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HomeMy WebLinkAboutJumping Mouse Children's Center - 111219PH "1,9-119 `9-11 9 PROFESSIONAL SERVICES AGREEMENT FOR J Between Jefferson County And Jumping Mouse Children's Center For The Brinnon School District -Mental Health Project THIS PROFESIONAL SERVICES AGREEMENT ("this Agreement") is entered into between the County of Jefferson, a municipal corporation ("the County"), and the Jumping Mouse Children's Center, ("the Contractor"), in consideration of the mutual benefits, terms, and conditions specified below. 1. Project Designation. tion. The Contractor is retained by the County to perform the following Project: to provide mental health services for young children, in the Brinnon School District, (along with support for their parents/caregivers), who have suffered trauma, including loss, abuse, neglect, and exposure to violence, mental illness, and substance abuse. 2. Scope of Services. Contractor agrees to perform the services identified on Exhibit "A" attached hereto including the provision of all labor. 3. Time for Performance. This Agreement shall commence on August 1, 2019 and continue through July 31, 2021. Work performed consistent with this Agreement during its term, but prior to the adoption of this Agreement, is hereby ratified. The Contractor shall perform all services pursuant to this Agreement as outlined on Exhibit "A". Time is of the essence in the performance of this Agreement. 4. Payment. The Contractor shall be paid by the County for completed work and for services rendered under this Agreement as follows: a. Payment for the work provided by Contractor shall be made as provided on Exhibit `B" attached hereto, provided that the total amount of payment to Contractor shall not exceed $64,848.00 ($32,424.00 in 2019/2020 and $32,424.00 in 2020/2021), without express written modification of the Agreement signed by the County. b. Invoices must be submitted by the 15th of the month for the previous month's expenses. Such invoices will be checked by the County, and upon approval thereof, payment will be made to the Contractor in the amount approved. Failure to submit timely invoices and reports pursuant to Exhibit B of the Agreement may result in a denial of reimbursement. Invoices not submitted within 60 days may be denied. c. Final payment of any balance due the Contractor of the total contract price earned will be made promptly upon its ascertainment and verification by the County after the completion of the work and submittal of reports under this Agreement and its acceptance by the County. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page i of 19 d. Contractor shall provide invoices and necessary backup documentation for all services including timesheets and statements (specifying the services provided). Any indirect charges require the submittal of an indirect cost methodology and rate using 2 C.F.R. Part 255 and 2 C.F.R. Part 230. The Contractor's records and accounts pertaining to this Agreement are to be kept available for inspection by representatives of the County and state for a period of six (6) years after final payments. Copies shall be made available upon request. f. County reserves first right to use as match the chemical dependency mental health tax funds and the services funded by them for purposes of qualifying for additional funding and grants. County may allow Contractor to use the chemical dependency mental health tax funds as match, at the County's sole discretion. Should the County decline to use chemical dependency mental health tax funds as match for additional funding and/or grants, then the County may authorize the Contractor to use such funds for match (see ATTACHMENT A). g. Where Contractor proposes to use chemical dependency mental health County tax funds for match, Contractor shall be solely responsible for compliance with all state and federal laws and regulations, including, but not limited to DSHS, CMS and MCSR funding rules, applicable to the use of MH/SA sales tax monies as match. Contractor shall document they have met this responsibility by submitting to the County Administrator, in writing, their match formula, allocation plan and any other documentation required of them pursuant to ATTACHMENT A, attached hereto and incorporated in this Agreement. h. The County may withhold authorization to utilize the MH/SA sales tax monies as match. Contractor's failure to provide adequate documentation does not relieve the Contractor of their responsibility to comply with all state and federal laws and regulations related to match. i. County reserves first right to use as match the chemical dependency mental health to the County Administrator, in writing, their match formula, allocation plan and any other documentation required of them pursuant to ATTACHMENT A, attached hereto and incorporated in this Agreement. 5. Ownership and Use of Documents. All non -confidential or de -identified documents, drawings, specifications, and other materials produced by the Contractor in connection with the services rendered under this Agreement shall be the property of the County whether the project for which they are made is executed or not. The Contractor shall be permitted to retain copies, including reproducible copies, of drawings and specifications for information, reference and use in connection with Contractor's endeavors. Contractor shall not be held liable for reuse of documents or modifications thereof, including electronic data, by County or its representatives for any purpose other than the intent of this Agreement. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 2 of 19 6. Compliance with laws. Contractor shall, in performing the services contemplated by this Agreement, faithfully observe and comply with all federal, state, and local laws, ordinances and regulations, applicable to the services to be rendered under this Agreement. 7. Audit. An audit will be submitted to the County upon request. Upon request, Contractor will submit the most recent financial audit within 30 days. a. Upon request, the County shall have the option of performing an onsite review of all records, statements, and documentation. b. If the County finds indications of potential non-compliance during the monitoring process, the County shall notify Contractor within ten (10) days. County and Contractor shall meet to discuss areas of contention in an attempt to resolve issues. c. Audit will provide statements consistent with the guidelines of Reporting for Other Non -Profit Organizations AICPA SOP 78-10, and is performed in accordance with generally accepted auditing standards and with Federal Standards for Audit of Governmental Organizations, Programs, Activities and Functions, and meeting all requirements of 2 C.F.R. Part 200, as applicable. 8. Indemnification. Contractor shall indemnify and hold harmless the County, its officers, and employees, from and against all claims, losses or liability, or any portion thereof, including reasonable attorney's fees and costs, arising from injury or death to persons, including injuries, sickness, disease or death to Contractor's own employees, or damage to property occasioned by a negligent act, omission or failure of the Contractor. Contractor shall be liable only to the extent of Contractor's proportional negligence. The Contractor specifically assumes potential liability for actions brought against the County by Contractor's employees, including all other persons engaged in the performance of any work or service required of the Contractor under this Agreement and, solely for the purpose of this indemnification and defense, the Contractor specifically waives any immunity under the state industrial insurance law, Title 51 R.C.W. The Contractor recognizes that this waiver was specifically entered into pursuant to provisions of R.C.W. 4.24.115 and was subject of mutual negotiation. 9. Insurance. Prior to commencing work, the Contractor shall obtain at its own cost and expense the following insurance coverage specified below and shall keep such coverage in force during the terms of the Agreement. a. Commercial Automobile Liability Insurance providing bodily injury and property damage liability coverage for all owned and non -owned vehicles assigned to or used in the performance of the work for a combined single limit of not less than $500,000 each occurrence with the County named as an additional insured in connection with the Contractor's performance of this Agreement. This insurance shall indicate on the certificate of insurance the following coverage: (a) Owned automobiles; (b) Hired automobiles; and, (3) Non -owned automobiles. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 3 of 19 b. Commercial General Liability Insurance in an amount not less than a single limit of one million dollars ($1,000,000) per occurrence and an aggregate of not less than two (2) times the occurrence amount ($2,000,000.00 minimum) for bodily injury, including death and property damage, unless a greater amount is specified in the contract specifications. The insurance coverage shall contain no limitations on the scope of the protection provided and include the following minimum coverage: i. Broad Form Property Damage, with no employee exclusion; ii. Personal Injury Liability, including extended bodily injury; iii. Broad Form Contractual/Commercial Liability — including coverage for products and completed operations; iv. Premises — Operations Liability (M&C); v. Independent Contractors and subcontractors; vi. Blanket Contractual Liability. c. Professional Liability Insurance. The Contractor shall maintain professional liability insurance against legal liability arising out of activity related to the performance of this Agreement, on a form acceptable to Jefferson County Risk Management in the amounts of not less than $1,000,000 Each Claim and $2,000,000 Aggregate. The professional liability insurance policy should be on an "occurrence" form. If the professional liability policy is "claims made," then an extended reporting periods coverage (tail coverage) shall be purchased for three (3) years after the end of this Agreement, at the Contractor's sole expense. The Contractor agrees the Contractor's insurance obligation to provide professional liability insurance shall survive the completion or termination of this Agreement for a minimum period of three (3) years. d. The County shall be named as an "additional named insured" under all insurance policies required by this Agreement, except Professional Liability Insurance when not allowed by the insurer. e. Such insurance coverage shall be evidenced by one of the following methods: (a) Certificate of Insurance; or, (b) Self-insurance through an irrevocable Letter of Credit from a qualified financial institution. f. The Contractor shall furnish the County with properly executed certificates of insurance that, at a minimum, shall include: (a) The limits of coverage; (b) The project name to which it applies; (c) The certificate holder as Jefferson County, Washington and its elected officials, officers, and employees with the address of Jefferson County Public Health 615 Sheridan Street, Port Townsend, WA 98368, and, (d) A statement that the insurance policy shall not be canceled or allowed to expire except on thirty (30) days prior written notice to the County. If the proof of insurance or certificate indicating the County is an "additional insured" to a policy obtained by the Contractor refers to an endorsement (by number or name) but does not provide the full text of that endorsement, then it shall be the obligation of the Contractor to obtain the full text of that endorsement and forward that full text to the County. Professional Services Agreement, Jumping Mouse /Brinnon School District -MH Project 2019-2021 Page 4 of 19 Certificates of coverage as required by this section shall be delivered to the County within fifteen (15) days of execution of this Agreement. g. Failure of the Contractor to take out or maintain any required insurance shall not relieve the Contractor from any liability under the Agreement, nor shall the insurance requirements be construed to conflict with or otherwise limit the obligations concerning indemnification of the County. h. The Contractor's insurers shall have no right of recovery or subrogation against the County (including its employees and other agents and agencies), it being the intention of the parties that the insurance policies, with the exception of Professional Liability Insurance, so affected shall protect both parties and be primary coverage for all losses covered by the above described insurance. i. Insurance companies issuing the policy or policies shall have no recourse against the County (including its employees and other agents and agencies) for payment of any premiums or for assessments under any form of policy. j. All deductibles in the above described insurance policies shall be assumed by and be at the sole risk of the Contractor. k. Any deductibles or self-insured retention shall be declared to and approved by the County prior to the approval of this Agreement by the County. At the option of the County, the insurer shall reduce or eliminate deductibles or self-insured retention, or the Contractor shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. 1. Insurance companies issuing the Contractor's insurance policy or policies shall have no recourse against the County (including its employees and other agents and agencies) for payment of any premiums or for assessments under any form of insurance policy. m. Any judgments for which the County may be liable, in excess of insured amounts required by this Agreement, or any portion thereof, may be withheld from payment due, or to become due, to the Contractor until the Contractor shall furnish additional security covering such judgment as may be determined by the County. n. Any coverage for third party liability claims provided to the County by a "Risk Pool" created pursuant to Ch. 48.62 RCW shall be non-contributory with respect to any policy of insurance the Contractor must provide in order to comply with this Agreement. o. The County may, upon the Contractor's failure to comply with all provisions of this Agreement relating to insurance, withhold payment or compensation that would otherwise be due to the Contractor. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 5 of 19 p. The Contractor's liability insurance provisions shall be primary and noncontributory with respect to any insurance or self-insurance programs covering the County, its elected and appointed officers, officials, employees, and agents. q. Any failure to comply with reporting provisions of the insurance policies shall not affect coverage provided to the County, its officers, officials, employees, or agents. r. The Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. s. The Contractor shall include all subcontractors as insured under its insurance policies or shall furnish separate certificates and endorsements for each subcontractor. All insurance provisions for subcontractors shall be subject to all the requirements stated herein. t. The insurance limits mandated for any insurance coverage required by this Agreement are not intended to be an indication of exposure nor are they limitations on indemnification. u. The Contractor shall maintain all required insurance policies in force from the time services commence until services are completed. Certificates, insurance policies, and endorsements expiring before completion of services shall be promptly replaced. All the insurance policies required by this Agreement shall provide that thirty (30) days prior to cancellation, suspension, reduction or material change in the policy, notice of same shall be given to the Jefferson County Public Health Contracts Manager by registered mail, return receipt requested. v. The Contractor shall place insurance with insurers licensed to do business in the State of Washington and having A.M. Best Company ratings of no less than A-, with the exception that excess and umbrella coverage used to meet the requirements for limits of liability or gaps in coverage need not be placed with insurers or re -insurers licensed in the State of Washington. w. The County reserves the right to request additional insurance on an individual basis for extra hazardous contracts and specific service agreements. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 6 of 19 10. Workers Compensation Industrial Insurance). a. If and only if the Contractor employs any person(s) in the status of employee or employees separate from or in addition to any equity owners, sole proprietor, partners, owners or shareholders of the Contractor, the Contractor shall maintain workers' compensation insurance at its own expense, as required by Title 51 RCW, for the term of this Agreement and shall provide evidence of coverage to Jefferson County Public Health, upon request. b. Worker's compensation insurance covering all employees with limits meeting all applicable state and federal laws. This coverage shall include Employer's Liability with limits meeting all applicable state and federal laws. c. This coverage shall extend to any subcontractor that does not have their own workers compensation and employer's liability insurance. d. The Contractor expressly waives by mutual negotiation all immunity and limitations on liability, with respect to the County, under any industrial insurance act, disability benefit act, or other employee benefit act of any jurisdiction that would otherwise be applicable in the case of such claim. e. If the County incurs any costs to enforce the provisions of this subsection, all cost and fees shall be recoverable from the Contractor. 11. Independent Contractor. The Contractor and the County agree that the Contractor is an independent contractor with respect to the services provided pursuant to this Agreement. The Contractor specifically has the right to direct and control Contractor's own activities, and the activities of its subcontractors, employees, agents, and representatives, in providing the agreed services in accordance with the specifications set out in this Agreement. Nothing in this Agreement shall be considered to create the relationship of employer and employee between the parties. Neither Contractor nor any employee of Contractor shall be entitled to any benefits accorded County employees by virtue of the services provided under this Agreement, including, but not limited to: retirement, vacation pay; holiday pay; sick leave pay; medical, dental, or other insurance benefits; fringe benefits; or any other rights or privileges afforded to Jefferson County employees. The County shall not be responsible for withholding or otherwise deducting federal income tax or social security or for contributing to the state industrial insurance program, otherwise assuming the duties of an employer with respect to Contractor, or any employee of Contractor. 12. Subcontracting Requirements. a. The Contractor is responsible for meeting all terms and conditions of this Agreement including standards of service, quality of materials and workmanship, costs, and schedules. Failure of a subcontractor to perform is no defense to a breach of this Agreement. The Contractor assumes responsibility for and all liability for the actions and quality of services performed by any subcontractor. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 7 of 19 b. Every subcontractor must agree in writing to follow every term of this Agreement. The Contractor must provide every subcontractor's written agreement to follow every term of this Agreement before the subcontractor can perform any services under this Agreement. The Public Health Director or their designee must approve any proposed subcontractors in writing. c. Any dispute arising between the Contractor and any subcontractors or between subcontractors must be resolved without involvement of any kind on the part of the County and without detrimental impact on the Contractor's performance required by this Agreement. 13. Covenant Against Contingent Fees. The Contractor warrants that he has not employed or retained any company or person, other than a bona fide employee working solely for the Contractor, to solicit or secure this Agreement, and that he has not paid or agreed to pay any company or person, other than a bona fide employee working solely for the Contractor, any fee, commission, percentage, brokerage fee, gifts, or any other consideration contingent upon or resulting from the award or making of this Agreement. For breach or violation of this warranty, the County shall have the right to annul this Agreement without liability or, in its discretion to deduct from the contract price or consideration, or otherwise recover, the full amount of such fee, commission, percentage, brokerage fee, gift, or contingent fee. 14. Discrimination Prohibited. The Contractor, with regard to the work performed by it under this Agreement, will not discriminate on the grounds of race, color, national origin, religion, creed, age, gender, sexual orientation, material status, sex, or the presence of any physical or sensory handicap in the selection and retention of employees or procurement of materials or supplies. 15. No Assignment. The Contractor shall not sublet or assign any of the services covered by this Agreement without the express written consent of the County. Assignment does not include printing or other customary reimbursable expenses that may be provided in an agreement. 16. Non -Waiver. Waiver by the County of any provision of this Agreement or any time limitation provided for in this Agreement shall not constitute a waiver of any other provision. 17. Termination. a. The County reserves the right to terminate this Agreement at any time by giving ten (10) days written notice to the Contractor. b. In the event of the death of a member, partner, or officer of the Contractor, or any of its supervisory personnel assigned to the project, the surviving members of the Contractor hereby agree to complete the work under the terms of this Agreement, if requested to do so by the County. This section shall not be a bar to renegotiations of this Agreement between surviving members of the Contractor and the County, if the County so chooses. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 8 of 19 c. The County reserves the right to terminate this contract in whole or in part, with 10 days' notice, in the event that expected or actual funding from any funding source is withdrawn, reduced, or limited in any way after the effective date of this agreement. In the event of termination under this clause, the County shall be liable for only payment for services rendered prior to the effective date of termination. 18. Notices. All notices or other communications which any party desires or is required to give shall be given in writing and shall be deemed to have been given if hand -delivered, sent by facsimile, email, or mailed by depositing in the United States mail, prepaid to the party at the address listed below or such other address as a party may designate in writing from time to time. Notices to the County shall be sent to the following address: Jefferson County Public Health Department 615 Sheridan Street Port Townsend, WA 98368 ATT: Anna McEnery-DDBehavioral Health County Coordinator Notices to Contractor shall be sent to the following address: Jumping Mouse 1809 Sheridan Street Port Townsend, WA 98368 ATT: Jenny Manza -Executive Director 19. Integrated Agreement. This Agreement together with attachments or addenda represents the entire and integrated Agreement between the County and the Contractor and supersedes all prior negotiations, representations, or agreements written or oral. No representation or promise not expressly contained in this Agreement has been made. This Agreement supersedes all prior or simultaneous representations, discussions, negotiations, and agreements, whether written or oral, by the County within the scope of this Agreement. The Contractor ratifies and adopts all statements, representations, warranties, covenants, and agreements contained in its proposal, and the supporting material submitted by the Contractor, accepts this Agreement and agrees to all of the terms and conditions of this Agreement. 20. Modification of this Agreement. This Agreement may be amended only by written instrument signed by both County and Contractor. 21. Disputes. The Parties agree to use their best efforts to prevent and resolve disputes before they escalate into claims or legal actions. Any disputed issue not resolved pursuant to the terms of this Agreement shall be submitted in writing within 10 days to the County Risk Manager, whose decision in the matter shall be final, but shall be subject to judicial review. If either party deem it necessary to institute legal action or proceeding to enforce any right or obligation under this Agreement, each party in such action shall bear the cost of its own attorney's fees and court costs. Any legal action shall be initiated in the Superior Court of the State of Washington for Jefferson County. The parties agree that all questions shall be resolved by application of Washington law and that the parties have the right of appeal from such decisions of the Superior Court in accordance with the laws of the State of Washington. The Contractor hereby consents to the personal jurisdiction of the Superior Court of the State of Washington for Jefferson County. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 9 of 19 22. Section Headings. The headings of the sections of this Agreement are for convenience of reference only and are not intended to restrict, affect, or be of any weight in the interpretation or construction of the provisions of the sections or this Agreement. 23. Limits of Any Waiver of Default. No consent by either party to, or waiver of, a breach by either party, whether express or implied, shall constitute a consent to, waiver of, or excuse of any other, different, or subsequent breach by either party. 24. No Oral Waiver. No term or provision of this Agreement will be considered waived by either party, and no breach excused by either party, unless such waiver or consent is in writing signed on behalf of the party against whom the waiver is asserted. Failure of a party to declare any breach or default immediately upon the occurrence thereof, or delay in taking any action in connection with, shall not waive such breach or default. 25. Severability. Provided it does not result in a material change in the terms of this Agreement, if any provision of this Agreement or the application of this Agreement to any person or circumstance shall be invalid, illegal, or unenforceable to any extent, the remainder of this Agreement and the application this Agreement shall not be affected and shall be enforceable to the fullest extent permitted by law. 26. Binding on Successors, Heirs and Assigns. This Agreement shall be binding upon and inure to the benefit of the parties' successors in interest, heirs, and assigns. 27. No Assignment. The Contractor shall not sell, assign, or transfer any of rights obtained by this Agreement without the express written consent of the County. 28. No Third party Beneficiaries. The parties do not intend, and nothing in this Agreement shall be construed to mean, that any provision in this Agreement is for the benefit of any person or entity who is not a party. 29. Signature in Counterparts. The parties agree that separate copies of this Agreement may be signed by each of the parties and this Agreement shall have the same force and effect as if all the parties had signed the original. 30. Facsimile and Electronic Signatures. The parties agree that facsimile and electronic signatures shall have the same force and effect as original signatures. 31. Arms -Length Negotiations. The parties agree that this Agreement has been negotiated at arms -length, with the assistance and advice of competent, independent legal counsel. 32. Public Records Act. Notwithstanding the provisions of this Agreement to the contrary, to the extent any record, including any electronic, audio, paper or other media, is required to be kept or indexed as a public record in accordance with the Washington Public Records Act, Chapter 42.56 RCW, as may hereafter be amended, the Contractor agrees to maintain all records constituting public records and to produce or assist the County in producing such records, within the time frames and parameters set forth in state law. The Contractor further agrees that upon receipt of any written public record request, Contractor shall, within two business days, notify the County by providing a copy of the request per the notice provisions of this Agreement. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 10 of 19 33. Confidentiality. With respect to all information relating to County that is confidential and clearly so designated, as required by the Health Insurance Portability and Accountability Act (HIPAA) and any other applicable privacy laws, the Contractor agrees to keep such information confidential. The Contractor shall not disclose, transfer, or sell any such information to any party, except as provided by law or, in the case of personal information, with the prior written consent of the person to whom the personal information pertains. The Contractor shall maintain the confidentiality of all personal information and other information gained by reason of this Agreement, and shall return or certify the destruction of such information if requested in writing by Jefferson County. This Agreement, once executed, will be a "public record" subject to production to a third party if same is requested pursuant to • the Washington Public Records Act, Chapter 42.56 RCW, as may hereafter be amended. 34. Criminal Histo . /ry Background Check. Each of the Contractor's employees, the employees of any of the Contractor's approved subcontractor, or volunteers used by the Contractor shall submit to a Washington State Patrol fingerprint identity and criminal history check before they are authorized to perform services for the Project. The County agrees to bear all reasonable costs incurred in the performance of this fingerprint identity and criminal history check. Contractors who may or will have regular access or limited access to any juveniles shall also: a. Require that each of the Contractor's employees, the employees of any of the Contractor's approved subcontractor, or volunteers used by the Contractor undergo not less often than once every three (3) years another Jefferson County approved criminal history and background check; b. Ensure all employees, subcontractors, or volunteers are knowledgeable about the requirements of RCW 13.40.570 and of the new crimes included in RCW 9A.44, DATED this Sexual Offense; Sign the Contractor Requirements for Responding to Situation of Sexual Misconduct Form, and shall submit to Jefferson County with signed Agreement. day of , 20 (SIGNATURES FOLLOW ON THE NEXT PAGE) Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 11 of 19 SIGNATURE PAGE sumo � � Yl/l�c�c Cil ��dreris Ce,+�f�e-v Name of Contractor J h fw W aA 2A Contractor Representative (Please print) a %-/— (Signature) 0 'FX ecu hr -G 0 o rttfu"', Title 11(Ifo 16 Date JEFFERSON COUNTY BOARDtOF COMMISSIONERS Kate Dean,Yha$/ David ullivan, -17w � D Gre erton, Member APPROVED AS TO FORM ONLY: c- Avz' "hl.? Philip C. Hunsucker Chief Civil Deputy Prosecuting Attorney Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 12 of 19 EXHIBIT A Scope of Work Jumping Mouse Children's Center For The Brinnon School District -Mental Health Project RESPONSIBILITIES: The County, as administrator of the 1/10th of 1% Sales and Use Tax Funds, and Jumping Mouse Children's Center agree that Jumping Mouse Children's Center will provide services to individuals as described in this Contract, including EXHIBIT A: Scope of Work:, EXHIBIT B: Fee Schedule:, and EXHIBIT C; Logic Model and Performance Measures; and further agrees to comply with the stipulations contained in ATTACHMENT A attached hereto and incorporated herein. The Jumping Mouse Children's Center Services agency as a contracted provider, agrees to: 1. Clinical and care management services for up to 8 children weekly using the Jumping Mouse model of play therapy at the Brinnon School District. 2. Provide support and education to the parents/caregivers of the children covered in this contract through monthly meetings and on-call support. 3. Provide classroom observation, ACEs (Adverse Childhood Experiences) education, support, and consultation for the teachers and staff in the Brinnon School District. 4. Work with social services or other agencies as needed for dually served families with mental health or chemical dependency issues. 5. Provide care coordination with other involved agencies, and referrals to supportive services such as housing, transportation and vocational services and track client involvement in recommended services. 6. Maintain a secure records system guaranteeing the confidentiality of PHI pursuant to HIPPA. 7. Bill other revenues whenever they exist. 8. Provide individual therapy, using promising and/or evidence based models of treatment. Applicant will identify the number of clients seen, how often each week and the number of hours per week and per month for treatment enrollment. 9. Make referrals for mental health medication and monitoring, as needed. 10. Prepare progress reports, if needed (e.g., for care coordination purposes). 11. Provide staff including two master's level Licensed Mental Health Counselor Associates, three Clinical Supervisors and support staff to include billing and administration. 12. Ensure all employees or subcontractors of the Contractor undertaking the performance of mental health/substance abuse services under this agreement are professionally licensed or certified by the State. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 13 of 19 13. Complete background checks; to be redone for every employee every 3 years. The names of licensed therapists will be given to the County. 14. Provide opportunities for regular clinical supervision and consultation for Jumping Mouse therapists staff who are working at the Brinnon site. Provide supervision for all therapists consisting of a minimum of one hour per week in individual consultation, one hour per week in group consultation and three hours per month in a clinical staff meeting. 15. Provide for clerical, billing, and general office support. 16. Provide agency oversight regarding record keeping, data collection, legal and ethical issues and standards of care are up to date and meet State of Washington standards. 17. Collect and prepare data for internal and external evaluation purposes, provide a monthly invoice to JCPH and a quarterly data report. Provide quarterly data on client utilization, referrals, outcomes, and any other required reporting, on a standard template provided by JCPH. 18. Provide data including: • Number of intakes, individual sessions, psychiatric visits, and adult education visits provided. • Age, sex, drug of choice, psychiatric diagnosis of clients. • Referrals to other agencies. • Client satisfaction form indicating client's view of how program helped in their life. • Type of education provided to Brinnon School District Staff and participation numbers 19. Attend and report to the Behavioral Health Advisory Committee once during the duration. 20. Opportunities for regular clinical supervision and consultation are available for staff on a regular basis. Supervision for all therapists, including interns and externs, consists of minimum one hour per week in individual consultation, one hour per week in group consultation and three hours per month in a clinical staff meeting. 21. A quarterly report of services and will be recorded on a form created or approved by the Public Health contracted Epidemiologist. 22. Quarterly electronic reports will be sent to the Public Health contracted Epidemiologist in a form as specified by Jefferson County Public Health and/or Kitsap County Health District, as outlined in the Quarterly Evaluation Reporting Template. 23. A copy of each electronic report will be sent to the JCPH Contract Representative. 24. Upon request, additional reports of activities and services provided, to the JCPH Contract Representative. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 14 of 19 Jefferson County 1/10th of 1% Sales Tax Jumping Mouse Children's Center August 1, 2019 - July 31, 2020 Budget Sheet Costs FTE & Salaries Requested SALES from TAX Other Source BudgetPersonnel (1) Therapist (20 hrs/wk)l $ 7,560 $ 12,000 $ 19,560 (2) Therapist (10 hrs/bi-weekly)l $ 6,012 $ - $ 6,012 (3) Clinical Supervisor on site (6 hrs/monthly)l $ 2,184 $ $ 2,184 (4) Clinical Supervisor at JumpingMouse(6hrs/monthly)1 $ 2,160 $ $ 2,160 (5) Clinical Supervisor at Jumping Mouse (6 hrs/monthly)l $ 2,328 1 $ $ 2,328 Benefits for Employees (1) Therapist (20 hrs/wk)l benefits $ 3,372 $ $ 3,372 (2) Therapist (10 hrs/bi-weekly)' benefits $ 1,068 $ $ 1,068 (3) Clinical Supervisor on site (6 hrs/monthly)l benefits $ 372 $ $ 372 (4) Clinical Supervisor at Jumping Mouse (6 hrs/monthly)l benefits $ 300 $ $ 300 (5) Clinical Supervisor at Jumping Mouse (6 hrs/monthly)' benefits $ 216 $ $ 216 SUBTOTAL $ 25,572 $ 12,000 $ 37,572 OPERATING COSTS Supplies/Materials —initial and ongoing $ 1,500 $ $ 1,500 Travel —Jumping Mouse to/from Brinnon2 $ 1,920 $ $ 1,920 (6) Admi in - no more than 10%3 $ 2,952 $ $ 2,952 OTHeiCOSTS Other- Utilities, maintenance, printing, postage, insurance.z $ 480 $ $ 480 Budget notes: 1) Therapist listed is licensed and will provide therapy to 8 children and consult with one child client's caregiver per week. 2) Therapist listed is licensed and will provide consultation with teachers/staff and classroom observation during set hours bi- weekly. 3) Clinical Supervisor will offer on site consultation to therapists and teachers during set hours monthly. 4) & 5) Clinical Supervisors provides required clinical supervision for licensed therapists. 6) Admin represents portion of staff time forfinancial and data management. 7) Other Funding Source is estimated earned income contribution (based on $600 invoiced average in completed portion of pilot, then doubled for increase in services over 10 months school is in session.) This will no longer be deducted from the grant billing so that it is not reduntantly accounted for. 1Bill monthly portion of total estimate. 2Bill monthly portion of total estimate. 3 Bill 10% program cost. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 15 of 19 Jefferson County 1/10th of 1% Sales Tax Jumping Mouse Children's Center August 1, 2020 - July 31, 2021 Budget Sheet Personnel Costs FTE & Salaries Requested SALES from TAX Other s Budget (1) Therapist (20 hrs/wk)' $ 7,560 $ 12,000 $ 19,560 (2) Therapist (10 hrs/bi-weekly)' $ 6,012 $ - $ 6,012 (3) Clinical Supervisor on site (6 hrs/monthly)' $ 2,184 $ $ 2,184 (4) Clinical Supervisor at Jumping Mouse (6 hrs/monthly)' $ 2,160 $ $ 2,160 (5) Clinical Supervisor at Jumping Mouse (6 hrs/monthly)' $ 2,328 $ I $ 2,328 Benefits for Employees (1) Therapist (20 hrs/wk)' benefits $ 3,372 $ $ 3,372 (2) Therapist (10 hrs/bi-weekly)' benefits $ 1,068 $ $ 1,068 (3) Clinical Supervisor on site (6 hrs/monthly)' benefits $ 372 $ $ 372 (4) Clinical Supervisor at Jumping Mouse (6 hrs/monthly)' benefits $ 300 $ $ 300 (5) Clinical Supervisor at Jumping Mouse (6 hrs/monthly)' benefits $ 216 $ $ 216 SUBTOTAL $ 25,572 $ 12,000 $ 37,572 OPERATING COSTS Supplies/Materials—initial and ongoingz $ 1,500 $ $ 1,500 Travel —Jumping Mouseto/from Brinnon2 $ 1,920 $ $ 1,920 (6) Admin - no more than 30%3 $ 2,952 $ $ 2,952 OTHER COSTS Other - Utilities, maintenance, printing, postage, insurance .2 $ 480 $ $ 480 Budget notes: 1) Therapist listed is licensed and will provide therapy to 8 children and consult with one child client's caregiver per week. 2) Therapist listed is licensed and will provide consultation with teachers/staff and classroom observation during set hours bi-weekly. 3) Clinical Supervisor will offer on site consultation to therapists and teachers during set hours monthly 4) & 5) Clinical Supervisors provides required clinical supervision for licensed therapists. 6) Admin represents portion of staff time forfinancial and data management. 7) Other Funding Source is estimated earned income contribution (based on $600 invoiced average in completed portion of pilot, then doubled for increase in services over 10 months school is in session.) This will no longer be deducted from the grant billing so that it is not reduntantly accounted for. 'Bill monthly portion of total estimate. 2Bill monthly portion of total estimate. 3Bill 10% program cost Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 16 of 19 Exhibit C Input 1) Master -level intern therapists 2) Licensed, certified supervisors 3) Administrative support staff 4) Facility and play materials that provide trust and safety in the therapy relationship 5) Long term, sustainable funding 6) Network of community supporting children and families Logic Model 2019-21 Jefferson County 1/10th of 1% Sales Tax Jumping Mouse Children's Center Process INN* Output 1) Provide mental health therapy for children ages 2-12 in East Jefferson County 2) Provide support and education for our children's parents and caregivers 3) Provide support and training to educators and school staff Professional Services Agreement, Jumping Mouse 90% of children served will successfully participate in therapy at their own pace, demonstrating: 1) increased emotional regulation, confidence, and self-esteem; 2) reduction of developmental delays and concerning behaviors; 3) increased trusting relationships with significant people in their lives; and 4) gained coping skills in dealing with difficult situations, so that trauma can be resolved and prevented. 80% of parents served will develop: 1) safer and more secure parental care that promotes healthy development and prevents additional trauma; 2) positive relationships with their child; 3) increased understanding and application of effective parenting skills; and 4) improved confidence, self-esteem, and ability to access support for their family when needed. 75% of educators and school staff served will develop: 1) reduced stress in the classroom; 2) increased emotional support and empathy for their students; 3) improved relationships with fellow staff, students, and parents; and 4) increased awareness and understanding of ACEs. Outcome Substance abuse and mental illness are prevented in children exposed to ACEs. Current and future generations experience less trauma and improved health and well-being. 1 Page 17 of 19 ATTACHMENT A JEFFERSON COUNTY MH/SA TREATMENT TAX FUNDING - MATCH POLICY Definitions: Match: is a requirement for the grantee to provide contributions of a specified amount or percentage to match funds provided by another grantor. Matching can be in the form of cash or in-kind contributions. Regulations: The specific requirements for matching funds are unique to each federal or state program. The A-102 Common Rule provides criteria for acceptable costs and contributions in regard to match. Jefferson County Policy: In 2005, the Washington State Legislature created an option for counties to raise the local sales tax by 0.1 percent, (the 1 / 10th of 1 % sales tax initiative) to augment state funding for mental health and chemical dependency treatment. Jefferson County collects and distributes the Mental Health/Chemical Dependency (MH/SA) tax. Services purchased by the County are allocated through a formal Request for Proposal (RFP) process, review and contracting; staffed by Jefferson County Public Health, overseen by Jefferson County Mental Health Substance Abuse Fund Advisory Committee and adopted by the Board of County Commissioners, (BOCC). BOCC does not assume any fiscal responsibility/liability for any of the Contractors they contract for services with. Jefferson County reserves the first right to use as match the chemical dependency mental health tax funds and the services funded by them for purposes of qualifying for additional funding and grants. County may make available to the Contractor the chemical dependency mental health tax funds for the Contractor to propose as match to state, federal or other entities, at the County's sole discretion. Contractor shall not use chemical dependency mental health County tax funds for match without prior authorization by the Jefferson County Administrator and County fiscal team. To request authorization of availability of the funds for match, Contractor must apply to the County Administrator in writing, and include their match formula and allocation plan and may include other documentation to support their request. The County Administrator will authorize or deny the availability of match funds in writing within 30 days of the application. If the County informs the Contractor of the availability of chemical dependency mental health County tax funds for match, then the Contractor shall be solely responsible for compliance with all state and federal laws and regulations, including, but not limited to DSHS, CMS and BIRR funding rules, applicable to the use of MH/SA sales tax monies as match. Following state, federal and local guidelines for match is the responsibility of the Contractor. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 18 of 19 For example, if a Contractor provides Title XIX Medicaid services (the Policy 19.50.02 or 42CFR 430.30) they are required by those rules to actually bill Medicaid for the services at the same time. If no Medicaid billing exists, the match would not comply with state and federal guidelines for match. Concurrent with its request for authorization of the availability of match, Contractor shall document it has met its responsibility to follow state, federal and local guidelines for match by submitting in writing to the County Administrator their match formula, allocation plan, and other documentation made mandatory pursuant to this Agreement and this Attachment A. At a minimum, the Contractor shall also provide the following to the County Administrator: 1. DSHS requires contractors to complete and submit a "Local Match Certification" form (DSHS 06-155) or a form that has equivalent data elements prior to any agreement for DSHS services. Submit a copy of this application and form when requesting match availability from the County and at each monthly billing. 2. Submit the current administrative policy within WA State regulating your services and the use of local match. 3. Submit to the County your last financial audit showing your use of match, County funds and tracking systems. 4. Submit to the County the terms of the agreement showing the MH/SA allocation is an allowable source of match. 5. Provide documentation that your financial reporting system tracks matching funds at a level that meets the level of documentation required by federal or state statutes. The County may reject permission for Contractor to utilize the MH/SA sales tax monies as match. Professional Services Agreement, Jumping Mouse Brinnon School District -MH Project 2019-2021 Page 19 of 19 615 Sheridan Street Port Townsend, WA 98368 MOM www.JeffersonCountyPublicHealth.org is Health Consent Agenda August 30, 2019 JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Philip Morley, County Administrator FROM: Vicki Kirkpatrick, Public Health Director Anna McEnery, DD & Behavioral Health County Coordinator DATE: SUBJECT: Agenda Item — Professional Services Agreement, Jumping Mouse Children's Center; August 1, 2019 —July 31, 2021; $64,848.00 STATEMENT OF ISSUE: Jefferson County Public Health, as the fund manager of the Behavioral Health (Mental Health & Substance Abuse) sales tax treatment funds, is requesting Board approval of a Professional Services Agreement with the Jumping Mouse Children's Center. Recognizing the lack of access & resources in this rural location of South Jefferson County, Jumping Mouse now has a satellite agency located in the Brinnon School in order to provide mental health services for young children in the Brinnon School District, who have suffered trauma, including loss, abuse, neglect, & exposure to violence, mental illness, & substance abuse; August 1, 2019 — July 31, 2021; $64,848.00 ($32,424 in 2019/2020 & $32,424 in 2020/2021). ANALYSIS/ STRATEGIC GOALS/PRO'S & CON'S: This agreement is between JCPH & Jumping Mouse, for clinical & care management services for up to 4 slots for children who attend school at the Brinnon School District, along with consults, education & support with teachers & staff. This service may include long-term therapy to children affected by and/or with risk factors for mental illness or substance abuse at home and/or in the community. Jumping Mouse will also provide support & education to the children's parents/caregivers through monthly meetings & on-call support. FISCAL IMPACT/COST BENEFIT ANALYSIS: This is sales tax revenue raised by the County in the 1/10 of 1% Fund & is allocated by the BOCC with advice from the Behavioral Health Advisory Committee. The agreement states if the sales tax revenue decreases the vendor will be contacted & the contract may be renegotiated. This Professional Services Agreement results from an RFP process & is recommended by the Behavioral Health Advisory Committee. RECOMMENDATION: JCPH management requests approval of the Professional Services Agreement with Jumping Mouse; August 1, 2019 — July 31, 2021; $64,848.00. REVIEWED BY: C4do, // jv Philipddan6yWCamty A ministrator Date Environmental Public Health Developmental Disabilities 360-385-9444 360-385-9400 (f) 360-379-4487 360-385-9401 (f) Always working for a safer and healthier community Public Heal CONTRACT REVIEW FORM CONTRACT WITH: Jumping Mouse TRACKING NO.: N-19-043 (Contractor/Consultant) CONTRACT FOR: Mental Health Services for young children TERM: 8/1/2019 - 7/31/2021 COUNTY DEPARTMENT: Jefferson County Public He It For More Information Contact: Anna M. Contact Phone #: x410 AUG 3 0 2919 RETURN TO: Jenny RETURN Bi3: (Person in Department) i .. � a � l AMOUNT: $64,848 PROCESS: ❑ xe process ❑ Consultant Selection Process Revenue ❑ Cooperative Purchase Expenditure $64,848 ❑ Competitive Sealed Bid Matching funds Required ❑ Small Works Roster Source(s) of Matching Funds ❑ Vendor List Bid ® RFP or RFQ ❑ Other - MOU Step 1: APPROVED FORM Comments REVIEW BY RISK N Review by: / - C 1. Date Reviewed: It ❑ Re A. for revision (See Comments) Step 2: REVIEW BY PROSE UTING ATTORNEY Review by:4eed _ Philip C. Hunsucker Date Reviewed. Chief Civil Deputy Prosecuting Attorney APPROVED AS TO FORM 4E] for revision (See Comments) Comments Step 3: (If required) DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND PROSECUTING ATTORNEY Step 4: CONTRACTOR/CONSULTANT SIGNS APPROPRIATE NUMBER OF ORIGINALS Step 5: SUBMIT TO BOCC FOR APPROVAL Submit original Contract(s), Agenda Request, and Contract Review form. Also, please send 2 copies of just the Contract(s) (with the originals) to the BOCC Office. Place "Sign Here" markers on all places the BOCC needs to sign. MUST be in BOCC Office by 4:30 p.m. TUESDAY for the following Monday's agenda. (This form to stay with contract throughout the contract review process.)