HomeMy WebLinkAbout120919_ca06 615 Sheridan Street
�' Port Townsend, WA 98368
. cefefison www.JeffersonCountyPublicHealth.org
Public Healt
Consent Agenda
September 5, 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 with MCS
Counseling Group, LLC; September 1, 2019 —June 30, 2021;
$144,962.00
STATEMENT OF ISSUE:
Jefferson County Public Health, (JCPH) as the fund manager of the Behavioral Health, (Mental
Health and Substance Abuse) sales tax treatment funds, is requesting Board approval of a
Professional Services Agreement with MCS Counseling Group, LLC; September 1, 2019 —June
30, 2021; $144,962.00 ($72,481.00 in 2019/2020 and $72,481.00 in 2020/2021).
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This agreement is between JCPH and MCS Counseling Group, LLC for behavioral health
counseling to children and youth who are affected by mental health issues and enrolled in in
the school districts of Port Townsend, Chimacum, Quilcene and Brinnon in Jefferson County,
Washington.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This is sales tax revenue raised by the County in the 1/10 of 1% Fund and 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 and the contract may be renegotiated.
This Professional Services Agreement results from an RFP process and is recommended by the
Behavioral Health Advisory Committee.
RECOMMENDATION:
JCPH management requests approval of the Professional Services Agreement with MCS
Counseling Group, LLC; September 1, 2019 to June 30, 2021; $144,962.00.
REVI A_ D :Y
/
Morle , A unty Administrator Date
Community Health 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
PROFESSIONAL SERVICES AGREEMENT FOR
Between
Jefferson County
And
MCS Counseling Group, LLC
For
School-based Mental Health Services
THIS PROFESIONAL SERVICES AGREEMENT ("this Agreement")) is entered into between
the County of Jefferson, a municipal corporation("the County"), and MCS Counseling Group,
LLC ("the Contractor"), in consideration of the mutual benefits, terms, and conditions specified
below.
1. Project Designation. The Contractor is retained by the County to perform the following
Project: to provide mental health services in the school districts of Port Townsend,
Chimacum, Quilcene and Brinnon for Jefferson County, Washington.
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 September 1, 2019 and
continue through June 30, 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 $144,962.00 ($72,481 in 2019/2020 and$72,481 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, MCS-SBMH SERVICES 2019-2021 Page 1 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.
e. 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, MCS-SBMH SERVICES 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, MCS-SBMH SERVICES 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 LiabilityInsurance. 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 therofessional liabilitypolicyis"claims made,"then
p
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. Certificates of coverage as required by this
section shall be delivered to the County within fifteen(15) days of execution of
this Agreement.
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 4 of 19
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.
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.
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 5 of 19
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 applyseparately Y 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, MCS-SBMH SERVICES 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 enforc
e 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.
b. Every subcontractor must agree in writing to follow every term of this
Agreement. The Contractor must provide every subcontractor's written
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 7 of 19
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, MCS-SBMH SERVICES 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-DD/Behavioral Health- County Coordinator
Notices to Contractor shall be sent to the following address:
MCS Counseling Group, LLC
9633 Levin Rd. Suite 100
Silverdale, WA 98383
ATT: Julie Canterbury-Owner-CEO
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, MCS-SBMH SERVICES 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, MCS-SBMH SERVICES 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 History/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,
Sexual Offense;
c. Sign the Contractor Requirements for Responding to Situation of Sexual
Misconduct Form, and shall submit to Jefferson County with signed Agreement.
DATED this day of , 20
(SIGNATURES FOLLOW ON THE NEXT PAGE)
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 11 of 19
SIGNATURE PAGE
MCS COUNSELING GROUP, LLC JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Julie Canterbury,Owner-CEO Date Kate Dean,Chair
David Sullivan,Member
Greg Brotherton,Member
APPROVED AS TO FORM ONLY:
a e /z/yX 9
Philip C.Hunsucker
Chief Civil Deputy Prosecuting Attorney
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 12 of 19
EXHIBIT A
Scope of Work
MCS Counseling Group, LLC
For
School-based Mental Health Services
RESPONSIBILITIES:
o
The County, as administrator of the 1/10th of 1% Sales and Use Tax Funds, and MCS Counseling
Group, LLC agree that MCS Counseling Group, LLC 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.
RESPONSIBILITIES:
The MCS Counseling Group,LLC, as a contracted provider, agrees to the following:
1. The COUNTY and the four(4) school districts agree to cooperate in order to provide
early behavioral health, intervention and treatment services in the schools for children or
youth grades K-12 who identify with behavioral health issues. MCS hours will be
distributed as 1 day a week at Brinnon SD, 1 day a week at Quilcene SD, 2 days a week
at Chimacum SD and 3 days a week at Port Townsend SD. 85 % of that time is spent
seeing students and 15% is spent on charting, travel or meetings.
2. Work with identified youth and their families throughout the school year to provide
individual counseling on a variety of issues and concerns including, but not limited to,
anger management, depression, stress, conflict resolution, relationship issues, feelings of
suicide, counseling for grief or loss, sexual and physical abuse, eating disorders, domestic
violence, mental illness, adjustment disorders, crisis events and substance use:
3. Provide education, support, and consultation for the teachers and staff in each School
District.
4. Work collaboratively with local mental health and substance abuse treatment agencies for
identified clients.
5. Allocate 85% of staff hours to clinical services.
6. Staff each site with licensed therapists who consistently work at the same site except for
needs for personal leave. Exceptions may only be made with the written approval of the
JCPH.
7. Provide the names of licensed therapists working in each school to School Districts and
JCPH.
8. Notify JCPH and the School Districts of any Counselor changes in writing, (before they
occur).
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 13 of 19
9. Notify JCPH and School Districts of any extended leave of absence for Counselors in
writing, (before they occur).
10. Notify the SBC if a Counselor is out sick and unable to make an appointment.
11. Provide background checks for all MCS employees working with children or youth who
provide services under this contract. School districts each have different requirements and
all require out of state FBI background checks for employees new to Washington State.
(Please verify requirements with the School District offices.)
12. Upon request, provide copies of background checks& Counselor resumes to JCPH.
13. Provide crisis interventions and emergency response services within MCS's scope of
practice.
14. Provide on-going supportive counseling as needed, to all youth. Services are not
dependent on Medicaid eligibility.
15. Work with children or youth to provide support services and referrals to behavioral health
or other treatment programs. Assist with the application and eligibility paperwork
necessary to receive outside services.
16. Contact parents or guardians of children or youth subject to HIPPA and any other
applicable federal laws and Washington State laws concerning age of consent.
17. Assist school staff in identifying and developing strategies to assist students with
behavioral health issues.
18. Work with social services or other agencies as needed for dually served children or youth
with behavioral health and/or chemical dependency issues.
19. Assure that the MCS Prject Supervisor is available to provide weekly clinical
and
supervisory oversight for the therapists providing services in this program.
20.Assure that the MCS Project Supervisor is available to attend Clinician meetings and
quarterly SBHC Advisory meetings in Port Townsend and Chimacum School Districts
and include the Quilcene School District if a school based health clinic is established at
any time during this contract period.
21. Assure that the MCS Project Supervisor is available to meet with the School
Superintendents and Principals at the Quilcene and Brinnon School Districts.
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 14 of 19
22.Assure that Counselors collaborate in regular consultations with the SBHC team of health
and school professionals.
23. Maintain a secure and confidential records system guaranteeing HIPPA and any other
applicable federal requirements for behavioral health and treatment services.
24. Assure that Counselors offer each student an opportunity for session feedback by
providing a Likert-type rating scale.
25. Provide a new"new client sheet" for every new client to services at each School.
26. Fill out a"visit details sheet"to collect information about the reasons for the visit,
referrals, and satisfaction with services, at every session.
27. Providero ram data from the new client and vii details sheets g visit d to s s eets mcludmg the number
and types of behavioral health issues, intervention and treatment services provided, and
electronically upload data to the SBHC data system.
28. Provide a yearly report on client(students and families), utilization,referrals, outcomes.
29. Assure that an Epidemiologist of the Kitsap County Health District has continued access
to the SBHC data system.
30. When requested, attend and report to the Behavioral Health Advisory Committee with
progress evaluation reports.
31. A quarterly report of services will be recorded on a form created or approved by the
Public Health contracted Epidemiologist.
32. 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.
33. A copyof each electronic report will be sent to the JCPH Contract Representative.
34. Upon request, additional reports of activities and services will be provided to the JCPH
Contract Representative.
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 15 of 19
EXHIBIT B
Fee Schedule
2019-2021
Personnel Costs Total Budget
FTE& Salaries for Each Employee Per Year 2 Year Totals
Totals
.6 FTE Therapist(24 Hours/Week) $25,920 $51,840
.4 FTE Therapist/Supervisor(16 $23,040 $46,080
Hours/Week)
.20 FTE Therapist(8 Hours/Week) $8,640 $17,280
.10 FTE Clinical Supervisor(4 Hours/Week) $5,050 $10,100
Health Insurance for Therapist/Clinical $1,566.00 $3,132
Supervisor
Operating Costs
Supplies/Materials/Training $1,515.00 $3,030
Travel/Mileage $500.00 $1,000
Admin. Fee $6250.00 $12,500
Total Cost $72,481.00 $144,962.00
Not to exceed a total of$144,962.00 for the duration of this contract without express
written amendment signed by both parties.
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 16 of 19
EXHIBIT C
Logic Model
School-based Mental Health Services 2019-2021
...so that...
Outcome
Output
...so that... 1) Participating youth's
quality of life will be
► improved in areas of
1) Participating youth family,social and
will display positive educational.
improvements in their 2) The Jefferson County
overall mental status as Schools and overall
determined by community will
Process resolution of the experience
youth's treatment plan improvement in
...so that... goals. participation as a resu
2) Youth will display of less school days
01. improvement per missed,decreased
1) Eligible youth will report of the youth. emergency room
receive mental health visits,less juvenile
3) Youth will gain coping
and/or chemical skills and mental justice/law
dependency health awareness enforcement
Input assessment to through evidenced involvement.
determine specific based counseling.
needs and level of care. 4) Youth will gain
The appropriate level awareness of their
of care may include ACE's score and
1) Eligible participants will be
familytherapy.
develop strategies ies to
youth and their families 2) Once assessment has
increase resiliency.
who are enrolled in publicbeen
completed the
schools in Jefferson County youth will receive
(Brinnon,Chimacum,Port clinically appropriate
Townsend,Quilcene School mental health and/or
Districts),who display substance use
mental health and/or treatment.
substance use issues. 3) Youth that require
2) .6 FTE therapist employed higher level of
with MCS Counseling treatment for either
Group. mental health or
3) .4 FTE therapist employed substance use issues
with MCS Counseling will be referred to
Group. appropriate level of
4) .2 FTE therapist employed care.
with MCS Counseling 4) Each youth will be
Group. provided with
5) .1 FTE supervisor employed evidenced based
with MCS Counseling coping strategies
Group. through CBT,DBT,
and Solutions focused
counseling skill.
5) Each youth will have
an Adverse Childhood
Experience Test
(ACE's)conducted to
gain a deeper
awareness of trauma
informed care.
Professional Services Agreement, MCS-SBMH SERVICES 2019-2021 Page 17 of 19
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 Ruleprovides criteria for acceptable costs and
p g P
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 Countyreserves the first right to use as match the chemical dependency mental health
g p Y
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, MCS-SBMH SERVICES 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, MCS-SBMH SERVICES 2019-2021 Page 19 of 19