HomeMy WebLinkAbout071414_ca07W Gov oG
JEFFERSON COUNTY PUBLIC HEALTH Consent Agenda
615 Sheridan Street o Port Townsend o Washington o 98368
www.jeffersoncountypublichealth.org
June 9, 2014
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director Jefferson County Public Health
Anna McEnery, Developmental Disabilities / Substance Abuse
DATE:
i
SUBJECT: Agenda Item — Contract Agreement, Amendment #3 Safe Harbor
Recovery Center Personal Services Agreement to provide case
management services for Family Therapeutic Court; January 1, 2014 —
December 31, 2014; additional $16,000 not to exceed $146,500
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of the Contract Amendment #3 with Safe Harbor
Recovery Center to provide case management services for Family Therapeutic Court.
ANALYSIS/ STRATEGIC GOALS /PRO'S and CON'S:
This amendment adds $16,000 dollars to the existing Professional Services Agreement with Safe Harbor
Recovery Center. Additional funds are to be divided $14,400 for case management and $1,600 for services
and /or incentives directly related to treatment progress. The entire Personal Services Agreement is not to
exceed $146,500 dollars without written amendment signed by both parties. This is a one year contract to
provide case management services previously negotiated by the BOCC Advisory Board.
FISCAL IMPACT /COST BENEFIT ANALYSIS:
The contract amendment is funded by the sales tax revenue raised by the County in the 1 /10`h of 1% Fund
and is allocated by the BOCC with advice from the Mental Health and Substance Abuse Sales Tax Advisory
Committee. The contract takes into account decreases in sales tax revenue and has in place protocols for
renegotiation.
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 Amendment #3 with Safe Harbor Recovery Center to
provide case management services for Family Therapeutic Court; January 1, 2014 — December 31, 2014;
Additional $16,000 in funding to be allocated $14,400 for case management services and $1,600 for
services and /or incentives directly related to treatment progress.
REVIEI
Philip ey, Co Admini *or
Date
CONTRACT AMENDMENT #3
By and Between
Safe Harbor Recovery Center
And
Jefferson County
Family Therapeutic Court 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 Family Therapeutic 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 $146,500 without express written amendment signed by both
parties.
5. 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
Icy:
(Contractor)
v 0
Safe Harbor Recovery Center, Amendment # 3
ATTACHMENT A
Jefferson County
Family Therapeutic Court
Case Manager
STATEMENT OF WORK
Summary:
Oversee the development, implementation and coordination of the Jefferson Family Therapeutic Court
Program, including the following duties:
Serve as a liaison among the Jefferson Family Therapeutic Court (3FTC) 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 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. that all are informed and
Coordinate communication network among the above team members so
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
JFTC-
Safe Harbor Recovery Center, Amendment N 3
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, 2.014
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 agreement will remain the sarne.
Dated this Oday f 2014
By: John I ustin, Chairman
Jefferson Board of county commissioners
try:
(Contractor)
Jefferson A roved as to form only
pro U �
CA-r!nW
O.Prosecutor's itice
David Alvarez, Chief Civil DPA
Safe Harbor Recovery Center, Amendment 4 2
ATTACHMENT A
Jefferson Mental Health Court
Case Manager
STATEMENT 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 netwo rk among the above team members so that all are informed and
knowledgeable of the program's progress, t so that the program remains
Ensure that concerns are quickly aired and resolution sough
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 Cou rt 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, AmendMerlt 4 2
41
a, CONTRACT AMENDMENT 91
By and Between
Safe Harbor Recovery Center
And
Jefferson County
For Expanded Mental Health (MU) & 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,
rr IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The term of the above referenced agreement ends December 31, 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 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
match, Contractor shall be solely responsible for compliance with all state and federal laws
and regulations, including, but not limited to DS1 IS, CMS and DBI IR funding rules,
applicable to the use of MH/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 Attaclu-nent
A, attached hereto and incorporated in this Agreement. The County may withhold
authorization to utilize the MH/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.
M�
3. Total compensation under this Agreement remains unchanged and shall not exceed $114,500.00
without express written amendment.
4. All other terms and conditions of the agreement will remain the same.
2014
Dated this day of
j
By:
John Atij'tinl Chairman
jeffersoit' Board of County Corninissioners
By:
proved as toforrn OnIY:
2 .1 /—A P
(Contractor) I
S,jfe Harbor Recovery Center, Amendment# I
Jefferson County Pros Cicc vi DPA ut r's Office
7
David Alvarez, Chief
JEFFERSON COUNTY MH CD TREATMENT TAX FUNDING -
MATCH POLICY
Definitions:
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.
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 /10th of 1% sales tax initiative) to augment state funding for mental health and chemical
dependency treatment. Jefferson County collects and distributes the Mental Health/Chemical 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).
BOCC does not assume any fiscal responsibility /liability for any of the 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 to 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 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 ail days of the application,
If the County informs the Contractor of the availability of 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 of MH /CD sales
tax monies as match. Following state, federal and local guidelines for match is the responsibility of the
contractor.
For example, if a Contractor provides Title XIX Medicaid services (the Policy 19.50.02 or 42CFR 430.30)
they are required by those rules to actually bill Medicaid for the services at the same time. If no Medicaid
billing exists, the match would not comply with state and federal guidelines for match.
Safe Harbor Recd rery center, Amendrrnent ra 1
Concurrent with its request for authorization of the availability of match, Contractor shaH document it has met its
a1ad|oca:i�nesfurmatchbysubmhtinginw�tieg tm the County
re «P onsibUitytnfoOow�ate'fe6en e
Administrator their match formula, allocation p\am, and other documentation made mandatory pursuant tothis
h U 1 idetbcfoUuvvin8t»the[ou»tY
AKrcennemtand this Attachnment/\' Atamimimwnm, the Contractor s � as�prov
Administrator:
� D5�S requires contractors complete and subnnita "Local Match Certification" form (DSH606-
h iva|entdataelememt�prinrtmanya�reement for DSHSservices.
�m that �sequ
155) or� form /. equivalent data __�___ , . ,
Submit a copy of this appc� ona
application ndform when requesting match availability from the County
and at each monthly billing.
I. 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 ofmatch, County funds and
tracking systems.
4. Submit to the County the terms of the agreement showing the MH/CD allocation is an allowable
smurceoƒmatch.
5. prov\dedocurnentatiomthatY»ur�mnncia|rmpmrt\ngxystemtracksmatchinQfwndseta(eve|that
meets the level ofdocmmentatimn required bY federal or state statutes.
The County mnay reject permissionforContraotnrtowtii|retheW1H/[Dsaiestaxnmzniesm»mmtch.
CONTRACT AGREEMENT
By and Between
Jefferson County
And
Safe Harbor Recovery Center
For 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 Safe Harbor Recovery Center (SHRC), herein referred to as the
"Contractor" to provide alcohol and substance abuse treatment services to individuals impacted
by mental health/substance abuse issues in Jefferson County, Washington.
Section 2: TERMS:
This Agreement shall com mence on January 1, 2014 and continue through December 31, 1 2014,
unless terminated as provided herein.
Section 3: SCOPE 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 Dependency Treatment, The
goal of this funding and sales tax increase is to improve the quality of life for Jefferson County
citizens by improving access to treatment and improving partnerships with Jefferson Mental
Health, Clients who need services of one agency will be screened and referred, if necessary, to
the other agency. These funds will be used to increase treatment services to citizens seeking
substance abuse treatment and those who have a co-occurring Mental Health disorder,
A. Contract Representatives:
Jefferson County and SHRC 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 Re resentative
Anna McEnery
Jefferson County Public Health
615 Sheridan SL
Port Townsend, WA 98368
(360) 385-9400
Contractor's Contract Representative
Teresa Wirth, Administrator
Wirth,
Safe Harbor Recovery Center
686 Lake Street, Suite 400
Port Townsend, WA 98368
(360) 355 -3866
Section 4: COMPENSATION:
The total amount payable shall not exceed $114,500,00 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 1-nc)st recently completed quarter year and the same quarter year revenues
Safe Huboi- Recovery Center-2014
for 2013, then this contract may be renegotiated. The parties acknowledge the funding �onnected
to s revenue of last resort and therefore Contractor will bill all other source:, Of
. his contract i
revenue first.
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 -12?.
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, 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. Conti-actor will submit the most recent financial audit within 30 days from the
beginning of this agreement.
b. The audit 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,
Safe Harbor Recovery ('enter-2o14
d. Audit and/or recent DBHR annual fiscal review 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: 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 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
($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 firnit per occurrence of one million dollars
(s1,000,0010) 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.
D. 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
Safe Harbor Recovery Center-2014
E. it is agreed by the parties that insurers shall have no right of recovery or sub,ogation
against the Cotinty (including its employees and other agents and agencies) it
being
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 RC W 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 T CONFIDENTIALITY:
Contractor, its employees, subcontractors and their employees will Maintain the confidentiality
of all information provided by JCPI I or acquired in performance of this Agreement as recluired
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: INDEPENDENCE
The Conti-actor 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. 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
Z� p
employee.
Section 9: 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 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`1 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, Attn: Finance
Saft, Hai-boi- RecovOIY Cciitei"-2014
Department, 615 Sheridan, port Townsend, and WA 98368. The County will review such
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: TERA41NATION
'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.
1. 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 Ex1fibit A.
3. With 30 days notice by the Contractor by voluntary resignation.
DISPUTE RESOLUTION
Section 12: or disagreement concerning the terms and obligations of this Contract shall initially
Any dispute t to the attention of the Public Health Director via a written document, The Public
be brough
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 Jefferson County Administrator (or as
may hereafter be amended), will decide the appeal of the Director's decision.
Section 13: 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 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.
p
S,jfe Htrbor ccovej-y ce;)ter-2014
2
Approved this day Of 0 jb
BOARD OF COUNTY COINIMISSION ERS
JEFFERSON couN'ry, WASHINGTON
mh
Pi n
John istin, Chairperson
Safe Harbor Recovery Center
ATTESI
"6166uty Cler& of the Boa
I
Safe Harbor Recovery Center-2014
Exhibit A
Scope of Work
The Safe Harbor Recovery Center agency as a contracted provider, agrees to:
1. Clinical and care management treatment services for additional Jeffierson County citizens
unable to be seen in other revenue sources.
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.
Background checks ,
Back 3 are required for all employees; to be redone for every employee
every g
n" years, 'Fhe names of licensed therapists will be given to the County,
4. Work collaboratively with local mental health courts and substance abuse treatment
agencies to identify and treat clients with CO-OCCUTring disorders,
j. 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.
Maintain a secure records system guaranteeing the confidentiality of PI-11 pursuant to
[IIPPA.
10, Bill other sources of revenue whenever they exist, Document what percent of clients are
covered by other sources of revenue.
11. Include Mental Health Court service hours in those billed under CODIT and Drug Court.
Please track separately.
12, Monthly report on client utilization, referrals, outcomes as specified by JCPH.
13. 1-11re Chemical Dependency Licensed professionals and maintain training and education
needs for those billing on this contract.
14. Group or individual therapy, or a combination of the two, of a specified duration, using
a. evidence based models of treatment. Applicant will identify the number of clients
seen,
how ofter, each week, and the number of hours per week and per month for
treatment
enrollment, also identify the after care plan weekly and monthly.
Ions on MH therapeutic couil, staffing for treatment and case
15, Participate in 20 14 discuss
inanagerne,nt.
S_ jja,n-bol, jteC()vel*y Cotter-?o1=
16, Chemical dependency, mental health and/or COD assessment, treatment plan
development and review.. documentation of client progress (group and individual session
notes), and aftercare planning and monitoring are documented and maintained for at least
five years or following WA state statutes.
17. Referral for mental health medication and monitoring as needed.
18. Services are available throughout the county.
19. Preparation of progress reports if needed, e.g. to court.
20. Agency oversight regarding record keeping, data collection, legal and ethical
issues and
standards of care are updated and meet State of Washington standards,
21. Opportunities for regular clinical supervision and psychiatric consultation are available
for staff on a regular basis.
22. Collection and preparation of service data for evaluation purposes, and reporting to
JCPf I monthly with the invoice. Use forms supplied by JCPH for data,
23. 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.
Safe Harbor pecovery Center -2014
Exhibit B
Fee Schedule
Chemical Dependency Professional Oa $25.00/hour
Accountant @ $23.00/hour
Clerical /data entry @$21.00/hour
Supervision/Program Management @D $50,00/hour
UA for CODIT clients monthly, based on lab invoices
Not to exceed $114,500-00 in completion of services for the duration of this contract without
express written amendment.
Safe Hai-' Recovery Ceiiter-2014
ATTACI ]MENT A
X 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 Jefferson County mental health countyl cheinical dependel7cy
treatment taYfundsfor match, without prier authorization of their malchformula and
allocation use, approved by the JefjLrson County Administrator and fiscal team. The
match may not he used without written permission,
Definitions:
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: I I o 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 snatch.
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 0th of 1% sales tax initiative) to augment state Funding for mental
Ilealth and clicinical dependency treatment. Jefferson County collects and distributes the Mental
Ilealth/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
jeff"'erson County Public Health, overseen by Jefferson County Mental Health Substance Abuse
Fund Advisory Committee and adopted by the Board of County Commissioners, (BOCC), h, e
BOCC does not assume any fiscal responsibility/liability for any of the vendors they contract for
services with. Services leveraged by a vendor using Mll/CD tax as match have no oversight or
agency relationship to Jefferson County; ftinding cannot be used without prior authorization of
the vendor's match formula and allocation by the Jefferson County Administrator and fiscal
tearn.
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Following state, federal and local guidelines for match is the responsibility of the vendor,
iccz i e. if a vendor is
all administrative policies autho ri zi n that u s
Jefferson County will follow
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 4' )0.3 )0) 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 (i.)syIS 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 MH/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.
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