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Home My WebLink About020215_ca06iw 615 Sheridan Street Port Townsend, WA 98368 wv,-w.JeffersonCountyPublicHealth.org JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERI Board of County Commissioners Philip Morley, County Administrator Jean Baldwin, Director re I'll ......... .. Consent Agenda December 9, 2014 SUBJECT: Agenda Item — Personal Services Agreement with Skagit Co. Public Hospital District #304 DBA: United General District #304 of Skagit County WA; November 1, 2014 — June 30, 2015; $3,000.00 STATEMENT OF _ISSUE: Jefferson County Public Health requests Board approval of the Personal Services Agreement with Skagit County Public Hospital District #304, DBA United General District #304, for tobacco prevention activities; November 1, 2.014 — June 30, 2015; $3,000-00 ANALySIS,fSTRATEGIC GOALS PRO,'S and CON'S: The purpose of this contract agreement between JCPH and United General District #304 is to retain JCPH to provide prevention activities to enhance community participation in youth tobacco prevention, identify and collaborate with existing coalitions; strengthen school and campus tobacco-free policies, support enforcement of laws and policies; develop leaders and leadership programs. This work will utilize School Based Health Center staff and JCPH's AmeriCoirps member and includes collaboration with Chimacum Prevention Coalition. No work has been done toward the fulfillment of this agreement's objectives in November and December of 2014. FISCAL IMPACT CtDT BENEFIT ANALYSIS: This contract agreement is fully funded by 'United General District #304. JCPH will bill quarterly, first billing April, 2015. RECOMMENDATION: JCPH management request approval of the Personal Services Agreement with United General District #304; November 1, 2014 — June 30, 2015. REVIEWE-D BY: Philip Morley, ,Coy flty Admini5frator cornmuniiy Health E)evebprnental DisablHies 360-385 9400 360-38-9-9401 (f) Date Always working for a safer and healthier community ErMiOnffienta Health Water audity 360-385-9444 (f) 360-379-4487 1113 1 1. 1 [44 CONTRACT AGREEMENT FOR SERVICES THIS AGREEMENT is made and entered into by Jefferson County Public Health and between Skagit County Public Hospital District 304, DBA United General District #304 of Skagit County, Washington referred to as "United" and Jefferson County Public Health hereinafter referred to as the Contractor. THE PURPOSE OF THIS AGREEMENT — Implement youth tobacco prevention activities outlined in the Chimacum Prevention Coalition work plan. THEREFORE, IT IS MUTUALLY AGREED THAT: STATEMENT OF WORK The contractor shall ensure the below mutual agreed upon activities are implemented Objective 1.1- Enhance community participation in youth tobacco prevention and control Identify and collaborate with existing coalitions and community-based resources, which may include Boys and Girls Clubs, oral health coalitions, school based coalitions, and local health organizations throughout the designated region to address the higher prevalence of tobacco use by youth from priority populations. Objective 1,2- Strengthen school and campus tobacco-free policies Support school enforcement and augmentation of existing laws and policies for tobacco use on K-12 campuses, at alternative high schools, and at institutions of high education and training Objective 13 Develop youth leaders who work to create healthier communities Support culturally and linguistically appropriate youth leadership development programs (like Teens Against Tobacco Use) to engage youth in the fight against youth tobacco initiation and use, PEROID OF PERFORMANCE The period of performance of this Agreement shall commence November 1, 2014 through June 30, 2015. PAYMENT - The cost of accomplishing the work herein will not exceed $3,000 and must 6� accordance with the Statement of Work and submitted budget (Exhibit A). This contract amount is based on actual reimbursements. Compensation for services provided shall be issued upon receiving a quarterly report (Exhibit B) and an invoice voucher (Exhibit C) with proper detailed back-up documentation. Food and equipment purchases are not allowable expenses. BILLING PROCEDURES BILLING �tothe Contractor for approved and completed work will be made by warrant by United within 14 days of receipt of the invoice. Upon expiration of the contract, any claim for payment not already made shall be submitted with 5 days after the expiration date,. AGREEMENT ALTERATIONS AND AMENDMENTS This agreement may be amended by mutual agreement of the parties. Such agreements shall not be binding unless they are in writing and signed by personnel authorized to bind each of the parties. CpNTRArCT .MEN` The contract manager for each of the parties shall be responsible for and shall be the contact person for all communications and billings regarding the performance of this agreement. The Contract Manager for United is: Carol Hawk United General District #304 2241 Hospital Drive I Sed,ro Woolley WA 9,8283 36&854,7170 1 Carol. Hawk@unitedgeneral.org The Contract Manager for the Contractor is: Karen Obe,rmeyer Jefferson County Public Health 615 Sheridan St I Port Townsend, WA 98368 360-385-9400 1 kobermeyer@co.jefferson.wa.us OWNERSHIP OF WORK PRODUCTS i 2�=Tta, materials, intellectual properties, discoveries, deliverables, memoranda All and other documents developed under this Agreement, whether finished or not, shall become property of United, shall be forwarded to United at its request and may be used by United as it sees fit. jGe.Q�VER,NANC�EAND DISPUTES This Agreement shall be construed under the laws of the State of Washington and applicable federal laws. Venue and jurisdiction over any dispute involving this Agreement shall be exclusively in the Superior Court in Skagit County, Washington. In the event either party, with respect to this Agreement, commences legal proceedings, the prevailing party shall be entitled to recover all costs and expenses incurred in connection with such action, including reasonable attorneys' fees. HOLD HARM'�ILESS The Contractor shall defend, protect and hold harmless United General District #304, or any employees thereof, from and against all claims, suits or actions arising for any intentional or negligent act or omission of the contractor, while performing under the terms of this contract. Page 2 of 3 PRIVACY Personal information collected, used, or acquired in connection with this contract shall be used solely for the purposes of this contract. Contractor agrees not zed release, divulge, publish, transfer, sell or otherwise make known to unauthori persons Personal information without the express written consent of the agency or as provided by law. Contractor agrees to implement physical, electronic, managerial safeguards to prevent unauthorized access to personal information. TERMINATION Either party may terminate the Agreement upon 30 days prior written notification to the other party- if this Agreement is terminated, the parties shall be liable only for performance rendered or costs incurred in accordance with the terms of this Agreement prior to the effective date of the termination. TERMINATION FOR CAUSE If for any cause, either party does not fulfill in a timely and proper manner its obligations under this agreement or if either party violates any of these terms and conditions, the aggrieved party will give the other party written notice of such failure or violation. The responsible party will be given the opportunity to correct the violation. if failure of violation is not corrected, this Agreement may be terminated immediately. ENTIRE AGREEMENT This agreement and attachment contain all the terms and condition agreed upon by the parties. No other understandings, oral, otherwise not contained herein shall be binding upon either party. United General District #304 CONTRACTOR vvyl Ted Brockmann I CEO/CFO, Signature bate Print Name Title LCarol, Hawk I irector M Page 3 of 3 Jefferson Co. youth Tobacco Prevention Program I Budget Worksheet — Year One The total allocation for each YTpP funded community is $3000. The fiscal year will be from November 1, 2.014 through June 30, 2015. The CPWl Community Coalition can allocate these funds at their discretion within the budget categories listed below. Funding must support the objectives and Planned Activities described in the YTPP work plan that was submitted on October 30, 2014. Personnel /Honorarium/ stipend 'Personnel_______— '"Innel Cost $2478 Amount Total P-5 ive How do the fund in this category support the activities in your work plan: Brief Narrative — Staff will work directly to a ccomplish YTPP workplan and with our School Based Health Center staff to support the engagement of youth in the fight against youth tobacco initiation. This work will include collaborating with the Chimacum Prevention Coalition to include tobacco use by youth as an important issues and to address tobacco use through school enforcement and policy. Staff will guide the AmeriCorps member in accomplishing the TATU project and provide training for SBHC practitioners. Brief Tobacco Intervention training � Amount I Travel i rnct MM Total irave Brief How do the fund in this category support the activities in your work plan: Narrative — I Mileage to both SBHC locations and to regional yTPP meeting and materials lies and Materials Cost Amount W11 Total aUF"__— do the fund in this category support the activities in your work plan: Brief Narrative — How Augmentation to school Policy may focus on e-cigarettes- educational materials to increase awareness of this emerging issue will be purchased for distribution to students, parents and school staff. This increased awareness of e-cigarette issues aims to engage community in youth tobacco related issues other Indirect other $ 272 Brief Narrative How do the fund in this category support the activities in your work plan: Supports administrative infrastructure including rent, IT, etc Ornwrt Total $3000 Exhibit A- -Jefferson County Quarterly Report Form Due January 1, 2015 county: Jefferson County Program Contact: Karen Obermeyer Fiscal Contact: Veronica Shaw Objective 1.1- Enhance community participation in youth tobacco prevention and control Planned activitY: identify and collaborate with existing coalitions and community-based resources, which may include Boys and Girls Clubs, oral health coalitions, school based coalitions, and local health organizations throughout the designated region to address the higher prevalence of tobacco use by youth from priority populations. Provide a brief description of the status of your planned activity. Please list all of the agencies/organization and other who have been active partners in this planned activity. Have there been barriers to the success of this planned activity? If so, please describe. What have been the successes related to this planned activity? Please list your project outputs or outcomes. (examples: number of new members of the CPWl coalition, number of new partnerships on projects, etc.) Any additional corn ments/q uestions/con cer ns? Exhibit B —Jefferson objective 1.3 Develop youth leaders who work to create healthier communities Planned activity: Support culturally and, linguistically appropriate youth leadership development programs (like Teens Against Tobacco Use) to engage youth in the fight against youth tobacco initiation and use. Provide a brief description of the status of your planned activity. please list all Of the agencies/organization and other who have been active partners in this planned activity. Have there been barriers to the success of this planned activity? if so, please describe. What have been the successes related to this planned activity? Please list your project outputs or outcomes. Any additional comments /questions /concerns? Exhibit B - Jefferson Exhibit C Contact Address Reference - PO # rams i'nvo'ke Number: Invoice Date.- nitedgeneral.org Exhibit C