HomeMy WebLinkAbout111813_ca08I
Consent Agenda
a�N JEFFERSON COUNTY PUBLIC HEALTH
*_ 615 Sheridan Street o Port Townsend o Washington o 98368
www.jeffersoncountypublichealth.org
October 21, 2013
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: rr -. rr I �s , -1-0 15
SUBJECT: Agenda Item — Agency Agreement — Division of Behavioral Health and
Recovery with DSHS, Amendment #6, October 1, 2013 —June 30, 2015;
language change
STATEMENT OF ISSUE:
Jefferson County Public Health is requesting Board approval of the Agency Agreement — Division of
Behavioral Health and Recovery with DSHS, Amendment #6, October 1, 2013 — June 30, 2015; language
change
ANALYSIS /STRATEGIC GOALS /PRO'S and CON'S:
This amendment represents a language change to correct errors or inconsistent language that was included
in the July 2013 contract, Amendment #5.
FISCAL IMPACT /COST BENEFIT ANALYSIS:
There is no fiscal impact to the department.
RECOMMENDATION:
JCPH management request approval of the Agency Agreement — Division of Behavioral Health and Recovery
with DSHS, Amendment #6, October 1, 2013 — June 30, 2015; language change
REVIEWED BY:
Phi i(SMorley, Cou ty Administrator Date
COMMUNITY HEALTH
DEVELOPMENTAL DISABILITIES
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: (360) 379 -4487
DSHS Central Contract Services
6024PF Contract Amendment (3- 31 -06)
Approved 8 t0 forl (III
Oa
' lYl'�
OfO01I CO. t ILO
David Alvarez, Chief Civil DPA
Page 1
DSHS CONTRACT NUMBER:
CONTRACT AMENDMENT
1163 -27310
wov,;�,,QQro�
DEPARTMIENT H
7�OCIAL6HE
Amendment No. 06
ES
SERVICES
This Contract Amendment is between the State of Washington Department of
Program Contract Number
Social and Health Services (DSHS) and the Contractor identified below.
Contractor Contract Number
CONTRACTOR NAME
CONTRACTOR doing business as (DBA)
Jefferson Count
CONTRACTOR ADDRESS
WASHINGTON UNIFORM BUSINESS
DSHS INDEX NUMBER
IDENTIFIER (UBI)
615 Sheridan St
Port Townsend, WA 98368-
161 - 001 -169
1223
CONTRACTOR CONTACT
CONTRACTOR TELEPHONE
CONTRACTOR FAX
CONTRACTOR E -MAIL ADDRESS
Julia Danskin
360 385 -9420
360 385 -9401
jdanski n cojefferson.wa.us
DSHS ADMINISTRATION
DSHS DIVISION
DSHS CONTRACT CODE
Behavioral Health and Service Integration
Division of Behavioral Health
1611CS -63
and Recovery
DSHS CONTACT NAME AND TITLE
DSHS CONTACT ADDRESS
Tiffany Villines
4500 10th Avenue SE
Administrator
Lacey, WA 98503
DSHS CONTACT TELEPHONE
DSHS CONTACT FAX DSHS CONTACT E -MAIL ADDRESS
360 725 -3726
360 586 -0341 tiffan .villines dshs.wa. ov
IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT?
CFDA NUMBERS
No
93.959
AMENDMENT START, DATE
CONTRACT END DATE..:
10/01/2013
06/30/2015 ..
PRIOR MAXIMUM CONTRACT AMOUNT
AMOUNT OF INCREASE OR DECREASE
TOTAL MAXI M CONTRACT AMOUNT
$93,345.00'-
$0.00
$93,345.gt1 t
REASON FOR AMENDMENT,
CHANGE OR CORRECT OTHER: SEE PAGE TWO
ATTACHMENTS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into
this Contract Amendment by reference:
❑ Additional Exhibits (specify):
This Contract Amendment including a# Exhibits and other, documents sincorporated ;by reference, contains all of the terms
and conditions agreed upon by the parties as changes toahe original Contract. No other understanding$ or
representations, oral or otherwise, regarding the subject matter of this Contract Amendment shall be deemed to exist or
bind the parties. All other terms and conditions of the original Contract remain in "full force'and effect The parties signing
below warrant that they have read and understand this Contract' Amendment and have authonty'to enter into this Contract
Amendment
CONTRACTOR SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
DSHS SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
Mike Rice, Senior Contracts Manager
DSHS Central Contract Services
6024PF Contract Amendment (3- 31 -06)
Approved 8 t0 forl (III
Oa
' lYl'�
OfO01I CO. t ILO
David Alvarez, Chief Civil DPA
Page 1
This Contract between the State of Washington Department of Social and Health Services (DSHS) and the
Contractor is hereby amended as follows:
Definitions.
The Definitions Section is modified as follows:
a. "BHSIA" means the Behavioral Health and Service Integration Administration.
Add new subsection a as follows:
e. "Media materials and publications" means:
News Release: A brief written announcement your agency provides to reporters highlighting key
events, research, results, new funding and programs, and other news.
Paid Media: Any advertising space/time that is purchased for prevention /coalition messages
(printed publications /newspapers, online, outdoor, on- screen, TV and radio).
Earned Media: Published news stories (print, broadcast or online) resulting from the Counties'
contacts with reporters.
Donated Media: Also known as public service announcements. Any free advertising space or time
from broadcast, print, outdoor, online, and other advertising vendors. Social Media: Also referred to
as new media: messages posted online on Facebook, Twitter, YouTube and similar sites.
2. Purpose.
The Purpose of this Contract amendment is:
a. Correct errors, or inconsistent language that was included in the July 2013 Contract amendment.
b. Extend the life of the current County contract for Prevention and Treatment outpatient services
scheduled to expire June 30, 2013 by an additional twenty -four months.
c. Items left unchanged remain in force.
3. Contract Term.
The term of this contract is amended to extend from July 1, 2013 until June 30, 2015.
4. Statement of Work.
Modify 1 st paragraph of this section as follows:
The County shall provide the services and staff, and otherwise do all things necessary for or incidental
to the performance of work, subject to the provision of funding by DSHS, as set forth below:
DSHS Central Contract Services Page 2
6024PF Contract Amendment (3- 31 -06)
5. Prevention Services Statement of Work, Consideration and Billing and Payment.
Replace Sections 5a. through 5d. in their entirety with the following:
The County shall provide the services and staff, and otherwise do all things necessary for or incidental
to the performance of work, as set forth below.
a. For the period July 1, 2013 through June 30, 2015, the County shall use prevention funds to
coordinate and implement prevention programs designed to prevent or delay the misuse and abuse
of alcohol, tobacco, and other drugs. Prevention programs and services include, but are not limited
to:
b. Coordination of Prevention Services
The County shall ensure:
(1) Subcontractor monitoring, using a DSHS approved subcontract monitoring protocol, including
annual on -site reviews of programs that directly serve children and /or families.
The County shall obtain prior approval before entering into any subcontracting arrangement. In
addition, the County shall submit to the DSHS Program Manager identified on Page 1 of the
contract at least one of the following for review and approval purposes:
L Copy of the proposed subcontract to ensure it meets all DSHS requirements; or
ii. Copy of the County's standard contract template to ensure it meets all requirements and
approve only subcontracts entered into using that template; or
iii. Certify in writing that the subcontractor meets all requirements under the contract and
that the subcontract contains all required language under the contract, including any
data security, confidentiality and /or Business Associate language, as appropriate.
(2) Media materials and publications developed with DSHS funds shall be submitted to the PSM for
approval prior to publication (DSHS will respond within 5 working days). DSHS must be cited as
the funding source in news releases, publications, and advertising messages created with or
about DSHS funding. The funding source shall be cited as: Washington State Department of
Social and Health Services. The DSHS /BHSIA logo may also be used in place of the above
citation.
Exceptions: The County does not need to submit the following items to PSM:
(a) Newsletters and fact sheets.
(b) News coverage resulting from interviews with reporters. This includes online news coverage.
(c) Newspaper editorials or letters to the editor.
(d) Posts on Facebook, YouTube, Tumblr, Twitter and other social media sites.
(e) When a statewide media message is developed by DBHR is localized.
(f) When the current SAMHSA- sponsored media campaign is localized. (As of August 2013,
this is the "Talk Hear You" campaign. http://www.samhsa.gov/underagedrinking
DSHS Central Contract Services Page 3
6024PF Contract Amendment (3- 31 -06)
(g) The County is still encouraged to submit copies of these items to PSM.
(3) If funding permits the County to provide Community Based Coordination services in addition to
meeting CPWI requirements, (i.e., Counties with communities that each have at least $110,000
of DSHS funding budgeted for CPWI implementation, annually) services may be provided at the
county level. Services shall reflect work of the County staff coordinating, organizing, building
capacity, providing education and information related to prevention initiatives at the county level.
c. Community Prevention and Wellness Initiative
hftp://www.theathenaforum-org /
The County shall:
(1) Provide CPWI services in accordance with the Key Objectives and Community Coalition Guide
found on the Athena Forum website which outlines the minimal standards to participate in the
CPWI.
(2) Submit an annual budget with projected expenditures, including salary and benefits for DSHS
funded prevention staff, program costs, training and travel to the Prevention System Manager
within 30 days upon request. A template will be provided.
(3) Enter approved programs into the PBPS by July 31, 2013 based on the priorities, goals and
objectives described in the approved Strategic Plan. Cohort 3 approved programs include the
CPWI Coalition and may include other programs as negotiated with BHA or designee.
(4) Ensure sixty percent (unless negotiated with BHA or designee) of programs supported by DSHS
funds will be replications or adaptations of "Evidence -based Practice" substance abuse
prevention programs as identified in the PBPS.
(5) Ensure all of the programs supported by DSHS will meet the Center for Substance Abuse
Prevention's (CSAP) Principles of Effective Substance Abuse Prevention, found on the Athena
Forum Website.
d. Prevention Training
(1) The County shall participate in all required training events identified by DSHS and listed in the
DBHR Community Coalition Guide.
(2) Non - Required Training in CPWI
(a) In the absence of a strategic plan and for trainings not identified in the approved strategic
plan, all additional (non- required) training paid for by DSHS shall be approved by BHA or
designee prior to training and meet the approved goals and objectives in PBPS.
(b) The County shall ensure any requests for training are requested in writing and sent directly
to the PSM, a minimum of ten working days before the date of the proposed training.
Trainings shall relate to one of the following four categories.
Coalition building and community organization.
ii. Capacity building regarding prevention theory and practice.
DSHS Central Contract Services Page 4
6024PF Contract Amendment (3- 31 -06)
iii. Capacity building for evidence based practice and environmental strategy
implementation, related to the goals and objectives of the coalition's approved strategic
plan.
iv. Capacity building in high need communities that meets overall goals and objectives of
CPWI in order to expand CPWI efforts may be approved by BHA or designee upon
request.
(c) The County shall ensure training paid for by DSHS that requires travel follows state travel
reimbursement guidelines accessible at http://www.ofm.wa.gov/policv/10.90,htrn.
(d) The County shall bill for training events on an A -19 per BARS code 22.7 and record training
events in the DSHS Performance Based Prevention System (PBPS) in accordance with the
monthly reporting requirements described in Section 2. g., Prevention Report Schedule /
Due Dates.
Amend subsection 5.i.(3) as follows:
(3) Funding Allocation
The County shall manage the contract to ensure that services are provided in a manner that
allocates the available resources over the period of the Contract for which DSHS provides
funding.
Amend subsection 5.j.(4) as follows:
(4) DSHS Obligation for Payment
DSHS shall not be obligated to reimburse the County for any services or activities, performed
prior to the effective date of this Contract.
6. Incentive Research Project
a. Modify subsection 9.f.(2) as follows:
DSHS will notify you in writing and /or by e-mail of the status of your subcontractors as to:
(2) Into which each of the categories in b. and c. above it has been placed after the randomization.
b. Modify subsection 9.g.(2) as follows:
The County shall:
(2) Forward the information provided to the County in section b. and c. above to all qualified
subcontractors.
TARGET2000 Requirements
Modify subsection 10.d.(7)(a) to the following:
Work towards TARGET input data no later than 7 calendar days after service was provided.
All other terms and conditions of this Contract remain in full force and effect.
DSHS Central Contract Services Page 5
6024PF Contract Amendment (3- 31-06)
ArnEN DMErJT 4F 5-
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6024PF Comact AmenomOl (3 -31 -06)
�arStrn O, �Tb+M1�'trtDr s �.
David Alvarez; Chief C +v+ PA
DSHS CONTRACT NUMBER.
CONTRACT AMENDMENT
1163 -273`10
T? H
g� s°c s
AmendmentNo. 06
t 2v`P E
Th�isCOntracf Amendment is between the State of Wasl tngton Depa tmen# of
Program GbnlrectNumbec
Social and Health Serves (DSHS) and the Contractor identified below,
Gbmractor Contract Number
CONTRACTOR NAME - - CONTRACTOR doing business as (DSA9_
Jeff Count . WASHINGTON UNIFO MBUSINESS DSHS INC) - NUMBER
CON -RAG ORADDRESS
IDENTIFIER (1161).
615 Sheridan St 1Gy -001 169 1223'
Fort Townsend, WA 983e$-
GTRACTORCOfiITACT CONTRACTOR TELEPHONE CONTRACTOR FAX CO TRACOR'E -M !L ODRESS
Julia Danskin 360 385- 9420 360 385 -9401 danskin co'efferson.wa,us
pSHS ADMINISTRATION DSH$DIVIStON DSHSCONTRACT CODE
Benaviora Health nd Service lntegration Division of Behavioral Health 1B11CS -63
and Rgg=
DSHS CONTACT NAME AND TITLE -
DSHS .CONTACT - ADDRESS
Steve Smothers
450016th Avenue -SE
prevention Services Lead
Lace , WA 98503
DSHS CONTACTT 1.€ HONE- 'DSHS CO TACT AX =CONTACT E -MAIL ADDRESS- -
dShS.wa: ov
3607P5 -3767 360 438 -8057 smothsw
I5 THE CONTRACTOR A .11BRECIRIENT fOR PURPOSES OF' -11S CONTRACT? C D .NUMBERS
93.959..
No
AMENDMENT YARTDATE CON -ACT ENDDATE
07/01/2013 0613D/2015
MAXimum CONTRACT AMOU T AMOUNTOFINCREASEORDECREASE TOTAL. MAXIMUM CONTRACT AMOUNT
PRIOR
$77,805;00 $15,540,00 $93,345:00
REASON FOR AMENOM NT;
PERIOD OF PERFORMANCE AND MAX CONTRACT AMOUNT
CHANGE OR CORRECT
ATTACHMENTS. When the box bebw s marked with an X, the following Exhibits are attached and are incorporated into
this Contract Amendment by refetence;
--i
❑ Ad tonal Exhibits s
This Contract Amendment, including alf Exhlb is and other documents incorporated by refelence, Contains allof'the terms
upon by the parties as changes to the original Contract. No other Understandings or
and conditions agreed
oral or otherwise, regarding the subject matter of this Contract Amendment shall be deemed to exist or
representations,
All other terms and conditiorts of the original Contract remain' in full force and effect. The parties sfgn#ng
bind the parties.
below warrant that they have read and understand this Contract Amendment, and have authority to enter into this Contract
Amendment. - DATE SIGNED'
- PRMTED NAME AND TITI E
CONTkAS.T't12! r..,NAT i
i'
�;^. --
- PRINTED NA AND -IT ` DATE SIGNED
DSHS Si AT/URE J6 G! .l s: Cam' ^� /sc7f ` "tom, � <� J
G `f�
I Ad/ r J Y''�7//-3
as to f0m only ! r t Page ,
DSHS Gents'at COMIaal SerAm r * t, l..:){ / S
6024PF Comact AmenomOl (3 -31 -06)
�arStrn O, �Tb+M1�'trtDr s �.
David Alvarez; Chief C +v+ PA
b. For the period July 1, 2013 through June 30, 2015, the Contractor shall use prevention funds to
coordinate and implement prevention programs designed to prevent or delay the misuse and abuse
of alcohol, tobacco, and other drugs. Prevention programs and services include, but are not limited
to:
c. Coordination of Prevention Services
The Contractor shall ensure:
(1) Subcontractor monitoring, using a DSHS approved subcontract monitoring protocol, including
annual on -site reviews of programs that directly serve children and /or families.
(2) Materials and media developed with DSHS funds shall be submitted to the BHA or designee for
approval prior to publication. Acknowledgment of DSHS as the funding source when articles
and materials related to prevention programs are published. The funding source shall be cited
as: Washington State Department of Social and Health Services — Division of Behavioral Health
and Recovery.
d. Prevention Redesign Initiative —link to http://www.theathenaforum.org/ Website
The Contractor shall:
(1) Provide PRI services in accordance with the Key Objectives and Task Guide found on the
Athena Forum website which outlines the minimal standards to participate in the PRI.
(2) Submit an annual budget with projected expenditures, including salary and benefits for DSHS
funded prevention staff, program costs, training and travel to the Prevention System Manager,
within 30 days upon request. A template will be provided.
(3) Enter approved programs into the PBPS by July 1, 2013 based on the priorities, goals and
objectives described in the approved Strategic Plan. Cohort 3 approved programs include the
PRI Coalition and may include other programs as negotiated with BHA or their designee.
(4) Ensure sixty percent (unless negotiated with BHA or designee) of programs supported by DSHS
funds will be replications or adaptations of "Evidence -based Practice' substance abuse
prevention programs as identified in the PBPS.
(5) Ensure all of the programs supported by DSHS will meet the Center for Substance Abuse
Prevention's (CSAP) Principles of Effective Substance Abuse Prevention, found on the Athena
Forum Website.
e. Prevention Training
(1) Required Prevention Training
(a) The Contractor shall participate in all required training events identified by DSHS and listed
in the DBHR PRI Task Guide.
(2) Non - Required Training in PRI
(a) In the absence of a strategic plan, all additional (non- required) training paid for by DSHS
shall be approved by BHA or designee prior to training and relate to approved goals and
objectives in PBPS.
DSHS Central Contract Services Page 3
6024PF Contract Amendment (3- 31 -06)
(b) The Contractor shall ensure any requests for training are requested in writing and sent
directly to the Prevention System Manager, a minimum of ten working days before the date
of the proposed training. Trainings shall relate to one of the following three categories.
i. Coalition building and community organization.
ii. Capacity building regarding prevention theory and practice.
iii. Capacity building for evidence based practice and environmental strategy
implementation, related to the goals and objectives of the coalition's approved strategic
plan.
(c) The Contractor shall ensure training paid for by DSHS that requires travel follows state
travel reimbursement guidelines accessible at http://www.ofm.wa.gov/policY/l 0.90.htm.
(d) The Contractor shall record training events in the DSHS Performance Based Prevention
System (PBPS) in accordance with the monthly reporting requirements described in Section
2. g., Prevention Report Schedule / Due Dates.
f. Prevention Reporting
(1) Prevention Reporting Requirements
The Contractor shall:
(a) Implement and monitor prevention programs and reporting to assure compliance with these
guidelines.
(b) Develop and submit a protocol for monitoring subcontractors.
(c) Conduct an on -site visit of prevention sub - contractors.
(2) Prevention Activity Data Reports — See Section 4. h., Prevention Report Schedule / Due Dates,
below for schedule and reporting due dates.
(3) The Contractor shall:
(a) Ensure that monthly prevention activities are reported in the DSHS PBPS in accordance
with the requirements and timelines set forth below.
(b) Ensure demographic information is provided for each participant in single events, mentoring,
environmental and recurring programs.
(c) Provide Community Coalition Coordination Reports on its efforts in the PBPS for each
month of the calendar year.
g. Outcome Measures
(1) The Contractor shall report on all required pre /post -tests in PBPS Program Selection
Instruments identified in the PBPS.
Special situations and exceptions regarding pre /post tests and Program Selection Instruments
identified in the PBPS include, but are not limited to, the following:
DSHS Central Contract Services Page 4
6024PF Contract Amendment (3- 31 -06)
(a) The Contractor may negotiate with the Prevention System Manager to reduce multiple
administrations of surveys to individual participants.
(b) Participants in recurring program groups in which the majority of participants are younger
than 10 years old on the date of that group's first service.
(c) Recurring programs that spend less than $1,000 of DSHS prevention funds each biennium.
(d) Programs that only provide single service events.
(e) Environmental /Media services.
h. Prevention Report Schedule/ Due Dates Guidelines
}3F?fttttfG'.
kfiEPt)
Rep sttte
ate
R?�t►9 '`
Programs approved by
July 31, 2013
One time
DBHR for Contract ending
PBPS
report
June 30, 2015
GPRA measures
As requested
_
-
, .. -.
.fizz
.� >;,t ,
Prevention activity data input
Prevent
for all active services
15' of each
including community coalition
month for
Monthly
coordination efforts, pre-
activities from the
PBPS
tests, post - tests, and
previous month
assessments
15 of each
Training Report
month for
PBPS
Monthly
trainings from the
revious month
i. Performance Work Statement / Evaluation
(1) The Contractor shall ensure program results show positive outcomes for at least half of the
participants in each program group.
(a) Positive outcomes means that at least half of the participants in a group report change
between pre and post -tests consistent with the positive outcome goal.
(b) Positive outcomes will be determined using the pre -test and post -test data reported in the
Performance Based Prevention System (PBPS).
(c) Survey results will be compared against the stated outcome for the program.
(d) Evaluation of PBPS data will occur on the 15th of the month following the final date of
service for each group.
(2) DSHS shall use the following protocol for evaluation:
DSHS Central Contract Services Page 5
6024PF Contract Amendment (3- 31 -06)
(a) Matched pre -test and post -test pairs will be used in the analysis.
(b) To allow for normal attendance drop -off, a 20% leeway will be given for missing post- tests:
(c) If there are missing post -tests for entered pre -tests in excess of 20% of pre- tests, missing
post -test will be counted as a negative outcome.
Example: there are 10 pre -tests and 7 post- tests. The denominator would be 8 and the
maximum numerator would be 7.
(3) Different groups receiving the same program will be clustered by school district.
(a) In cases where multiple providers are serving the same school district, groups will be
clustered by school district and provider.
(b) The results of one provider in a given school district will not impact another provider in the
same district.
(4) In cases where the survey instrument selected for a given program includes more than one
scale, the scale that is most closely aligned with the outcome linked to the program in PBPS will
be used.
(5) Results for groups with services that span two contracting periods will be analyzed in the
contracting period that the post -test was administered.
If fewer than half of the participants in a group, within a given school district, report positive
change in the intended outcome:
(a) The Contractor shall submit a Performance Improvement Plan (PIP) for the non - compliant
program to the BHA or designee within 45 days of notice by DSHS.
(b) Reimbursement for the CSAP Category row on the A19 for that program will be held until
the PIP is approved by the BHA or their designee.
(c) If a second group within that same school district has fewer than half of the participants
report positive change in the intended outcome, then the following steps will be taken:
i. In cases where there is no active non - compliant program, the Contractor shall
discontinue implementation of that program within the specified geography.
ii. In cases where the same programs as the non - compliant program are active and
continuing in the same school district, those groups will be allowed to complete the
expected number of sessions. No new groups will be started.
iii. Following the conclusion of all groups completing the program, results will be reviewed
for those groups.
iv. If the results do not show positive change for each group, the Contractor shall take the
following action:
(A) In cases where the program is being delivered by a single provider in the specified
geography, the Contractor shall discontinue implementation of that program in the
specified geography.
DSHS Central Contract Services Page 6
6024PF Contract Amendment (3- 31 -06)
(B) In cases where the program is being delivered by multiple providers in the specified
geography, the Contractor shall discontinue implementation of that program by the
underperforming provider in the specified geography.
(6) A non - compliant program that resulted in the need for a Performance Improvement Plan during
July 1, 2013 to December 31, 2013 will carry that record forward into the January 2014- June
30, 2015 contract period.
5. Consideration:
Maximum consideration payable to Contractor for satisfactory performance of the work under the
Prevention Statement of Work is identified on the Awards and Revenue document attached as Exhibit
A, including any and all expenses, and shall be based on the following:
a. The source of funds is the federal Substance Abuse Prevention and Treatment (SAPT) Block Grant.
The Catalog of Federal Domestic Assistance number is 93.959.
b. Reimbursable Costs
The Contractor shall ensure all expenditures for services and activities under this Contract are
submitted on the A -19 invoice appropriate for PBPS entry.
c. Funding Allocation
The Contractor shall manage the contract to ensure that services are provided in a manner that
allocates the available resources over the life of the contract.
d. Administrative Cost Limitations
Contract funds shall not be used for administrative costs.
e. Period of Performance Service Costs
The Contractor shall ensure that service costs incurred are within the period of performance of this
Contract.
In addition, if there are unspent funds from the July 1, 2011 through June 30, 2013 time period,
these funds may not be used for the July 1, 2013 to June 30, 2015 time period.
g. Billing and Payment for the Prevention Statement of Work.
a. Invoice System
The Contractor shall submit invoices using State Form A -19 Invoice Voucher, or such other form as
designated by DSHS. Consideration for services rendered shall be payable upon receipt of properly
completed invoices which shall be submitted to the DSHS Contact Person stated on page one (1) of
this contract, by the Contractor, not more often than monthly. The invoices shall describe and
document to DSHS' satisfaction a description of the work performed, activities accomplished, the
progress of the project, and fees. The rates shall be in accordance with those set forth in Section 5,
Consideration, of this Contract.
b. Billing for CSAP
Page 7
DSHS Central Contract Services
6024PF Contract Amendment (3- 31 -06)
The Contractor shall ensure expenditures for each of the six CSAP strategies are reported monthly
as part of the A -19 invoice.
c. Timely Payment
Payment shall be considered timely if made by DSHS within thirty (30) days after receipt and
acceptance by the DSHS Contact Person of the properly completed invoices. Payment shall be
sent to the address designated by the Contractor on page one (1) of this Contract. DSHS may, at
its sole discretion, withhold payment claimed by the Contractor for services rendered if Contractor
fails to satisfactorily comply with any term or condition of this Contract.
d. DSHS Obligation for Payment
DSHS shall not be obligated to reimburse the Contractor for any services or activities, performed
prior to having a fully executed copy of this Contract.
e. Duplication
The Contractor assures that work performed and invoiced does not duplicate work to be charged to
the State of Washington under any other contract or agreement with the Contractor.
f. Claims for Payment
The Contractor shall:
(a) Submit invoices for costs due and payable under this agreement that were incurred prior to
the expiration date within 90 days of the date services were provided.
(b) The Contractor shall submit final billing for services provided during each fiscal year within
90 days after the end of that fiscal year.
g. Non - Compliance
(1) Failure to Maintain Reporting Requirements:
(2) In the event the Contractor or a subcontractor fails to maintain its reporting obligations under
this Contract, DSHS reserves the right to withhold reimbursements to the Contractor until the
obligations are met.
h. Recovery of Costs Claimed in Error:
If the Contractor claims and DSHS reimburses for expenditures under this Contract which DSHS
later finds were (1) claimed in error or (2) not allowable costs under the terms of the Contract,
DSHS shall recover those costs and the Contractor shall fully cooperate with the recovery.
Subcontractor Monitoring
The following language is added as item d.
d. The Contractor shall obtain prior approval before entering into any subcontracting arrangement. In
addition, the Contractor shall submit to the DSHS Program Manager identified on Page 1 of the
contract at least one of the following for review and approval purposes:
DSHS Central Contract Services Page 8
6024PF Contract Amendment (3- 31 -06)
(1) Copy of the proposed subcontract to ensure it meets all DSHS requirements; or
(2) Copy of the contractor's standard contract template to ensure it meets all requirements and
approve only subcontracts entered into using that template; or
(3) Certify in writing that the subcontractor meets all requirements under the contract and that the
subcontract contains all required language under the contract, including any data security,
confidentiality and /or Business Associate language, as appropriate.
All remaining sections are automatically renumbered as b. through d. and remain in force.
8. Advance Payment and Billing Limitations.
The following language replaces the language in sections a. and b. of the Advance Payment and Billing
Limitations section of the contract.
a. Advance Payment
DSHS shall not make any payments in advance or in anticipation of the delivery of services to be
provided pursuant to this Contract.
b. Authorized Services
DSHS shall pay the Contractor only for authorized services provided in accordance with this
Contract. If this Contract is terminated for any reason, DSHS shall pay only for services authorized
and provided through the date of termination.
(1) Timely Billing
DSHS shall not pay any claims for payment for services submitted more than ninety (90) days
after the calendar month in which the services were performed, unless otherwise specified in
this Contract.
(2) Exception to 90 -day billing limitation
The Contractor may submit a bill for services beyond the 90 -day limitation:
(a) When additional funds are added to or funds are decreased from the Contract by written
amendment, those services previously provided shall be entered as a Community Services
Fund source in TARGET.
(b) When a billing submitted to the Medicaid payment system is denied due to ineligibility, the
Contractor may submit a billing for the denied service using an A -19 invoice. The Contractor
shall attach a copy of the Medicaid payment system denial to the A -19 to document the
denial.
All remaining sections, items c. though e. remain unchanged and in force.
All other terms and conditions of this Contract remain in full force and effect.
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6024PF Contract Amendment (3 -31 -06)
Exhibit A
Awards and Revenues
This document is being sent by e-mail along with the 2013 -2015 amendment.
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6024PF Contract Amendment (3- 31 -06)
AWARD AND REVENUES
2013 -2015 Biennium
COUNTY Jefferson (Prevention)
PROGRAM AGREEMENT NUMBER 1163-27310
The above named County(ies), is hereby awarded the following amounts for the purposes listed.
REVENUE
SOURCE TYPE OF SERVICE
CODE:
333.99.59 SAPTGrant -in -Aid
SHPT Base
SFY 14
$15,540
Sn
AWARDAMOUNTS
Biennial
SFY 15 Funds
$0
Total Federal Funds $15,540 $0
Total State Funds $0 $0
Exhibit A
Total 13 -15
Biennium
$15,540
$0
$d
$0
$0 $0
$I
$0 $15,540
$0
Federal CFDA:
SAPT Grant -in -Aid -CFDA 93.959 Substance Abuse and Mental Health Services Administration (SAMHSA)
Title XIX - CFDA 93.778
County participation match programs include State Grant -in -Aid, Federal SAPT Grant -in -Aid, TXIX Fed Wvr and CJTA.
2011 -13 Jefferson Amend 5
Prevention
$15,540
50
334.04.6X
State Grant -in -Aid
$0
$0
$0
State GJA Administration
$0
Criminal Justice Treatment Account
$0
$0
334.04.6X
334.04.6X
Drug Court - State Funds
$0
$0
STATE - SPECIAL PROJECTS
$0
$0
334.04.6X
TA NF Treatment Services
$0
$0
$0
$0
334.04.6X
CA Parents in Reunification
FEDERALGRANTS
$0
$0
Waiver for DL and ADATSA clients ONLY
$0
$0
333.97.79
TXIX -Fed
Total Federal Funds $15,540 $0
Total State Funds $0 $0
Exhibit A
Total 13 -15
Biennium
$15,540
$0
$d
$0
$0 $0
$I
$0 $15,540
$0
Federal CFDA:
SAPT Grant -in -Aid -CFDA 93.959 Substance Abuse and Mental Health Services Administration (SAMHSA)
Title XIX - CFDA 93.778
County participation match programs include State Grant -in -Aid, Federal SAPT Grant -in -Aid, TXIX Fed Wvr and CJTA.
2011 -13 Jefferson Amend 5