HomeMy WebLinkAbout012516_ca05615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountyPublicHealth.org
Pub. MIC l ' l
Consent Agenda
January 11, 2016
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
TO:
FROM:
DATE:
SUBJECT:
AGENDA REQUEST
Board of County Commissioners
Philip Morley, County Administrator
Jean Baldwin, Director
Anna McEnery, Developmental Disabilities Coordinator
/ � 2--5 2-0
Agenda Item — Contract Agreement Amendment 1— Jefferson Mouse
Children's Center; January 1, 2015 — December 31, 2016; $27,570.00
STATEMENT OF ISSUE:
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 A-1— Jumping Mouse
Children's Center; January 1, 2015 — December 31, 2016; $27,570.00
ANALYSIS STRATEGIC GOALS PROS and CON'S:
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 IMPACT COST BENEFIT ANALYSIS
This is sales tax revenue raised by the County in the 1/10 of 1% Fund and is allocated by the BCCC with
advice from Mental Health and Substance Abuse Sales Tax Advisory Committee. The contract provides for
revenue fluctuations.
RECOMMENDATION:
JCPH management request approval of the Contract Agreement A-1— Jumping Mouse Children's Center;
January 1, 2015 — December 31, 2016; $27,570.00
REVIEWED BY:
Pili ipl�g� yjty AdmN.rr� q Date Environmental Health
Developmental Disabilities Water Quality
360-385-9400 360-385-9444
360-385-9401 (f) Always working for a safer and healthier community (f) 360-379-4487
CONTRACT AMENDMENT #1
By and Between
Jefferson County
And
Jumping Mouse Children's Center
For Expanded Mental Health (MH) & Chemical Dependency (CD) Treatment
CONTRACT AGREEMENT
WHEREAS, Jefferson Mental Health (Contractor) and Jefferson County (County) entered into an
agreement on January 1, 2015 for Professional Services in connection with mental health services to
individuals impacted by mental health/substance abuse issues in Jefferson County, Washington.
WHEREAS, the parties desire to amend the terms of that agreement.
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The term of the above referenced agreement ends December 31, 2016.
2. Jumping Mouse Children's Center will provide mental health treatment options to Jefferson county
residents as stated in Exhibit A -Statement of Work, Exhibit B -Fee Schedule and Attachment
A -Match Policy in order to increase the number of citizens receiving Mental Health services.
3. This amendment adds $27,570 in funding to be used specifically for case management services and
incentives directly related to the positive progress of program participants.
4. This contract shall not exceed $55,140 without express written amendment signed by both parties.
5. All other terms and conditions of the agreement will remain the same.
Dated this day of 12016.
By:
Kathleen Kler, Chair
Jefferson Board of County Commissioners
(Contractor)
JUMPING MOUSE CHILDREN'S CENTER- Amendment 4 1 2016
ro
Je arwn Co. rosecotor"s ice
David Alvarez, Chief Civi DPA
Exhibit A
Scope of Work
RESPONSIBILITIES:
The Jumping Mouse Children's Center Services agency as a contracted provider agrees to:
1. 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/substance 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 repeated 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.
7. Maintain a secure records system guaranteeing the confidentiality of PHI pursuant to HIPPA.
8. Bill other revenues whenever they exist.
9. Track monthly data template on client utilization, referrals, outcomes, and required reporting in
standard form as specified by Jefferson County Health.
10. Group or 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 to
JCPH monthly with the invoice. Use forms supplied by JCPH for data.
JUMPING MOUSE CHILDREN'S CENTER- Amendment 4 1 2016
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:
• 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.
JUMPING MOUSE CHILDREN'S CENTER -Amendment# 1 2016
Exhibit B
Fee Schedule
Therapy and Care Management @ $42 per session. Clinical supervision @$534 per month.
Not to exceed $55,140.00 in completion of services for the duration of this signed amendment.
JUMPING MOUSE CHILDREN'S CENTER- Amendment # 1 2016
JEFFERSON COUNTY MH/CD TREATMENT l: AX FUNDING,
MATCH POLICY
On October 14, 2013 Jefferson County Board of County Commissioners (BOCC) adopted the following
language in the allocation of the Mental Health Chemical Dependency treatment dollars.
Agencies may not use Jefferson County mental health county/ 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:
Match: is a requirement for the grantee to provide contributions of a specified amount or
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 0.1
percent, (the 1 / 10th of 1 % sales tax initiative) to augment state funding for mental health and chemical
dependency treatment. Jefferson County collects and distributes the Mental Health/Chemical Dependency
(Ml-I/CD) tax. Services purchased by the County are allocated through a formal Request for Proposal
(RFP) process, review and contracting; staffed by Jefferson County Public Health, overseen by Jefferson
County Mental Health Substance Abuse Fund 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 MH/CD tax as match have
no oversight or agency relationship to Jefferson County; funding cannot be used without prior
JUMPING MOUSE CHILDREN'S CENTER- Amendment # 1 2016
authorization of the vendor's match formula and allocation by the Jefferson County Administrator and
fiscal team.
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:
1. 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.
JUMPING MOUSE CHILDREN'S CENTER- Amendment #I 1 2016
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:
THIS 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, 2015 and continue through December 31, 2015,
unless terminated as provided herein.
Section 3: SCOPE OF AGREEMENT:
Coaitractor will increase rrrerrtal hea:rltla ta•eatment optiorrs i() Jefferson coaanly re:�iden(s as outlined
ira Exhibit A, licrein inco-Porated ley refercnce. "l h.roargh the Use of these fraaryds the provider will
increase t ae nw-n er of citizens receiviiig Meratal Health services.1'he goal ol'this funding grid
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:
CI, [.:IC'ont.�°ao ]�, p oe,titalivc
Anna McEnery
Jefferson County Public Health
615 Sheridan St.
Port Townsend, WA 98368
(360) 385-9400
Contractor's C:"&m c,-,�Ittatav .
Kris Becker, Executive Director
Jumping Mouse Children's Center
1809 Sheridan St.
Port Townsend, WA 98368
(360) 379-5109
Section 4: COMPENSATION:
The total amount payable under this Contract by County to CONTRACTOR, shall not exceed
$27,570.00 as outlined in Exhibit B- 1,'ec Schedule, in conipletion 01, this pj-o, ' jcct without express
writteiiarnendment signed by both Parties to this Agrcernent.J'he parties acknowledge that
4
kind.ing this contract Is Contingent on the continuation of sales, tax i-eventle in 2015. If the
sa,,fles tax revenue decreases by ten percent (10%) when applicable sales tax revenues are
compared between the most recently completed %tarter yeat: and the same quarter year revemies
'Flieparties acknowledge the funding connected
for 2014,theca this contract niay be renego6ated.
to this contract is revenue of last resort and therefore Contractca, will bill all other sow-ces 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 98368, Attn: Finance Department, for payment of work actually
completed to date.
C. hiVoict-S 111LIst be sLibniitted by'dic 3rd Monday of the month for the previous 11-101ithis
expellses,]"he County will review such invoices, and upon approval thereof, paynient will
be made to the Contractor in the arnoinil approved. Failure to submit timely invoices may
result in a denial of reimbursement.
D. Contractor shall provide invoices and necessary backul,) doctirrientation for all invoices
jilelticiing timesheets -wid stateiricnis. Any indirect cljarges require the submittal of an
indirect cost methodology and rate using OMB Circular's A-87 and A-122.
E. Courity reserves first right to use as match the chemical dependency mental health tax
ftinds and the services funded by them for purposes of qualifying to,, additional funding
and grarils. 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 Coninactor proposes to use chemical dependency mental health County tax hinds
for match, Contractor shall be solely responsible for compliance with, all state and fedenil
laws and regulations, including, but not limited to DSHS, CMS and DBHR funding rules,
applicable to the LISO of MJ-1/SA sales tax monies as rn,'Itcli. Contractor shall document
they have rnet this responsibility by subinitting to the County Administrator, in writing,
their match fbi,nitila, allocation 1 -flan and any other docutrientation rccplired of thern.
pursuant to Attachment A, attached hereto and iiicorporated in this Agreenictil.
G. Contractor records and accotints pertairling to this agreet-neiiI are to be kept available for
inspectioii by rcprescnt,afi\,es of the Cotiiity and state for as period of six (6) years after
final INj y 11, elljs, C(-)I?ies shall lac niade 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 regLt s t the County shall have the option of performing an onsite
review of all records, staatenients, 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 of OBM Circular A-133 or A-128, as applicable.
Section 5: INDEMNIFICATION:
The Contractor shall inden-a.nify, defend and hold harmless the County, its officers, agents and
etriployecs, fi'oiri and against any and aril clairn.s, lawsuits, demands for money damages, losses or
liability, or any portion thereof, including attorney's fees and costs, arising lr•o�rn any ii1)ury to
person 01pea°sons (ilacluding the death or rrajury ofthe Contractor or damage to personal property)
if said in a.ar-y oa ekunage 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
Mouse does not own a fleet of vehicles that are titled in their name.
B. General Liability (1) .- with a anininiuna lina.it per occurrence of one anillion dollars
(51,0O0,01: 0) and an ag„greLpte of tial less than two million dollars ($2,000,000) for
bodily in,Sury, death and property damage braless otliewrwise speci led in the crantract:.
specifications. This insurance coverage shall contain no l.irnitations oar the scrape Of
the protection provided and rndica.ale on the certrlicate of instrrance the following
coverage:
PAGE
1. Broad Form Property Damage with no employee exclusion;
2. Pea -conal Injury Lkibility, inelaading extended bodily inlul,y;
3. Broad Foran f`aaaatraac'tt,i al/L,`otyaanercial 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.
E. It is agreed by the parties that insurers shall have no right of recovery or subrogation
against, the County (including its employees and otheragents acid agencies) it being
the intention of the parties that the insuraaa-ace policies listed above shall protect both
par ties and be primary coverage iiia° any aand all losses covered by the above -listed
insurance policies. It is lui1 er agreed by the p,rties that any and all dedaic.tibles
nt ade part of (he above -listed insurance policies shall be assn nen by, paid for Barad, 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 RCW shah be noxa-contribaatoa-y with
respect to any policy of insurance the Contractor must provide to comply with this
Agreement.
G. If the proof of insurance or certificate indicating the County is an "additional
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.
H. 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 perforniance of this Ag,reetrient as ;re(piire(�1.
by HIPAA and other privacy laws. This Contract, once executed by the panties, 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 pr.rrswr rrat to this agreement. Nothing in this agreement shall be
CC)TI,Sidered to create the relationship of ernployer and employee between the parties hereto. The
Contractor shall not be entitled to any benefits accorded County employees by virtue of the
set -vices provided under this agreernent. The County shall not be responsible for withholding or
othel,wise 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: REPORTING:
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.
J'he niontlfly report shall cont,"in the report Of services arid (lie total hours worked by which staff".
,1,11e 1,11oTitilly repoil shall be submitted to Jcfl'erson County Public Health in care of Anna
Nlcf�'Ineq, 6l5 Slicridan, Port Townsend, and WA 98368. The County will review such reports,
and Lqx)n approval fficre0f, payllient will be made to the Contractor in the amount approved.
Failure to stibruit titnely reports may result in a denial of reimbursement.
Section 11: TERMINATION:
The County reserves the right to terminate this contract it, whole Or iii part, with 30 days' notice,
in the event that expected or actual f0riding froin any funding sotirce is withdrawn, redUCCC1, 017
limited in any way after the effective date ol ' 'this agreement, Iii the event of termination under
this clause, the Coinity 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:
1 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
3. With 30 days' notice by the Contractor by voluntary resignation.
Section 12: MODIFICATION: f either
'I'llis professional services ,igreement may be modified at any time by written agreement o
pm-ty aticl inay be modified if lax revenue decreases.
PAGE 5
Section 13: DISPUTE RESOLUTION:
Any dispLile oi- disagreement concerning (fie terins and obligations of this (.'Ontract shall initially
be bn-flight to the attention of the Public, Health 1)irector via a written doe I Lini-e-tit, Ttie Public
I-lealih Director shall ni�ake a deterniination with reasotiable ;X10111ptness,decision within
ten business days shall be deemed to have been made with reasonable promptness. 11" the
aggrieved party is not lial)PY witli that decisioti, then the Jeffel-son County Administrator (or as
inay hereafter be amended), will decide the appeal of t1wDitector's decision.
Section 14: INTEGRATED AGREEMENT:
This Agreement together with attachments or addenda represents the entire and integrated
agreement betweeri (lie, County an ' d the Contractoi- and supersedes all prior negotiations,
representations, 01- ag]-cenlents written or rural between the parties, This agreenient rnay be
ani ended only by written iiistrUni.ent signed by both County and (-antractor,
Approved this � 6(—day of 711
-� a
-20 5
BOARD OF COUNTY COMMISSIONERS
JEFFERSON C J'NTY, WASHINGTON
Chairlierson
IV t
Jumping Mouse Children's (.',entcr
ApprOved aws t form'on,
Co.
- ------------------------------ —J-cl—rc�rson CO. "Prosecllt"�
xl ���.
A � —th e- B— o ai d Je
Deputy Cl David Alvarez. Chief Civil DPA
VON=