HomeMy WebLinkAboutWashington State Department of Health (DOH), Amendment No. 4 - 102218N
JEFFERSON COUNTY PUBLIC HEALTH
2018 — 2020 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH18247 AMENDMENT NUMBER: 4
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and JEFFERSON COUNTY PUBLIC HEALTH hereinafter referred to as "LHJ", pursuant to the
Modifications/Waivers clause, and to make necessary changes within the scope of this contract and any subsequent
amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows:
® Adds Statements of Work for the following programs:
Family Planning - Effective September 1, 2018
Office of Emergency Preparedness & Response - Effective July 1, 2018
Z Amends Statements of Work for the following programs:
Maternal & Child Health Block Grant - Effective January 1, 2018
Office of Immunization & Child Profile -Perinatal Hepatitis B - Effective July 1, 2018
OICP-Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2018
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-4 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-3 Allocations as
follows:
® Increase of $148,077 for a revised maximum consideration of $685,428.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C-4 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces
Exhibit C-3.
Unless designated otherwise herein, the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof.
JEFFERSON COUNTY PUBLIC HEALTH
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
-
Date Dlite
7hilip
bedasto Date:C. H sucker, Chief Civil Deputy Prosecu ing Attorney
Jefferson County Prosecuting Attorney's Office
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 25
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615 Sheridan Street
Port Townsend, WA 98368
enson www.JeffersonCountyPublicHealth.org
�e
Consent Agenda
is H 5 September 7, 2018
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Vicki Kirkpatrick, Director
DATE: tDIN9
SUBJECT: Agenda Item — Consolidated Contracts A-4 with the Department of
Health; January 1, 2018 — December 31, 2020; Add'I $148,077 for a
total of $685,428
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of the Consolidated Contracts A-4 (Amendment #4)
between JCPH and State of Washington Department of Health; January 1, 2018 - December 31, 2020; the
amendment provides an add'I $148,077 for a total of $685,428.
ANALYSIS/ STRATEGIC GOALS/PRO'S and CON'S:
This agreement with the Department of Health comprises State and Federal funds. This amendment adds
$148,077 in revenue to the existing contract and amends Statements of Work as follows:
• $77,612. Family Planning: Added funding for the period of performance ending 08/31/2019.
• $36,700. Maternal & Child Health Block Grant: Added funding, activities and deliverable due dates,
and extended the period of performance and funding period from September 30, 2018 to September
30, 2019 for continuation of MCHBG related activities.
• $33,765. Office of Emergency Preparedness & Response: Added funding for the period of
performance ending 06/30/2019.
• $0. Office of Immunization and Child Profile -Perinatal Hep B: Revised to correct Chart of Accounts
Program Name/Title and the Master Index Code.
• $0. OICP-Promotion of Immunizations to Improve Vaccination Rates: Revised to correct Chart of
Accounts Program Name/Title and the Master Index Code.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
Total consideration for this Contract Amendment is $148,077 for a total of $685,428. The Consolidated
Contract is funded by the Department of Health, and comprises both Federal and State funds.
RECOMMENDATION:
JCPH management request approval of Consolidated Contracts, A-4; January 1, 2018 - December 31, 2020;
add'I $148,077 for a total of $685,428.
REVIEWED BY:
Philip oorlemmux�t Cioaulnty inistrator
Developmental Disabilities
360-385-9400
Date
360-385-9401 (f) Always working for a safer and healthier community
Environmental Health
Water Quality
360-385-9444
(f) 360-379-4487
615 Sheridan Street
Port Townsend, WA 98368
Mon www. Jeff ersonCountyPublicHealth.org
Public Heealt
CC -18-02-A4
CONTRACT REVIEW FORM
CONTRACT WITH: Department of Health j V— I'0
CONTRACT FOR: Consolidated Contracts Amendment #4 TERM:
2020
COUNTY DEPARTMENT: Jefferson County Public Health
For More Information Contact: Julia Danskin SEP 10 2018
Contact Phone #: X420
JEFFERSON COUNT
RETURN TO: Jenny Matter RETURN BY: WA
%ovMMiSSIONFRC
AMOUNT: Add'I $148,077 for total $685,428 PROCESS:
Revenue:
Expenditure:
Matching Funds Required:
Source(s) of Matching Funds:
Step 1: REVIEW BY RISK
Review by:
Date Revie ed. -
K APPROVED FORM
Comments:
❑ Exempt from Bid Process
❑ Consultant Selection Process
❑ Cooperative Purchase
❑ Competitive Sealed Bid
❑ Small Work Roster
❑ Vendor List Bid
❑ RFP or RFQ
❑x Other: State and
federal funding
r revision (See Comments)
Step 2: REVIEW BY PROSECUTING TT RNE
jj
Review by:
Date Reviewed: 2 t$
APPROVED AS TO FORM% I LJ Returned for revision (See Comments)
Comments: (` .L_/, CM kc�
(This form to stay with contract throughout the contract review process)
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