HomeMy WebLinkAbout120516_ca02615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountyPublicHealth.org
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Julia Danskin, Public Health Manager
DATE: i'D /,5 I I (P
Consent Agenda
November 1, 2016
SA -15-07-A-3
SUBJECT: Agenda Item — Agency Agreement — Division of Behavioral Health and
Recovery with DSHS A-3, September 30, 2016 — June 30, 2017;
Additional $40,941 for a total of $214,500
STATEMENT OF ISSUE:
Jefferson County Public Health is requesting Board approval of the Agency Agreement — Division of
Behavioral Health and Recovery (DBHR) with DSHS, September 30, 2016 — June 30, 2017; Additional
$40,941 for a total of $214,500.
ANALYSIS/ STRATEGIC GOALS PRO'S and CON'S:
This ongoing contract with DBHR provides Federal and State funding through Substance Abuse Block Grant
(SABG) CFDA 93.959, Partnership for Success CFDA 93.243 to coordinate and implement prevention
programs designed to prevent or delay the misuse and abuse of alcohol, marijuana, tobacco, and other
drugs among youth up to age 18 and adults ages 18-25. The DBHR contract funds Community Prevention
and Wellness Initiatives and Community Coalition activities including coordination, prevention, and training
based on evidence -based practices as identified in the Excellence in Prevention Strategies List. This
amendment to the current contract, 1563-42479, increases the funding to SABG Prevention by $500 and
increases the funding to the PFS -Total by $40,441, for a total of $40,941.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This contract is fully funded through Federal Substance Abuse Block Grant, CFDA 93.959 and Partnership
for Success CFDA 93.243, and the state's general fund and increases by $40,941 the amount of funding for
a total of $214,500.
RECOMMENDATION:
JCPH management request approval of the Agency Agreement — Division of Behavioral Health and Recovery
with DSHS A-3 which increases the amount by $40,941, September 30, 2016 — June 30, 2017; for a total of
$214,500.
REVIEWED
Phili ` Orley, Cohn""' FAdministrafior Date
Community alih 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
COUNTY PROGRAM AGREEMENT
r Department of social AMENDMENT
7 1 0 }iealth Services
Transforming lives Prevention Services
This Program Agreement Amendment is by and between the State of Washington
Department of Social and Health Services (DSHS) and the County identified below.
DSHS ADMINISTRATION
Behavioral Health
Administration
DSHS CONTACT NAME
Lucilla Mendoza
DSHS DIVISION
Division of Behavioral
Health and Recovery
DSHS Agreement Number
1563-42479
Amendment No.
03
Administration or Division
Agreement Number
SP020155 / T1010056
County Agreement Number
DSHS INDEX NUMBER CCS CONTRACT C,)DE=
1223 1 1223
DSHS CONTACT ADORE
4500 10th Ave SE
DSHS CONTACT E-MAIL
mendol2(@_dshs.wa.g
COUNTY CONTACT E
d ban ke r@co.j efFer.
UMBERS
TOTAL MAXIMUM PR(
AMOUNT
$214,500.00
wa.us
REEMENT
REASON FOR AMENDMENT;
CHANGE OR CORRECT CONTRACT TERMS OR SOW, SEE PAGE TWO
EXHIBITS. When the box below is marked with a check (4) or an X. the following Exhibits are attached and are
incorporated into this Program Agreement Amendment by reference -
0 Exhibits (specify):
This Program Agreement Amendment, including all Exhibits and other documents incorporated by reference, contains all
of the terms and conditions agreed upon by the parties as changes to the original Program Agreement. No other
understandings or representations, oral or otherwise, regarding the subject matter of this Program Agreement Amendment
shall be deemed to exist or bind the parties. All other terms and conditions of the original Program Agreement remain in
full force and effect. The parties signing below warrant that they have read and understand this Program Agreement
Amendment, and have authority to enter into this Pro ram A reement Amendment.
COUNTY SIGNATURE(S) PRINTED NAME(S) AND TITLE{S) DATES) SIGNED
DSHS SIGNATURE
PRINTED NAME AND TITLE I DATE SIGNED
BHA Contracts 1
DSHS Central Contracts and Legal Services
1644CS County Program Agreement Amendment (10-28-2015) Page 1
Lacey, WA 98503-
DSHS CONTACT TELEPHONE
DSHS CONTACT FAX
(360)725-3760
Click here to enter text.
COUNTY NAME
COUNTY ADDRESS
Jefferson County
615 Sheridan St
Port Townsend, WA 98368- _
COUNTY FEDERAL EMPLOYER IDENTIFICATION
COUNTY CONTACT NAME
NUMBER
Denise Banker
COUNTY CONTACT TELEPHONE
COUNTY CONTACT FAX
360 385-9400
1 360 385-9401
IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM CFDA N
AGREEMENT?
93.959
Yes
AMENDMENT START DATE
PROGRAM AGREEMENT END DATE
09/30/2016
06/30/2017
PRIOR MAXIMUM PROGRAM AGREEMENT
AMOUNT OF INCREASE OR DECREASE
AMOUNT
$173,559.00
$40,941.00
DSHS CONTACT E-MAIL
mendol2(@_dshs.wa.g
COUNTY CONTACT E
d ban ke r@co.j efFer.
UMBERS
TOTAL MAXIMUM PR(
AMOUNT
$214,500.00
wa.us
REEMENT
REASON FOR AMENDMENT;
CHANGE OR CORRECT CONTRACT TERMS OR SOW, SEE PAGE TWO
EXHIBITS. When the box below is marked with a check (4) or an X. the following Exhibits are attached and are
incorporated into this Program Agreement Amendment by reference -
0 Exhibits (specify):
This Program Agreement Amendment, including all Exhibits and other documents incorporated by reference, contains all
of the terms and conditions agreed upon by the parties as changes to the original Program Agreement. No other
understandings or representations, oral or otherwise, regarding the subject matter of this Program Agreement Amendment
shall be deemed to exist or bind the parties. All other terms and conditions of the original Program Agreement remain in
full force and effect. The parties signing below warrant that they have read and understand this Program Agreement
Amendment, and have authority to enter into this Pro ram A reement Amendment.
COUNTY SIGNATURE(S) PRINTED NAME(S) AND TITLE{S) DATES) SIGNED
DSHS SIGNATURE
PRINTED NAME AND TITLE I DATE SIGNED
BHA Contracts 1
DSHS Central Contracts and Legal Services
1644CS County Program Agreement Amendment (10-28-2015) Page 1
This Program Agreement between the County and the State of Washington Department of Social and Health
Services (DSHS) is hereby amended as follows:
Amend the maximum contract consideration to add $40,941, therefore increasing the maximum
consideration from $173,559 to $214,500. The Awards and Revenues (A&R) is attached as Exhibit B.
2. Amend Section 1. Definitions aa. by deleting and replacing with the following:
aa. "Performance-based Prevention System" or "PBPS" or its replacement means the management
information system maintained by DSHS that collects planning, demographic, and prevention
service data.
3. Amend Section 1. Definitions by adding the following definition:
ff. "Regular annual schedule" means consistent, reliable services with a pattern of implementation
intervals throughout the year.
4. Amend Section 4. Performance Work Statement a.(1) and (2) is deleted and replaced in its entirety with
the following:
(1) Provision of CPWI services in accordance with the CPWI Community Coalition Guide located on
the Athena Forum website
http://www.theathenaforum,oW/cpwi community coalition aide u dated au ust 2015 rvsd
10 12 15 which outlines the minimal standards to participate in the CPWI. County/Contractor
shall plan to reach the ideal benchmarks related to the community coalition's efforts and staffing
with the Dedicated Marijuana Funding.
(2) Contractor shall ensure that a regular annual schedule of direct prevention services for the
public dissemination is established.
(a) Regular annual schedule shall take into account items including, but not limited to:
implementation times that maximize participation and service outcomes; local needs and
gaps; leveraged resources; and, other locally identified factors that influence service delivery
throughout the year.
(b) Regular annual schedule and community dissemination plan shall be identified within SFY
2017 as part of the CPWI Strategic Plan Update and submitted to Contract Manager or
designee by June 15, 2017 for DSHS review.
5. Amend Section 4. Performance Work Statement e. by adding (3) as follows:
(3) If special circumstances arise and Contractor is unable to enter the data by the reporting
deadline(s), the Contractor shall ensure any requests for extensions to reporting deadlines are
requested in writing and sent directly to the PSM via email five (5) working days before the
report due date.
The maximum extension request permitted is ten (10) working days.
(a) Monthly Invoices submitted with active data entry extensions will be denied and may be re-
submitted by Contractor once data for the month(s) in question is complete.
(b) Contractors with three (3) or more consecutive months of data entry extensions or late
reporting or four (4) or more program data entry extensions or late reporting within a six (6)
month period shall be required to submit a Corrective Action Plan to DSHS.
DSHS Central Contracts and Legal Services
1644CS County Program Agreement Amendment (10-28-2015) Page 2
Extensions granted due to PBPS technical issues will be excluded from this count.
All other terms and conditions of this Program Agreement remain in full force and effect.
DSHS Central Contracts and Legal Services
1644CS County Program Agreement Amendment (10-28-2015) Page 3
AWARD AND REVENUES
2015-2017 Biennium
CONTRACTOR NAME Jefferson County
CONTRACT NUMBER 1563-42479
COUNTY Jefferson
The above named Contractor is hereby awarded the following amounts for the purposes listed.
REVENUE
SOURCE TYPE OF SERVICE
CODE:
333.99.59
334.04.6X
334.04.6X
333.92.43
SABG Prevention
GF -State- Admin (for SABG Prevention)
Dedicated Marijuana Account -Fund 315 -State
PFS -Total
Year 2 FFY14 (7.1.15-9.29.15)
Year 3 FFY15 (9.30.15-9.29.16)
Year 4 FFY16 (9.30.16-6.30.17)
AWARD AMOUNTS
SFY 16 SFY 17
$30,098 $30,598
Biennial
Funds
Exhibit B
Tota 115-17
Biennium
$60,696
$2,617
$2,617
$5,234
$17,364
$23,364
$40,728
$53,921
$53,921
$0 $107,842
$13,480
$13,480
$40,441
$13,480
$53,921
$40,441
Total Federal Funds $84,019 $84,519 $0 $168,538
Total State Funds $19,981 $25,981 $0 $45,962
TOTAL ALL AWARDS $104,000 $110,500 $0 $14,500
Federal CFDA;
SABG-Substance Abuse Block Grant -CFDA 93.959 Substance Abuse and Mental Health Services Administration (SAMHSA)
PFS -Partnership for Success-CFDA 93.243 Substance Abuse and Mental Health Services Administration (SAMHSA)
2015-17 Jefferson Amend 12