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__ Consent Agenda
ON '
it1~,~('~\ JEFFERSON COUNTY PUBLIC HEALTH
. ~,~~~/ 615 Sheridan Street. Port Townsend' Washington' 98368
~",,,,O. www.Jeffel'8oncounlypubllchealth.org
September 30, 2011
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: Gc~ 10 I ~Il
SUBJECT: Agenda Item - Agency Agreement with Department of Social and
Health Services for Substance Prevention, #-963-68037, Amendment
#4; November 1, 2010 - June 30, 2011; -0-
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of the Agency Agreement with Department of SocIal
and Health Services for Substance Prevention, #-963-68037, Amendment #4; November 1, 2010-
June 30, 2011; -0-
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This Is an ongoing agreement with DSHS, DMslon of Alcohol and Substance Abuse (DASA). This contract
continues to support chemIcal dependency prevention services. Services are provided throughout the
community by partnerlng with other local agencies, which follows an approved prevention and Intervention
6-Year Plan written by JCPH, Community Mobilization/Jefferson County Community Network and Safe
Harbor Treatment and Recovery Center.
There was no reduction In JCPH funding for these program services. This amendment doses out the last
biennium.
FISCAL IMPACT/COST BENEFIT ANALYSIS=-
There Is no fiscal Impact to the department
COMMUNITY HEALTH
DEVELOPMENTAL DISABILmES
MAIN: (360) 385-9400
FAX: (360) 385-9401
PUBLIC HEALTH
AlWAYS WORKING FOR A SAFER AND
HEALTHIER COMMUNITY
ENVIRONMENTAL HEALTH
WATER QUALITY
MAIN: (360) 385-9444
FAX: (380)379-4487
"
Consent Agenda
RECOMMENDATION:
JCPH management request approval of the Agency Agreement with Department of Social and Health
Services for Substance Prevention, #-963-68037, Amendment #4; November I, 2010 - June 30, 2011; -0-
dJ/SiR
Date
(Routed to all Public Health Managers)
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This Contract Amendment is between the State of Washington Department of
Social and Health Services (DSHS) and the Contractor identified below.
CONTRACT AMENDMENT
DSHS CONTRACT NUMBER:
0963-68037
Amendment No. 0963-68037-04
Program Contract Number
Contractor Contract Number
CONTRACTOR doing business ss (DBA)
CONTRACTOR NAME
Jefferson County
CONTRACTOR ADDRESS
PO Box 1220
1820 Jefferson Street
Port Townsend, WA 98368
CONTRACTOR CONTACT
WASHINGTON UNIFORM
BUSINESS IDENTIFIER (UBI)
161-001-169
CONTRACTOR TELEPHONE CONTRACTOR FAX
OSHS CONTACT NAME AND TITLE
(360) 385-9408 Ext (360) 385-9401
DSHS DMSION
Division of Behavioral Health
and Recovery
DSHS CONTACT ADDRESS
Jean Baldwin
OSHS ADMINISTRATION
Aging and Disability Services Administration
Harvey Funai
Regional Administrator
400 Mercer Street, Suite 600
Seattle WA 98109-4641
DSHS CONTACT TELEPHONE DSHS CONTACT FAX
(206) 272-2156 Ext (206) 298-4443
IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT?
DSHS INDEX NUMBER
1223
CONTRACTOR E-MAIL ADDRESS
ibaldwin@co.lefferson.wa.us
OSHS CONTRACT CODE
4011 CS-63
DSHS CO,!,"ACT E-MAIL ADDRESS
funaihmrQldshs.wa.oov
CFDA NUMBERS
Yes
~~DMI'!~rnTAln DATE _ -
- -- .'>'c;,"--,'
93.959
..
Ce!l~G'L~NJ) DATE
',d_, ___ --.- _. ._' _....
-
tOTAL MAXIMUM CONTRACT AMOUNT
.$flM30.00 -
.
DATE SIGNED
DSHS SIGNATURE
PRINTED NAME AND TITLE
Eric Crawford, Senior Contracts Manaaer
DATE SIGNED
DSHS Central Contract Servlcss
6024PF Contract Amendment (3-31-06)
Approved as to fo~ only:
J)~ . aP~OILflUJJI
-lefferson Co. Proseollto~OmOO
Page 1
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This Contract between the State of Washington Department of Social and Health Services (DSHS) and the
Contractor is hereby amended as follows:
1. Purpose: Due to the forecasted budget shortfalls, through Executive Order 10-04, the Govemor
ordered across the board budget cuts. DSHS has determined it necassary to reduce the funding and
services provided under your current contract in order to meet the requirements of the order.
. 2. An allowable amount of Substance Abuse Prevention and Treatment (SAPT) block grant funds from
Fiscal Year 2010 are rolled-over to Fiscal Year 2011 (CFDA# 93.959).
3. The maximum consideration for the entire contract remains $65,430. All Funding changes described
above are identified on the attached A&R, Exhibit A.
All other terms and conditions of this Contract remain in full force and effect.
OSHS Central Contract Services
6024PF Contract Amendment (3-31-06)
Page 2
..... ...-~ ~
Exhlb~ A
AWARD AND REVENUES
2009-2011 Biennium
COUNlY Jefferson (Prevention)
PROGRAM AGREEMENT NUMBER 0963-68037
The above named Caunty(les), Is hereby awarded the fo/lowlng amaunts Jar the purposes listed
REVENUE
SOURCE
CODE:
TYPE OF SERVICE
AWARD AMOUNTS
State FIscal Year 2010 State Fiscal Year 2011 2009-11 Biennium
$32,440 $32,990 $65,430
$30,215 $30,215 $60,430
$2,225 $2,775 $5,000
$32,440 $32,990 $65,430
$0 $0 $0
$32,440 I $32,990 I $65,430 I
333.99.59
5APT Grant-In-Aid
Prevention
Community Prevention Training
Total Federal Funds
Total State Funds
ITOTAL ALL AWARD5
SAPT Grant-in-Aid -CFDA 93.959 Substance Abuse and Mental Health Services Administration (SAMHSA)
2009-11 Contract Amendment 4