HomeMy WebLinkAbout012615_ca01N
t� 615 Sheridan Streef
Port Townsend, WA 98368
www. Jefferson C ountyPu bl ic Health, org
Consent Agenda
Public Healt
January 21, 2014
JEFFERSON COUNTY
BOARD • OMMISSIONERI
it i
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: jean Baldwin, Director
Anna McEnery, Developmental Disabilities Coordinator
DATE:
f r I
SUB3ECT: Agenda Item —Contract Agreement -
January 1, 2015 — December 31, 2015; $27,570.00
ST
Jefferson County Public Health, as the fund manager of the Mental Health and Substance Abuse sales
tax treatment funds, is requesting Board approval of the Contract Agreement —114 MaW
&Y46r_ January 1, 2015 — December 31, 2015; $27,570.00
AN COALS IPR 'S and CONS:
This contract funds clinical and care management services for up to 21 children and their caregivers, this
may include long-term therapy to children affected by and/or with risk factors for mental illness or
substance abuse at home and/or in the community. Jumping Mouse is required to: work with social services
and other agencies as needed for dually served families. Group, individual, or combined group/individual
evidence-based therapies will be utilized, and referrals for mental health medication and monitoring are
required as needed. This contract increases mental health service access to Jefferson County citizens.
FISCAL 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
advice from Mental Health and Substance Abuse Sales Tax Advisory Committee. The contract provides for
revenue fluctuations.
RE
JCPH management request approval of the Contract Agreement Z�r4 rfv?) MN6e-- 644_�MAI�
January 1, 2015 — December 31, 2015; $27,570.00
ITMMU�_
Philip Morjey;r County Administrator Date
Community Health Environimat:rilal Health
Developmental Usabililfies Water Qucilily
36Q-385-9400 360-385-9444
360-385-9401 if} PjwClyS working for ca safer and healthIP-r community (fl 3610-379-4487
CONTRACT AGREEMENT
By and Between
Jumping Mouse Children's Center
And
Jefferson County
For Expanded Mental Health (MH) & Chemical Dependency (CD) Treatment 2015
Section 1: PURPOSE:
TI-IIS AGREEMENT for Professional Services is entered into between Jefferson County herein
referred to as the "County" and Jumping Mouse Children's Center, herein referred to as the
"Contractor" to provide mental health services to individuals impacted by mental
health/substance abuse issues in Jefferson County, Washington.
Section 2: TERMS:
This Agreement shall commence on January 1, 2.015 and continue through December 31, 2015,
unless terminated as provided herein.
Section 3: SCOPE OF AGREEMENT:
Contractor will increase mental health treatment options to Jefferson county residents as outlined
in Exhibit A, herein incorporated by reference. Through the use of these funds the provider will
increase the number of citizens receiving Mental Health services. The goal of this funding and
sales tax increase is to improve the quality of life for Jefferson County citizens by improving
access to mental health and substance abuse treatment.
A. CONTRACT REPRESENTATIVES:
Jefferson County and Jumping Mouse Children's Center will each have a contract representative
who will have responsibility to administer the contract for that party. A party may change its
representative upon providing written notice to the other party. The parties' representatives are as
follows:
JCPH -Contract Re resentativ Contractor's Contract Representative
Anna McEnery Kris Becker, Executive Director
Jefferson County Public Health Jumping Mouse Children's Center
615 Sheridan St. 1809 Sheridan St.
Port Townsend, WA 98368 Port Townsend, WA 98368
(360) 385-9400 (360) 379-5109
PAGE 1
Section 4: COMPENSATION:
The total amount payable under this Contract by County to CONTRACTOR, shalt not exceed
$27,570.010 as outlined in Exhibit B- Fee Schedule, 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 2015. If the
sales tax revenue decreases by ten percent (10%) when applicable sales tax revenues are
compared between the most recently completed quarter year and the same quarter year revenues
for 2014, then this contract may be renegotiated. The parties acknowledge the funding connected
to this contract is revenue of last resort and therefore Contractor will bill all other sources of
revenue first.
A. Contractor shall be paid for services as outlined in Exhibit A — Scope of Work.
B. CONTRACTOR shall submit monthly invoices to JCPH, 615 Sheridan St., Port
Townsend, WA 99368, Attn: Finance Department, for payment of work actually
completed to date.
C, Invoices must be submitted by the 3rd Monday of the month for the previous month's
expenses, The County will review such invoices, and upon approval thereof, payment will
i
be made to the Contractor n the amount approved. Failure to submit timely invoices may
result in a denial of reimbursement.
D. Contractor shall provide invoices and necessary backup documentation for all invoices
including timesheets and statements. Any indirect charges require the submittal of an
indirect cost . methodology and rate using OMB Circular's A-87 and A-122.
E. 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).
F. Where Contractor proposes to use chemical dependency mental health County tax funds
for match, Contractor shall be solely responsible for compliance with all state and federal
laws and regulations, including, but not limited to DSHS, CMS and DBHR funding rules,
applicable to the use of MH/SA sales tax monies as match. Contractor shall document
they have met this responsibility by submitting to the County Administrator, in writing,
their match formula, allocation plan and any other documentation required of them
pursuant to Attachment A, attached hereto and incorporated in this Agreement.
G, Contractor records and accounts pertaining to this agreement are to be kept available for
inspection by representatives of the County and state for a period of six (6) years after
final payments. Copies shall be made available upon request.
PAGE 2
H. An audit will be submitted to the County annually.
a. Contractor will submit the most recent financial audit or recent compiled financial
statements to accompany our annual 990 tax form filing within 30 days from the
beginning of this agreement.
b. The audit or recent compiled financial statements to accompany our annual 990 tax
form filing shall be completed by the WA State Auditor's Office or a mutually agreed
upon entity. Upon request the County shall have the option of performing an onsite
review of all records, statements, and documentation.
C, If the county finds indications of potential non-compliance during the monitoring
process, the County shall notify Contractor within ten (10) days. County and
Contractor shall meet to discuss areas of contention in an attempt to resolve issues,.
d. Audit or recent compiled financial statements to accompany our annual 990 tax form
filing will provide statements consistent with the guidelines of Reporting for Other
Non-Profit Organizations AICPA SOP 78-10, and is performed in accordance with
generally accepted auditing standards and with Federal Standards for Audit of
Governmental Organizations, Programs, Activities and Functions, and meeting all
requirements oft) BM Circular A -133 or A -1213, as applicable.
Section 5: INDEMNIFI CATION:
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
any injury to
e I
liability, or any portion thereof, including attorney's fees and costs, arising from
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 is waived based on the fact that Jumping
N4ouse does not own a fleet of vehicles that are titled in their name.
B, General Liability (1) — with minimum limit per occurrence of one million dollars
($1,000,000) and an aggregate of not less than two million dollars ($2,000,000) for
bodily injury, death and property damage unless otherwise specified in the contract
specifications. This insurance coverage shall contain no limitations on the scope of
the protection provided and indicate on the certificate of insurance the following
coverage:
PAGE 3
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; $3,000,000
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.
L. 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
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 shall be non-contributory with
respect to any policy of insurance the Contractor must provide to comply with this
Agreement.
Cr. If the proof of insurance or certificate indicating the County is an "additional
T
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.
11, The County may, upon the Contractor's failure to comply with all provisions of this
contract relating to insurance, withhold payment or compensation that would
otherwise be due to the Contractor.
Section 7: CONFIDENTIALITY:
Contractor, its employees, subcontractors and their employees will maintain the confidentiality
of all information provided by JCPH or acquired in performance of this Agreement as required
by HIPAA and other privacy laws. This Contract, once executed by the parties, is and remains a
Public Record subject to the provision of Ch. 42.56 RCW, the Public Records Act.
PAGE 4
Section 8: ASSIGNMENTS AND SUBCONTRACTING:
The Contractor shall not sublet or assign any of the services covered by this agreement without
the express written consent of the County.
Section 9: INDEPENDENCE:
The Contractor and the County agree that the Contractor is an independent Contractor with
respect to the services provided pursuant to this agreement. Nothing in this agreement shall be
considered to create the relationship of employer and employee between the parties hereto. The
Contractor shall not be entitled to any benefits accorded County employees by virtue of the
services provided under this agreement, The County shall not be responsible for withholding or
otherwise deducting federal income tax or social security or for contributing to the state
industrial insurance program, otherwise assuming the duties of an employer with respect to
employee.
Section 10: RE
. PORTING:
The Contractor will provide a monthly service summary report to the County at the same time as
invoices and must be submitted by the 3rd Monday of the month for the previous month's work.
The monthly report shall contain the report of services and the total hours worked by which staff.
The monthly report shall be submitted to Jefferson County Public Health in care of Anna
McEnery, 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 I I: TERMINATION:
The County reserves the right to terminate this contract in whole or in part, with 30 days' notice,
in the event that expected or actual funding from any funding source is withdrawn, reduced, or
limited in any way after the effective date of this agreement. In the event of termination under
this clause, the County shall be liable for only payment for services rendered prior to the
effective date of termination.
A. This agreement may also be terminated as provided below:
I With 30 days' notice by the Board of County Commissioners for any
reason, or
2. With 30 days' notice by the Board of County Commissioners for non-
performance of the specific job duties in Exhibit A
1. With 30 days' notice by the Contractor by voluntary resignation.
Section 12: MODIFICATION:
This professional services agreement may be modified at any time by written agreement of either
party and may be modified if tax revenue decreases.
PAGE 5
Section 13: DISPUTE RESOLUTION:
Any dispute or disagreement concerning the terms and obligations of this Contract shall initially
be brought to the attention of the Public Health Director via a written document, The Public
Health Director shall make a determination with reasonable promptness, i.e., a decision within
ten business days shall be deemed to have been made with reasonable promptness. If the
aggrieved party is not happy with that decision, then the Jefferson County Administrator (or as
may hereafter be amended), will decide the appeal of the Director's decision.
Section 14: INTEGRATED AGREEMENT:
This Agreement together with attachments or addenda represents the entire and integrated
agreement between the County and the Contractor and supersedes all prior negotiations,
representations, or agreements written or oral between the parties, This agreement may be
amended only by written instrument signed by both County and Contractor.
Approved this day of
BOARD OF COUNTY COMMISSIONERS
JEFFERSON COUNTY, WASHINGTON
John Austin, Chairperson
.lumping Mouse Children s enter
ATTEST:
Deputy Clerk of the Board
PAGE 6
20_
Exhibit A
Scope of Work
RF,SPONSIBILITIES:
The Jumping Mouse Children's Center Services agency as a contracted provider, agrees
to:
Clinical and care management services for up to 21 children and their caregivers per
billing period,
2. All employees or subcontractors of the Contractor undertaking the performance of mental
health/sub stance abuse services under this agreement are required to be professionally
licensed or certified by the State.
3, Background checks are required for all employees; to be redone for every employee
every 3 years, The names of licensed therapists will be given to the County.
4. provide long-term therapy to children affected by and/or with risk factors for mental
illness or substance abuse at home and/or in the community.
5. Provide parent support and education to the adults of the children covered in this
contract.
6. Work with social services or other agencies as needed for dually served families with
mental health or chemical dependency issues.
T Maintain a secure records system guaranteeing the confidentiality of PHI pursuant to
JUPPA.
9- Bill other revenues whenever they exist.
9. Monthly data template on client utilization, referrals, outcomes, and required reporting,
in standard form as specified by Jefferson County Health.
10. Group of individual therapy, or a combination of the two, using evidence based models of
treatment. Applicant will identify the number of clients seen, how often each week and
the number of hours per week and per month for treatment enrollment.
11. Referral for mental health medication and monitoring as needed.
12. Care coordination with other involved agencies, and referral to supportive services such
as housing, transportation and vocational services; tracking of client involvement in
recommended services, including 12 -step or comparable support.
13. Preparation of progress reports if needed, e.g. to court.
14, Collection and preparation of data for internal and external evaluation purposes, and
reporting, e � to jcpfl monthly with the invoice. Use forms supplied by JCPH for data.
PAGE 7
15. Staffed by 5 master's level, Licensed Mental Health Counselors, one master's level
Licensed Mental Health Counselor Associate, 5 master's level intern and extern
therapists (supervised by Washington State Approved Clinical Supervisors), and one
master's level social worker, with support staff to include billing and administration.
16. Clerical, billing, and general office support,
17, Agency oversight regarding record keeping, data collection, legal and ethical issues and
standards of care are updated and meet State of Washington standards.
18, Services are available throughout the county.
19. provide data including:
e Number of intakes, individual sessions, psychiatric visits, and adult education visits
provided
Age, sex, drug of choice, psychiatric diagnosis of clients.
Referrals to other agencies.
Client satisfaction form indicating client's view of how program helped in their life.
20. opportunities for regular clinical supervision and psychiatric consultation are available
for staff on a regular basis. Supervision for all therapists, including interns and externs,
consists of minimum one hour per week in individual consultation, and 3 hours per
month in a clinical staff meeting,. Additional individual support and supervision to interns
is also provided on a continual, as-needed basis.
21. Attend and report to the Mental Health Substance Abuse Sales Tax Advisory Committee
twice during the duration of this contract period, at regularly scheduled meetings, with
progress evaluation reports.
PAGE 8
Exhibit B
Fee Schedule
Therapy and Care Management @ $42 per session, Clinical Oa supervision
1 ,$534 per month.
Not to exceed $27,570-00 in completion of services for the duration of this contract without
express written amendment.
PAGF 9
ATTACHMENT A
JEFFERSON COUNTY MH/CD TRFATMENT TAX FUNDING-
MATCH POLICY
On October 14, 2013 Jefferson County Board of County Commissioners (130CC) adopted the
following language in the allocation of the Mental Health Chemical Dependency treatment
dollars.
Agencies may not use .Jefferson County mental health countyl chemical dependency
treatment tax funds for match, without prior authorization of their match formula and
allocation use, approved by the Jefferson County Administrator and fiscal team. The
match may not be used without written permission.
Definitions:
I specified amount or
Match: is a requirement for the grantee to provide contributions of a specif
percentage to match funds provided by another grantor. Matching can be in the form of
cash or in-kind contributions.
Auditors objective: To determine whether the match amount or percentage of
contributions from JC is an allowable source of funding and that the vendor has an
accurate accounting system to track the match.
Regulations: The specific requirements for matching funds are unique to each federal or
state program- The A-102 Common Rule provides criteria for acceptable costs and
contributions in regard to match.
Jefferson County Policy:
In 2005, the , Washington State Legislature created an option for counties to raise the local sales
tax by U.1 percent, (the I/loth of I% sales tax initiative) to augment state funding for mental
health and chemical dependency treatment. Jefferson County collects and distributes the Mental
1.1calth/Cheynical Dependency (MI /CD) tax. Services purchased by the County are allocated
through a formal Request for Proposal (RF'P) process, review and contracting; staffed by
Jefferson County Public Health, overseen by Jefferson County Mental Health Substance Abuse
J'und Advisory Committee and adopted by the Board of County Commissioners, (BOCC). The
BOCC does not assume any fiscal responsibility/liability for any of the vendors they contract for
services with. Services leveraged by a vendor using MI 1 /CD tax as match have no oversight or
agency relationship to Jefferson County; funding cannot be used without prior authorization of
the vendor's match formula and allocation by the Jefferson County Administrator and fiscal
team.
PAGE 10
Following state, federal and local guidelines for match is the responsibility of the vendor.
Jefferson County will follow all administrative policies in authorizing that use. If a vendor is
disallowed the use of funds for match according to the State of Washington or the federal
government, Jefferson County funds will not be available as matching funds.
For example, if a vendor provides Title XIX Medicaid services (the Policy
19,50.02 or 42CFR 430.30) they will not be allowed the use of match without
actually billing Medicaid for the services at the same time. If no Medicaid billing
exists, the match cannot be applied.
The County shall verify that the local entity's financial reporting system tracks
matching funds at a level to support the use of funds; that meets the level of
documentation required by federal or state statutes.
The verification and application process for Match use within the County will include the
following steps:
DSHS requires contractors to complete and submit a "Local Match Certification"
form (DSHS 06-155) or a form that has equivalent data elements, prior to any
agreement for DSHS services. The County must review a copy of this application
and form prior to granting match authorization of MH/CD funds for Match and at
each monthly billing.
2. Submit the current administrative policy within WA State regulating your services
and the use of local match.
3. Submit to the County your last financial audit showing your use of match,
County funds and tracking systems,
4. Submit to the County the terms of the agreement to ascertain the 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.
PAGE I1