HomeMy WebLinkAbout020314_ca05JEFFERSON COUNTY PUBLIc HEArni Consent Agenda
615 Sheridan Street c Port Tr winsend o WasNngton () 98368
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January 7, 2014
MaRMISUMI
-to: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE, F'e_E,,r ,tA t,, r L
SUBIECT: Agenda Item — Contract Agreement with Jumping Mouse Children's
Center; January 1, 2014 — December 31, 2014; language change only
STATEMENT OF ISSUE.-
Jefferson County Public Health, as the fund manager of the 1/10 of 1% sales tax treatment funds, requests
Board approval of the Contract Agreement with Jumping Mouse Children's Center, to provide mental health
services; January 1, 2014 — December 31, 2014; language change only
ANALYSIS / STRATEGIC GOALS/113110"S and CON'So.
This contract with Jumping Mouse is serving 7-10 Jefferson County at-risk youth (2 — 12 years of age) and
their families. This Contractor will provide expressive mental health therapy to children and intensive
education and support for their parents.
This amendment is a language change only. This amendment adds language regarding requirements and
compliance for using chemical dependency mental health County tax funds for match.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
There is no fiscal impact to the department or county.
RECOMMENDATION:
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; language change only
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12
ity Administr"Otor Date
COMMUM ry HEALTH ENWRONMENTAL MEA11 T n o
DEVE LC' MENI'AL MA U] I �ES PUBLIC HEALTH WA rER QUAL ffY
MAHC (360) 385 9400 AIWA” YS WORKING IFOR ASAFEIR AND MAIN' (360) 385 9444
FAX: (360� 385-9401 HEALTHIER COMMUNITY PAX: (360) 379 4487
CONTRACT AMENDMENT #1
By and Between
Jumping Mouse Children's Center
And
Jefferson County
For Expanded Mental Health (MIDI) & Chemical Dependency (CD) Treatment 2014
WHEREAS, the Jumping Mouse Children's Center (Contractor) and Jefferson County
(County) entered into an agreement on January 1, 2014 for Professional Services to be
provided in connection with the provision of mental health services to individuals impacted
by mental health/substance abuse issues in Jefferson County, Washington.
WHEREAS, the parties desire to amend the terms of that agreement.
rr IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The term of the above referenced agreement ends June 30, 2014,
2. This amendment strikes Section 4. E. of the original agreement and is replaced by
the following language:
a. County reserves first right to use as match the chemical dependency mental
health tax funds and the services funded by them for purposes of qualifying for
additional funding and grants. County may allow Contractor to use the
chemical dependency mental health tax funds as match, at the County's sole
discretion. Should the County decline to use chemical dependency mental
health tax funds as match for additional funding and/or grants, then the County
may authorize a Contractor to use such funds for match. (See Attachment A)
b. Where Contractor proposes to use chemical dependency mental health County
tax funds for match, Contractor shall be solely responsible for compliance with
all state and federal laws and regulations, including, but not limited to DSHS,
CMS and DBHR funding rules, applicable to the use of Mf--I/CD sales tax
monies as match. Contractor shall document it has met this responsibility by
submitting in writing to the County Administrator their match formula,
allocation plan and any other documentation required of them pursuant to
Attachment A, attached hereto and incorporated in this Agreement. The County
may withhold authorization to utilize the Ml-l/CD sales tax monies as match.
Contractor's failure to provide adequate documentation does not relieve the
Contractor of their responsibility to comply with all state and federal laws and
regulations related to match.
3, 'total compensation under this Agreement remains unchanged and shall not exceed
$30,000 without express written amendment.
4. All other terms and conditions of the agreement will remain the same.
Dated this day of ,2014
By:
John Austin, Chairman
Jefferson Board of County Commissioners
jurnwng Mouse Children's Center, Amendment # I
By:
Contractor
Approved as to form 71y:
LAI,
Jefferson County P-iC-)seCullf,;—SC—)fi--iC e
David Alvarez, Chief Civil :SPA
MATCH POLICY
Definitions:
Match: tsa requirement for the grantee Uo provide contributions mf a specified amount mr percentage 10
match funds provided by another grantor. Matching can be|n the form of cash or in-kind contributions.
Regulations: The specific requirements for matching funds are unique to each federal mr 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 01
percent, (the1/1Othofl96saiestax|mitiat� augment moemta|health and cherm1cmi
� t � ]eff�rsonCmun�ycovUec�a�n��istr��u��stheK8enta|H�ahh/Chemmioa|Oependemcy
dep�mdemcytreamn�m . Health/
Chemical
�en/icea�archasedby the County are a0ocatedthrough a formal Request for Prupoyal(RFp)
` ' ' ot� staffed overseen by Jefferson County &8en1a|
process, review and oomtra n�� s a '
Health Substance Abuse Fund Advisory Committee and adopted by the Board of County Commissioners, (BOCC).
BOCC does not assume any fiscal responsibility/liability for any ofthe Contractors they contract for services with.
Jefferson County reserves the first right to use as match the chemical dependency mental health tax funds and
the services funded by them for purposes of qualifying for additional funding and grants. County may make
available tn the Contractor the chemical dependency mental health tax funds for the Contractor to propose as
match to state, federal or other entities, at the County's sole discretion, Contractor shall not use chemical
dependency mental health County tax funds for match without prior authorization by the Jefferson County
Administrator and County fiscal team. To request authorization of availability of the funds for match, Contractor
must apply tothe County Administrator imwriting, and include their match formula and allocation pUan and may
include other documentation to support their request. The County Administrator will authorize or deny the
availability mf match funds im writing within 38 days mf the application.
|f the County informs the Contractor of the availability mf chemical dependency mental health County tax funds
for match, then the Contractor shall be solely responsible for compliance with all state and federal laws and
regulations, including, but not limited to DSHS, CMS and DBHR funding rules, applicable to the use ofMH/CDsales
tax monies asmatch. Following state, federal and local guidelines for match im the responsibility mfthe
Contractor,
w For example, if a Contractor provides Title XIX Medicaid services (the Policy 19.SO.02 or 42CFR
430'3O) they are required hvth ose r !astoactuaHyb0MedicaidfVrtheservicesotthesane
time, if no Medicaid billing exists, the match would not comply with state and federal guidelines
for match,
jumping Mouse cmuuen'sUnter, Amendment w/
Concurrent with its request for authorization of the availability of match, Contractor shall document h has met its
responsibility to follow state, federal and local guidelines for match by submitting in writing to the County
Administrator their match formula, allocation plan, and other documentation made mandatory pursuant 1Vthis
Agreement and this Attachment A. At minimum, the Contractor shall also provide the following to the County
1. DSHS requires contractors to complete and submit a "Local Match Certification" form (0SHS.D6-
IS5) ora form that has equivalent data elements prior to any agreement for DSHSservices.
Submit a copy of this application and form when requesting match availability from the County
and a1 each monthly billing.
2. Submit the current administrative policy within VVA State regulating your services and the use of
local match.
3. Submit tu the County your last financial audit showing your use of match, County funds and
backing systems.
4. Submit to the County the terms of the agreement showing the MH/CD allocation is an allowable
source ofmatch.
5. Provide documentation that your financial reporting system tracks matching funds at a level that
meets the level of documentation required bw federal or state statutes.
The County may reject permission for Contractor bmutilize the MH/CD sales tax monies as match.
julrnp/rgmmwue Children's Center, Amendment w1
CONTRACT AGREEMENT
By and Between
Jumping Mouse Children's Center
And
Jefferson County
For Expanded Mental Health (MI-1) & 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 l.lealth 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. CONTRACT PRERESENTATIVES:
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:
JCFI--[_ Contract -Repres LltgLtiv�-
Jean Baldwin
Jefferson County Public Health
615 Sheridan St.
Port Townsend, WA 98368
(360) 385-9400
Contractor's Contract RIM�esentative
Kris Becker, Executive Director
Jumping Mouse Children's Center
1.809 Sheridan St.
Port Townsend, WA 98368
(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 Centei� - 2014
A. Contractor shall be paid for services as outlined in Exhibit B — Fee Schedule.
B. 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 JefTerson 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.
'led 11 annual a form
d. Audit or recent compiled financial statements to accompany our an ua 990 tax
filing will provide statements consistent with the guidelines of Reporting for Other
jumping Mouse Children's Center - 2014
Non-Profit Organizations AICPA SOP 78-10, and is performed 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: INDEMNIFfCATION:
The Contractor shall inderrinify, 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 6: 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
$500,000 per occurrence and an aggregate of not less than one million dollars
($I,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 Fon-n. 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
Jurnping Mouse ClAdren's Center . 2011
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 full text to the County.
H. 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
Contractor shall not be entitled to any benefits accorded County employees by virtue of the
'
services provided under this agreement. T f or withholding or
he County shall not be responsible
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
jumpirig Mouse Children's Center - 21114 4
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.
jL1111ping Molise Children's Cealteo` - 2014
2 06�
Approved this,_ �J) YL b- e �"-
BOAF-D OF COUN'ry COMMISSIONERS
JEFFERSON COUNTY, WASHINGTON
.. . ....... . ..
stin, Chairperson
jumping 1\1couse t_, D I I 9JIvn's Center
"
the E3oard
dkurrtiprq 7 Nj(��jsc ("Aiddrel"S Center . 2014
Exhibit A
Scope of Work
RESPONSIBILITIES:
The Jumping 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
healthjsubstance abuse services under this agreement are required to be professionally
licensed or certified by the State.
I 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 PFIl pursuant to
HIPPA
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 for 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.
13. 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 JCPFI monthly with the invoice, Use forms supplied by JCPI I for data.
Jumping Mouse Children's Cesiter - 2014
15. Staffed by 6 master's level, Licensed Mental Health Counselors, one master's level
Licensed Mental Health Counselor Associate, and one niaster'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:
e 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 avai.lable
for staff on a regular basis.
21, Attend and report to the Mental Health Substance Abuse Sales Tax Advisory Committee
twice during the duration of this contract period, at regularly scheduled meetings, with
progress evaluation reports.
juji,piiig Mouse Children's Center - 2014
Exhibit B
Fee Schedule
Therapy and Care Management @ $35.00/h our
Not to exceed S30,000-00 in completion of services for the duration of this contract without
express written amendment.
Rimping Mouse Children's Center. 2014 9
ATTACH mENT A
G-
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 Je
'f
,ferson County mental health countyl chemical dependency
treatment tax funds for match, without prior authorization of their match fbrmula and
allocation use, approved by the .Jefferson County Administrator and fiscal team. The
match may not be used without written permission.
Definitions:
Klatch: 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 COUTITY Policy:
In 2005, the Washington State Legislature created an option for counties to raise the local sales
tax by 0.1 percent, (the 1 /10th of 1% sales tax initiative) to augment state funding for mental
health and chemical dependency treatment. Jefferson County collects and distributes the Mental
I-lealth/Chernical Dependency (MI'I/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 assurne any fiscal responsibility /liability for any of the vendors they contract for
services with, Services leveraged by a vendor using MHJCD 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.
jujlpij,lg N�Jouse Children's Center - 2014 to
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:
DSHS requires contractors to complete and submit a "Local Match Certification"
form (DSHS 06-155) or a fortri 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.
1 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 Ml1/CD
allocation is an allowable source of match.
The County Administrator will authorize or deny the use of match in writing
within 30 days of the application.
juniping Mouse Childivn's Centei- - 2014 1 1