HomeMy WebLinkAbout060820_ca03 615 Sheridan Street
Port Townsend, WA 98368
Alletson www.JeffersonCountyPublicHealth.org
Public Health Consent Agenda
May 18, 2020
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Vicki Kirkpatrick, Director
Susan Parke, Financial Operations Coordinator
DATE:
SUBJECT: Agenda Item — Amendment No. 1 to the Program Agreement with DSHS
for Working Advance Long-term Payable; July 1, 2020 June 30, 2021
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of Amendment No. 1 to the Program Agreement with
DSHS for Long-term Payables; July 1, 2020 - June 30, 2021.
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
The agreement advances funds, in anticipation of the actual approval of those plans filed by the Contractor
(JCPH) with DSHS for the Division of Developmental Disabilities (DDD) program operated during the contract
period. This agreement is governed by terms in accordance with the General Terms and Conditions between
DSHS and the Contractor.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This contract has no fiscal impact.
RECOMMENDATION:
Jefferson County Public Health requests Board approval of Amendment No. 1 to the Program Agreement with
DSHS for Long-term Payables; July 1, 2020—June 30, 2021.
REVIE .
Philip Morley, Co A 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
DSHS CONTRACT NUMBER:
Washington State COUNTY PROGRAM or INTERLOCAL 1963-56860
711 Department of Social
&Health Services Amendment No. 01
LONG-TERM PAYABLE AGREEMENT
Transforming lives
AMENDMENT
This Amendment is between the State of Washington Department of Social and Program Contract Number
Health Services(DSHS)and the Contractor identified below. Click here to enter text.
Contractor Contract Number
CONTRACTOR NAME CONTRACTOR doing business as(DBA)
Jefferson County
CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS DSHS INDEX NUMBER
IDENTIFIER(UBI)
Castle Hill Center
615 Sheridan 161-001-169 1223
Port Townsend, WA 98368-2476
CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS
Susan Parke (360) 385-9400 (360) 385-9401 sparke@co.jefferson.wa.us
DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE
Facilities, Finance and Analytics Financial Services 8030CS-63
Administration
DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS
Mariann Schols PO Box 45842
Manager, Finance
Olympia,WA 98504-5842
DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS
(360)902-8170 (360)664-5775 scholmj@dshs.wa.gov
IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBERS
No
AMENDMENT START DATE CONTRACT END DATE
07/01/2020 06/30/2021
PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM CONTRACT AMOUNT
$0.00 N/A Based on Annual Review
REASON FOR AMENDMENT;
CHANGE OR CORRECT PERIOD OF PERFORMANCE
ATTACHMENTS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into
this Amendment by reference:
❑ Additional Exhibits(specify):
This Amendment, including all Exhibits and other documents incorporated by reference, contains all of the terms and
conditions agreed upon by the parties as changes to the original County Program Agreement or Interlocal Agreement. No
other understandings or representations, oral or otherwise, regarding the subject matter of this Amendment shall be
deemed to exist or bind the parties. All other terms and conditions of the original County Program Agreement or Interlocal
Agreement remain in full force and effect. The parties signing below warrant that they have read and understand this
Amendment, and have authority to enter into this Amendment.
CONTRACTOR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
Clarissa Brechwald, Contracts Consultant
DSHS Central Contracts and Legal Services
ApRroved as to form only: rs
V5• s1 Date: ..S 4v i o•za
Philip C. Hunsucker,Chief Civil Deputy Prosec ing A orney
DSHS Central Contracts and Legal Services Jefferson County Prosecuting Attorney's Office Page 1
6046 LF Long-Term Payable Amendment(5-5-20)
This Agreement between the State of Washington Department of Social and Health Services (DSHS) and the
Contractor is hereby amended as follows:
1. DSHS extends the Agreement End Date twelve months from June 30, 2020, to June 30, 2021, as
stated on Page One of this Amendment.
All other terms and conditions of this Agreement remain in full force and effect.
DSHS Central Contracts and Legal Services Page 2
6046 LF Long-Term Payable Amendment(5-5-20)