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Home My WebLink About042715_ca11V, Public It 615 Sheridan Street Port Townsend, WA 98368 www. JeffersonCountyPublicHealfh.org Consent Agenda March 11, 2015 JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS TO: FROM: DATE: SUBJECT: AGENDA REQUEST Board of County Commissioners Philip Morley, County Administrator Jean Baldwin, Director Agenda item — Personal Services Agreement with Skagit Co. Public Hospital District #304 DBA: United General District #304 of Skagit County WA Amendment 1; November 1, 2014 — June 30, 2015; $2,000.00 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, Amendment 1 to increase funding in support of youth tobacco prevention activities; November 1, 2014 — June 30, 2015; $2,000.00 ANALYSIS /STRATEGIC 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 AmeriCorps member and includes collaboration with Chimacum Prevention Coalition. This amendment adds $2,000.00 to support youth participation, pay coordinator, cover travel expenses, and cover indirect expenditures. FISCAL IMPACT /COST 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, Amendment 1; November 1, 2014 — June 30, 2015; $2,000. RE''WE BY:,,""'"'? o Pill p,-M D� ie** 'l r1ty�IlAdminlStrator Date Environmental Health 1es Water Quality 360 - 385 -9400 360- 385 -9444 360 -385 -9401 (f) Always working for a safer and healthier community (f) 360 -379 -4487 UNITED GENERAL DISTRICT 304 Building Healthier Communities This Contract between United General District 304 and Jefferson County Public Health (the contractor) is hereby amended as follows: Purpose: The purpose of this amendment is to provide additional funding to the contractor, in partnership with Chimacum Prevention Coalition (CPWI), to train at least 4 youth in conducting CANS and assess at least 4 stores in the Chimacum School District area. Chimacum Prevention Coalition Coordinators will assist JCPH staff and students in implementing the assessment and follow -up with Stores. Billing and Payment is amended as follows: 1. Total increase of $2000 - • Coordinator - $1,268 • Youth Stipends -$2S0 • Travel - $300 • Indirect -$182 2. The cost of accomplishing the work herein will not exceed $2,000 and must accordance with the Statement of Work and above budget. This contract amount is based on actual reimbursements. Compensation for services provided shall be issued upon receiving a quarterly report and an invoice voucher with proper detailed back -up documentation. Food and equipment purchases are not allowable expenses. This Contract Amendment contains all of the terms and conditions agreed upon by the parties as changes to the original contract. No other understanding or representations, oral or otherwise, regarding the subject matter of the Contract Amendment shall be deemed to exist or bind the parties. All other terms and conditions of the original contract remain in full force and effect. The parties signing below warrant that they have read and understand this contract Amendment and have authority to enter into this Contract Amendment. CONT RACTORSIGNATURE PRINTED NAMEAND TITLE - DATE..-. ------ _ ..m _.�........ UNITED GENERAL DISTRICT ATE PRINTED NAME AND TITLE D- SIGNATURE Carol Hawk, Director Community Health Outreach Programs United General District 304 _ Approved as form only, J m Je f rs on Co. Pr recut oes ' David Alvarez, Chief Civ DPA Jefferson Co. Youth Tobacco Prevention Program I Budget Worksheet — Year One The total allocation for each YTPP funded community is $3000. The fiscal year will be from November 1, 2014 through June 30, 2015. The CPWI Community Coalition can allocate these funds at their discretion within the budget categories listed below. Funding must support the objectives and Planned Activities described in the YTPP work plan that was submitted on October 30, 2014. Budget worksheet submitted 11/13/14 Personnel / Honorarium / St — ipend Amount Personnel ($ 2478/34.92 hourly rate with benefits = 71 hours of Karen's time) _...— Total Personnel .M ��_ ......�__._..... - . ......... nel Cost $ 2478 Brief Narrative do the mmmmmmmmmmory sup es in -ITl e fund in this category support the activities in your work plan. Staff will work directly to accomplish 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 Brief Tobacco Intervention training for SBHC practitioners. .Travel....— .........._ —.�.. ..�.�.....�.— .... —..a. ____......._ -�.. -- ..... _.. .._.�_�_ Amount Total Travel Cost .... .... _ ...—_ $... 50 _ Brief Narrative — How do the fund in this category support the activities in your work plan: Mileage to both SBHC locations and to regional YTPP meeting Supplies and Materials Amount Total m — � the __ � _ _ — ....... $ n .......... 200 pp l Materials Cost Narrative — How do fud in this category su pp ort the activities in your work w _ plan: 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 _.,.—..- �- ._... _......... .— .......__.. ___....._ -. _� _..mm Other Amount Indirect I_Total Other .-.-_- .— ..._- .�— ......�.�m..�_._�,. _...... ___ ......... .........._, �..�,_ $ 272 Brief Narrative — How do the fund in this category support the act ��k - _ — ...g..._..� _.._. p p . . activities in your work plan:. Supports administrative infrastructure including rent, IT, etc DISTRICT 304 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 dlesignated 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 -12 campuses, at alternative high schools, and at institutions of high education and training Objective 1.3 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 is Agreement shall commence November 1, 2014 through June 30, 2010. PAS The cost of accomplishing the work herein will not exceed $3,000 and must accordance with the Statement of Work and submitted budget (Exhibit A). This contract amount is based on actual reirnbursements. 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. Page 1 of 3 1p ,, .,,,`„ ., _... ..,,,, ,,,, ,. „��.''� _�.. d �''a✓ ��r � `- +.,,.,wG�� r' „k' „��„!a- � „1 „�r, �oEk:.roA. », �1,.ti „F�,v!rr ,.��,.,J�, ,.�,�,.� ..,� „��,,,,�r;�ih BILLING 'PROCEDURES Payment to the 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. CONTRACT MANAGEMENT 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 Sedro Woolley WA 98283 360.854.7170 1 Carol.Hawk @unitedgeneral.org The Contract Manager for the Contractor is: Karen Obermeyer Jefferson County Public Health 615 Sheridan St I Port Townsend, WA 98368 360- 385 -9400 1 kbermeyer@co.jefferson.wa.us OWNERSHIP OF WORK PRODUCTS All data, materials, intellectual properties, discoveries, deliverables, memoranda 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. GOVERNANCE AND 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. HOLE) HARMLESS The Contractor shall defend, protect and hold harmless United General District x#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 render 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 to release, divulge publish, transfer, sell or otherwise make known to unauthorized 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 gay 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 Ted Brockmann � CEO /CFO Date ` v 0 _ Carol Hawk hector. CONTRACT+O _. �. Signat a e� �.. Print Name V ✓n Title Date.... �.__ ..._.. .............��..e��.�e.. 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, 2014 through June 30, 2015, The CPW l 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 S ti - Personnel _...._.._....... —.. �.....� I Personnel Cost $ 2478 Amount 10L C1 f Narrative d o accomplish directly p Br-1eL e fund in this category support the activities in your work plan. Staff will work y ccomplish YTPP work Ian 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 Brief t - . . .. .. .....- ._......_Amoun... 4 Tef Tobacco Intervention training for SBHC practitioners _ _ _ T CostHow do the fund in this category support the activities in our work _ _ 5 _ Brief N r ativ y k plan: Mileage to both SBHC locations and to regional YTPP meeting m_. . d Supplies es an Materials Amount Total Supplies anHo do the fund in this category support the activities in youur work plan: Materials Cost policy may focus ._ ... an: Brief Narrative Augmentation to school p 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 +01 Other Amount $ 272 Brief Narrative — How do the fund in this category support the activities in your work plan Supports administrative mAnAS ra e infrastructure ucture including rent, IT, etc Project To .. __ w._ 3. 000 .. Exhibit A — Jefferson County