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Consent Agenda
Public HealthJuly 8, 2020
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Apple Martine, Community Health Director
DATE:
SUBJECT: Agenda Item — Interlocal Agreement with Port Townsend School District,
Chimacum School District, and Quilcene School District for School Based
Health Centers; Upon signature — June 20, 2024, with all services
beginning and ending in the coincident school year.
STATEMENT OF ISSUE:
Jefferson County Public Health, Community Health, is requesting Board approval of the Interlocal Agreement
between Port Townsend School District, Chimacum School District, and Quilcene School District for School
Based Health Centers; Upon signature —June 20, 2024
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
Jefferson Healthcare (JHC) and JCPH partner to provide clinical services in Port Townsend, Quilcene and
Chimacum School Districts. The schools provide clinic space, IT, and custodial care; JHC and JCPH provide
clinical services in the high schools. The three School Boards, Student Body associations, and two advisory
groups have been supportive of this service arrangement and have volunteered hours of work to make this
happen.
Studies have noted the challenges in providing needed healthcare services for adolescents. This partnership will
increase access to care for school-aged youth. The adolescent population is the least likely to access needed
mental, behavioral, oral and physical health care. Without preventive services, many health conditions afflicting
youth have developed into health care crises, resulting in not only high fiscal costs, but also long term negative
health outcomes.
School Based Health Centers (SBHC) are an effective model to provide access to preventive services and health
care for this population. Extensive research has demonstrated that school-based health centers improve health
status, and promote the health and well-being of school-age youth. Although the primary goal of SBHC is to
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
provide healthcare that is readily accessible to youth, there are a number of other benefits from SBHCs, which
include:
• Increased general access to care for students
• Increased access to mental health services
• Increases participation in sports and other school based activities
• Improved contraception use
• Decreased use of acute services including emergency room visits
• Decreased costs associated with asthma, diabetes and other chronic diseases
• Reduction in overall healthcare costs
• Reduction in teen pregnancies
• Reduced high school drop-out rates
The school-based health center allows students to access care conveniently at their high school, which
facilitates a relationship between the health care provider and the student.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
Clinic bills private insurance and Medicaid to cover the cost of staff time.
RECOMMENDATION:
JCPH management request the approval of the Interlocal Agreement between Jefferson County Public Health,
Port Townsend School District, Chimacum School District, and Quilcene School District for School Based Health
Centers; Upon signature —June 20, 2024
REVIEWED BY:
,f,"77/ „
4
`--Philip Morley, County 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
Interlocal Agreement
Between
Jefferson County Public Health, Chimacum School District#49, Port Townsend School
District #50, and Quilcene School District #48 For School-Based Health Centers
This Interlocal Agreement ("ILA") is designed to formalize the relationship between the Parties
to this ILA: Jefferson County Public Health ("JCPH"), Chimacum School District #49
("CSD"), Port Townsend School District #50 ("PTSD"), and Quilcene School District #48
("QSD") (collectively, "the Parties"), regarding the operation of a School-Based Health Center
("SBHC") in each of these three Jefferson County school districts. The conditions of this ILA
are consistent with RCW 39.34.
The SBHCs are governed by a Governance Board and an Advisory Committee.
The Governance Board. Directs the operations and policies of the SBHCs. The Governance
Board is comprised of representatives from the Parties, namely the Chimacum School District
Superintendent or designee, the Port Townsend School District Superintendent or designee, the
Quilcene School District Superintendent or designee, and the Jefferson County Public Health
Director or designee. The parties agree to collaborate on the implementation and operation of the
SBHCs.
The Advisory Committee. Provides community leadership, helps identify school health needs,
evaluates educational materials used in the SBHCs, and designs ways to deliver SBHC services
in the schools. The Advisory Committee is comprised of school principals, SBHC staff, school
counselors and nurses, parents, school board members, and students from Chimacum, Port
Townsend and Quilcene schools, as well as other members of the public.
Confidentiality. The Parties and their employees and representatives, and subcontractors and
their employees, will maintain the confidentiality of all Student Health information. Health
records and information maintained by PTSD, CSD, and QSD staff are considered "education
records" regulated by the protection of the Family Educational Rights and Privacy Act of 1974
(FERPA). 20 U.S.C. 1232g and 34 C.F.R. Part 99 as well as RCW 28A.605.030 and other
applicable federal and state laws. All Medical and Mental Health records and information
maintained by JCPH are protected as required by the Health Insurance Portability and
Accountability Act of 1996 ("HIPPA") and all other applicable federal and state privacy laws.
This ILA, once executed by the Parties, is and remains a public record and is therefore subject
to the provision of C11.42.56 RCW, the Public Records Act. This ILA does not create a separate
and distinct public agency. This ILA may be obtained as a public record from any part to this
ILA.
Terms of ILA
1. Obligations of Jefferson County Public Health. Jefferson County Public Health will:
A. Serve on the Governance Board through its Director or designee.
School-Based Health Center 2020
B. Provide a consistent Nurse Practitioner ("ARNP") for each SBHC along with appropriate
medical training, supervision,and medical malpractice/liability insurance.
C. Provide a medical assistant or clerical support person to each SBHC during medical
clinic hours.
D. Provide the following scope of services: age appropriate primary care, reproductive
health care, screening and treatment for sexually transmitted infections, mental health and
substance abuse screening and referral, health education and promotion to reduce risky
behaviors, and coordination with and referral to other medical, drug/alcohol, and social
services. ARNP, assistants, and clerical support who may contact children in the course of
their duties on school premises will be identified to PTSD, CSD, and QSD prior to the
performing services, and will submit to background checks and be fingerprinted consistent
with RCW 28A.400.303 through .309.
E. Provide a service summary of the SBHCs to each Party, Jefferson County Board of
Health, and any funding sources,and provide an annual report.
F. Provide health care equipment and supplies for use in SBHCs. Equipment shall remain
the property of Jefferson County.
G. Provide maintenance of medical records per HIPAA, state,and federal requirements.
H. Provide one laptop computer, modem, and encryption service for electronic medical
records.
I. Provide a cell phone for each clinic for use by clinic staff as needed.
J. Provide medical supervision of clinic support staff, and overall medical oversight and
guidance by the3efferson County Health Officer.
K. Provide billing far services.
L. Provide maintenance and disposal of hazardous wastes.
M. Consult annually with member school districts via the Advisory Committee to review
school health program needs and work with schools to adjust the scope of services
accordingly.
N. JCPH staff will convene and facilitate the Advisory Committee meetings.
O. JCPH will contract for mental health services and deliverables in the school
districts. Mental health services in the school districts will be provided through the 1/1
0th of 1% Sales and Use Tax for Mental Health and Chemical Dependency, subject to
successful responses to the RFP process and recommendation of Behavioral Health
Advisory Committee and approval of the Board of County Commissioners. Any providers
of mental health services through the school based health clinic will be identified to
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PTSD, CSD, and QSD prior to the provision of such services, and such providers will
submit to background checks and be fingerprinted consistent with RCW 28A.400.303.
2. Obligations of Chimacum School District. Chimacum School District will:
A. Serve on the Governance Board with the other Parties through its Superintendent or
designee.
B. Serve on the Advisory Committee through its School Building Principal or designee.
C. Provide information to interested students and families about the services available through
the SBHC.
D. Provide space and facilities support for school-based health center at Chimacum High
School.
E. Provide for all utilities including internet access. JCPH recognizes and acknowledges that
records of any internet activity and communication through the government-operated
servers of CSD will be retained by CSD as required by law and constitute records subject to
the Washington Public Records Act, Chapter 42.56 RCW.
F. Provide routine maintenance, repairs, and supplies related to facilities being utilized
by the SBHC (e.g. light bulbs, windows, ceiling tiles, hand towels, toilet paper).
G. Provide custodial services such as mopping floors, rubbish removal (non-hazardous
waste).
H. Provide for distribution of SBHC enrollment/consent of services forms to interested
students and families.
I. Include SBHC staff in parent nights and other events as appropriate to provide
information about services available to students and families through SBHC.
3. Obligations of Port Townsend School District. Port Townsend School District will:
A. Serve on the Governance Board with the other parties through its Superintendent or
designee.
B. Serve on the Advisory Committee through its School Building Principal or designee.
C. Provide information to interested students and families about the services available through
the SBHC.
D. Provide space and facilities support for school-based health center at Port Townsend
High School.
E. Provide for all utilities including internet access. JCPH recognizes and acknowledge that
records of any internet activity and communication through the government-operated
servers of PTSD will be retained by PTSD as required by law and constitute records
subject to the Washington Public Records Act, Chapter 42.56 RCW.
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F. Provide routine maintenance, repairs, and supplies related to facilities being utilized
by the SBHC (e.g. light bulbs, windows, ceiling tiles, hand towels, toilet paper).
G. Provide custodial services such as mopping floors, rubbish removal (non-hazardous
waste).
H. Provide for distribution of SBHC enrollment/consent of services forms to interested
students and families.
I. Include SBHC staff in parent nights and other events as appropriate to provide
information about services available to students and families through SBHC.
4. Obligations of Quilcene School District. Quilcene School District will:
A. Serve on the Governance Board with the other parties through its Superintendent or designee.
B. Serve on the Advisory Committee through its School Building Principal or designee.
C. Provide information to interested students and families about the services available through
the SBHC.
D. Provide space and facilities support for school-based health center at Port Townsend
High School.
E. Provide for all utilities including internet access. JCPH recognizes and acknowledge that
records of any internet activity and communication through the government-operated
servers of PTSD will be retained by PTSD as required by law and constitute records
subject to the Washington Public Records Act, Chapter 42.56 RCW.
F. Provide routine maintenance, repairs, and supplies related to facilities being utilized
by the SBHC (e.g. light bulbs, windows. ceiling tiles, hand towels, toilet paper).
G. Provide custodial services such as mopping floors, rubbish removal (non-hazardous
waste).
H. Provide for distribution of SBHC enrollment/consent of services forms to interested
students and families.
I. Include SBHC staff in parent nights and other events as appropriate to provide
information about services available to students and families through SBHC.
5. Confidentiality and Consent.
A. Information received at the SBHCs will be kept confidential in accordance with applicable
state and federal healthcare privacy laws, including but not limited to HIPPA.
Health/medical records shared with school personnel at PTSD, CSD, or QSD become
"education records" governed by FERPA and RCW 28A.605.030, to which parents of
students under the age of eighteen have the right of access.
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B. A signed parental consent form is required before any student can receive primary
healthcare at the SBHC with two exceptions:
C. Per RCW 9.02.100(2) and RCW 71.34.530 people thirteen or older may self-consent for
mental health services, and people of any age may self-consent for reproductive health
services.
D. A Consent To Release form must be signed by a student in order to release confidential
health information to parent(s) or guardian(s).
E. JCPH will make available sample materials to provide parents with accurate.
information and appropriate consent options about school-based health services.
F. Staff and volunteers of JCPH will not access education records of students under
the age of eighteen enrolled at PTSD, CSD, or QSD except by written and dated
parental authorization.
6. Times SBHC Services will be Provided. SBHC services will be provided from the start of
each school year, approximately mid to late August of each year, through the end of the school
year, or June 30, whichever date is earlier. SBHC Services will not be provided during the
summer. No student shall be transported away from school premises by staff or volunteers of JCPH
during the school day without express authorization of both a parent/guardian and the school building
administrator.
7. Termination. Any Party may terminate this ILA for any reason upon at least sixty (60)
days written notice. Such notice to terminate shall not be effective until completion of said
school semester. Any Party may also terminate this ILA at any time if any of the other Parties
default in any of its material obligations hereunder, but only if such defaults have continued for a
period of ten (10) days after the receipt of a written notice thereof from another Party. Upon
termination of this ILA, JCPH shall make good-faith efforts to refer students who are receiving
services to an alternative health care provider.
8. Amendment. This ILA may be amended by mutual written consent by all Parties.
9. No Partnership of Joint Venture. Nothing herein shall create or be deemed to create any
relationship of agency, joint venture, or partnership between Parties to this ILA. Neither shall
any Party have the power to bind or obligate any other in any manner except as expressly
provided in this ILA.
12. Limitation on Waiver. Any waiver, express or implied, by any Party of any rights, terms,
or conditions of this ILA shall not operate to waive such right, terms, or conditions or any other
rights,terms, or conditions beyond the specific instance of waiver.
13. No Discrimination. No Party shall discriminate or permit discrimination against any person
or group of persons on the basis of race, religion, creed, color, immigration status, national
origin, age, honorably-discharged veteran or military status, sex, sexual orientation, gender
expression or identity, marital status, the presence of any sensory, mental or physical disability,
or the use of a trained dog guide or service animal by a person with a disability. All parties
School-Based Health Center 2020
shall comply with the Americans with Disabilities Act and all regulations interpreting or
enforcing such Act.
14. Indemnity. Each Party to this ILA shall indemnify, defend, and hold harmless each of the
other Parties and their officers, agents, employees, and volunteers from and against any and all
claims, lawsuits, demands for money damages, losses or liability, or any portion thereof,
including attorney's fees and costs, arising from any injury to person or persons (including the
death or injury to any other Party to this ILA or damage to personal property) if said injury
or damage was caused by the negligent acts or omissions of that Party. In the event of
concurrent liability, the Parties shall have the right of contribution in proportion to the
respective liability of each Party. Nothing contained in this section shall be deemed to waive
immunities established pursuant to state statute or to create third-party right or immunities.
15. Required Liability and Workers Compensation Coverage. The Parties to this contract
shall obtain and keep in force during the terms of this Agreement or as otherwise required, the
following coverage with commercial companies or through other sources such as Risk Pools,
approved by the State Insurance Commissioner pursuant to Ch. 48.05 RCW:
A. Worker's compensation and employer's liability insurance as required by the State of
Washington.
B. Commercial Automobile Liability Coverage 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 $1,000,000 each
occurrence.
C. General Commercial Liability Coverage. or the equivalent from other sources such as Risk
Pools legally authorized to operate in the State of Washington, in an amount not less than a
single limit of one million dollars ($1.000,000.00) 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. The insurance coverage shall contain no limitations
on the scope of the protection provided and shall include the following minimum coverage:
1) Broad Form Property Damage, with no employee exclusion;
2) Personal Injury Liability, including extended bodily injury;
3) Broad Form Contractual/Commercial Liability- including completed operations
4) Premises - Operations Liability(M&C):
5) Independent;
6) Blanket Contractual Liability.
16. Required Professional Liability Insurance. If JCPH, or their employees are required to be
professionally licensed or certified by the State in the performance of services under this
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ILA, that JCPH through Jefferson County shall maintain professional liability insurance in the
amount of not less than one million dollars ($1,000,000).
17. No Joint Acquisition of Property. This ILA does not contemplate the joint acquisition of
property by the Parties. At termination, each party will remain the sole owner of its ownproperty.
18. Integration. This ILA, together with attachments or addenda, represents the entire and
integrated agreement between Jefferson County and the said Parties and supersedes all prior
negotiations, representations, or agreements written or oral between the Parties. This ILA may
be amended only by written instrument signed by all Parties.
19. Term of this ILA. Unless otherwise modified by written agreement of all the Parties, this
ILA shall be in effect until June 20, 2024 or until such time as a successor ILA is approved by
all Parties. However, this ILA will automatically renew each September 1 unless terminated
by a party to this ILA pursuant to Section 7.
(SIGNATURES APPEAR ON THE FOLLOWING PAGES)
School-Based Health Center 2020
Approved this day of , 2020.
JEFFERSON COUNTY, WASHINGTON
Greg Brotherton, Chair
Jefferson Board of County Commissioners
Vicki Kirkpatrick, Director
Jefferson County Public Health Department
SEAL:
ATTEST:
Carolyn Galloway Date
Deputy Clerk of the County Board of Commissioners
Approved as to form only:
0)- r- I
Philip C. Hunsucker ate
Chief Civil Deputy Prosecuting Attorney
C4.
Rick Thompson, Superintendent John Polm, Superintendent
Chimacum School District Port Townsend School District
Fra Redmon, Superintendent
Quilcene School District
School-Based Health Center 2020
Attachment A
Jefferson School Based Health Centers
Governance Board
Chimacum School District Superintendent or delegate
Port Townsend School District Superintendent or delegate
Quilcene School District Superintendent or delegate
Jefferson County Public Health Director or delegate
School-Based Health Center 2020