HomeMy WebLinkAbout062518_ca08 615 Sheridan Street
4 Port Townsend, WA 98368
aerrerson www.JeffersonCountyPublicHealth.org
Public HeC Ulf f 1 Consent Agenda
June 20, 2018
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Vicki Kirkpatrick, Public Health Director
DATE: June 20, 2018
SUBJECT: Agenda Item — Group Health Foundation Grant — General Support for the
CHIP; Upon Signature — June 29, 2018; $7,500.00
STATEMENT OF ISSUE:
Jefferson County Public Health, requests Board approval of the Group Health Foundation Grant to support the
CHIP (Community Health Implementation Grant); Upon signature - no later than June 29, 2018; $7,500.00.
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
The purpose of this grant is for general support of the CHIP. Stipulations of the grant include: 1) submitting a
brief, reflective presentation about challenges, successes, and key !earnings related to the process of engaging
and partnering with communities on health equity issues and, 2) agreeing to provide the Foundation a
perpetual (but non-transferable and non-exclusive) license to use all or part of the presentation, with
attribution, in written materials or oral presentations the Foundation may develop.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
There is no impact to the general fund.
RECOMMENDATION:
JCPH management requests approval of the Group Health Foundation Grant to support the CHIP (Community
Health Implementation Grant); Upon signature — not later than June 29, 2018; $7,500.00.
RE W BY:
Philip Morley, ounty Administrato 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 U) 360-379-4487
GROUP HEALTH
FOUNDATION
Lessons Learned from Community Engagement
Presentation Instructions
Thank you for offering to share your perspectives with us.We are looking forward to learning from you.We
want to provide you with direction and context for your paper(or other preferred type of presentation)so that
your time is well spent.We are particularly interested in hearing about your process—the ways you have
invited,engaged,and created paths for community members to identify the issues that matter most to them.
We hope you will share a reflective presentation about challenges,successes,and key learnings related to the
process of engaging and partnering with communities on health equity issues.
Your insights will help inform and shape Group Health Foundation's long-term strategy. Learning from you
about the best ways to support place-and identity-based communities in their journey to find equitable
solutions will enable us to do the same.We intend to share all submissions through our website(with your
permission)so that others can benefit from your expertise as well.
With that in mind,here are our requests and expectations for your paper/presentation:
• Please limit your paper to six pages,including all attachments and appendices.
• Please limit the description of your organization,mission,and program(s)to one or two paragraphs.
• Please address the following questions:
1. How have you engaged,convened,and maintained relationships with your
community/communities?
2. How have you co-designed or co-created solutions with your community/communities?
3. How have you addressed systematic inequities that affect health (such as power differentials or
racism)as part of your community engagement work?
4. What about your organization's way of working has made you successful?How has your
organizational culture or structure changed to allow for authentic community relationships?
Include examples of how your staff and your board (if relevant)contributed to the culture and
values that enabled your success.
5. What have been your most significant challenges,obstacles,and missteps?We know that we can
learn as much from setbacks as we can from successes,so please don't hold back! (If you are
concerned about sharing challenges publicly,just let us know and we will omit your response to
this question from the version we share publicly.)
6. What changes have you seen that give you hope about a future that is more equitable?
Please feel free to answer the questions in the order that they are listed above or present your narrative in a
different way that works better for you. If you prefer to use graphics or another format besides narrative to
address these questions,we are open and interested.
Please contact us at infoPgrouphealthfoundation.org if you have any questions.We trust your experience
and expertise and are open to your creativity and honesty.Thank you again for giving us the opportunity to
learn alongside you.
Please submit your presentation to infoc grouphealthfoundation.org by June 29,2018.
GROUP HEALTH
FOUNDATION
Grant Agreement
Lessons Learned from Community Engagement
May 29,2018
Dear John,
We are grateful for the opportunity to support your efforts.
This document describes the agreement between Group Health Community Foundation (EIN 30-0889914,"the
Foundation") and your organization as described below(please provide any updates or corrections).
Information you submitted: Updates or corrections:
Organization(must be Jefferson County Community Health
the legal entity that will Improvement Plan(CHIP)
receive the grant)
EIN 91-60001322(please check this number)
Street address 615 Sheridan St.
City,state,and zip code Port Townsend,WA 98368
Primary contact(name) John Nowak
Alternate:Lori Flemming
Primary contact(email) jnowak@jeffersonhealthcare.org lfleming@co.jefferson.wa.us
You will receive a grant for general support of your mission in the amount of$7,500.
By signing this agreement,you represent that your organization is(please check the correct box):
O Qualified as an organization described in Section 501(c)(3) of the Internal Revenue Code of 1986(the
"Code"),as amended,and that you do not know of any proposal by,or reason for,the IRS to revoke or
change that status;
O Qualified as an organization described in Section 501(c)(4)of the Code,and that you do not know of
any proposal by,or reason for,the IRS to revoke or change that status;
III A duly established agency of the United States government,or of the government of a state or a
political subdivision of a state such as a county,city,or special district;or
O A Tribal government.
Please note that organizations with a 501(c)(3)or 501(c)(4) classification must use grant funds exclusively for
purposes described in Section 501(c)(3)or 501(c)(4), respectively,of the Code.
By signing this agreement,you agree to submit a brief,reflective presentation about challenges,successes,
and key learnings related to the process of engaging and partnering with communities on health equity
issues.The instructions for your presentation are attached to this agreement.The deadline for sharing your
presentation is June 29,2018.
In keeping with our values of learning and transparency,we hope to share all of the presentations we receive.
By signing this agreement,you agree to provide the Foundation a perpetual(but non-transferable and non-
exclusive) license to use all or part of your presentation,with attribution,in written materials or oral
presentations the Foundation may develop.
0 Please check this box if you are not willing to provide this license to the Foundation.
In carrying out work supported by this grant,you agree that you will not unlawfully discriminate in your
employment practices,volunteer opportunities,or the delivery of programs or services on the basis of race,
ethnicity,national origin,ancestry,religion,gender,gender identity/expression,age,medical condition,
disability,veteran status,marital status,sexual orientation,or any other characteristic protected by
applicable federal,state,or local law.
The Foundation is not seeking any recognition or publicity for this grant. If it helpful to your organization to
publicize the award,you are welcome to mention that support was provided by Group Health Foundation.
Terms of agreement accepted by:
For grant recipient organization
Signature
Printed name
Title
Date
For the Foundation
Signature
Printed name Cory Sbarbaro
Title Acting President&CEO
Date