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Consent Agenda
JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street. Port Townsend. Washington. 98368
www.jeffersoncountypubllchealth.org
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Oc:tDber 27, 2011
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
. TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: VtCU'V\b..VI -5 I 2-0\\
SUBJECT: Agenda Item - Contract Amendment with Olympic Educational Service
District 114 for School Nurse Corp Program, Amendment #2;
November 1, 2011 - January 31, 2012; add1 $2,063 total $34,527 plus
mileage
STATEMENT OF ISSUE:
Jefferson County Public Health, Community Health, Is requesting Board approval of the Contract Amendment
with Olympic Educational ServIce DIstrict 114 for School Nurse Corp Program, Amendment #2;
November 1, 2011 - January 31, 2012; add1 $2,063 total $34,527 plus mileage
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This Is an on"9olng agreement between Jefferson County Public Health and Olympic Educational Service
District 114 for school nurse services. This amendment funds additional school nursIng hours to the Brlnnon
and Qullcene School DIstricts from November 2011 through January 2012. This amendment will fund 4
health service hours per month (3 visits) to the Brlnnon School DIstrict and 6 health services hours every
other week (7 visits) to the Qullcene School District. Nursing staff mileage will also be reimbursed.
Jefferson County Public Health services Indude: assessment, referrals and follow-up of emergent care,
assess physical and emotional health needs, providing training, superviSion and consultation to school
personnel, IdentIfyIng resources for health care as requested, partldpatlon In MDT meetings, consultation In
communicable disease, assisting In development/revision of district health polldes & procedures Including
forms and records, consulting In ImmunIzation compliance, and providing mandated screenings programs.
COMMUNITY HEAlTH
DEVELOPMENTAL DISABILITIES
MAiN: 360385-9400
FAX: 36Q.385-9401
PUBLIC HEALTH
ALWAYS WORKING FOR A SAFER AND
HEALTHIER COMMUNITY
ENVIRONMENTAL HEALTH
WATER QUALITY
MAIN: 360385-9444
FAX: 36(}379-4487
Consent Agenda
FISCAL IMPACT ICOST BENEFIT ANALYSIS:
ThIs agreement wIll fund the addItional school health hours that we provide to Brlnnon and Qullcene
Schools from November 1, 2011 through January 2012.
RECOMMENDATION:
JCPH management request approval of the Contract Amendment wIth OlympIc Educational Service DIstrict
114 for School Nurse Corp Program, Amendment #2; November 1, 2011- January 31, 2012; add1 $2,063
total $34,527 plus mileage
I!IS/~
Date
(Routed to all Public Health Managers)
CONTRACT AMENDMENT 2011-12
Modification of Contract between the
Olympic Educational Service District 114, State of Washington
(hereinafter referred to as OESD)
and
Jefferson County Health Deoartment
(hereinafter referred to as Contractor)
Which commenced the I at day of November, 2011, and terminates the 31 st day of January, 2012.
For and in consideration of the mutual promises contained in this modification of contract, the OESD and
Contractor do mutually agree to modify the contract identified above as follows:
A. DUTIES OF OESD, The OESD agrees to amend the contract to read as follows,
Pay Contractor thirtyeight dollars and nineteen cents ($38.19) per hour to provide 4 health
services hours per month (3 visits) to the Brinnon School District, not to exceed $459.
Pay Contractor thirtyeight dollars and nineteen cents ($38.19) per hour to provide 6 hefllth
services hours every other week (7 visits) to the Quilcene School District, not to exceed $1,604.
Provide for reimbursement of nursing staff for mileage incurred in connection with provision of
above services at the rate of$.51/mile, not to exceed $300.
Brinnon mileage $116 (3 visits).
Quilcene mileage 180 (7 visits).
CONTRACTOR
OLYMPIC EDUCATIONAL
SERVICE DISTRICT 114
(Contractor Signature)
Who certifies that he/she is the
Contractor identified herein, or
in the alternative, a person duly
qualified and authorized to bind
the Contractor so identified to
the foregoing agreement.
Dr. Walt Bigby, Superintendent
Signed this day
of .2011.
Signed this day
of ,2011.
Approved as ta fO~ only:
~ . I ,Ill q }/J
Jefferson Co. Prosecu 's Office
OESD USE ONLY
PURCHASE ORDER NO.
3601112013
.
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CONTRACT AMENDMENT 2011-12
Modification of Contract between the Olympic Educational Service District 114, State of Washington
(hereinafter referred to as OESD)
and
Jefferson County Health Denartment
(hereinafter referred to as Contractor)
Which commenced the 29tbday of August. 2011, and terminates the October 31, 2011.
For and in consideration of the mutual promises contained in this modification of contract, the OESD
and Contractor do mutually agree to modify the contract identified above as follows:
A. DUTIES OF OESD, The OESD agrees to amend the contract to read as follows,
Pay Contractor thirty-eight dollars and nineteen cents ($38.19) per hour to provide 4
health services hours per month (2 visits) to the Brinnon School District, not to exceed
$306.
Pay Contractor thirty-eight dollars and nineteen cents ($38.19) per hour to provide 6
health services hours every other week (5 visits) to the Quilcene School District, not to
exceed $ 1,146.
Providefor reimbursement of nursing stafffor mileage. incurred in connection with
provision of above services at the rate of$.51/mile, not to exceed $210.
Brinnon mileage $77 (2 visits).
Quilcene mileage $128.40 (5 visits).
CONTRACTOR
($~
Who certifies that he/she is the
Contractor identified herein, or
in the alternative, a person duly
qualified and authorized to bind
the Contractor so identified to
the foregoing agreement.
Signed this 'S ~ day
of CJr-:t' . 2011.
Approved as _ form only:
{) qJ21.l11
OLYMPIC EDUCATIONAL
SERVICE D TRICT 114
Signed thih . day
of 10 eo .2011.
(
OESD USE ONLY PURCHASE ORDllR NO.
Jefferson Co. Pro
. 's Office