' 98368
-'" ,0' www.jeffersoncountypublichealth.org
Consent Agenda
July 11, 2011
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: A1U}LiSi B I ;)..0 II
SUBJECT: Agenda Item - Professional Services Agreement - Elizabeth Hendricks,
LMHC, July 1, 2011 - June 30, 2012; $3,120
STATEMENT OF ISSUE:
Jefferson County Public Health, Developmental Disabilities Division, requests Board approval of the
Professional Services Agreement - Elizabeth Hendricks, lMHC, for Consulting, Group Counseling and
Technical Assistance to DD clients and Employment Staff; July 1, 2011- June 30, 2012; $3,120
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
People with developmental disabilities may have challenging behaviors, so a Positive Behavior Support Plan is
written to eliminate behavior and/or to develop and enhance positive behaviors to replace the challenging
behavior. Elizabeth Hendricks (Subcontractor) has the expertise to write a Positive Behavior Support Plan and
provide technical assistance around it. Elizabeth Hendricks will provide consulting, counseling services and
technical services to DD clients and Employment Staff.
Subcontractor will conduct a counseling group for up 8 individuals in Jefferson County and no less than 5
individuals, age 21 and older who are clients of the Division of Developmental Disabilities in Jefferson
County. The focus will be on social skills, impulse control skills, grief and loss, life transitions, anger
management and feelings identification, while employing various therapeutic techniques such as art
therapy, feeling identification cards and sharing life stories. Subcontractor will conduct a Women's Support
Group, meeting once a month, focusing on social skills, physical and emotional health, and issues of self
esteem. Subcontractor will provide consulting and technical assistance to Employment Staff discussing the
best way to support clients who have challenging behaviors.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This contract is funded through the biennium contract with DSHS, Developmental Disabilities Division.
COMMUNITY HEALTH
DEVELOPMENTAL DISABILITIES
MAIN: (360) 385-9400
FAX: (360) 385-9401
PUBLIC HEALTH
ALWAn WORKING fOR A SAfER AND
HEALTHIER COMMUNITY
ENVIRONMENTAL HEALTH
WATER QUALITY
MAIN: (360) 385-9444
FAX: (360) 379-4487
Consent Agenda
RECOMMENDATION:
JCPH management request approval of the Professional Services Agreement - Elizabeth Hendricks, LMHC,
July 1, 2011 - June 30, 2012; $3,120
REVIEW~E~ BY:
I -'
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Philip Morley, C ul}
A
7//.2-/((
Date
(Routed to all Public Health Managers)
PROFESSIONAL SERVICES AGREEMENT
BETWEEN
JEFFERSON COUNTY
AND
ELIZABETH HENDRICKS, LMHC
This agreement is entered into between the County of Jefferson, a municipal corporation, hereinafter
referred to as "the County" and Elizabeth Hendricks, LMHC hereinafter referred to as "the Subcontractor"
in consideration of the mutual benefits, terms, and conditions hereinafter specified.
Section I.
Section 2.
Section 3.
Section 4.
Desil!nation
The County, on behalf of the Jefferson County Public Health, the Developmental
Disabilities Program, acting in compliance under the Contract with Elizabeth Hendricks,
LMHC in agreement with the terms and conditions of the Statement of Work hereby
contracts with the Subcontractor to perform duties as described in Exhibit A.
Terms
This agreement shall commence on July 1,2011 and continue through June 30, 2012
unless terminated as provided herein. The agreement may be extended beyond June 30,
2012 upon mutual written consent of the County and the Subcontractor.
Scope of Al!reement
The Subcontractor agrees to perform the services, identified in Exhibit A.
A. The Subcontractor works for the Jefferson County Developmental Disabilities
Program to support its goals and objectives.
B. The specific duties of the Subcontractor are outlined in Exhibit A.
C. The Subcontractor shall provide reporting detailed in Section 10.
Compensation
The Subcontractor 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 the Subcontractor shall not exceed $65.00 an
hour for a lotal of$3,120 in the completion of this project without express
written amendment signed by both parties to this Agreement.
B. The Subcontractor may submit invoices to the County for work completed to
date. The County will review such invoices, and upon approval thereof, payment
will be made to the Subcontractor in the amount approved.
C. The total compensation to the Subcontractor is limited to the terms of this
Agreement.
D. The County will make final payment of any balance due the Subcontractor
promptly upon its ascertainment and verification after the completion of the work
under this agreement and its acceptance by the County.
Elizabrth Hendricks. LMHC Agreement
Page 1
Section S.
Section 6.
Section 7.
E. The Subcontractor records and accounts pertaining to this agreement are to be kept
available for inspection by representatives of the County and state for a period of
six (6) years after final payments. Copies shall be made available upon request.
F. Ownership and use of documents. The Subcontractor acknowledges and agrees
that any and all work product directly connected and/or associated with the services
rendered hereunder, including but not limited to all documents, drawings,
specifications, writings, samples, reports, pictures and the like which the
Subcontractor drafts, makes, conceives, develops in the performance of the service
hereunder, either solely and/or jointly with the County shall be the sole and
exclusive property of the County. The Subcontractor further acknowledges that
such material shall be considered work for hire and the Subcontractor
acknowledges the County's sole and exclusive right to such copyright, patent,
trademarks, trade names and other intellectual property right claims for said
materials. Other materials produced by the Subcontractor in connection with the
services rendered under this agreement shall be the property of the County whether
the projects for which they are made are executed or not. The Subcontractor shall
be permitted to retain copies, including reproducible copies, of drawings, writings,
samples, reports, and specifications for information, reference, and use in
connection with Subcontractor endeavors. The Subcontractor agrees not to
publish, submit for publication, display or otherwise use said material for any
reason whatsoever, without the express written consent of the County.
Comoliance with laws
The Subcontractor 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.
Indemnification
The Subcontractor shall indemnify, defend and hold harmless the County, its officers,
agents and employees, from and against any and all claims, lawsuits, demands for money
damages, losses or liability, or any portion thereof, including attorney's fees and costs.
arising from any injury to person or persons (including the death or injury of the
Subcontractor or damage to personal property) if said injury or damage was caused by the
negligent acts or omissions of the Subcontractor.
Insurance
The Subcontractor shall obtain and keep in force during the terms of the Agreement, or as
otherwise required.
A. Commercial Automobile Liability Insurance providing bodily injury and property
damage liability converge 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. Contractor shall provide proof of insurance to the County in care of
Developmental Disabilities County Coordinator at Jefferson County Public Health,
Developmental Disabilities Program, 6 I 5 Sheridan St. Port Townsend. W A 98368
prior to commencing employment.
B. Professional Liability Insurance providing $ J ,000,000 per incident;
$2,000,000 aggregate. Contractor shall name Jefferson County Public Health as
Elizabetb Hendricks LMHC Agreement
Page 2
Section 8.
Section 9.
Section 10.
Section 11.
additional insured and provide proof of insurance to the County in care of
Developmental Disabilities County Coordinator at the address previously listed.
C. All employees or subcontractors of Subcontractor who are required to be
professionally licensed or certified by the State in the performance of services
under this agreement shall maintain professional liability insurance in the amount
of not less than one million dollars ($1,000,000). In no case shall such professional
liability to third parties be limited in any way.
D. Worker's Compensation and employer's liability insurance as required by the
State of Washington.
E. It is agreed by the parties that 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 listed above shall
protect both parties and be primary coverage for any and all losses covered by the
above-listed insurance policies. It is further agreed by the parties that any and
all deductibles made part of the above-listed insurance policies shall be assumed
by, paid for and at the risk of the Subcontractor,
Indenendence
The Subcontractor and the County agree that the Subcontractor is an independent
Subcontractor with respect to the services provided pursuant to this agreement. Nothing
in this agreement shall be considered to create the relationship of employer and employee
between the parties hereto. The Subcontractor shall not be entitled to any benefits
accorded County employees by virtue of the services provided under this agreement. 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 employee,
Assil!Dments and Subcontractin1!
The Subcontractor may sublet or assign any of the services covered by this agreement but
only with the express written consent of the County.
Reportin1!
The Subcontractor will provide a monthly report to the County. The monthly report shall
contain a brief summary of the work performed, relationship to the tasks identified in
Exhibit A and the total hours worked. The monthly report shall be submitted to
Jefferson County Public Health in care of the Developmental Disabilities County
Coordinator, 615 Sheridan, Port Townsend, and W A 98368.
Termination
A. The County reserves the right to terminate this contract in whole or in part, without
prior written notice, in the event that expected or actual funding from any funding
source is withdrawn, reduced, or limited in any way after the effective date of this
agreement. In the event of termination under this clause. the County shall be liable
for only payment for services rendered prior to the effective date of termination.
B. This agreement may also be terminated as provided below:
1. With 14 days notice by the Board of County Commissioners for any
Reason. or
Elizabeth .Iendrlcks LMHC Agreement
Page 3
2. With 14 days notice by the Board of County Commissioners for non-
perfonnance of the specific job duties in Exhibit A.
3. With 14 days notice by the Subcontractor by voluntary resignation.
Section 12.
Modification
This employment agreement may be modified at any time by written agreement of both
parties.
Section 13.
Intel!rated Al!reement
This Agreement together with attachments or addenda represents the entire and integrated
agreement between the County and the Subcontractor and supersedes all prior
negotiations, representations, or agreements written or oral between the parties. This
agreement may be amended only by written instrument signed by both County and
Subcontractor.
Approved this day of
BOARD OF COUNTY COMMISSIONERS
JEFFERSON COUNTY, WASHINGTON
.2011.
John Austin, Chairman
t:\i:
) Un t\C-
ATTEST:
Clerk of the Board
By: ~
Jefferson County Deputy Prosecuting Att
1)19
Z'J/1
EI1:z.abtth Hendricks LMHC Agreement
Page 4
EXHIBIT A
STATEMENT OF WORK
ELIZABETH HENDRICKS, LMHC
I. WORK STATEMENT
The Subcontractor will provide Positive Behavior Supports consulting and technical assistance to
Employment Staff, on how to best help their clients with significant behavioral issues who are involved in
County Supported Employment or Person to Person services. The Subcontractor will conduct counseling
groups for individuals age 21 and older who are clients of the Division of Developmental Disabilities, in
order to increase their ability to successfully enter the workforce or to be successful in current places of
employment.
II. PROGRAM DESCRIPTION
A. Tasks
I. The Subcontractor may provide Positive Behavior Supports consulting and technical assistance to
Employment Staff on how to best help their clients with significant behavioral issues who are
involved in County supported Employment or Person to Person services for up to 12 hours from July
2011 to June 2012.
2. Conduct a counseling group for up eight individuals and no less than five individuals age 21 and older
who are clients of the Division of Developmental Disabilities in Jefferson County. The group will
meet two times a month for one hour, but can bill up to two hours, (the first hour for counseling the
second half.hour for set up, take down and documentation), from July 2011 to June 2012.
This counseling group will focus on the following topics in order to increase their ability to
successfully enter the workforce or to be successful in current places of employment:
. Social skills
. Impulse control skills
. Grief and loss
. Life transitions
. Anger management
. Feelings identification
The Subcontraetor will employ some or all of the following therapeutic techniques:
. Art therapy
. Feeling identification cards
. Sharing life stories
. Therapeutic games
. Group cohesion exercises
. Role play
Elizabeth Hendricks LMHC AKreeraent
Page 5
3. Conduct a Women's Support Group designed for up eight women with no less than four individuals
age 21 and older who are clients of the Division of Developmental Disabilities in Jefferson County.
The group will meet once a month for one hour, but can bill up to two hours, (the first hour for
counseling the second half-hour for set up, take down and documentation), from July 2011 to June
2012. Instructional handouts and other materials, therapeutic games and art will be employed to assist
participants in meeting employment goals.
This counseling group will focus on the following topics in order to increase their ability to
successfully enter the workforce or to be successful in current places of employment:
. Social skills
. Physical and emotional health by addressing relationship issues
. Issues of self esteem
. Assertiveness and anger control
. Sexuality and healthy lifestyles
. Role play
. Sharing life stories and experiences
4. Subcontractor will meet with clients after informing and receiving permission from the DDD case
managers .
B, Requirements
1. Provide up to 8 hours of Positive Behavior Supports consulting and technical assistance to
Employment Staff, on how to best support their clients who have challenging behaviors and are
involved with Employment or Person to Person services.
2. Provide group counseling services, two times a month, but can bill up to two hours, (one hour for
counseling the second hour for set up, take down and documentation), for twelve months, for a
total of 48 hours from July 2010 to June 2011, to a minimum of five individuals who are served by
the Division of Developmental Disabilities who are 21 years of age or older and live in
Jefferson County.
3. Provide a Women's Support Group designed for up eight women with no less than four individuals
age 21 and older, who are clients of the Division of Developmental Disabilities in Jefferson County.
Once a month for one hour, but can bill up to two hours, (one hour for counseling & the second hour
for set up, take down and documentation), for ten months, for a total of20 hours from July 2010 to
June 2011.
4. Provide up to three hours of outreach in order to market group counseling services for people with
developmental disabilities who are 21 years of age or older and live in Jefferson County and provide
Positive Behavior Supports consulting and technical assistance to Employment Staff.
5. Meet or have a phone meeting with the DD Coordinator every month to discuss progress.
C. Reporting
I. Progress Reports for services providcd are due at the conclusion of each month with a separate invoice
for bi \I ing.
Elizsbeth Hendricks LMHC Agreement
Page 6
2, Quarterly Progress Reports for each Client who is receiving Services,
D. Perfonnanee Standards
1. The Subcontractor shall provide Services as defined in Tasks Section II. A above.
2, The Subcontractor will adhere to the Requirements as defined in Section II. C above.
3. The Subcontractor shall provide an invoice for services with documentation on a monthly basis.
Elizabeth ltendrlek5 LMItC Agreement
Page 7