HomeMy WebLinkAbout031014_ca03W o-50N OG
JEFFERSON COUNTY PUBLIC HEALTH Consent Agenda
615 Sheridan Street o Port Townsend o Washington o 98368
www.jeffersoncountypublichealth.org
January 21, 2014
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE:'%
SUBJECT: Agenda Item — Contract Agreement with Safe Harbor Recovery Center,
Amendment #2 to provide Case Management Services for Jefferson
Mental Health Court; January 1, 2014 — December 31, 2014; add'I
$16,000 not to exceed $130,500
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of the Contract Agreement with Safe Harbor
Recovery Center, Amendment #2 to provide Case Management Services for Jefferson Mental Health Court
(JMHC); January 1, 2014 — December 31, 2014; add'I $16,000 not to exceed $130,500
ANALYSIS /STRATEGIC GOALS /PRO'S and CON'S:
This is a one year contract to provide mental health substance abuse treatment services previously
negotiated by the BOCC Advisory Committee.
Safe Harbor Recovery Center is working with JMHC to provide case management services, increasing the
court's ability to quickly address the therapeutic needs of its participants. JMHC will supervise, coordinate
and have oversight of treatment provided to parents /families who have substance abuse /mental health
issues with the intended outcome to reduce child abuse and neglect, reduce out of home placement of
children and termination of parental rights and reduce substance abuse /mental health symptoms among
parents or guardians and their children.
FISCAL IMPACT /COST BENEFIT ANALYSIS:
This is sales tax revenue raised by the County in the 1 /10 of 1% Fund and is allocated by the BOCC with
advise from the Mental Health and Substance Abuse Sales Tax Advisory Committee. The contract states if
the sales tax revenue decreases the vendor will be contacted and the contract may be renegotiated.
Jefferson Mental Health Court responded to a local Request for Proposal which was reviewed and chosen by
the Committee.
COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH
DEVELOPMENTAL DISABILITIES WATER QUALITY
MAIN: (360) 385 -9400 ALWAYS WORKING FOR A SAFER AND MAIN: (360) 385 -9444
FAX: (360) 385 -9401 HEALTHIER COMMUNITY FAX: (360) 379 -4487
Consent Agenda
RECOMMENDATION:
JCPH management request approval of the Contract Agreement with Safe Harbor Recovery Center,
Amendment #2 to provide Case Management Services for Jefferson Mental Health Court; January 1, 2014 —
December 31, 2014; add'I $16,000 not to exceed $130,500
REVIEWED B
Philip Morley, ounty Admini trator
Date
CONTRACT AMENDMENT #2
By and Between
Safe Harbor Recovery Center
And
Jefferson County
For Expanded Mental Health (MH) & Chemical Dependency (CD) Treatment 2014
WHEREAS, the Safe Harbor Recovery Center (Contractor) and Jefferson County (County) entered into
an agreement on January 1, 2014 for Professional Services in connection with the provision of alcohol and
substance abuse treatment 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.
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. 'The term of the above referenced agreement ends December 31, 2014,
2. Safe Harbor Recovery Center is working with Jefferson Mental Health Court to provide case
management services, as provided in Attachment A, Statement of Work, increasing the court's
ability to quickly address the therapeutic needs of its participants.
3. This amendment adds $16,000 in funding, $14,400 of which is to be used specifically for case
management services and $1,600 is to be used for services and / or incentives directly related to
the treatment progress of program participants.
4. This contract shall not exceed $130,500 without express written amendment signed by both
parties.
5. All other terms and conditions of the aj,'Yreement will remain the same.
Dated this day of 2014
By:
John Austin, Chairinan
Jefferson Board of County C0111ITlissionei-s
By:
(Contractor)
Safe Harbor Recovery Center, Amendment # 2
U —(TOWN -ITOWNFU DO IN
Jefferson Mental Health Court
Case Manager
STA TEMEN T OF WORK
Summary:
oversee the development, implementation and coordination of the Jefferson Mental Health Court
Program, including the following duties:
• Serve as a liaison among the Jefferson Mental Health Court (JMHC) Judge(s), Washington State
Attorneys General, Superior Court Clerk and deputy clerks, Public Defenders, Juvenile and Family
Services, CASA/GAL Program, Department of Social and Health Services Division of Children and
Family Services, Chemical Dependency Treatment provider, Mental Health treatment provider.
• Support the development, implementation and continual coordination of the JMHC partnership.
• Arrange, conduct and participate in team meetings ensuring that key members are present and
that their input is recorded, considered and that group conclusions are recorded and
implemented.
• Coordinate communication network among the above team members so that all are informed and
knowledgeable of the program's progress.
• Ensure that concerns are quickly aired and resolution sought so that the program remains
focused,
•, Develop and maintain an action plan, which outlines objectives, strategies and tasks; monitor
progress and report regularly to designated agencies.
• In conjunction with the Superior Court Administrator and the Juvenile Court Administrator,
update procedures manuals, forms and other materials as needed.
• Adjust and enhance the implemented program based on appropriate feedback from the judge.
• In conjunction with the Superior Court Administrator and the Juvenile Court Administrator,
develop budget and budget reports for the County and any other funding agencies.
• Respond with the Superior Court Judge or other team member to public inquiries concerning the
JMHC.
Safe Harbor Recovery Center, Amendment # 2
CONTRACT AMENDMENT #1
By and Between
Safe Harbor Recovery Center
And
Jefferson County
For Expanded Mental Health (MH) & Chemical Dependency (CD) Treatment 2,014
WHEREAS, the Safe Harbor Recovery Center (Contractor) and Jefferson County (County) entered into
an agreement on January 1, 2014 for Professional Services in connection with the provision of alcohol and
substance abuse treatment 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.
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The term of the above referenced agreement ends December 31, 2014.
2. 'I"his amendment strikes Section 4. 1". 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 the Contractor to use such funds for match. (See Attachment A)
b, Where Contractor proposes to use chemical dependency mental health County tax funds for
snatch, Contractor shall be solely responsible for compliance with all state and federal laws
and regulations, including, but not limited to DSf IS, CNIS and DBHR funding rules,
applicable to the use of M11/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 Attaclurient
A, attached hereto and incorporated in this Agreement. The County may withhold
authorization to utilize the M11/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, 'l'otal compensation Linder this Agreement remains unchanged and shall not exceed $114,500.00
without express written aniendrnent.
4. All other terms and conditions of the agreement will remain the same.
Dated tllis_day of,, 2014
By: �
lohn AUStill, Oiairrnaii
Jefferson Board of CoulltY C01111nissioners
0
13y: -7-'o LLAXZ1 provedasto OMO IY:
(Contractor) Zj11tf
pa
cavery Center, Amendment# I
Safe [larbor Re, Jefferson County Pro-sec r Office
David Alvarez, Chief Civi. DPA
MATCH POLICY
Definitions:
Match: is a requirement for the grantee tu provide contributions of a specified amount or percentage tm
match funds provided by another gra:ntor. Matching can be in the form of cash or in-kind contributions.
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 1/10tb of196 sales tax initiative) to augment state funding for mental health and chemical
dependency treatment. Jefferson County collects and distributes the Ment�l Health/Chemical Dependency
(K8H/CD) tax. Services purchased by the County are aUmcatedthrough a formal Request for Proposal (BpP)
��ns review cmn�r�cdm��sta���bv]effermomCoumLyPmb|icNea|tb,uwerseenbyJeffersonCountyK4enta|
process, � '
Health Substance Abuse Fund Advisory Committee and adopted bv the Board of County Commissioners, /8OCCl.
8OCC does not assume any fiscal respomsibiNt«/§ahi||ty for any of the Contractors they contract for services with,
Jefferson County reserves the first right to use as match the chemical dependency mental h�alth tax funds and
the Services funded by them for purposes of qualifying for additional funding and grants. County may make
available to the Contractor the chemical dependency mental health tax funds for the Contractor to propose aa
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 to the County Administrator in writing, and include their match formula and allocation plan and may
include other documentation to support their request. The County Administrator will authorize or deny the
availability of match funds in writing within 30 days of the application.
if the County informs the Contractor of the availability of chernical dependency mental health County tax funds
for match, then the Contractor shall be solely responsible for compliance with all state and federal laws and
reigulations, including, but not limited to DGNS, CMS and DBHRfunding rules, applioab|e to the use ofMH/CD sales
tax monies asmatch. Following state, federal and local guidelines for match }s the responsibility mfthe
Contractor.
�
For example, if a Contractor provides Title XIX Medicaid services (the Policy 19.50,02 or4ZCFH43D.3CA
they are required by those rules to actually bill Medicaid for the yewloos at the same time. If no Medicaid
billing exists, the rnatch would not comply with state and federal guidelines for match.
Safe Harbor Recovery Center, AniepdmentxI
Concurrent with its request for authorization of the availability of match, Contractor shall document it 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 tuthis
Agreement and this Attachment A. At a minimum, the Contractor shall also provide the following to the County
1. DSHS, requires contractors to complete and submit a "Local Match Oartffica1iom°form /USH506-
155\ura 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 at each monthly billing.
2. Submit the current administrative policy within WA State regulating your services and the use of
local match.
I Submit to the County your last financial audit showing your use of match, County funds and
tracking systems.
4. Submit tothe 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 bvfedera|or state statutes.
The County may reject permission for Contractor to utilize the MH/CD sales tax monies as match.
Sale *orhm,memvrycente�� Amendment wz
C0NTR-ACT AG'REEMf`,NT
By and Between
,Jefferson County
And
Safe Harbor Recovery Center
For Mental Health (M11) & Chemical Dependency (CD) Treatment 2014
Section I -- PURPOSE:
THIS AGkF�.EMENT for Professional Services is entered into between Jefferson County herein
referred to as the "County" and Safe Harbor Recovery Center (SI-IRC), herein referred to as the
,,Contractor" to provide alcohol and substance abuse treatment services to individuals irnpacted
by mental health1substance abuse Issues in Jefferson County, Washington.
Section 2: TERMS*
This Agreement shall conjinence on January 1, 2014 and continue through December 31, 2014,
unless terminated as provi ded herein.
Section 3: SCoII,-' OF AGREEMENT:
Contractor Will increase chemical dependency 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 Chemical De pendency 'freatment. The
goal of this funding and sales tax increase is to improve the quality of life for Jefferson County
citizens by it access to treatment and improving partnerships with Jefferson Mental
I-lealth. Clients who need services of one agency will be screened and referred, if necessary, to
the other agency,'['11ese funds will be used to increase treatment services to citizens seeking
substance abuse treatment and those who have a co-occtirring Mental Health disorder.
A. Contract Representatives:
jefferson County and S11RC 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:
Anna McEnery
Jefferson County Public Realth
615 Sheridan St.
Port Townsend, WA 98368
(360) 385-9400
Contractor's Conmict Representative
Teresa Wirth, Adi-ninistrator
Safe Harbor Recovery Center
686 Lake Street, Suite 400
Port Townsend, WA 98368
(360) 385-3866
4: C()MPENSATION
The total payablc shall not exceed $114,500,00 in completion of this pro . ]eel WithOLIt
express Wl-jtteTi aniendri,jetij signed by both parties to this Agreement. The pallies acknowledge
that tundin I g for this Contract is cOntingent oil the Continuation of sales tax revenue M 2014. If the
sales tax reveriuc. decreases bY ten percent (10%) when applicable sales tax rLvenacs are,'
collipared between the 1-110st recently completed ClLlffller Year and the sarne quarter year revenues
Salo: I 1,,irbm Recovery ('CtIM .20 14
this �D . e parties ack.nowledge the funding connected
for 2013, then s contract may be renegotiated. Th Li , o
to . t reve'RIC of I ast resort and therefore Contiactor w; 11 bill all other so rces f
� tl-iis conti-ar;
revenue, Cirst.
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`1 Monday of the month for the previous month's
expenses, I The County will review such invoices, and upon approval thereof, payrnent
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. A-ny 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 farads 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. ,he 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 car, and does accept the work performed by the Contractor.
G. Contractor records, client records, documents, reports 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.
An audit will be submitted to the County annually.
a. ContractOrwill subt
-nit the most recent financial audit within 30 days frorn the
beginning of this agreern ent.
L�
b ,,Ile �jjjcjlt shall be completed by the WA State Auditor's Office or a mutually agreed
capon entity, jjpon request the County shall have the option of'performing an onsite
ve%,i,w of',111 records, statements, and documentation.
c. if the County finds indications. of potential non-cornpliance dctririg the irlonitorITIO
process, the (,'O`ntY Shall notify Contractor within ten (10) days. County and
Contractor shall meet to discuss, areas of contention in an atterript to resolve issUes,
-r-20 14
d. Audit and/or recent DBHR annual fiscal review and is perfori-ried in accordallce with
generally ac cc ptecl auditing standards and with Federal Standards for Audit of
(lovernryiental organizations, Programs, Activities and Functions, and meeting all
requirements of OBM Circular A -133 or A- 128, as applicable,
04NIFICATION:
Section 5: INDr ify, defend and hold harmless the County, its officers, agents and
The Contractor shall indemni
employees, frorn and against any and all claims, lawsuits, demands for money damages, losses or
fees and costs, arising from any in'
liability, or any portion thereof, including attorney's f jury to
person or persons (including the death or injury jury 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 prov iding bodily injury and property
damage liability coverage for all owned and non owned vehicles assigned to
or used in the performance of the work fora single limit of not less than
$500,000 per occurrence and ariaggregate of not less than one million dollars
($1,00(),()00) Contractor shall provide proof of insurance to the County
c/o Contracts Manager at Jefferson County Public Health, 615 Sheridan St. Port
'fownsend, 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 ($2,00(1,000) 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:
L Broad Form Property Marriage with no employee exclusion;
2. Personal In , jury Liability, including extended bodily injury;
3 1 ions
), Broad Form. C011tractual/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. Profession,"] Lial)ility Insurance providing $2,000,000 per incident; $4,000,000
aggregate, name Jefferson County Public f lealth as additional
insured,
D, "l "he Contractor shall pa
rticipate In the Worker's Compensation and Ernployer',s,
Liability 111silratice Program as niay be required by the State of Washington.
I it agreed by the pat-ties that insurers shall have no right of recovery or subrogation
I agencies) it being
��igainst the (-A)IInty (Including its employees and otheragents and ,
S Ifo R,ucuvery Celiter-2014
It is agreed by the parties that insurers shall have no right of recov(-,ry or subrogation
a les) it being
against the COUItv (including its employees and other agents and agenc
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 alcove -- listed insurance policies hall be assumed by, paid for and at
the risk of the Contractor.
E Any insurance coverage for third party liability claims provided to the County by a
f�
"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.
& 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.
1-1, The County rn,ay, upon the Contractor's failure to comply with all provisions of this
contract relating to insurance, withhold payment or compensation that would
other-Wise be due to the Contractor.
Section 7: cONFIDENTIALITY:
subcontractor,; and their employees will maintain the confidentiality
Contractor, its er"Ployees' 'o
provided by JCPH or acquired in performance of this Agreement as required
of all information prov laws This Contract, once executed by the parties, is and remains a
by 1T )AA and Other privacy ,
Public Record subject to the provision of Ch. 42,56 RCW, the Public Records Act.
Section 8: INDEPENDENCE
The Contractor and the County agree that the Contractor is an independent Contractor with e
respect to the services provided pursuant to this agreement. Nothing in this agreement shall b
considered to create, the relationship of employer and employee between the parties hereto. The
C,()jitractor Shall not be entitled to any benefits accorded County employees by virtue of the
I
provided under this agreement. The County shall not be responsible for withholding or
services pro ial security or for contributing to the state
otherwise (�,,,jcraj iticome tax or soc
erwise deductini, rograTil, otherwise assn ring the duties of an employer with respect to
ifIciustrial insurance 1)
,,r,pj(,)yee.
,�,SSIGNNIEN't'S AND SUK"ONTRACTING
Section 9� c assign any ()f the services covered by this aqreenient without
flee Contra 'to,, sjj�jll not sublet or
eprL,,`;swrittell consent of the County.
Sect.c)ll jo�
I service sunirnary report to the County ",A the same time as
,I'lle Contractorwill 13R)"(" a 111()"t[ily nd 'MOrIth'S work,
)EI 111LIs twd by tlic 2 Monday ot'the month for the PrCViMl�
[nV0[CeS a "t
.1,11c 1,nonthly report skall contaill the report of serviced and the total hours worked by which stal.
Illy iepol,t ,jj,jq bc, ,obrnitted to Jeffiersoll GOLIWY Public Fleallh, Attn: Finance
�-J,je mont :) 4. 1
4,ai,boy Recover Cen e,n -20 14
DepartTrient, 615 eridan, port
Townsend, and WA 98368. The County will review such
Sh
- on a-. r0V,.1l t1lereof, payment will be made to the Contractor in the amount
re,po-rts, and ap -- -In"
re 'to S3,111 i"ll 1 t timely reports may result in a denial of reirribui
-sernent.
approved- 1"ailu )
See -1141NATION
'tion 11: Ty�, ,R
erves the right to terminate this contract in whole or in part, with 30 days notice,
The County reS t expected or actual funding frorn any funding source is withdrawn, reduced, or
in the event tha,
way after the effective date of this agreement. in the event of termination under
Iiinited in aTiY e County shall be liable for only payment for services rendered prior to the
this clause, tb
effective date of termination.
A. 'Fills agreement may also be terminated as provided below;
With 30 days notice by tile Board of County Commissioners for any
reason, or I loners for
2, With 30 days notice by the Board of County Commissioners non-
performance of the specific job duties in Exhibit A.
3, With 30 (lays notice by the Contractor by voluntary resignation.
111,ection 12', I)ISPUTE Rf,�SOIAJTION
disagreement concerning the terms arid obligations of this Contract shall initially
bey dispute o r brought to the attention Of the Public Health Director via a written document. The Public
health Director shall make her 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 Jeffcrson County Administrator (or as
n-lay hereafter be amended), will decide the appeal. of the Director's decision.
S 13 MODIFICAT.1'ON agrectnent of either
ection 13� . - agreement may be modified at anytime by written
This professional services -
party arid may be modified if tax revenue decreases.
Section 14-, INTEGRA1 TD AGREEMENT
This Agreernent together witli attachments or addenda represents the entire and integrated
between the County and the Contractor and supersedes all prior negotiations,
4:1
This apreement rnay be
,,r,cetnent b tents written or oval between Llic parties , In
or agrcerT
alTlende'd only by written 111strurrient signed by both County arid Contractor.
Approved this day of
BOARD OF COMMISSIONERS
coUNI'Y, WASHINGTON
JEFFERSON f--1
fzm-W Pstits, Chairperson
ter
j
Sa- cry Cen
c 14-arbor RecOv
A
D �IY
as arm only
) Z-) q/
I
oes o
Chief Civil
Doid Alvat
4,t1e' 11mbW (.1'e[Itcr20
201-
Exhibit A
Scope of Work
Safe Harbor Recovery Center agency as a contracted provider, agrees to.
1. Clinical and care management treatment services for additional Jefferson County citizens
unable to be seen in other revenue sources.
cc
Ployees or
2. All ern, , subcontractors of the Contractor undertaking the performan f mental
health/substance abuse services under this agreement Marc required to be proflessionally
licensed or certified by the State.
Backg
round checks are required for all employees; to be redone for every employee
every ye ars. [he narnes of licensed therapists will be given to the County.
4, Work collaboratively with local mental health courts and substance abuse treatment
gencies to identify and treat clients with co-occurring disorders.
a
5, provide UA for co-occurring disorder clients.
6 provide crisis interventions.
7. Run groups as appropriate;,
work with social services or other agencies as needed for dually served families with
mental health or chemical dependency issues.
9. Maintain a secure records system guaranteeing the confidentiality of PIII pursuant to
tEPPA.
to. Bill other ounces' whenever they exist, Document what percent of clients are
covered by ss,ources of 'revenue.
other s
Include Men,tal flealth ('ourt service hours in those billed under CODIT and Drug Court,
Please track separately. CPIL
12, Monthly report oil client utilization, referrals, outcomes as speci 'tied by J
1,3, Hire Chernical Dependency I..,icerised professionals and maintain training and educition
needs, for those bilh,V, Oil thus contract.
if Groti,ran iridual flierapy, or a h,ru ocified ClUrati011, Using
L�vdericsd rnodels oftreatmen Apphc,- I
I int will identify the number of clients
secl],
b, low c)j-tejj each week, and the number ot'llours per week and per month for
treatniellt
enrollinerlt, �']`) identify the after care plart weekly arid monthly.
-1pealtic court, staffing for treat, e, - (I case
15, Particil')ate M 2014 (JISCLIssiorls oil MI -1 ther, r1l Ilt un
mariagel"It"It-
S td e I k-ii bo , ftec()very (,, Ejjet-20t
6.
17.
is
19
I depel-idency, mental health and/or COD assessment, treatnient plan
Chernlc'(,) view, docuirientation ofelienL progress (grourp and individual session.
n to , a lanning and monitoring are docurnented and maintained for at least
) nd aftercare P
�Ijg IYVA state statutes
s llowi
f r fo
live year ion and rrionitorincy as needed.
12,eferral i-or mental health rnedicat t5
Se '
Services are available throughout the county.
Preparation of progress reports if needed, e.g. to court.
Agen-cY oversight regarding record keeping.l., data collection, legal arid ethical issues arid
stal,idards ofcare are updated and meet State of Washington standards.
Oppo unities for regular clinical supervision arid psychiatric consultation are, available
rt
for staff on a regular basis.
Collection and preparation on o . f service data for evaluation purposes, and reporting to
JCPII rrionthly with the invoice. Use forms supplied by JCPH for data.
ivtend and report to the Mental Health Substance Abuse Sales 'Fax Advisory Committee
twice during the duration of this contract period, at regularly scheduled rnectings, with
progress evaluation reports.
20.
21.
22
23
fe,
", I
)a
Exhibit B
Fee Schedule
Chemical J>ependencY professional @b $25,001hour
Accountant @ $23,00/bour
'21 hour
Clerical/data entry @$ �00/ =ent @ $50,00/hour
supervision/Program Manage
I for CODIT clients monthly, based on lab invoices
Not to exceed $1, 14,500-00 in completion of services for the duration of this contract without
express written amendment.
S,,,If,e I ko'bm' kecOvc Y (.-('o'tcr-20 14
A'r'fACHMl..',,',NT A
)LM _ JNPZLQ
1LIELM5L) N'-gs-L _BZQ TREATMENTTAX
MATCH POLICY
On Octc)ber 14, 2013 jeflersol-i C ' ounty Board of County Commissioners (BoCCI) adopted the
following lanco'uage in the, allocation of the Mental Health Chernical Dependency treatment
dollars.
not .Ise Jef dependency
Agencies may ferson County mental health county/ chemical dependc
treatrnent tax Jundsfor snatch, without prior outhorization of their snatch formula and
allocation use, Op roved by the Jefft.rson County Adi-ninistrator and fiscal teorn, The
rylatch may not be used without wriltenpermission.
is a req
Match.. uire rnen t for the grantee to provide contribuI
t ons of a specified amount or
percentage to match funds provided by another grantor. Matching can be in the form of
cash or Iii-kind contributions.
. : 'J'o determine whether the rnatch amount or percentage of
Audi tors objective j(,,, is . an allowable source of funding and that the vendor has an
ri butions f"O"
accountjng
accu'r,ate system to track the match,
Regulatiorls: 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
C)ntri butio Is iI n re gard to match.
jefterson Coul-Ity policy:
W,cls ate Legistature created an option for counties to raise the local sales
lra 2005., Ll1C gashing
St� I initiative) , for niental
tea by peycelit. (the 1/10til 01" 1% sales tax initiative) to augnient state funding
heaWl',ATIci chemical (Iepenc6eflcY treatnierlL. jeffe, -son Couv)ty collect and distrlbWeS tile IC11LAI
c�jcv (MI ) tax, Services purchased by the County are allocated
JJca�01/C.A1e,r1,,'ca1 Depend and contracting; staffed by
tJlV0L1g,h a fol"I'l lZecluest for J)rohowl (RFP) process, revi
seen by Jefferson C Jealth Substance A.buse
IC 11th, vei ounty Mental I
jef't'etson County Publ' l,le,
I-'juid AdvisorY adopted 1)), the Board ol'County Coninalssioners, (BOC(). The
Tic)t assuillc�llly 1-iscal responsibility/hability for any ofthe vendors they contract 1:'()r
BOCC CIOC� CS ➢evcj,wcd by a, vendor using Nit l/CF) uix as match have no overst'ght or
sctvlce'� Witil, �cxvlc
S I f'j, rs(on (_ounty; funding cannot beused Nthout prior authorization oC
relatiol'sl"l? to J� c ffloc,,�,.ition b�y the Jefferson ("oul'ity Administrator ancl fiscal
venclor's inatch
10
d local guidelines for is the responsibility ofthe vendor.
lowing state, federal all �D �zjljc,, fliat uSe. If a 'elIC101- i-
111 . all adi-ninistIn"itive Pol�icies in au-2- V
,eflfersoin Co"inty W� f1b, 1 1101 NO,
disallowed the use of funds for match according to the State of Washington or the federal
government, Jeffersorl County funds will not be available as matching funds.
0 For example, if a vendor provides Title XIX Medicaid services (the Policy
19. 50.02 or 42CFR 430.3 )0) they will not be allowed the use of match without
actually billing Medicaid for the services at the same tirne. If no Medicaid billing
exists, the match cannot be applied.
1,11c (,,ounty shall verify that the local entity's financial reporting systern tracks
matching funds at a level to support the use of funds; that meets the level of
docurnentation required by federal or state statutes.
The verification and application process for Match use within the County will include the
following steps
DSIIS requires contractors to complete and submit a "Local Match Certification"
,form. (MIS 06-155) or a form that has equivalent data elerrients, prior to any
agreement for DSIIS services. The County must review a copy of this application
and fora, prior to granting match authorization of MFl/CD funds for Match and at
each monthly billing.
21 Submit the current administrative policy within WA State regulating your set-vices
and the use of local niatch,
3� Submit to the County your last financial audit showing your use of match,
County funds and tracking systems. i
4. Submit to the County the terms of the agreement to asce rt in a the MJJ/CD
allocation is an allowable source of match.
5. j,he Coltrity Administrator will authorize or deny the use of match in writing
within 0 days of the application.
hal hOr Re coveq