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Home My WebLink About070615_ca07615 Sheridan Street Port Townsend, 6 www.JeffersonCountyPublicHealth.org Consent Agenda June 15, 2015 JEFFERSON COUNTY"' BOARD OF COUNTY COMMISSIONERS TO: FROM: DATE: SUBJECT: AGENDA REQUEST Board of County Commissioners Philip Morley, County Administrator Jean Baldwin, Director Julia Danskin, Public Health Supervisor 4/ 1 Agenda Item – DBHR DSHS Youth Mental Health First Aid ( YMHFA); June 1, 2015 — September 30, 2015 STATEMENT OF 1 E: Jefferson County Public Health requests Board approval of the DBHR DSHS contract for Youth Mental Health First Aid training; June 1, 2015 - September 30, 2015; $2000.00 ANALYSIS STRATE IC GOALS PR ' and 'S: DSHS, Division of Behavioral Health and Recovery, Behavioral Health and Service Integration, Community Prevention and Wellness Initiatives (CPWI) asserts $2,000.00 for one YMHFA training in Jefferson County, WA for a minimum of fifteen (15) people completing the class, including, if involved in planning or delivering trainings, five (5) CPWI coalition members. CPWU focuses on prevention services in high -need communities in Washington State as selected by county and approved by DSHS and CPWI coalitions. This training is an 8 -hour course utilizing role - playing and simulations to introduce participants to a variety of risk factors and warning signs as well as provides resources for action. FISCAL, IMPA T BENE FIT ANALYSIS: This contract is paid for with DSHS /DBHR Youth Mental Health First Aid grant funds awarded to the Chimacum Prevention Coalition in the sum of $2,000.00. RECOMMENDATION: JCPH management request approval of Youth Mental Health First Aid, DBHR /DSHS; June 1, 2015 – September 30, 2015; $2,000.00 RE Philip Morle rin 'Ad"- inistrator Date 101161 . 360-385-9400 360-385-9401 - ' r, v ' y ,_ , =-. Water a uality 360-385-9444 360-379-4487 7%6o/j5 cC'. X 11"31 )6 E,ENE® e��;r+ �f suL Os 2015 U DSHS Central Contract Services 6017CF County Program Agreement (2 -23 -2012) Applill as to form only 6 1�qL) Is p Co. Prosy t.:.. ice 7M.rid Alvarez Chw! PA Page 1 �6SIA Budget greement Number COUNTY ,,¢¢ 1563 -39862 AL A!"--rAtILTH 7 .R HEALTH SERVICES PROGRAM AGREEMENT Mental Health First Aid This Program Agreement is by and between the State of Washington Administration or Division Department of Social and Health Services (DSHS) and the County identified Agreement Number below, and is issued in conjunction with a County and DSHS Agreement On County Agreement Number General Terms and Conditions, which is incorporated by reference. DSHS ADMINISTRATION DSHS DIVISION DSHS INDEX NUMBER DSHS CONTRACT CODE Behavioral Health and Service Division of Behavioral Health 1223 1000CC -63 Integration and Recove DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS Scott Waller 4500 10th Avenue SE Program Coordinator Lacey, WA 98503 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E -MAIL 360 725 -3782 360 586 -0341 scott.waller dshs.wa. ov 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 co.jefferson.wa.us IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM CFDA NUMBERS AGREEMENT? 93.958 No PROGRAM AGREEMENT START DATE PROGRAM AGREEMENT END DATE MAXIMUM PROGRAM AGREEMENT AMOUNT 06/01/2015 09/30/2015 $2,000.00 EXHIBITS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this County Program Agreement by reference: M Exhibits (specify): No Data Security Exhibit ; Exhibit A ❑ No Exhibits. The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive understanding between the parties superseding and merging all previous agreements, writings, and communications, oral or otherwise, regarding the subject matter of this Contract. The parties signing below represent that they have read and understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DSHS only upon si nature by DSHS. COUNTY SIGNAT E(S) PRINTED NAME(S) AND TITLE(S) DATE(S) SIGNED DSHS SIGNATURr P TE AME AND I� BHSIA ontr�acts DATE SIGNED tit U DSHS Central Contract Services 6017CF County Program Agreement (2 -23 -2012) Applill as to form only 6 1�qL) Is p Co. Prosy t.:.. ice 7M.rid Alvarez Chw! PA Page 1 Special Terms and Conditions 1. Definitions. a. "Community Prevention and Wellness Initiatives" 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 the Community Prevention and Wellness Initiative coalitions. b. "DBHR" means the Division of Behavioral Health and Recovery, within DSHS. c. "DSHS" means the Washington State Department of Social and Health Services. d. "DUNS" or "Data Universal Numbering System" means a unique identifier for businesses. DUNS numbers are assigned and maintained by Dun and Bradstreet (D &B) and are used for a variety of purposes, including applying for government contracting opportunities. e. "Youth Mental Health First Aid" or "YMHFA" means an 8 -hour course that introduces participants to risk factors and warning signs of mental health concerns, builds understanding of their impact, and overviews common treatments. The course uses role - playing and simulations to demonstrate how to assess a mental health crisis; select interventions and provide initial help; and connect persons to professional, peer and social supports as well as self -help resources. 2. DUNS Number. The Contractors DUNS number is: 184826790. 3. Purpose. The purpose of this project is to deliver Youth Mental Health f�'L t Aid (YMHFA) trainings in the Contractor's community. 4. Statement of Work. a. Plan and implement a minimum of one (1) YMHFA training with a minimum of fifteen (15) people completing the class. If they are involved in planning or delivering the trainings, CPWI coalitions will need to demonstrate that a minimum of five (5) coalition members participated in the training. b. Report the results of the YMHFA post -test results to the Division of Behavioral Health and Recovery (DBHR). c. Complete project report and submit to DBHR. 5. Consideration. The maximum consideration includes $2,000 per training X 1 trainings = $2,000 total maximum consideration, inclusive of performance based consideration. 6. Performance Based Consideration: Contractor shall receive $200 for each training if the average number of participants in the Youth Mental Health First Aid trainings exceeds the minimum requirement of fifteen (15): a. Fifteen (15) or more participants equal $2,000 per training. DSHS Central Contract Services 6017CF County Program Agreement (2 -23 -2012) Page 2 Special Terms and Conditions b. Fourteen (14) or fewer participants equal $1,800 per training. 7. Billing and Payment. a. Invoice System. The County /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 DBHR Contract Manager listed on page 1, PO Box 45330, Olympia, WA 98504 -5330 by the County /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. b. Eligible expenses. Reimbursement will be made for actual expenses that occur during the billing period that conform with the most restrictive guidance from either OMB Budget Circular A -87 or other local rules. c. Payment. Payment shall be considered timely if made by DSHS within thirty (30) days after receipt and acceptance by the DSHS Contract Contact 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. DSHS Central Contract Services 6017CF County Program Agreement (2 -23 -2012) Page 3 Special Terms and Conditions Exhibit A Youth Mental Health First Aid Training June 1, 2015 - September 30, 2015 The goal is to increase the capacity for delivery of effective mental health promotion and suicide prevention efforts in Washington State communities. The County /Contractor shall provide the services and staff, and otherwise do all things necessary for or incidental to the performance of work, as set forth below: Youth Mental Health First Aid (YMHFA) training. Communities will schedule and deliver the contracted number of YMHFA trainings as indicated in Section 4. Consideration. a. The training must be delivered by certified YMHFA instructors; b. A minimum of one (1) YMHFA training must be delivered within ninety (90) days of signing the Contract; c. If a Community Prevention and Wellness Initiative (CPWI) coalition is the applicant for the funds, or is involved in the planning and delivery of the training, then a minimum of five (5) coalition members must receive the training; d. The training must utilize the training curriculum and instructional materials associated with YMHFA, a trademarked program marketed by the National Council for Behavioral Health, bttp-,//www.thenation,qlcouncil.or /about/mental hegjth- first -aid; e. The training must be delivered in one of the following formats: (1) One (1) session with eight (8) hours of instruction; or, (2) Two (2) sessions with a total of eight (8) hours of instruction; or, (3) Four (4) sessions with a total of eight (8) hours of instruction. 2. Reporting. a. Enter post -test results for each participant in the YMHFA training(s) using materials or processes supplied by DBHR. b. Submit a brief report with the billing for the project that describes the implementation of the YMHFA training(s) using materials or processes supplied by the DBHR. DSHS Central Contract Services 6017CF County Program Agreement (2 -23 -2012) Page 4