HomeMy WebLinkAbout070516_ca06615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountPubl�cHealth.org
Consen Agen a
June 27.2016
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
r
Agenda Item – Olympic Educational Service District 114 (OESD 114)
School Nurse Asthma Case Management -A1; October 19, 2015—May
27, 2016; Additional $1,126 to $6,639.00 for a total of $7,765.00
STATEMENT OF ISSUE:
Jefferson County Public Health (JCPH) requests Board approval of the OESD 114 School Nurse Asthma Case
Management Al; October 19, 2015 — May 27, 2016; Additional $1,126.00 for a total of $7,765.00
ANALYSIS/ STRATEGIC GOALS/PRO'S and CON'S:
This amendment adds $1,100.00 to the OESD 114 Asthma Case Management contract. OESD 114 contracts
JCPH to provide one registered nurse to identify and support students with a history of asthma as identified
by the school nurse. The main objective is to assess and support health and school performance,
specifically measuring absenteeism, math, and reading scores over the school year. JCPH nurse will provide
physical, emotional, and disease-specific training and seek student's family support. JCPH nurse will also
help identify students with asthma to district school nurse for health plan creation. The OESD 114 will pay
for 25 additional health services hours for the period of May 2, 2016 to May 27th, 2016, not to exceed
$1,100; plus $26.00 in mileage. Work performed prior to the signing of this contract is hereby ratified. This
contract amendment extends the length of service in order to pay for nursing services.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This contract amendment provides $1,100 dollars for nursing services, $26 for mileage. This is a budget
neutral amendment.
RECOMMENDATION:
JCPH management request approval of OESD 114 School Nurse Asthma Case Management Al; October 19,
2015 – May 27, 2016; Additional $1,126.00 for a total of $7,765.00.
REV BY:
Philip Morley, I CZnty AdministFaeor Date
Community Health 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
2015-16 School Year
Asthma Case Management
CONTRACT AMENDMENT
2015-16
Modification of Contract between the
Olympic Educational Service District 114, State of Washington
(hereinafter referred to as OESD)
and
Jefferson County Health and Human Services
(hereinafter referred to as Contractor)
Which commenced the 1St day of October 2015, and terminates the 27th day of May 2016.
For and in consideration of the mutual promises contained in this modification of contract, the OESD and
Contractor do mutually agree to modify the contract identified above as follows:
The OESD agrees to amend the contract to read as follows,
Pay Contractor for 25 additional health services hours for the period of May 02, 2016 to May 27r"
2016 to the Port Townsend School District, not to exceed $1,100.
Pay Contractor for travel incurred to provide these services, not to exceed $26.
CONTRACTOR
(Contractor Signature)
Who certifies that he/she is the
Contractor identified herein, or
in the alternative, a person duly
qualified and authorized to bind
the Contractor so identified to
the foregoing agreement.
Signed this day
of 2016.
Approved for Submittal:
Jennifer Acuna, OESD 114 Director Date
Stephanie Parker, ORSD 114 Assistant Superintendent Date
Monica Ilunsaker, OESD 114 Assistant Superintendent Date
OLYMPIC EDUCATIONAL
SERVICE DISTRICT 114
Greg Lynch, Superintendent
Signed this day
of .2016.
OESD USE ONLY
PURCHASE ORDER NO.
3701516003
APFbVel A -5--to F612
2015-16 School Year
Asthma Case Management
INTERGOVERNMENTAL AGREEMENT
BETWEEN
OLYMPIC EDUCATIONAL SERVICE DISTRICT 114
SCHOOL NURSE CORPS PROGRAM
(hereinafter referred to as OESD 114)
105 National Avenue North
Bremerton, WA 98312
AND
Jefferson County Public Health
(hereinafter referred to as Contractor)
615 Sheridan Port Townsend, WA 98368
This agreement is entered into by the School Nurse Corps Program as
administered by the Olympic Educational Service District 114 (OESD 114) and
Jefferson County Public Health for the purpose of providing nursing services
appropriate to the needs of identified students in Port Townsend School
District.
Jefferson County Public Health agrees to provide registered nurse services to
include the following:
1. Identify and support students with history of asthma as identified by
school nurse. Activities are consistent with nurse case management of
students with chronic health conditions; with main objective to assess
and support health and school performance. Specifically measuring
absenteeism, math and reading scores from the fall and spring 2015-16
school year.
2. Identified students will receive physical, emotional and disease-specific
training by Contractor. Family involvement will be actively sought by
Contractor.
3. Contractor will educate school staff regarding chronic disease
management of asthma and share information that will improve support of
student while in school in the absence of direct nursing intervention as
needed.
4. Contractor may also help identify students with asthma to district
school nurse for health plan creation.
5. Contractor will verify immunization status of student involvement in
nurse case management activities.
6. Contractor will also form relationships and partnerships in the community
including communication with health care providers, community support
groups, and any other agency that can further assist in supporting
student and family with asthma -specific condition.
7. Contractor will communicate and collaborate as needed to evaluate
interventions with OESD 114 program supervisor.
1 4
Asthma Case Management
JCPH 2015-16
Page 2
8. Contractor will document activities in specified computer program
provided by OESD 114 program supervisor. This information will be viewed
jointly with the OESD 114 program supervisor and ESD 113 grant support
staff.
9. Contractor will maintain monthly Time and Effort.
10.If necessary, Contractor will provide nursing care to identified students
according to their health plan. Will communicate intervention to school
nurse as needed.
11.Maintain proper liability insurance coverage on all its nursing personnel
performing the above -enumerated duties.
The Olympic Educational Service District 114 agrees to provide the following:
1. Nurse Contractor will be supervised by the OESD 114 Nursing Program
Specialist.
2. Pay Contractor forty-four dollars $44) per hour for nursing services
described above for up to sixteen (16)hours monthly, not to exceed
$5,632. The period of performance shall be from Oct. 01, 2015 through
May 01, 2016.
3. Pay Contractor for mileage incurred to provide these services, not to
exceed $127. (This is from Jefferson County Public Health to Port
Townsend Schools).
4. Pay Contractor to attend two 8 -hour trainings tentatively in Tacoma
including mileage, not to exceed $880.
Billing shall be done monthly with a final bill submitted prior to July 30,
2016.
Either party upon 30 days advance written notice to the other party may
terminate this agreement in whole, or in part.
The period of performance for this agreement shall be Oct. 01, 2015 through Ma
01, 2016 school year.
OESD agrees to comply with all provisions of the Americans with Disabilities
Act and all regulations interpreting or enforcing such act.
Each party to this agreement shall be solely responsible for any damage or
injury to persons or property resulting from its own negligence or the
negligence of its employees, agents or officers, and the cost or expense of
defending, including attorney's fees any claim, action, suit or other legal
proceeding arising or caused by the allegedly negligent acts and omissions of
its employees, agents or officers. The parties acknowledge this paragraph
required each of them to hold the other party harmless and indemnify them for
the negligent acts and omissions of its employees, agents, or officers.
Neither party assumes responsibility to the other party for consequences of
acts or omissions of any persons, companies or corporations not party to this
agreement.
Asthma Case Management
JCPH 2015-16
Page 3
IN WITNESS THEREOF, OESD 114 and Contractor have executed this Agreement
consisting of three pages.
CONTRACTOR
The undersigned certifies that
he/she is the person duly
qualified and authorized to
bind the Contractor so
identified to the foregoing
Agreement and under pen.a.lty of
perjury, certifies the Social
Security Number or Federal
Identification Number provided
is correct.
Signedi this >-7;ac
of
i
Contra tor's S gnature
O
w l
a
4
OLYMPIC
EDUCATIONAL SERVICE DISTRICT 114
Signed this — day
of �i 5
OESD USE ONLY
APPROVALS:
�9
dc 1
URSING PROGRAM S ECIALIST A
PA 'MENT AD DATE
VISION HEAD DATE