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-.ON - Consent Agenda
'(~~)) JEFFERSON COUNTY PUBLIC HEALTH
~~o~' 615 Sheridan street. Port Townsend. Washington. 98368
-' www.Jeffel'8oncountypubDcheaIth.org
FebI1l8Jy 2, 2012
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO:
Board of County Commissioners
Philip Morley, County Administrator
FROM:
DATE:
Jean Baldwin, Director
Marc~ 2012
Agenda \lm - Contract Amendment with Olympic Educational Service
District 114 for SChool Nurse Corp Program (OESD), Amendment #3;
January 1, 2012 - June 30, 2012; add1 $2,063 total $36,590 plus
mileage
SUBJECT:
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 (OESD), Amendment #3;
January 1, 2012 - June 30, 2012; add1 $2,063 total $36,590 plus mileage
~NAL YSIS/STRAU:.GIC GOALS/PRO'S and CON'S:
This Is an on-going agreement between Jefferson County Public Health and Olympic Educational Service
DIstrict 114 for school nurse services. This amendment continues funding additional school nursing hours to
the Brlnnon and Qullcene School DIstricts from January - June 2012. This amendment will fund 4 health
service hours per month (6 visits) to the Brlnnon School DIstrict and 6 health services hours every other
week (12 visits) to the Qullcene School DIstrict. Nursing staff mileage wlll 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 policies & procedures Indudlng
forms and records, consulting In Immunization compliance, and providing mandated screenings programs.
COMMUNITY HEALTH
DEVELOPMENTAL DISABILmES
MAIN: (360) 385-9400
FAX: (360) 385-9401
PUBLIC HULTH
lIi.lIIIAVS W11I1KIIIG FOil AI SMEll AND
HWTHIER COMMUNITY
ENVIRONMENTAL HEALTH
WATER QUALITY
MAIN: (360) 385-9444
FAX: (360) 3794487
Consent Agenda
FISCAL IM~Ac;r leoST BENEFIT ANALYSIS:
This lIgreement will fund the lIddltlonlll school helllth hours thllt we provide to Brlnnon lInd QuIlcene
Schools from JlInullry 1, 2012 through June 30, 2012.
RECOMMENDATION:
JCPH mllnllgement request lIpproVllI of the Contrllct Amendment with Olympic Educlltlonlll Service
DIstrict 1l4for School Nurse Corp Progrllm (OESD), Amendment #3; JlInulIry 1, 2012 - June 30, 2012;
add1 ~Clfe3.totlll $Pi<>,'5'lOi plus mIlellge
(' J/:JI2-
Date
(Routed to all Public Health Managers)
CONTRACT AMENDMENT-3
2011-12
Modification of Contract between the
Olympic Educational Service District 114, State of Washington
(hereinafter referred to as OESD)
and
Jefferson COImty Health Denartment
(hereinafter referred to as Contractor)
Which commenced the 1st day of February, 2012, and terminates the 15th day of June, 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 thirty-eight dollars and nineteen cents ($38.19) per hour to provide 4 health
services hours per month (5 visits) to the Brinnon School District, not to exceed $764.
Pay Contractor thirty-eight dollars and nineteen cents ($38.19) per hour to provide 6 health
services hours every other week (11 visits) to the Quilcene School District, not to exceed $2,521.
Provide for reimbursement of nursing staff for mileage incurred in connection with provision of
above services at the rate of$.51/mile, not to exceed $757.
Brinnon mileage $193(5 visits).
Quilcene mileage $564 (11 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
Approved as t. form only:
, z../1. '2-} 12...
Signed this day
of .2012.
Signed this day
of .2012.
OESD USE ONLY PURCHASE ORDER NO.
("::ONTRACT AMENDMENT 2011-(
-A f'I1 END ME I'll 2..
Modification of Contract between the
Olympic Educational Service District 114, State of Washington
(hereinafter referred to as OESD)
and
Jefferson County Health Deparlment
(hereinafter referred to as Contractor)
Which commenced the 1st day of November, 2011, and terminates the 31st day ofJanuary, 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 hoW" to provide 4 health
services haW"s per month (3 visits) to the Brinnon School District, not to exceed $459.
Pay Contractor thirtyeight dollars and nineteen cents ($38.19) per haW" to provide 6 health
services haW"s every other week (7 visits) to the Quilcene School District, not to exceed $1,604.
Provide for reimbursement of nW"sing staff for mileage inCW"red in connection with provision of
above services at the rate of$.51/mile, not to exceed $300.
Brinnon mileage $116 (3 visits).
Quilcene mileage 180 (7 visits).
CONTRACTOR
OLYMPIC EDUCATIONAL
SERVICE DISTRICT 114
~~B~'rintendent
Signature)
Who ce . es 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 '5"'" day
of'PtC'*N.V.2011.
Signed 1
of I '1
day
,2011.
OESD USE ONLY
PURCHASE ORDER NO.
3601112013
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ArnENDl'nE..rJT l
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 De1Jartment
(hereinafter referred to as Contractor)
Which commenced the 29th day of August, 2011, and terminates the October 31, 2011.
For and in consideration of the mutnal 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.
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 $210.
Brinnon mileage $77 (2 visits).
Quilcene mileage $128.40 (5 visits).
CONTRACTOR
(~~
Who certifies that he/she is the
Contractor identified berein, or
in the alternative, a person duly
qualified and authorized to bind
the Contractor so identified to
the foregoing agreement.
Signed this ~ <Zt> day
of 6M"" . 2011.
ApproVed as 1!0 fonD. only:
~~~
OLYMPIC EDUCATIONAL
SERVICED TRICT 114
nt
Signed this A day
of /0 to .2011.
{
OESD USE ONLY PURCHASE ORDER NO.
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Ol:.'.(lflPle: BPUQ\'l'IONAL SERVICllIlISTRIcr11.4
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Cberainli\ftar.tafe~dto ali'Contraqt~rl
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This " ~gi-ea~~t, i~ente#eQ .irittih.'1 the.. Sc.hQotNurse Corps .'PtOgramas administered
bythe'Olympic :Educational'Servi!>>'District (OIlSDI andJeft...rsonCountyH~lth &
Human Services for thepul.1lose ,<>f .l?rovidi.ngnUrli'il1!J 'sarvices appt'opriata to the
. nsadli'ofidanl;ified Jafferson CciuntY pllbl,ic sc$ools', ....
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JeffersOn cduntYHe8.ith,&~nservie_ag1:~l;O provide ragistered nurss
$!ttrlCesdtQ include tliefolloWing:".; ..' ...... .....'. ..
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1. 'ASs-. aitdp~ide' for thgelll~rgent~enOOds of stud ants. emergency
l?lans forstlldantswi1;h Hfe'-threatening 1IISdic:a1conditions. students
....i tW'acute or '. chroni.c pealthcorttli tions..,tudants ,wi thhea1 thconcerns
and/oJ;' r9quiriJ1g.,nursing. treatmel'ts or care. Developitidividua1illed
cal'Etplarls .fol' these Student$. inclUding trlliningof .unUcensedstaff
in the care'C)f students, '. .' .
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l\l;JssmithEtPllysical Bnde1/lOtiona1 he.althof stl.ldentsas.e1llted to ,thS'
aduc:atj.()oa1 procassaIidw'ithin the scOpeof'j;he schpolnursa prin:tica:;
i~itiatereferrals'forfur1;ner diagnoeili!and treatment of idElnt.iHad .
haalth~itSads at)d ~prov!de~911OW-Ul?:COIIIlillmi(:lltehea1thccncarns that. .
.1fJIIlt..!inpllctloornJ.ngto appropriate Iltaffw!1;hparentafui/li>r stuclent .
cona~nt.\.'. ','" .. . . "," ' '. . .
Del"gateandp!'o:Vldetl1sining,a!1<i (:onsultatiorio.f'non-nurse school
staff ill'.1;\1:SPcroVisionofnursiitg sarv!cesand' procedures that can
by law: b9delaga):edto unli'cens.edschpOl ,pe.n;onnel'; ..
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l'rOVid~'uite:rpretat!on ofln8ciiC>11'~nd nursilig naadsand dbtrict .
',.,. reaourceSfpx:haaltb.careto 'parel't8,ofstndents, wHhhealth problems
as requeSltad by distric.t8, . .... . .' ..., "" '..,
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6.., ..~Biitiihlisii proc8du.es.,f'or amergencycat:aof studElntsarid ttalrting of !
Sltaff. ,.. ,.' . - '. "
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IntElTI~retmedi(:al~<>>rds for district .lIta ffas aduc,\tionalplaeem';;nt
'.. and,l'8rvJ;~are.baillg li<iltarininad. .
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,.'Provide nUl'Singconsultationi:-sgardingstooents ills?ecial educatio1'l':
-Participate inMDTllteetillgs for .sttidetitswi th significant lnEldical .'.
problems.and,assist In ini tilll d..veloplllSnt ofnP as resourcee pe):1llit.
. Pr!OVidelllrt'sing; ccnsuhation.1n cOliImunfc~lble d~isease.
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Jefferson
I~ governmental Agreement
County Health Dept. 2011-12
Page 2
.
Provide health education directly or in consultation with school
sta ff .
Assist in development and/or revision of district health policies and
procedures. records and forms as indicated and requested by districts.
12. Provide nursing consultation in student immunization compliance.
13. Establish mandatory screening programs (per WAC 249-148. 248-150) for
districts.
14. Provide supervision and evaluation of nursing staff in performance of
the above-enumerated duties.
15. Maintain proper liability insurance coverage on all its nursing
personnel performing the above-enumerated duties.
The Educational Service District agrees to provide the following:
1. Provide a nurse coordinator who will support. consult. and train nursing
staff assigned to perform above duties.
2. Pay Contractor thirtyeight dollars and nineteen cents ($38.19) per hour
or less (depending on staff assigned) for nursing services described
above for up to eight (8) hours weekly. for thirty-six (36) weeks. not to
exceed $11.000(Chimacum School District).
10.
11.
3. Pay Contractor thirtyeight dollars and nineteen cents ($38.19) per hour
or less (depending on staff assigned) for nursing services described
above for up to eight (8) hours weekly. for thirty-six (36) weeks. not to
exceed $11.000(Port Townsend School District).
4. Pay Contractor thirtyeight dollars and nineteen cents ($36.19) per hour
or less (depending on staff assigned) for nursing services described
above for four (4) additional nursing services hours per week for 11
weeks beginning August 2011 and ending October 2011. not to exceed $1.680
(Chimacum School District).
5. Pay Contractor thirtyeight dollars and nineteen cents ($38.19) per hour
or less (depending on staff assigned) for nursing services described
above for sixteen (16) additional nursing services hours per week for 12
weeks beginning August 2011 and ending November 2011. not to exceed
$7.332 (Port Townsend School District).
6. 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 $537.
l Pay Contractor for school health provider's Professional Development
expenses. i.e.. registration. mileage. lodging and meals offered by the
School Nurse Corps. not to exceed $700. Note: hourly reimbursement while traveling
and attending the conference Is not Included.
Billing shall be done monthly with a final bill submitted prior to June 30. 2012.
Either party upon 30 days advance written notice to the other party may terminate
this agreement in whole. or in part.
The period of performance for this agreement shall be Auaust 2011 throu9h June
2012 school Vear.
OESD agrees to comply with all provisions of the Americans with Disabilities Act
and all regulations interpreting or enforcing such act.
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Ea(:h party t<li, tl> 8$11Mmt.-~l1 be .,. , iJ~l.dor any 1$J!lwi' or tlljilry
to persons, or pr ,t"eSlll t:lng frOlll gr "'r. ne$'lii....., of its
, $IIlploylll!l8> apn~ OJ:' of~icers. 'an<! ''t~ ' " of defendin\f" ,~uding
: "..~torney' s fCl'!llll. 'any cla~lIl. 4"tion. ,su.'t,"or,"ctber 1 proceeding Art1!iiIl9, or
caulled by t_ ,all~ly negligent acts and 'Ollli$lldons.f ,its llIllp~." *"ts or
offi",,", , The: ~J;ies acJ<nowledge l1Ms paragrbph requil'ed each of,' ~to hold '
the other party' Ii_l_s and!ndemni fy thela, for 'tIte ' ligent ,aet..,*<i,QJRj,ssion....
of <its emplO!fllllN'., agllnts. or officers. 'Neit~r , .... reap08ll-i;ibility to f
tlie other pi!ll:'W" tor',~u9':'ces,of acts or QIIli i~S" ot,. lI1ly,person",., c:ompanies or
c:orpOfations, 1lO1;' .,."r:ty to th~s agreement", '
"TERMI~ ' " ' '
This ContI'4<14;~,~ 'tSf'lltinated by the~n4,fllJperilltendent at lllDY j;..iJI9. vith,
'Or witlu:>ut"r~,.~l1P9n, written notifiG\4UGii,tfrilreof to the Contrl!i:to:c,' Th~s ",'
notice shaUl" ~U't' t~ date o! tetIBinaU..and shall be,' COllclUlid:~ly deellted to ,
.nave been dliiUv8l'ectto 'and, re<;ll'~ved by "the Conl:rl'lctcr ag of midnigtl:lli~'Of' the $eCond
dllY follOWing ,t~ daw of ~ts posting i1\ the'United' States man~'aa
firllt noted h!Keln--4.n tbe absen.,.. ",f prwf O'f Ilctual"'delivery to 4iIlf receipt by
the Coet,ractot' by!P8U 0; other means at M" earli.,. data and/or ,tilllJ. '
In the ~ ~f: ~1'IIlination by the CIl!SD,,~1... J:he ContI-a<;:tor.sliall be antitled to
an eq,uitabl'lll,prO' ration of the total c~l:~on provided het'"9in for .'
lIn~~','eeJ'V&coes. vhieh have bon PGJ;f~all of the~dat.. of .t,el'l1lination -of
this ~t..,. .
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. rC.}iJOWr.":'n~l .Agreement
Couniy tiellt~':OIpi:, 2011-12
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Irl governmental Agreement
Jefferson County Health Dept. 2011-12
Page 4
IN WITNESS THEREOF. OESD 114 and Contractor have executed this Agreement
consisting of three pages.
CCNTRAcroR
OLYMPIC
EDUCATIONAL SERVICE DISTRICI' 114
The undersigned certifies that
he/she is the person duly
qualified and authorized to
bind the Contractor so
identified to the foregoing
Agreement and.under penalty of
perjury. certlfies the Soclal
Security Number or Federal
Identification Number provided
is correct.
Signed this
LSW'
day
Signed this
day
of
~LJ.L~
2011.
of
~~
2011
OESD USE ONLY
Approved as t3 form only:
~gJ ~ ~f3JZPll
JeffeIson Co. ProteClItOI". ~
APPROVALS:
DATE
*
DATE
PURCHASE ORDER NUMBER