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Home My WebLink About062518_ca05615 Sheridan Street Port Townsend, WA 98368 www.JeffersonCountyPublicHealth.org Public Health Consent Agenda June 4, 2018 JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Philip Morley, County Administrator FROM: Vicki Kirkpatrick, Director Anna McEnery, Developmental Disabilities Coordinator DATE: (0/X f -�Oj SUBJECT: Agenda Item — Amendment No. 2 with Department of Social and Health Services for Developmental Disabilities Administration, (DDA); May 29, 2018 — June 30, 2019; additional $326,571 for a total of $623,843 STATEMENT OF ISSUE: Jefferson County Public Health, Developmental Disabilities Division, is requesting Board approval of amendment No. 2 with Department of Social and Health Services for Developmental Disabilities Administration, (DDA); May 29, 2018 — June 30, 2019; additional $326,571 for a total of $623,843 ANALYSIS STRATEGIC GOALS PRO'S and CON'S: This amendment adds funding and changes the expiration date from 6/30/2018 to 6/30/2019 for the continuation of services to clients with developmental disabilities in Jefferson County. The developmental disabilities program services provide educational opportunities for life-long learning and training to a specific workforce that allows interactions, equal opportunity, and integrated participation with non -disabled community members. FISCAL IMPACT COST BENEFIT ANALYSIS: This is a contract with the Department of Social and Health Services and includes both State and Waiver revenue. This revenue will be used to support programs in the Developmental Disabilities Programs. There is no impact to the general fund. RECOMMENDATION: JCPH management request approval of t amendment No. 1 with Department of Social and Health Services for Developmental Disabilities Administration, (DDA); May 29, 2018 — June 30, 2019; additional $326,571 for a total of $623,843 REVIEWED BY: Philip Morley, County Administrator Date Community Health Developmental Disabilities 360-385-9400 360-385-9401 (f) Always working for a safer and healthier community Environmental Health Water Quality 360-385-9444 (f) 360-379-4487 DSHS CONTRACT NUMBER: Washington State CONTRACT AMENDMENT 1763-96185 Department of Social n V& 71 Health Services Amendment No. 02 Transforming lives This Contract Amendment is between the State of Washington Department of Program Contract Number Social and Health Services (DSHS) and the Contractor identified below. Click here to enter text. Contractor Contract Number CONTRACTOR NAME CONTRACTOR doing business as (DBA) Jefferson County Jefferson County DDA County Services CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS DSHS INDEX NUMBER 615 Sheridan St IDENTIFIER (UBI) 1223 Port Townsend, WA 98368- 161-001-169 CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS Anna McEnr 360 385-9410 I (360) 385-0073 amcenery@co.jefferson.wa.us DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE Developmental Disabilities Admin Division of Developmental 1769CS-63 Disabilities DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS Wendi Winchel PO BOX 45315 Regional Business Manager Olympia, WA 98504-5315 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS 360 725-4264 360 586-6502 winchwa@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? I CFDA NUMBERS No AMENDMENT START DATE CONTRACT END DATE 05/29/2018 06/30/2019 PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM CONTRACT AMOUNT $297,272.00 $326,571.00 $623,843.00 REASON FOR AMENDMENT ' CHANGE OR CORRECT PERIOD OF PERFORMANCE AND MAX CONTRACT AMOUNT ATTACHMENTS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this Contract Amendment by reference: E Additional Exhibits (specify): Exhibit B This Contract 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 Contract. No other understandings or representations, oral or otherwise, regarding the subject matter of this 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. CONTRACTOR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED Melissa Diebert, Contract Specialist A7,,uada to r�t[, Date: PhIlip C. Hunsucker, Chief Civil Deputy Prosecuting Attorney Jefferson County Prosecuting Attorney's Office torney DSHS Central Contract Services Page 1 6024PF Contract Amendment (1-26-2018) This Contract between the State of Washington Department of Social and Health Services (DSHS) and the Contractor is hereby amended as follows: 1. The Total Maximum Contract Amount is hereby increased in the amount of $326,571 for a new Contract Amount of $623,843. 2. The Program Agreement end date is extended to June 30, 2019. 3. Special Terms and Conditions, Section 8, Billing and Payment is amended as follows: a. Program Agreement Budget: DSHS shall pay the County all allowable costs, which are defined by DDA as costs incurred by the program for: Program Administration: The County will provide program administration and may bill for administrative costs up to the identified amount in Exhibit B. Administrative costs reimbursement will not exceed 7% of the total combined allocation for Consumer Support and Other Consumer Support services unless millage has been declared or the Assistant Secretary of DDA approves a request for an exception under Chapter 388-850 WAC. Monthly claims for administrative costs will be for allowable expenditures incurred or 1/12 of the maximum Administration amount identified in Exhibit B, or the lessor of the two. 4. Exhibit B. Program Agreement Budget is hereby amended to include the following Budget Revision: All other terms and conditions of this Contract remain in full force and effect. EXHIBIT B Original Budget XXX Budget Revision REVENUES Fiscal Year Fund Source Original 1s� Revision 2nd Revision $158,421 3rd Revision 2018 State only $155,562 $158,421 Waiver $172,628 Waiver Total Rev. $291,930 $297,272 $298,342 $ Total Rev. $ $ $325,501 Fiscal Year Fund Source Original 1st Revision 2nd Revision 3rd Revision 2019 State $172,628 Waiver Total Rev. $ $ $325,501 $ DSHS Central Contract Services Page 2 6024PF Contract Amendment (1-26-2018) COUNTY FY 18 SPENDING PLAN COUNTY FY 19 SPENDING PLAN Planned PASRR Funds State Funds $70 $10,696 $9,996 Expenditures Medicaid Funds TOTAL ADMINISTRATION (CMIS/AWA BARS 11) OTHER CONSUMER SUPPORTS (CMIS/AWA Code 31, 32, 41, 92, 93.94) CONSUMER SUPPORT STATE -ONLY Child Development $8,752 $8.179 $19,518 $18,175 $ 8,942 $ 19,872 $15,809 $15,809 MEDICAID CLIENTS $ 16,125 $1000 $121,920 $1,070 $158,421 $121,920 $138,851 $244,840 ROADS to COMMUNITY LIVING TOTAL MEDICAID CLIENTS $298,342 COUNTY FY 19 SPENDING PLAN DSHS Central Contract Services Page 3 6024PF Contract Amendment (1-26-2018) PASRR Funds $ 32 State $ $ Planned Funds 11,695 10,930 Expenditures Medicaid Funds TOTAL $ 9,568 $ 21,295 ADMINISTRATION (CMIS/AWA BARS 11) OTHER CONSUMER SUPPORTS (CMIS/AWA Code 31, 32, 41, 92, 93,94) CONSUMER SUPPORT STATE -ONLY $ 8,942 $ 19,872 Child Development $ 16,125 $ 16,125 MEDICAID CLIENTS $ 453 $ 133,878 $ 133,878 $ 268,209 ROADS to COMMUNITY LIVING TOTAL $ 485 $ 172,628 $ 152,388 i $ 325,501 DSHS Central Contract Services Page 3 6024PF Contract Amendment (1-26-2018)