HomeMy WebLinkAbout121613_ca11JEFr4ERSON COUNTY PUBLic HEALTH Consent Agenda
615 Sheridan Street o Port To'wnsend o Washington o 918368
www.jefferso icoun:typ jai bVichea 0°ii.oirg
November 26, 2013
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To'.. Board of County Commissioners
Philip Morley, County Administrator
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SUBJECT: Agenda Item — Contract Agreement with Jumping Mouse Children's
Center; January 1, 2014 — December 31, 2014; $30,000
Consent Agenda
RECOMMENDATIQN:
JCPH management request approval of the Contract Agreement with Jumping Mouse Children's Center,
to provide mental health services; January 1, 2014 — December 31, 2014; $30,000
(Routed to all Public Health Managers)
Vim-
CONTRACT AGREEMENT
By and Between
Jumping Mouse Children's Center
And
Jefferson County
For Expanded Mental Health (MH) & Chemical Dependency (CD) Treatment 2014
Section 1: PURPOSE:
THIS AGREEMENT for Professional Services is entered into between Jefferson County herein
referred to as the "County" and Jumping Mouse Children's Center, herein referred to as the
"Contractor" to provide mental health services to individuals impacted by mental
health/substance abuse issues in Jefferson County, Washington.
Section 2: TERMS:
This Agreement shall commence on January 1, 2014 and continue through December 31, 2014,
unless terminated as provided herein.
Section 3: SCOPE OF AGREEMENT:
Contractor will increase mental health treatment options to Jefferson county residents as outlined
in Exhibit A, herein incorporated by reference. Through the use of these funds the provider will
increase the number of citizens receiving Mental Health services. The goal of this funding and
sales tax increase is to improve the quality of life for Jefferson County citizens by improving
access to mental health and substance abuse treatment.
A, CONTRACTPRERESENTATIVES:
Jefferson County and Jumping Mouse Children's Center will each have a contract representative
who will have responsibility to administer the contract for that party. A party may change its
representative upon providing written notice to the other party. The parties' representatives are as
follows:
JCPH Contract Representative Contractor's Contract Representative
Jean Baldwin Kris Becker, Executive Director
Jefferson County Public Health Jumping Mouse Children's Center
615 Sheridan St. 1809 Sheridan St.
Port Townsend, WA 98368 Port Townsend, WA 98368
(360) 385-9400 (360) 379-5109
Section 4: COMPENSATION:
The total amount payable under this Contract by County to Contractor shall not exceed
$30,000.00 in completion of this project without express written amendment signed by both
parties to this Agreement. The parties acknowledge that funding for this contract is contingent
on the continuation of sales tax revenue in 2014. If the sales tax revenue decreases by ten percent
(10%) when applicable sales tax revenues are compared between the most recently completed
quarter year and the same quarter year revenues for 2013, then this contract may be renegotiated.
The parties acknowledge the funding connected to this contract is revenue of last resort and
therefore Contractor will bill all other sources of revenue first,
Jumping Mouse Children's Center - 2014
A. Contractor shall be paid for services as outlined in Exhibit B — Fee Schedule.
& CONTRACTOR shall submit monthly invoices to JCPH, 615 Sheridan St., Port
Townsend, WA 98368, Attn: Finance Department, for payment of work actually
completed to date.
C, Invoices must be submitted by the 2'd Monday of the month for the previous month's
expenses. The County will review such invoices, and upon approval thereof, payment
will be made to the Contractor in the amount approved. Failure to submit timely invoices
may result in a denial of reimbursement.
D. Contractor shall provide invoices and necessary backup documentation for all invoices
including timesheets and statements. Any indirect charges require the submittal of an
indirect cost methodology and rate using OMB Circular's A-87 and A-122.
E. Contractor will not use County treatment tax funds for match without prior authorization
of their match formula and allocation use approved in writing by the Jefferson County
Administrator and County fiscal team. Please submit both formula and allocation plan for
approval, funds can not conflict with ,existing DSHS, CMS or DBHR funding rules. (See
Attachment A)
F, The County will make final payment of any balance due the Contractor promptly upon
determining that i) the Contractor has completed its obligations under this Agreement and
ii) the County can and does accept the work performed by the Contractor.
G. Contractor 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.
H. An audit will be submitted to the County annually,
a. Contractor will submit the most recent financial audit or recent compiled financial
statements to accompany our annual 990 tax form filing within 30 days from the
beginning of this agreement.
b. The audit or recent compiled financial statements to accompany our annual 990 tax
form filing shall be completed by the WA State Auditor's Office or a mutually agreed
upon entity. Upon request the County shall have the option of performing an onsite
review of all records, statements, and documentation.
c. If the County finds indications of potential non-compliance during the monitoring
process, the County shall notify Contractor within ten (10) days. County and
Contractor shall meet to discuss areas of contention in an attempt to resolve issues.
d. Audit or recent compiled financial statements to accompany our annual 990 tax form
filing will provide statements consistent with the guidelines of Reporting for Other
Jumping Mouse Children's Center - 2014 2
Non-Profit Organizations AICPA SOP 78-10, and is perfortried in accordance with
generally accepted auditing standards and with Federal Standards for Audit of
Governmental Organizations, Programs, Activities and Functions, and meeting all
requirements of OBM Circular A-133 or A-128, as applicable.
Section 5: INDEMNIFICATION-
The Contractor 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 Contractor or damage to personal property)
if said injury or damage was caused by the negligent acts or omissions of the Contractor.
Section : INSURANCE:
The Contractor shall obtain and keep in force during the terms of this Agreement, or as otherwise
required:
A. Commercial Automobile Liability Insurance providing bodily injury and property
damage liability coverage for all owned and non owned vehicles assigned to
or used in the performance of the work for a single limit of not less than
$500,000 per occurrence and an aggregate of not less than one million dollars
($1,000,000) Contractor shall provide proof of insurance to the County
c/o Contracts Manager at Jefferson County Public Health, 615 Sheridan St. Port
Townsend, WA 98368 prior to commencing employment.
B. General Liability (1) — with a minimum limit per occurrence of one million dollars
($1,000,000) and an aggregate of not less than two million dollars ($2,000,000) for
bodily injury, death and property damage unless otherwise specified in the contract
specifications. This insurance coverage shall contain no limitations on the scope of
the protection provided and indicate on the certificate of insurance the following
coverage.
1. Broad Form Property Damage with no employee exclusion;
2. Personal Injury Liability, including extended bodily injury;
3. Broad Form Contractual/Commercial Liability including completed operations
(contractors only);
4. Premises — Operations Liability (M&C)
5. Independent Contractors and Subcontractors; and
6. Blanket Contractual Liability,
(1) Note: The County shall be named as an additional insured party under
this policy.
C. Professional Liability Insurance providing $2,000,000 per incident; $4,000,000
aggregate. Contractor shall name Jefferson County Public Health as additional
insured,
1). The Contractor shall participate in the Worker's Compensation and Employer's
Liability Insurance Program as may be 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
Jumping Mouse Children's Center - 20 14
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 Contractor.
F. Any insurance coverage for third party liability claims provided to the County by a
"Risk Pool" created pursuant to Ch, 48.62 RCW shall be non-contributory with
respect to any policy of insurance the Contractor must provide to comply with this
Agreement.
G, If the proof of insurance or certificate indicating the County is an "additional
insured" to a policy obtained by the Contractor refers to an endorsement (by number
or name) but does not provide the full text of that endorsement, then it shall be the
obligation of the Contractor to obtain the full text of that endorsement and forward
that fall text to the County.
K The County may, upon the Contractor's failure to comply with all provisions of this
contract relating to insurance, withhold payment or compensation that would
otherwise be due to the Contractor.
Section 7: CONFIDENTIALITY:
Contractor, its employees, subcontractors and their employees will maintain the confidentiality
of all information provided by JCPH or acquired in performance of this Agreement as required
by HIPAA and other privacy laws, This Contract, once executed by the parties, is and remains a
Public Record subject to the provision of Ch. 42.56 RCW, the Public Records Act.
Section 8: ASSIGNMENTS AND SUBCONTRACTING:
The Contractor shall not sublet or assign any of the services covered by this agreement without
the express written consent of the County.
Section 9: INDEPENDENCE:
The Contractor and the County agree that the Contractor is an independent Contractor 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
Contractorshall 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.
Section 10: REPORTING:
The Contractor will provide a monthly service summary report to the County at the same time as
invoices and must be submitted by the 2 d Monday of the month for the previous month's work.
The monthly report shall contain the report of services and the total hours worked by which staff.
The monthly report shall be submitted to Jefferson County Public Health in care of Jean
Baldwin, Director, 615 Sheridan, Port Townsend, and WA 98368. The County will review such
Jumping Mouse Children's Center - 2014
reports, and upon approval thereof, payment will be made to the Contractor in the amount
approved, Failure to submit timely reports may result in a denial of reimbursement.
Section 11: TERMINATION:
The County reserves the right to terminate this contract in whole or in part, with 30 days 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.
A. This agreement may also be terminated as provided below:
I With 30 days notice by the Board of County Commissioners for any
reason, or
2. With 30 days notice by the Board of County Commissioners for non-
performance of the specific job duties in Exhibit A
3. With 30 days notice by the Contractor by voluntary resignation.
Section 12: MODIFICATION:
This professional services agreement may be modified at any time by written agreement of either
party and may be modified if tax revenue decreases.
Section 13: DISPUTE RESOLUTION:
Any dispute or disagreement concerning the terms and obligations of this Contract shall initially
be brought to the attention of the Public Health Director via a written document. The Public
Health Director shall make a determination with reasonable promptness, i.e., a decision within
ten business days shall be deemed to have been made with reasonable promptness, If the
aggrieved party is not happy with that decision, then the Jefferson County Administrator (or as
may hereafter be amended), will decide the appeal of the Director's decision,
Section 14: INTEGRATED AGREEMENT:
This Agreement together with attachments or addenda represents the entire and integrated
agreement between the County and the Contractor 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 Contractor,
Jumping Mouse Children's enter. 2094
Approved this day of ............ —.20.
BOARD OF COUNTY COMMISSIONERS
I
JETTERSON COUNTY, WASHINGTON
John Austin, Chairperson
Jumping Mouse Children's Center
ATJEST:
Deputy Clerk of the Board
a r AT
JURIPiM" Mouse (Afildren's Center - 2014
Exhibit A
Scope of Work
FIR-OWDINIHIM111 X3
The Jump,ing Mouse Children's Center Services agency as a contracted provider, agrees
to:
1. Clinical and care management services for 7-10 clients
2. All employees or subcontractors of the Contractor undertaking the performance of mental
health/substance abuse services under this agreement are required to be professionally
licensed or certified by the State.
3, Background checks are required for all employees; to be redone for every employee
every 3 years. The names of licensed therapists will be given to the County.
4. Provide long-term therapy to children affected by mental illness or substance abuse at
home and/or in the community
5. Provide parent support and education to the adults of the children covered in this contract
6. Work with social services or other agencies as needed for dually served families with
mental health or chemical dependency issues
7. Maintain a secure records system guaranteeing the confidentiality of PHI pursuant to
FIIPPA
8. Bill other revenues whenever they exist
9. Monthly data template on client utilization, referrals, outcomes, and required reporting,
in standard form as specified by Jefferson County Health
10, Group or individual therapy, or a combination of the two, of a specified duration, using
evidence based models of treatment. Applicant will identify the number of clients seen,
how often each week, and the number of hours per week and per month for treatment
enrollment
11, Referral ]"or mental health medication and monitoring as needed
12, Care coordination with other involved agencies, and referral to supportive services such
as housing, transportation and vocational services; tracking of client involvement in
recommended services, including 12-step or comparable support.,
11 Preparation of progress reports if needed, e.g. to court.
14. Collection and preparation of data for internal and external evaluation purposes, and
reporting to JCPF1 monthly with the invoice, Use forms supplied by JCP14 for data.
Jumping Mouse Children's Center - 2014 7
15, Staffed by 6 master's level, Licensed Mental Health Counselors, one master's level.
Licensed Mental Health Counselor Associate, and one master's level social worker, with
support staff to include billing and administration.
16. Clerical, billing, and general office support
17, Agency oversight regarding record keeping, data collection, legal and ethical issues and
standards of care are updated and meet State of Washington standards.
18. Services are available throughout the county
19. Provide data including:
*Number of intakes, individual sessions, psychiatric visits, and adult education visits
provided
• Age, sex, drug of choice, psychiatric diagnosis of clients
• Referrals to other agencies
• Client satisfaction form indicating client's view of how program helped in their life
20. Opportunities for regular clinical supervision and psychiatric consultation are available
for staff on a regular basis.
2 1. Attend and report to the Mental Health Substance Abuse Sales'rax Advisory Committee
twice during the duration of this contract period, at regularly scheduled meetings, with
progress evaluation reports,
Jumping Mouse Children's Center - 2014
Exhibit B
11 M-11INITIM-M
Therapy and Care Management @ $35.00/hour
Not to exceed $30,000.00 in completion of services for the duration of this contract without
express written amendment.
Rimping MOUse Children's Center - 2014 9
UVEX4661Z "NOWN-1
JEFFERSON COUNTY MH/CD TREATMENT TAX FUNDING-
MATCH POLICY
On October 14, 2013 Jefferson County Board of County Commissioners (BoCC) adopted the
following language in the allocation of the Mental Health Chemical Dependency treatment
dollars.
Agencies may not use .Jeff rson County mental health county / chemical dependency
treatment taxfundv,fbr match, without prior authorization of their match formula and
allocation use, approved by the.lefferson County Administrator and fiscal team. The
match may not be used without written permi . ssion.
bNo 1104 M1
Match: is a requirement for the grantee to provide contributions of a specified amount or
percentage to match funds provided by another grantor. Matching can be in the form of
cash or in-kind contributions.
Auditors Objective: To determine whether the match amount or percentage of
contributions from JC is an allowable source of funding and that the vendor has an
accurate accounting system to track the match.
Regulations: The Specific requirements for matching funds are unique to each federal or
state program. The A -102 Common Rule provides criteria for acceptable costs and
contributions in regard to match.
Jefferson County Policy:
In 2005, the Washington State Legislature created an option for counties to raise the local sales
tax by 0.1 percent, (the 1 /1 Oth of I %sales tax initiative) to augment state funding for mental
health and chemical dependency treatment. Jefferson County collects and distributes the Mental
I Icalth/Chernical Dependency (MH/CD) tax. Services purchased by the County are allocated
through a formal Request for Proposal (RFP) process, review and contracting; staffed by
Jefferson County Public Health, overseen by Jefferson County Mental Health Substance Abuse
Fund Advisory Committee and adopted by the Board of County Commissioners, (BOCC). The
BOCC does not assume any fiscal responsibi lity/liability for any of the vendors they contract for
services with. Services leveraged by a vendor using MII/CD tax as match have no oversight or
agency relationship to Jefferson County; funding cannot be used without prior authorization of
the vendor's match formula and allocation by the Jefferson County Administrator and fiscal
team.
Jumping Mouse Children's Center - 201 4 10
Following state, federal and local guidelines for match is the responsibility of the vendor,
Jefferson County will follow all administrative policies in authorizing that use. If a vendor is
disallowed the use of funds for match according to the State of Washington or the federal
government, Jefferson County funds will not be available as matching funds.
For example, if a vendor provides Title XIX Medicaid services (the Policy
19,50,02 or 42CFR 430,30) they will not be allowed the use of match without
actually billing Medicaid for the services at the same time. If no Medicaid billing
exists, the match cannot be applied.
The County shall verify that the local entity's financial reporting system tracks
matching funds at a level to support the use of funds; that meets the level of
documentation required by federal or state statutes.
The verification and application process for Match use within the County will include the
following steps:
1. DSHS requires contractors to complete and submit a "Local Match Certification"
form (DSHS 06-155) or a form that has equivalent data elements prior to any
agreement for DSHS services, The County must review a copy of this application
and form prior to granting match authorization of MH/CD funds for Match and at
each monthly billing.
2. Submit the current administrative policy within WA State regulating your services
and the use of local match.
3. Submit to the County your last financial audit showing your use of match,
County funds and tracking systems,
4. Submit to the County the terms of the agreement to ascertain the M14/CD
allocation is an allowable source of match,
5. The County Administrator will authorize or deny the use of match in writing
within 30 days of the application.
Jumping Mouse Children's Center - 2014 11