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HomeMy WebLinkAbout011215_ca03615 Sheridan Street Port Townsend, WA 98368 www.JeffersonCountyPublicHealth.org Consent Agenda December 17, 2014 JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS TO: FROM: DATE: SUB3ECT: AGENDA REQUEST Board of County Commissioners Philip Morley, County Administrator Jean Baldwin, Director II /z11s Agenda Item — Agency Agreement — Division of Behavioral Health and Recovery with DSHS, Amendment #10, November 1, 2014 —June 30- 2015; revises language to clarify objectives. STATEMENT OF ISSUE: Jefferson County Public Health is requesting Board approval of the Agency Agreement — Division of Behavioral Health and Recovery with DSHS, Amendment #10, November 1, 2014 — June 30, 2015; ANALYSIS /STRATEGIC GOALS/ PRO'S and CON'S: This amendment's primary purpose is to clarify that Jefferson County Public Health is not responsible for the Treatment Services, rather it is only responsible for prevention and therefore not affected by Service rate Plan. The Amendment goes on to reflect clarifications to definitions and the addition of a new section. This is largely corrections to the July, 2014 amendment FISCAL IMPACT /COST BENEFIT ANALYSIS: There is no fiscal impact. RECOMMENDATION: JCPH management request approval of the Agency Agreement — Division of Behavioral Health and Recovery, DSHS, Amendment #10, November 1, 2014 —June 30, 2015. RE ED BY kitfi'p Morle , inistrator Date Community Health Developmental Disabilities 360- 385 -9400 360 -385 -9401 (f) Always working for a safer and healthier community Environmental Health Water Quality 360 -385 -9444 (f) 360.379 -4487 as O f)rm tll .Appmoved )Zr-3i7,, DSHS Central Contract Services 1611 CS County Program Agreement Amendment (6 -12 -2014) Jefferson Co. Prosecut ice Page 1 David Alvarez, Chief Civil DPA DSHS Agreement Number COUNTY PROGRAM AGREEMENT 1163 -27310 DEPART ENT OF ITMIA AMENDMENT SOLI SERVICESTH Amendment No. 10 This Program Agreement Amendment is by and between the State of Washington Administration or Division Department of Social and Health Services (DSHS) and the County identified below. Agreement Number County Agreement Number DSHS ADMINISTRATION DSHS DIVISION DSHS INDEX NUMBER CCS CONTRACT CODE Behavioral Health and Service Division of Behavioral 1223 1223 Inte ration Health and -overy DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS Steve Smothers 4500 10th Avenue SE Lace V, WA 98503 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E -MAIL 360 725 -3767 (360 ) 438 -8057 SMothsw@dshs.wa.gov COUNTY NAME COUNTY ADDRESS Jefferson County 615 Sheridan St Port Townsend, WA 98368 - COUNTY FEDERAL EMPLOYER IDENTIFICATION COUNTY CONTACT NAME NUMBER Julia Danskin COUNTY CONTACT TELEPHONE COUNTY CONTACT FAX COUNTY CONTACT E -MAIL 360 385 -9420 360 385 -9401 danskin cojefferson.wa.us IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM CFDA NUMBERS AGREEMENT? 93.959 Yes AMENDMENT START DATE PROGRAM AGREEMENT END DATE 11/01/2014 06/30/2015 PRIOR MAXIMUM PROGRAM AGREEMENT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM PROGRAM AGREEMENT AMOUNT AMOUNT $141,599.00 $0.00 $141,599.00 REASON FOR AMENDMENT; CHANGE OR CORRECT CONTRACT TERMS OR SOW, SEE PAGE TWO EXHIBITS. When the box below is marked with a check (4) or an X, the following Exhibits are attached and are incorporated into this Program Agreement Amendment by reference: ❑ Exhibits (specify): This Program Agreement Amendment, including all Exhibits and other documents incorporated by reference, contains all of the terms and conditions agreed upon by the parties as changes to the original Program Agreement. No other understandings or representations, oral or otherwise, regarding the subject matter of this Program Agreement Amendment shall be deemed to exist or bind the parties. All other terms and conditions of the original Program Agreement remain in full force and effect. The parties signing below warrant that they have read and understand this Program Agreement Amendment, and have authorit to enter into this Pro ram Agreement Amendment. COUNTY SIGNATURE(S) PRINTED NAME(S) AND TITLE(S) DATE(S) SIGNED DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED as O f)rm tll .Appmoved )Zr-3i7,, DSHS Central Contract Services 1611 CS County Program Agreement Amendment (6 -12 -2014) Jefferson Co. Prosecut ice Page 1 David Alvarez, Chief Civil DPA 0 This Contract between the State of Washington Department of Social and Health Services (DSHS) and the County is hereby amended as follows: The purpose of the amendment is to: revise incorrect Section references contained in the July 2014 amendment; update the list of Prevention/Treatment County /Contractors; add new definitions; provide clarification language regarding the Service Rate Plans. Modify the list of County's /Contractors regarding Prevention and /or Treatment Services, and Service Rate Plan as follows: Section 8, Prevention Statement of Work does not apply to the following as of November 1, 2014: Beacon of Hope Skamania County (Community Health) Kittitas County Stevens /Ferry County Klickitat County Yakima County Palouse River Counseling Section 9. Treatment Statement of Work does not apply to the following as of November 1, 2014: Educational Service District 112 Skamania County (Skamania Sherriff's Office) Jefferson County Republic School District Kittitas CCPHS Network Sunnyside School District Mt. Adams School District Tekoa School District Section 10. Additional Services applies only to the identified County for the specific Exhibit(s) as of November 1. 2014: County /Contractor Exhibit(s): County /Contractor Exhibit(s): Clark County D Pierce County D Grant County F Snohomish County D King County D. E, G, H Spokane County D Kitsap County E, H Mt. Adams SD I Service Rate Plan does not apply to the following as of November 1, 2014: Educational Service District 112 Skamania County (Skamania Sherriff's Office) Jefferson County Republic School District Kittitas CCPHS Network Sunnyside School District Mt. Adams School District Tekoa School District Amend Section 1, Definitions, Section "w ", this was an incorrect Section reference in the July 2104 amendment. The correct definition is for Section "z" as follows: z. "IDU and IVDU" means the same population: Injecting Drug User and Intra- venous Drug User. The acronyms may be used interchangeably to refer to a person or patient who has used a needle one or more times to illicitly inject drugs. DSHS Central Contract Services 1611 CS County Program Agreement Amendment (6 -12 -2014) Page 2 Amend Section, 1, Definitions, to add new Section "uu" and "vv" as follows: uu. "SAPT Block Grant" means Substance Abuse Block Grant, SABG, Substance Abuse Prevention and Treatment Block Grant and SAPT are interchangeable. vv. "Miscellaneous" means a category of special projects with prior approval that may not be funded through any other source. Funding for these projects will be provided by State GIA funding. Services must be negotiated and agreed upon in writing between the County and DBHR prior to initiating the project. Correct error in July 2014 amendment, delete Treatment Section of Work, Section 9. cc. (6)(c) iii., Medicaid Rules and Limitations in which an incorrect number was provided. The correct section number for the deleted language is 9. kk. (2)(d)iii. Add New Section 5, Requirements f. (2) (c) as follows: (c) Notice of Federal Block Grant Funding Requirement A portion of the funding for this contract may be from the federally funded Substance Abuse Block Grant (SABG) CFDA# 93.959. The amount allocated will be detailed in the contractor's authorization for service. Contractor will be notified of the amount of SABG expended each calendar year. Funds designated solely for a specific state fiscal year in this contract may be obligated only for work performed in the designated fiscal year. Correct error in July 2014 amendment, in which language was included in Section 8, Prevention, instead of Section 9, Treatment. This amendment deletes the Prevention Statement of Work Section 8k.( 2) (c) iii. The following is added to Section 9, Treatment, Multiple Payments for the Same Claim /Duplication kk. (2) (c) iii as follows: iii. The County shall not reimburse providers for individual's co- payment or deductible fees using any DBHR funding or SAPT Block grant funds. Replace language from the July Amendment 2014 amendment regarding Service Rate Plans as follows: Section 9. cc. Consideration (4) Reimbursement Rates (4) DSHS shall reimburse the County based upon the Service Rate Plan (SRP), this shall be provided by DBHR to the County and may be updated on a periodic basis. Any changes made to the SRP by DBHR will not be provided by an amendment, but via email, or letter. Exhibit C. Service Rate is deleted as an Exhibit to the Contract. All other terms and conditions of this Contract remain in full force and effect. DSHS Central Contract Services 161 1CS County Program Agreement Amendment (6 -12 -2014) Page 3 COUNTY PROGRAM AGREEMENT -pEP°R NTH AMENDMENT SERVt�CFASTH This Program Agreement Amendment is by and between the State of Washington Depart ment of Social and Health Services (DSHS) and the County identified below. Behavioral Health and Service Lauri Turkovsky Jefferson County NUMBER AGREEMENT? No — ANQUNT $139,96100 Division of Behavioral 1223 4500 10th Avenue SE Lacev, WA 98503 615 Sheridan St Port Townsend, WA 98368 - CnI1NTY CONTACT NAME Julia Danskin $1,636.00 93.959 DSHS Agreement Number 1163 -27310 Amendment No. 09 Administration or Division Agreement Number County Agreement Number CCS CONTRACT CODE 1223 AMOUNT CHANGE OK EXHIBITS. When the box below is marked with a check (4) or an X, the following Exhibits are attached an are incorporated into this Program Agreement Amendment by reference: ® Exhibits s ecif Exhibit B, Exhibit D, Exhibit IF This Program Agreement Amendment, including all Exhibits and other documents incorporated by reference, contains all ra of the terms and conditions agreed upon by the pa ties as changes to the original Program Agreement. No other understandings or representations, oral or othervvise, regarding the subject matter of this Program Agreement Amendment shall be deemed to exist or bind the Padlbelowlwar antt hat the haveltread and understandrthis Pr ggram Agreementn in full force and effect. The pa ties si90 ner into this Program Agreement Amendment. PRINTED NAME AND TITLF� DATE SIGNED Qv / DBHR Contracts • ._7 /G/ ' „/ Approved a to form only 3 'oI)� Jefferson Co. Prosecu s office David Alvarez, Oil ivil DPA DSHS Central Contract Services Page 1 161105 County Program Agreement Amendment (6 -12 -2014) This Program Agreement between the State of Washington Department of Social and Health Services (DSHS) and the County is hereby amended as follows: The Maximum Amount Payable is increased by $1,636, from $139,963 to $141,599. The Awards and Revenues (A &R) for the July 14 through June 2015 time period is attached as Exhibit B. Amend Definitions, Section 1 h -j. as follows: h. "Substance Use Disorder (SUD)" means a problematic pattern of alcohol /drug use leading to clinically significant impairment or distress as categorized in the DSM 5. This definition replaces the definition for Chemical Dependency. "Community Prevention and Wellness Initiative" or "CPWI" means the DSHS substance abuse prevention delivery system that focuses prevention services in high -need communities in Washington State as selected by County and approved by DSHS. Contract Manager" means the DSHS contact identified on page one of this Contract. j. "Contract Manager" means the DSHS contact identified on page one of this Contract. Amend Definitions, Section 1w as follows: W. acrd and IVDU" mean may be used interchangeably 'to refertolna person or patienit who has used ag needle one acronyms may or more times to illicitly inject drugs. Amend Definitions, Section 1x. as follows: x. 'Indigent Patients" means those receiving a DSHS income assistance grant (e.g., TANF, SSI) or WA Apple Health. They are usually identified by a Medicaid identification card. Food stamp recipients are not considered indigent patients unless they also receive one of the above grant or medical assistance programs. Add new Definitions, 1tt as follows: tt. "Appointment time" means the time set for assessment or treatment service for Medicaid - qualified clients; appointments are set based on priority populations. Amend Definition 1 q as follows: qq. "Waiting List' means a list of SAPT - qualified clients for whom a date for service has not been scheduled due to a lack of capacity. A person will be selected from the list to fill an opening based on the required order of precedence identified in the Contract. Add new section 5 Requirements, g_, Other Requirements subsection (3) as follows: g. Other Requirements (3) Federal Block Grant Annual Report The County shall submit to the DSHS contact listed on Page 1 the following information on an annual basis: (a) Needs Assessment — (See 45 CFR 96.133, 45 CFR 96.122 and 42 USC 300x.29) i. How have the needs of the population identified in the county strategic plan or other demographic report been met? DSHS Central Contract Services Page 2 1611CS County Program Agreement Amendment (6 -12 -2014) ii. What strategies have been used to improve existing programs, create new programs, or actions taken to remove barriers? (b) Provide specialized services for pregnant women and women with dependent children — (See 42 USC 300x- 22(b)(1)(C) and 45 CFR 96.124(c)(e)) i. Treatment services designed for pregnant women and women with dependent children ii. How the county ensure subcontractors make available prenatal care and child care. (c) Capacity Management How many providers are at or above capacity? li. Describe how the county ensures treatment admission is provided within 14 -120 days. iii. What activities or initiatives are in place to ensure that IVDUs and PPWs receive treatment, referrals, or interim service? (d) Provide continuing education for treatment and prevention staff - (See 42 USC 300x -28(b) and 45 CFR 96.132(b)) i. Describe efforts made to ensure that training is made available to treatment and prevention staff. ii. What has the county done to ensure that subcontractors provide opportunities for staff to attend trainings? (e) Coordinate prevention activities and treatment services with other appropriate services - (See 42 USC 300x -29(c) and 45 CFR 96.132(c)) Add new section 5 Requirements, g., Other Requirements, subsection (4) as follows: g. Other Requirements (4) CJTA Annual Report Requirements for Innovative Project The County shall submit to the DSHS contact listed on Page 1 the following information on an annual basis: i. Identify the of project (innovation, best practice, or regional project) ii. Status of project (innovation, best practice, or regional project) (A) How has implementing the project enhanced treatment services? iii. Capacity — number of people serve in the report period iv. Progress in meeting project's goals and objectives v. Evaluation strategy that addresses at a minimum: (A) Treatment retention /completion (B) Reduced involvement in criminal activity DSHS Central Contract Services 1611CS County Program Agree mentAmendment (6 -12 -2014) Page 3 Amend Prevention Statement of Work, Section 8f. (7) (a), Consideration as follows: (a) Pass a local sales tax, or secure local funds through other private or public entities. Amend Treatment Statement of Work, Section 9v.(2) (b) i., Other Required Services, Screens and Urinalysis Testing, (b) i. Certification as follows: The County shall ensure the following standards and protocols are used as minimum requirements when contracting for urinalysis testing services with testing laboratories: i. Certification The testing facility must maintain current laboratory certifications with the Department of Health and Human Services (HHS) and one of the following: (A) Substance Abuse and Mental Health Services Administration (SAMHSA) (B) Other national laboratory certification body Amend Treatment Statement of Work, Section 9v. (1) Other Required Services as follows: Section v. (1) (a) Childcare and prenatal services are provided at the treatment facility or arrangements for provision of these services are made for patients receiving chemical dependency assessment and treatment services from subcontracted providers. Section v. (1) (d) is deleted. Delete Treatment Section of Work, Section 9cc. (6) (b) Allocating Medicaid Match. Delete Treatment Section of Work, Section 9cc. (6) (c) iii., Medicaid Rules and Limitations. Amend Treatment Statement of Work, Section 9x. Driving Under the Influence (DUI) repeat offender Services as follows: Driving Under the Influence (DUI) repeat offender Services (1) For the time period January 1, 2014 through June 30, 2015, the County shall provide court ordered chemical dependency assessment and treatment services for low- income or Medicaid eligible "repeat DUI offenders" Eligible individuals, defined as "repeat DUI offenders ", must meet the following conditions: (a) Have a current offense for a violation of RCW 46.61.502 (Driving Under the Influence) or 46.61.504 (Physical Control of Vehicle Under the Influence). (b) Have at least one prior offense under RCW 46.61.5055 (14)(a). (2) The County shall: (a) Prioritize the use of the DUI funds as the first source for reimbursement of services to the DUI repeat offenders. (b) Use no more than ten percent of the total DUI funds for County administration. (c) Use no more than ten percent of the total DUI funds for the combined cost of the following support services: nSHS Central Contract Services Page 4 161 1CS County Program Agreement Amendment (6 -72 -2014) i. Transportation ii. Child Care Services (3) The County may provide any of the following treatment services for adults and youth: (a) Community Intervention and Referral (b) Interim Services (c) Outreach (d) Crisis Services (e) Detoxification Services (f) Involuntary Commitment (g) Outpatient Treatment (h) Opiate Substitution Treatment (i) Case Management 0) Assessment (k) Screens and UA tests limited to no more than eight (8) tests per month for each repeat DUI offender. (1) Expanded Assessment (m) Residential Treatment Services: i. Intensive Inpatient ii. Long Term Care iii. Recovery House iv. Parenting and Pregnant Women's Services including Residential Services and Therapeutic Childcare v. Youth Intensive Inpatient Level 1 vi. Youth Intensive Inpatient Level 2 vii. Youth Recovery House viii. Youth Acute Detoxification ix. Youth Sub -acute Detoxification (4) TARGET Requirements. The County shall require subcontractors to document "repeat DUI Offender" services in TARGET using the following codes: (a) Contract Type — Criminal Justice DSHS Central Contract Services 1611 cs County Program Agreement Amendment (6 -12 -2014) Page 5 (b) State Special projects —the County shall use one of the following: i. CJ — DUI Court - to be used in those cases where the client is enrolled in a state - recognized DUI Court. ii. CJ — Non -DUI Court - to be used in those cases where the client is not enrolled in a state - recognized DUI Court. (5) For the time period January 1, 2014 through June 30, 2014, the County shall bill for DUI Repeat Offender Services on a monthly basis on an invoice provided by DBHR. DUI Repeat Offender Services shall be billed separately from the other services outlined in this Contract. (6) For the time period July 1, 2014 through June 30, 2015, the County shall bill for DUI Repeat Offender Services on a monthly basis on the county community services contract billing invoice under the column designated for DUI Repeat Offender Services. (7) The County shall maintain documentation in the client's file of the following: (a) That both the previous and current offense occurred within ten years of the arrest for the current offense; and (b) The order by a court that the client participates in chemical dependency assessment and treatment services for low- income or Medicaid eligible clients. Amend Service Availability, Section 4 as follows: The County shall budget funds awarded under this Contract that are allocated for prevention, assessment and treatment services in such a manner to ensure availability of such services throughout the entire term of this Contract subject to available funds. Amend Requirements, Section 51o. (1) as follows: (1) Ensure all services and activities provided by the County or subcontractor under this Contract shall be designed and delivered in a manner sensitive to the needs of all diverse populations. Amend Requirements, Section 5d. as follows: The County shall ensure all subcontractors, whether treatment providers or CPWI /prevention subcontractors, understand that Single Source Funding means that a subcontractor can use only one source of funds at any given time. (1) Treatment: All Treatment services provided to an individual patient during any one period of time must be funded from a sole source of funds under this Contract. (2) The funding designated by the treatment subcontractor in TARGET defines the single source of funds to be used to fund the treatment services provided to an individual patient. (3) Prevention: Each cost reimbursement Prevention service provided must be billed only one time through the source selected for funding this expense. At no time may the same expense be billed through more than one funding source. Amend Requirements, Section 5f (3) as follows: (3) Peer Review Required (42 USC 300x -53(a) and 45 CFR 96.136) DSHS Central Contract Services Page 6 1611CS County Program Agreement Amendment (6 -12 -2014) The SAPT Block Grant requires an annual peer review by individuals with expertise in the field of drug abuse treatment. At least five percent of treatment providers will be reviewed. The County and subcontractors shall participate in the peer review process when requested by DSHS. Delete Strategic Plan, Section 7 in its entirety and replace as follows: Strategic Plan a. Guidelines for County Two Year Strategic Planning 2014 -2016 The following serves as the guidelines for the County Strategic Planning process and should addresses the Prevention - Intervention- Treatment- Aftercare (P- I -T -A) continuum of services. The County may opt to continue with the traditional six year process. (1) Plan is Due: July 1, 2014 (2) Guidelines on process: (a) Networking and community assessment (b) Mobilize and/or build capacity to address needs (c) Develop comprehensive strategic plan (d) Implementation (e) Evaluation (3) Authorities: RCW 70.96A.320 (3) - the County legislative authority shall submit a plan that meets the following conditions: (a) Describes the services and activities to be provided (b) Anticipated expenditures and revenues (c) Plan must be prepared by the County CD board and adopted by the County legislative authority (d) Reflect maximum effective use of existing services and programs, and (e) Meet other conditions as defined by DSHS b. Block Grant requirements: County shall provide responses to the following Block Grant requirements: (1) Needs assessment (45 CFR 96.133, 45 CFR96.122, and 42 USC 300x.29). (a) Include copies of any other demographic reports used for the responses. (b) What strategies will the county use to improve existing programs, create new programs, or actions taken to remove barriers? DSHS Central Contract Services 161 1C County Program Agreement Amendment (6-12 -2014) Page 7 (c) Describe specialized services provided for pregnant women and women with dependent children (42 USC 300x- 22(b)(1)(C) and 45 CFR 96.124(c)(e)). i. Describe treatment services that are designed for pregnant women and women with dependent children. (d) Describe continuing education plan for treatment and prevention staff (42 USC 300x -28(b) and 45 CFR 96.132(b)). (e) Describe the County's plan to ensure that training is made available to treatment and prevention staff. (f) Describe process for coordination of prevention activities and treatment services with other appropriate services. (42 USC 300x -29(c) and 45 CFR 96.132(c)). (g) Describe what activities or initiatives will be implemented to coordinate services. (h) Describe the County's plan to support better coordination of services. (i) Describe the County's plan to raise public awareness in communities. (2) Additional Requirements: (a) Strategies for monitoring the increased capacity need for Medicaid services. (b) Details on how counties will meet Medicaid expansion including how the determination will be made to increase capacity and the subsequent processes. (c) Address how counties will incorporate Systems of Care principles (d) What steps will counties take to help support Evidence Based Practices within their community. (e) Details on how counties will support care coordination and linkages to primary health care. (t] Identify Recovery Support Services and resources. (3) CJTA: (a) Requirements Specific to the Criminal Justice Section A narrative describing how funds from the Criminal Justice Treatment Account (CJTA) allocation will be expended, to include: Estimated number of offenders with an addiction problem against whom charges are filed by a prosecuting attorney in Washington State. ii. Estimated numbers of persons with a substance abuse problem that, if not treated would result in addiction, against whom charges are filed by a prosecuting attorney in Washington State. iii. Estimated number of nonviolent offenders for a drug court program. iv. Role of the County's judicial system in delivery of PITA services. v. Residential service needs for offenders. DSHS Central Contract Services Page 8 1611 CS County Program Agreement Amendment (6 -12 -2014) (b) A narrative describing how funds from the Innovated Grant portion of the CJTA allocation will be expended to include: Selection of one or more of the following types of projects: Innovation Project: An approach that contains either traditional /cultural treatment methods, or elements of a Best Practice to treat an underserved population(s) of offenders. ii. Best Practice Project: A treatment strategy that has been documented as a Best Practice in published research. See the following website to assist in identifying Best Practices: Evidence Based Practices for Treating Substance Use Disorders - Home page. iii. Regional Project: A project in which a minimum of two (2) counties combine funding to provide treatment services to offenders. (c) A narrative of the type of project(s) chosen (see above) that includes: i. A description of the project and how it will enhance treatment services ii. Reason for choosing either a drug court or non -drug court project iii. Number of persons that will receive services iv. Measurable goals and objectives (4) Prevention: The County must follow the strategic plan guidelines as set forth in the DBHR Community Coalition Guide for each Community Prevention and Wellness Initiative (CPWI) community. if funding permits County to provide community based coordination (CBC) services in addition to meeting CPWI requirements, (i.e. contractors with CPWI communities that each have at least $110,000 per community of DBHR funding budgeted for CPWI implementation annually) and services will be provided at the County level the County must include plans for CBC prevention services in their County strategic plan. Narrative should include: (a) Goals, objectives, and strategies /activities for CBC. (b) Explanation for how CBC strategies and activities connects to overall County strategic plan including the assessment. (c) Explanation of how it supports furthering work of CPWI. (d) The CBC goals and objectives must be entered into PBPS and approved prior to implementation. Amend Treatment Statement of Work, Section 9b. Other Treatment as follows: b. Other Treatment (1) Access to Services The County shall, subject to allocated funds, ensure that treatment services to eligible persons are not denied to any person regardless of: DSHS Central Contract Services 161 1C County Program Agreement Amendment (6 -12 -2014) Page 9 (a) The person's drug(s) of choice. (b) The fact that a patient is taking medically - prescribed medications. (c) The fact that that a person is using over the counter nicotine cessation medications or actively participating in a Nicotine Replacement Therapy regimen. (d) Washington State resident's County of residence. The County shall, subject to allocated funds and service availability, serve all eligible Washington State residents who may be transient and require services. Amend Treatment Statement of Work. Section 9d heading as follows: J. Waiting List and Initial Appointment Requirements Amend Treatment Statement of Work, Section 9f. (1)(c) by adding the following: (c) Refer client to Health Plan Finder Website for eligibility determination at http�//www.wa h bexch an ge. o rq/. Delete Treatment Statement of Work, Section 9f (2)(c) in its entirety. Amend Treatment Statement of Work, Section 9g (5), Screening and Assessment as follows: (5)The year maximum number In the event an additional nal med callly necessary assessment is required, year period, is two (2). Y N q contact the DBHR contract manager for an exception. Amend Treatment Statement of Work, Section 9k.(4)(a), Services specific to Post -Partum Women as follows: (a) Assessment and treatment services are scheduled within 14 days after the service has been requested Amend Treatment Statement of Work, Section 9k.(5)(a), Services specific to Parenting Persons as follows: (a) Assessment and treatment services are scheduled within 120 days after the service has been requested Amend Treatment Statement of Work, Section 9m. (1) and (2), Performance -based Goals as follows: m. Performance -based Goals (1) Youth (a) Effective July 1, 2014, if the County's baseline is in good standing at or above the statewide goal of 76.2% for 90 -day retention, the County shall maintain good standing. If, during any monitored calendar quarter, the County falls below the statewide goal, the County shall follow the process for correction in Section "n." below. (b) Effective July 1, 2014, if the County's baseline for 90 -day retention performance is lower than the statewide goal, the County shall increase the 90 -day retention performance rate by 10% of their individual baseline or reach the statewide goal, by the end of the fiscal contract year. For example, if the County has a baseline completion rate of 62 %, the expectation would be an increase of 6.2 %. DSHS Central Contract Services Page 10 161 1CS County Program Agreement Amen dment (6 -12 -2014) If, during any monitored calendar quarter, the County does not demonstrate progress towards the expected 90 day- retention goal, the County shall follow the process for correction in Section "o." below. (2) Adult (a) Effective July 1, 2014, if the County is in good standing at or above the statewide average of 70.7% for 90 -day retention, the County shall maintain good standing. If, during any monitored calendar quarter, the County falls below the statewide goal, the County shall follow the process for correction in Section "n." below. (b) Effective July 1, 2014, if the County's baseline for 90 -day retention performance is lower than the statewide goal, the County shall increase the 90 -day retention performance rate by 10% of their individual baseline or reach the statewide goal, by the end of the fiscal contract year. For example, if the County has a baseline completion rate of 62 %, the expectation would be an increase of 6.2 %. Amend Treatment Statement of Work, Section 9n. as follows: n. Performance Goals Results /Actions for a County falling below the statewide goal If performance outcome falls below the statewide goal or performance expectation within a calendar quarter, as determined through SCOPE or report generated by DSHS, the County shall: (1) Submit a Performance Improvement Plan (PIP) to the DSHS Manager within 45 days of notice by DSHS. (2) Have 90 days to return to the original individual 90 -day retention baseline percentage. (a) Submit an updated PIP requesting an additional 90 days for performance improvement to the DSHS Manager, if after the original 90 days, the 90 -day retention baseline percentage has still not been reached. Amend Treatment Statement of Work, Section 90. as follows: o. Performance Goals Results /Actions for a County starting below the statewide goal If performance outcome does not demonstrate progress toward the expected rate for 90 -day retention within a calendar quarter, as determined through SCOPE or report generated by DSHS, the County shall: (1) Submit a Performance Improvement Plan (PIP) to the DSHS Manager within 45 days of notice by DSHS. (2) Have 90 days to demonstrate progress toward the expected rate for 90 -day retention. (a) Submit an updated PIP requesting an additional 90 days for performance improvement to the DSHS Manager, if after the original 90 days, the 90 -day retention baseline percentage has still not been reached. Amend Treatment Statement of Work. Section 9y. (7)(d) as follows: (d) Send the separate A -19 for the project to Ruth Leonard leonamr(adshs.wa gov and cc Amy Martin martiak2(a)dshs.wa.g2v or designee who will review and forward valid A -19s for payment. DSHS Central Contract Services 161 1CS County Program Agreement Amendment (6 -12 -2614) Page 11 Amend Treatment Statement of Work, Section 9cc., Consideration (4) Reimbursement Rates as follows: (4) DSHS shall reimburse the County based upon the Service Rate Plan. Amend Prevention Statement of Work, Section 8k, Advance Payment and Billing Limitations, by adding new (C)(iii) as follows: iii. The County shall not reimburse providers for individual's co- payment or deductible fees using any DBHR funding or SAPT Block grant funds. Delete Exhibit C. Service Rate Plan (SRP) and any reference to the SRP in any section of the Contract. Exhibit D is revised and included as an attachment. Exhibit F is revised and included as an attachment. All other terms and conditions of this Contract remain in full force and effect. DSHS Central Contract Services Page 12 161 1C County Program Agreement Amendment (6 -12 -2014) Exhibit B AWARD AND REVENUES 2013 -2015 Biennium COUNTY Jefferson (Prevention) PROGRAM AGREEMENT NUMBER 1163 -27310 The above named County(ies), is hereby awarded the following amounts far the purposes listed. REVENUE SOURCE TYPE OF SERVICE $0 AWARD AMOUNTS 334.04.6X TANF Treatment Services CODE: $0 SO 334.04.6X CA Parents in Reunification $0 $0 SD SFY 14 SFY 15 Biennial Total 13 -15 FEDERAL GRANTS $0 Funds Biennium 333.99.59 SAPT Grant -in -Aid $31,079 $32,715 $63,794 SAPTTreotment So $0 $0 Prevention $31,079 $32,715 $63,794 334.04.6X State Grant -in -Aid $0 $0 $0 State GIA Administration $0 So Cn 334.04.6X Criminal Justice Treatment Account $0 $0 $0 334.04.6X Drug Court - State Funds $0 $0 $0 STATE - SPECIAL PROJECTS $0 $0 $0 334.04.6X TANF Treatment Services $0 $0 SO 334.04.6X CA Parents in Reunification $0 $0 SD FEDERAL GRANTS $0 $0 $0 $0 333.97.78 "TXIX -Fed Waiverfor DL and ADATSA clients ONLY $0 $0 0 Total Federal Funds $31,079 $32,715 $0 $63,794 Total State Funds $0 $0 $0 TOTAL ALL AWARDS $31,079 $32,715 $0 $63,794 Federal CFDA: SAPT Grant -in -Aid -CFDA 93.959 Substance Abuse and Mental Health Services Administration (SAMHSA) *Title XIX - CFDA 93.778 - DL and ADATSA is for July- December, 2013 services only County participation match programs include State Grant -in -Aid, Federal SAPT Grant -in -Aid, and CJTA. 2013 -15 Jefferson Amend 9 Exhibit D PROGRAM STANDARD AND GUIDELINES CHEMICAL FOR CHILDREN'S ADMINISTRATION C TREATMENT SERVICES ENTS (CAR) The County shall provide funding for chemical dependency assessment, detoxification, treatment, and case management services to clients who are not Medicaid eligible and seeking to remain or reunify with their families. These clients shall be known as "Children's Administration Parents in Reunification" patients and shall have priority access category status. DSHS shall reimburse the County as identified on Exhibit B, Awards & Revenues. Limitations: The County may provide any of the following services as described in the Division of Behavioral Health and Recovery (DBHR) Budgeting, Accounting and Reporting System supplement: a. Chemical Dependency Assessment b. Outpatient Treatment, General c. Case Management, General d. Chemical Dependency Detoxification e. Opiate Substitution Treatment 2. Patient Identification and Referral The Children's Administration social workers are the primary source of referrals for this program. Children's Administration social workers will identify clients as "Children's Administration Parents in Reunification" on the referral form. The treatment provider or Children's Administration social worker is responsible for notifying the county when a client may need ancillary services, such as transportation and childcare, in order to participate in assessment and treatment. 3, Medicaid Eligibility The County shall ensure that all clients are screened for Title XIX financial eligibility and referred to the Washington Health Plan Finder at http' //www.wahealthplanfinder.o for Title XIX eligibility determination if the financial screen so warrants. State funding source shall only be the payer of last resort. If the client is eligible for Medicaid, the County shall ensure services are paid through the Medicaid funding source. This funding source is designed to serve CA clients who cannot access other sources of funding. httlo llwww wahbexchange.orq( Eligible Providers All assessment, detoxification, and treatment services provided by these funds must be provided by DBHR certified treatment providers. DSHS Central Contrail Services Page 13 1611CS County Program Agreement Amendment (6 -12 -2014) 5. Service Rates The rates paid shall not exceed the County negotiated low- income rates for services outlined above. Reporting Requirements a. The County shall comply with the DBHR TARGET data entry and reporting requirements using a specific TARGET state special project code, CA- REUNITE, to identify clients for treatment, interim and ancillary services (support services). b. The County shall ensure the treatment provider communicates with the Children's Administration social worker regarding the client's progress, with appropriate written consent. Communication is expected to include but not be limited to: (1) verification of client attendance at appointments, (2) efforts made to engage the client; (3) treatment recommendations; and (4) client progress and outcomes. GAIN -SS shall be entered into TARGET by the treatment provider of first access. DSHS Central Contract Services 161 1C County Program Agreement Amendment (6 -12 -2014) Page 14 Exhibit F Parent Child Assistance Program (PCAP) — Grant County 1. Definitions Specific to Exhibit. The words and phrases listed below, as used in this Exhibit, shall each have the following definitions: a. "Advocate" means a paraprofessional case manager working within the Parent Child Assistance Program. b. "Agencies" means any state office or activity of the executive and judicial branches of the state government, including state agencies, departments, offices, divisions, boards, commissions, and educational, correctional, and other types of institutions. c. "Agreement" means this tnterlocal Agreement, including all Exhibits and other documents attached or incorporated by reference. d. "Contract Manager" means DSHS contact person stated on page one (1) of this contract, responsible for the day to day management of the contract. e. "Contract Monitor" means the person identified by the Contract Manager that monitors the contract. f. "DBHR" means the DSHS Division of Behavioral Health and Recovery. g. "DSHS" means the Department of Social and Health Services. h. "PCAP" means Parent Child Assistance Program for women who abuse alcohol and /or drugs during pregnancy or postpartum. 2. Statement of Work. The Contractor shall: a. Ensure the following requirements are met: (1) Based on the new legislative requirements of the THIRD ENGROSSED SUBSTITUTE SENATE BILL 5034, Chapter 4, Laws of 2013, 63rd Legislature, 2013 2nd Special Session, Operating Budget, Sec 208- (1) (b), page 72, PCAP will be required to implement "program modifications needed to maximize access to federal Medicaid funding [which] will be phased in over the course of the 2013 -2015 fiscal biennium." (2) Beginning immediately and without exception or exemption, all PCAP advocates and clinical supervisors hired on or after August 1, 2013 shall be required to hold at least a bachelor's degree. b. Maintain the Parent Child Assistance Program (PCAP) site. c. Ensure that the site has a minimum number of slots, as identified in 1. below to serve the highest risk women in the Contractor County. d. Enroll women who: (1) Abuse alcohol and/or drugs during pregnancy; and (2) Are pregnant or postpartum (priority shall be given to women who are pregnant and up to six months postpartum; referrals shall be accepted up to twelve months postpartum on a space available basis), and, DSHS central contract Services Page 15 161 1cs county Program Agreement Amendment (6 -12 -2014) (3) Are not successfully or effectively engaged with community service providers. e. Alternatively, women may be enrolled who: (1) Have previously had a child diagnosed with Fetal Alcohol Spectrum Disorders; and (2) Are currently abusing alcohol and /or drugs; and (3) Are in childbearing years. f. Ensure that each advocate have an active caseload of up to eighteen clients, with a minimum full - time advocates on staff as identified in I. below. g. Provide advocacy services to clients and their families that shall include, but are not limited to, the following: (1) Identification and prioritization of realistic goals, initiation of necessary steps, and evaluation of progress toward these goals. (2) Support for substance abuse treatment, recovery, and follow -up. (3) Support for utilization of local resources including, but not limited to, family planning, safe housing, health care, domestic violence services, parenting skills, and mental health services. (4) Respond appropriately to client needs in a timely manner. (5) Provision of funds for food, unmet health needs, other necessities, and incentives as needed. The contractor shall only use State funds to pay for this component. h. Provide appropriate and timely PCAP supervision at the FTE level, as identified in I. below at each site and ongoing training to advocates to ensure provision of the best advocacy possible, and to safeguard advocates, clients, and their families- i. Provide comprehensive training to ensure maintenance of the core components of the PCAP advocacy model and consistency among sites. Participate in the protection of Human Subjects for clients enrolled in research activities at the PCAP site through the State of Washington Department of Social and Health Services' Human Research Review Section using approved protocols and informed consent procedures, and the Federal Certificate of Confidentiality. k. Develop and maintain professional relationships with community providers. I. Submit monthly reports to the PCAP State Director at the University of Washington, describing the number of clients enrolled at the site. Submit to the PCAP Director at the University of Washington, quarterly reports (every six months) describing progress at the site, number of referrals, advocate training, community linkages, client characteristics, and client and child outcomes. m. Site Requirements (1) Each site will provide appropriate supervision. Complaints or concerns by regional partners, DBHR, other PCAP sites or other entities will be referred to the Clinical Supervisor of the appropriate PCAP site or the PCAP State Director at the University of Washington. (2) Each site will have a minimum FTE to support staff in clerical and administrative duties as follows: DSHS central contract Services 161 1cs county Program Agreement Amendment 16-12 -2014) Page 16 Mi F S St nimum Full Time Advocates 2.0 u ervision FTE 0.3 aff Support FTE 0.2 mum Client Slots 30 (3) Each site will hire an exit interviewer to conduct interviews with clients who complete PCAP (approximately three years after enrollment). The exit interviewer will be trained by PCAP at the University of Washington according to evaluation protocols. Each exit interview will require approximately five hours (1 hour for scheduling /rescheduling /transportation; 2 hours to conduct the interview; 2 hours to code the interview and enter data in the PCAP web -based system). There is not a minimum FTE requirement. Exit interviewers may be paid on a per exit interview basis. Exit interviewers cannot be an advocate, the site Supervisor, or the same person who did the intake interview. A site Supervisor may administer exit interviews to clients from other PCAP sites. (4) Each site (to include program staff and host site staff) will attend PCAP meetings as requested by the PCAP State Director at the University of Washington or the DBHR Contract Manager. n. CORE COMPONENTS REQUIRED FOR THE PARENT -CHILD ASSISTANCE PROGRAM This is a three -year home visitation case management model for very high -risk substance abusing women and their children. Caseload recommendation is fifteen to eighteen active client families per advocate. The Contractor shall ensure that the following Core components of the program are met: (1) Clients are not asked to leave the program because of relapse or setbacks. (2) To facilitate an effective service plan, advocates develop and coordinate a network of contacts with family, friends, and providers involved in a client's life. (3) At least every four months, advocates work with clients to define and evaluate the clients' personal goals and steps towards those goals; advocates coordinate client goals with program goals. (4) Advocates link clients with appropriate and available community services. (5) Advocates work with both mother and target child regardless of who has custody, and provide advocacy for other family members as needed. (6) A minimum of twice- monthly group staffing sessions are required. (7) A minimum of twice- monthly individual supervision is required. Notes from these sessions shall be submitted monthly to University of Washington PCAP State Director for review. (8) Supervisors and advocates are required to submit completed evaluation instruments according to PCAP protocol. Performance Work Statement. The Contractor shall provide the services and staff, and otherwise do all things necessary to serve 85% or more of contracted monthly clients as set forth in 2. Statement of Work above. DSHS Central Contract Services Page 17 1611CS County Program Agreement Amendment (6 -12 -2014) (3) Each site will hire an exit interviewer to conduct interviews with clients who complete PCAP (approximately three years after enrollment). The exit interviewer will be trained by PCAP at the University of Washington according to evaluation protocols. Each exit interview will require approximately five hours (1 hour for scheduling /rescheduling /transportation; 2 hours to conduct the interview; 2 hours to code the interview and enter data in the PCAP web -based system). There is not a minimum FTE requirement. Exit interviewers may be paid on a per exit interview basis. Exit interviewers cannot be an advocate, the site Supervisor, or the same person who did the intake interview. A site Supervisor may administer exit interviews to clients from other PCAP sites. (4) Each site (to include program staff and host site staff) will attend PCAP meetings as requested by the PCAP State Director at the University of Washington or the DBHR Contract Manager. n. CORE COMPONENTS REQUIRED FOR THE PARENT -CHILD ASSISTANCE PROGRAM This is a three -year home visitation case management model for very high -risk substance abusing women and their children. Caseload recommendation is fifteen to eighteen active client families per advocate. The Contractor shall ensure that the following Core components of the program are met: (1) Clients are not asked to leave the program because of relapse or setbacks. (2) To facilitate an effective service plan, advocates develop and coordinate a network of contacts with family, friends, and providers involved in a client's life. (3) At least every four months, advocates work with clients to define and evaluate the clients' personal goals and steps towards those goals; advocates coordinate client goals with program goals. (4) Advocates link clients with appropriate and available community services. (5) Advocates work with both mother and target child regardless of who has custody, and provide advocacy for other family members as needed. (6) A minimum of twice- monthly group staffing sessions are required. (7) A minimum of twice- monthly individual supervision is required. Notes from these sessions shall be submitted monthly to University of Washington PCAP State Director for review. (8) Supervisors and advocates are required to submit completed evaluation instruments according to PCAP protocol. Performance Work Statement. The Contractor shall provide the services and staff, and otherwise do all things necessary to serve 85% or more of contracted monthly clients as set forth in 2. Statement of Work above. DSHS Central Contract Services Page 17 1611CS County Program Agreement Amendment (6 -12 -2014) 4. Consideration. Total consideration available for PCAP services is based on performance and is identified on Exhibit B, Awards & Revenues. a. Reaching the 85% goal: Number of Clients At Set Rate Per Month if 85% and Above Utilization is 85% and Above 26 $13,594 b. Failing to reach the 85% goal: Number of Clients Rate Per Client if Below 85% Utilization is Below 85% or Less 25 $453 c. Unless otherwise specified in this Contract, DSHS shall not pay any claims for payment for services submitted more than 90 days after the calendar month in which the services were performed. 5. Billing and Payment. Invoice System. The Contractor shall submit invoices using State Form A -19 Invoice Voucher, or such other form as designated by DSHS. Consideration for services rendered shall be payable upon receipt of properly completed invoices which shall be submitted to the DSHS Contact Person stated on page one (1) of this contract by the Contractor not more often than monthly. The invoices shall describe and document to DSHS' satisfaction a description of the work performed, activities accomplished, the progress of the project, and fees. The rates shall be in accordance with those set forth in Section 5, Consideration, of this Contract. b. The Contractor shall bill monthly for services under this contract: The invoice shall list: (1) Month of service, and (2) Number of clients served during the billing month; and (3) If serving less than 85% of contracted slots per month, the invoice shall reflect and DSHS shall pay $453 per client, per month as identified in 4. Consideration above; or (4) If serving 85% clients or more per month, the invoice shall reflect and DSHS shall pay the monthly set rate as identified in the 4. Consideration above. c. Payment. Payment shall be considered timely if made by DSHS within thirty (30) days after receipt and acceptance by DSHS Contact Person of the properly completed invoices. Payment shall be sent to the address designated by the Contractor on page one (1) of this Contract. DSHS may, at its sole discretion, withhold payment claimed by the Contractor for services rendered if Contractor fails to satisfactorily comply with any term or condition of this Contract. 6. Background Checks. Revised Code of Washington (RCW) 43.43 and Washington Administrative Code (WAC) 388 - 805 - 200(2) require criminal background checks (CBCs) when employing staff members, including volunteers and subcontractors, who have unsupervised access to child, adolescents, vulnerable adults, and persons who have developmental disabilities. All Contractor's staff members; subcontractors, such as treatment staff members, prevention staff members, case managers, outreach staff members, etc.; or volunteers who have unsupervised access to children, adolescents, or vulnerable adults are required to have a background check. DSHS Central Contract Services 161 1CS County Program Agreement Amendment (6 -12 -2014) Page 18 Reporting. When a participant in Parent Child Assistance Program (PCAP) also participates in the WorkFirst program, the contractor shall: a. Coordinate the PCAP and services at the local level with the Community Service Offices and WorkFirst Case Manager. b_ When a verification form is provided by WorkFirst program Specialist or Social Worker, the Contractor will return a completed WorkFirst participation Verification Form, DSHS 04 -432, or its successor, on the fifth (5th) of every month to the WorkFirst Program Specialist or Social Worker indicating that a TANF participant received services from the Contractor. g. Data Security Requirements — See Exhibit A DSHS Central Contract Services Page 19 1611CS County Program Agreement Amendment (6 -12 -2014)