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HomeMy WebLinkAbout022221_ca14615 Sheridan Street Port Townsend, WA 98368 �ethson www.JeffersonCountyPublicHealth.org Public He� Consent Agenda JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Philip Morley, County Administrator FROM: Vicki Kirkpatrick, Director Anna McEnery, DD & BH County Coordinator DATE: SUBJECT: Agenda Item — a Memorandum of Understanding Agreement to Jefferson County District Court; January 1, 2021 — December 31, 2022; $100,000.00 STATEMENT OF ISSUE: Jefferson County Public Health, as the fund manager of the 1/loth of 1% Behavioral Health Sales Tax Treatment Funds, is requesting Board approval of a Memorandum of Understanding Agreement with the Jefferson County District Court; for Behavioral Health Court Case Management Services for individuals affected by substance abuse, chemical dependency and mental health issues; January 1, 2021— December 31, 2022; $100,000.00 ($50,000.00 in 2021 and $50,000.00 in 2022). ANALYSIS/STRATEGIC GOALS/PRO'S and CONS: This Memorandum of Understanding, is with the Jefferson County District Court; for Behavioral Health Court Case Management and other services for Jefferson County citizens with co-occurring disorders, seeking mental health, substance abuse and chemical dependency treatment. This Memorandum of Understanding Agreement, results from an RFP process and is recommended by the Behavioral Health Advisory Committee. FISCAL IMPACT/COST BENEFIT ANALYSIS: This is sales tax revenue raised by the County in the 1/10 of 1% Behavioral Health Sales Tax Treatment Fund; is allocated by the Board of County Commissioners with advice from the Behavioral Health Advisory Committee. The MOU states if the sales tax revenue decreases, the Court will be contacted and the agreement may be renegotiated. RECOMMENDATION: JCPH management request approval of a Memorandum of Understanding Agreement to Jefferson County District Court; January 1, 2021— December 31, 2022; $100,000.00 ($50,000.00 in 2021 and $50,000.00 in 2022). Date (-ommunity heairn Developmental Disabilities 360-385-9400 360-385-9401 (f) Always working for a safer and healthier community Environmental Public Health 360-385-9444 (f) 360-379-4487 MEMORANDUM OF UNDERSTANDING Between Jefferson County District Court and Jefferson County Board of County Commissioners as Administrator of 1/10t' of 1% Behavioral Health Sales Tax Fund — 2021-2022 WHEREAS, this Memorandum of Understanding (MOU) is between Jefferson County District Court (Court) and the Jefferson County Board of County Commissioners (County) which administers the 1/101h of 1% Behavioral Health Sales Tax Fund through Jefferson County Public Health; and WHEREAS, this Memorandum of Understanding describes the mutually -agreed conditions under which 1/IOth of 1% Behavioral Health Sales Tax; (Fund 131) is being allocated to Jefferson County District Court for the Court's Case Management Services for individuals affected by substance abuse, chemical dependency and mental health issues; and WHEREAS, the Jefferson County Behavioral Health Advisory Committee voted to recommend the 1/101h of 1% Behavioral Health Sales Tax; (Fund 131) be allocated for therapeutic court case management services in 2021-2022 as follows; $100,000 for Behavioral Health Court case management and services in Jefferson County District Court; WHEREAS, the Board of County Commissioners approved a 2021-2022 County Budget that allocates funding from the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131) the consistent with the Jefferson County Behavioral Health Advisory Committee's recommendations; and WHEREAS, the District Court will administer the contracts and expenditures to provide the therapeutic court case management services pursuant to this MOU from January 1, 2021 to December 31, 2022; and WHEREAS, Work performed between January 1, 2021 and the execution of this Agreement that is consistent with the provisions of this Agreement is hereby ratified; and WHEREAS, all funds from the 1 /loth of 1 % Behavioral Health Sales Tax; (Fund 131) may only be used for their intended purpose within that budget year, and any unexpended funds remaining at the end of a budget year must be returned to the Fund 131 fund balance, to be available for allocation for eligible services in future years; and WHEREAS, District Court agrees to regularly report deliverables and metrics to Jefferson County through the Jefferson County Public Health as specified under this MOU as a condition of receiving, 1/101h of 1% Behavioral Health Sales Tax; (Fund 131); and to facilitate overall management of the Fund; NOW, THEREFORE, it is mutually agreed that: The County, as administrator of the 1/1o1h of 1% Behavioral Health Sales Tax; (Fund 131); Jefferson County District Court mutually agrees for the Court to provide case management services and other services to individuals enrolled in Behavioral Health Court, as described in this MOU, including EXHIBIT A: Scope of Work: Behavioral Health Court and EXHIBIT B: Therapeutic Courts Logic Model and Performance Measures, EXHIBIT C: Jefferson County, 1/10t' of 1% Behavioral Health Sales Tax; (Fund 131) Spreadsheet and EXHIBIT D: Fee Schedule; attached hereto and incorporated herein. 1 of 13 2. Funding from the 1/101h of 1% Behavioral Health Sales Tax; (Fund 131); to the District Court for the services pursuant to this MOU shall be up to $50,000 in 2021 and up to $50,000 in 2022 as described in EXHIBIT D: Fee Schedule, subject to modification pursuant to Section 4 of this MOU. District Court will use the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131); for all participants enrolled in in Behavioral Health Court. Services include case management, court time, administrative duties, therapeutic court team staffing, treatment supervision and client support, (e.g. housing, urine analyses, Court incentives, out of custody assessments, in custody assessments, training, and alternative to jail) for participants, per EXHIBIT D: Fee Schedule. 3. Funding approved pursuant to this MOU will be included in the 2021 and 2022 expenditure appropriation budgets of District Court. In addition, a quarterly transfer from the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131); for a total equal to the amount expended during the YTD period minus previous expenditure reimbursements from this award not to exceed the authorized annual amounts in Section 2, above will be made to the District Court revenue budget upon timely submittal of required reports. Funds provided pursuant to this MOU will be tracked separately by the Court and may only be used for its intended purpose within that budget year. At the end of each budget year, if documented actual authorized expenditures pursuant to this MOU services related to/for the Behavioral Health Court are less than the authorized budgeted amount, the difference will be transferred back to the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131). District Court will not exceed the amount provided by the 1/101h of 1% Behavioral Health Sales Tax; (Fund 131); without obtaining an appropriation. 4. Funding provided by the 1 / 1 Oth of 1 % Behavioral Health Sales Tax; (Fund 131); will be used to monitor participant compliance and as well as help participants improve psychiatric symptoms and functioning, reduce substance use, reduce hospitalizations, increase housing stability, reduce arrests, and improve quality of life. Funding will be used to assist participants with the above areas. Funding listed per EXHIBIT D: Fee Schedule; are approximations for each line item, (with the exception of Administration) and may be shared between the descriptions, with budget updates given to Public Health. 5. District Court will use the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131) Spreadsheet; see EXHIBIT C - Jefferson County, 1/101h of 1% Behavioral Health Sales Tax; (Fund 131) Spreadsheet for actual paid monthly expenses that have incurred. 6. A copy of EXHIBIT C —Jefferson County, 1/1011 of 1% Behavioral Health Sales Tax; (Fund 131) Spreadsheet will be emailed quarterly to the Auditor's chief accountant. 7. District Court and any Contractors it may use to provide Case Management with the 1/10th of 1% Behavioral Health Sales Tax; (Fund 131); shall comply with the following: ATTACHMENT A - Jefferson County 1/10th of 1% Behavioral Health Sales Tax Match Policy. a. The County reserves first right to use as match, the Chemical Dependency or Mental Health Treatment Sales and Use Tax, (now known as the 1/10th of 1% Behavioral Health Sales Tax) and the services funded by them for purposes of qualifying for additional funding and grants. The County may allow the Contractor to use the 1/loth of 1% Behavioral Health Sales Tax funds as match, at the County's sole discretion. Should the County decline to use the 1/101h of 1% Behavioral Health Sales Tax funds as match for additional funding and/or grants, then the County may authorize the Contractor to use such funds for match consistent with this MOU; as required by ATTACHMENT A - Jefferson County 1/loth of 1% Behavioral Health Sales Tax Funding Match Policy. 2of13 b. Where the Court or its Contractor proposes to use 1/101h of 1% Behavioral Health Sales Tax funds for match, the Court or its Contractor shall be solely responsible for compliance with all state and federal laws and regulations, including but not limited to DSHS, CMS and DBHR funding rules, applicable to the use of 1/loth of 1% Behavioral Health Sales Tax funds as match. The Court or its Contractor shall document it has met this responsibility by submitting in writing to the District Court and County Administrator their match formula, allocation plan and any other documentation required of them by ATTACHMENT A - Jefferson County 1/1011 of 1% Behavioral Health Sales Tax Funding Match Policy. The County may withhold authorization to utilize the 1/10th of 1% Behavioral Health Sales Tax as match. The Court's or its Contractor's failure to provide adequate documentation does not relieve the Court or its Contractor of their responsibility to comply with all state and federal laws and regulations related to match. 8. This MOU may be amended by mutual written agreement of both parties. The basis for amending this agreement includes, but is not limited to, an increase or decrease in sales tax funding, or addition of required tasks not addressed in this agreement. 9. This MOU shall remain in effect from January 1, 2021 until December 31, 2022, unless terminated before then by either party with 30 days' prior written notice, except that the requirements to provide financial and program reports and other documentation required pursuant to EXHIBIT A, EXHIBIT B, EXHIBIT C, EXHIBIT D and ATTACHMENT A shall remain in effect until fulfilled. All work performed in 2021 and 2022 consistent with this MOU prior to its adoption is hereby ratified. DATED this day of 2021. Jefferson County Board of Commissioners Jefferson County District Court Kate Dean, Chair Attest: Carolyn Gallaway, Clerk of the Board Mindy Walker, Presiding Judge Approved as to Form Only: Philip Hunsucker, Chief ivil 6eputy Prosecuting Attorney 3of13 EXHIBIT A Scope of Work: Behavioral Health Court Jefferson County District Court agrees to utilize the 1/101h of 1% Behavioral Health Sales Tax; (Fund 131); to provide the following services and provide tracking reports through this MOU, as follows: Provide case management services for all citizens enrolled in Behavioral Health Court. a) At a minimum, case management shall include: • Prepare and maintain files or a data base on enrollees to track and document their attendance and participation in the therapeutic court, the enrollee's treatment plan, their progress in following the treatment plan, and their progress toward graduation from the therapeutic court. • Communicate with enrollees outside of court as necessary to answer questions, steer enrollees to appropriate resources, and provide guidance to help them comply with their treatment plans. • Coordinate the scheduling and participation of, and communication between, all representatives of agencies that are part of the therapeutic court, such as the Judge/Commissioner, Prosecutor, Public Defenders, and Treatment Providers. • Provide administrative support for the smooth functioning of the therapeutic court as may be required by District Court. • Collect and share statistics and data as may be required for the administration of the therapeutic court and for reporting purposes. b) If the Court utilizes funds under this MOU to hire a Contractor to provide services subject to this MOU, the Court agrees to prepare for BoCC approval a Professional Services Agreement with the Contractor, which Agreement has been approved by the County's Risk Management and Legal review, and which requires Contractor's compliance with the provisions of this MOU, including compliance with the provisions of Section 5 of this MOU, and requires the Contractor to timely provide all financial and program reports and other documentation necessary for the Court to comply with this MOU. 2. Adults charged in Jefferson County for criminal activity whose criminal behavior is related to, or affected by, mental illness may be eligible to participate in Behavioral Health Court, which is up to a two-year voluntary program that promotes treatment and accountability. Participants are required to comply with law abiding behavior, participate in recommended treatment, submit to random urinalyses, attend regular court reviews and maintain frequent contact with Behavioral Health Court Staff. 3. The I/loth of 1% Behavioral Health Sales Tax; (Fund 131); provides support needed to operate Behavioral Health Court, which protects public safety while reducing offender risk for future justice involvement and placement in a higher, more restrictive level of care or incarceration. Funds are provided to assist in housing, jail alternatives, in and out of custody assessments, treatment not covered by insurance, as well as the substance use monitoring services of urine analysis (UA) testing and biological alcohol monitoring devices (Sober -Link) to determine compliance with court orders. 4of13 EXHIBIT B: The Behavioral Health Court Logic Model and Performance Measures are attached hereto and incorporated herein. If the Court utilizes funds under this MOU to hire a Contractor to provide case management services or administration and billing services subject to this MOU, the Court agrees to prepare for BoCC approval a professional services agreement with the Contractor, which Agreement has been approved by the County's Risk Management and Legal review, and which requires Contractor's compliance with the provisions of this MOU, including compliance with the provisions of Section 5 of this MOU, and requires the Contractor to timely provide all financial and program reports and other documentation necessary for the Court to comply with this MOU. 2. Provide at least the following for the Behavioral Health Court; so, the Behavioral Health Advisory Committee is able to review usage of allocated funds in order to assure access to appropriate treatments and services: a) Provide quarterly financial reports per EXHIBIT C -Jefferson County, 1/10th of 1% Behavioral Health Sales Tax; (Fund 131) Spreadsheet for actual paid monthly expenses that have incurred emailed quarterly to the Auditor's chief accountant and Public Health representative. b) District Court will provide an estimate of projected expenditures under this MOU for the remainder of the year at the end of October of 2021 and at the end of October 2022 to Public Health. c) District Court will provide all 2021 invoices to the Auditors office for processing during the Open Period, a.k.a. 13th Month, in January and the final reporting by January 20, 2022 and January 19, 2023. d) Provide to Jefferson County through Jefferson County Public Health a copy of any service contracts (and all amendments associated therewith) with the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131) under this MOU. e) Jefferson County District Court will provide quarterly statistics in an electronic form that is developed and may be revised by Jefferson County Public Health and the Kitsap Health District, in consultation with the Court, for statistical and program data collection. f) Jefferson County District Court will ensure that quarterly electronic reports for the Behavioral Health Court are sent to Amanda Tjemsland of Kitsap County Health District, at: Amanda. Tjemslandgkitsappublichealth.org and that a copy of each electronic report is also sent to Anna McEnery of Jefferson County Public Health at amcenerykco jefferson.wa.us. o Quarterly reports will be reviewed by Public Health and Kitsap County Health District for accuracy. Any questions will be referred back to the Court. 5of13 IXHIBIT 1-1 Behavioral Health Court - Logic Model Jefferson County - 1/10 of 1% Sales Tax Environment Situation 0 Seriously wertalK, ill "SPAP, defendants spEre n-c-re th­ie in and '181QU gicaivi dirficulty -iavigal.ing tho crin-i-la justico systorn (CJGi 0 Persons vvith SMI are likely to repeat criminal behavior (when illness coea untreated) * Tie Vadijoral Orr inal j .45t.ice process is typically not affective for oa,aons with SPAI e There is a high incidence cf mental illness among offenders Context Addreasing crimiral oel-avior within mental health issuca is becoming a prioritywithinJefferson County Districi Court has created a bEnavioral health theraneutin court yBHCl, Local bchavicral health providcrs, have appoln'cd jail lialsms Target Population icrfu,3an County Re* (1QrA* M, V � T_ 1=1 ft"K z = Defendants in the Jefferson Ccun-.y Dir,,,ric.-.' and Superior COL. n "haul- f"'k-6 A., H W I Slid currently rocciving or will roccivc, scrviccs a CPSA provider. Exclusion Criteria i-elony chargea, ind.Xing rnurler. sexual asmull. or ch[10 niolestatlori Theory & Assumptions Theory al A specialized BHO helps reduce the -ii9h amoun-, o-- time an':" rewouroea th- dc.aforidartt with S3M I canf-jtiio in tho normal CJS Defen darte are leaa likely to recidivate.4evoke when ap uearirg raors f-eqjlait y before a Judge A kCarrj ltrpioah 4unit* vinrkinC. in callahcralion" vA 11 : reate an eff ciert and, ef--e.-tive prc-ceee Court orde -ad ire at-r e nt for defendants with Sf,,'l increases comp) ante Intent To create a rricre efficiem and effective praaess for Defendants with SPAJ in he US, while protocting public �afcty and p reseri ng accounta bi I ty. Assumptions • Defendants With SI'Vil Will slp,oind less tirne in jail Fewer 3etiliana to revoke will be filed fc.r probationers .Ni � - if SM I • Le,55 recidivi,5rn • Court will hold defendants acoo,untable, while cor s ideri n g =; i e mental illness • The BHC will be a more cost and time efficient pre- sontoncing proco%s • Ensures dofenc2ri's with Skill receive services 6 of 13 MI_M`1 . 1011111111A1 n- 1-chavioral Health Court - Logic Model Jefferson County - 1110 of 1 % Sales Tax Intervention Collaboration District Guurl, Di*covui.v Beh a vi ura I Health, Ad _j t P robaflorf, Jeforson County Shofiff Pori Townsond Policc. Dcpart-non', Olymap, Safe Harbor, Believe In Recovery, Defense and Prosecution designate specific perwn(s`l. peer graduates to scrvc vM-i the NIHO Identification & Case Flow 0 COrridant -kwi,.h StAl is idcntificd by raTorring party. 0 X,-.Terral twm iq _qLJt)n11ttR1 i�Ten: a assis1s, Ir tho coord na;lon of snrvicos 'or dotondant. 0 llp?<,ndar. tollcrkvs naunal tlj,.ov tit initial arraignmcrt. Fmtrial, c;w. urn il refer,al press. is =rriple-,e& 0 Ccfcndant is ciagnasod •pith an Axie ' c iag naa is and there i e a nexus to dime - C P A agrees to fx;Wion� 6 The BHC tLai-i rev eves petition and decides -,i ertry 4110 Defendant enter into SOC (Stipulated Order cf Continuance' • UcTo r4a nt on,ors Irto p lascs cT BHC flans: wwu*v* act glees Post -Sentence • Dofendan" ploads gLiii,-y and is scntcrccd to post -adjudication 01 IC o r a referral is made LY defe nse, prosecutor. • Referral and PefifiGn packets are campleod - Judge agrees to entry 9 Doicndant enters into ip-iascs of BHC and accesses sereoes. Outcomes Process a Time deia i n ed in jail wi 11 bo loss * Lower -oat to 5plern {through lessjail time and trial costs) * Defendants wiih S1,11 .spcnd lc-" pro-acntcni; rig Ilin'10 in Mir, -0 Commun catior, collaboration, and accountability among SHC team • Monitoring sentencing of BHC defendants Outcomes: • Defendants are loss likely to recidivate. • Fo-.-.(-2r rc.vooatiors ar petitions to revoke are filed • Less now offonscs whilo on prohmion ,6 Partidpanta ma ntair treatment and rnedica".icn a Overall decrease in risk to public safoty 7 of 13 EXHIBIT C: JEFFERSON CO 1/1011 of 1% Behavioral Health Sales Tax; (Fund 131) SPREADSHEET BEHAVIORAL HEALTH COURT-2021 BEHAVIORAL HEALTH COURT TOTAL AWARD: $50,000.00 Month of Vendor Svc Date Paid Amount Description/Service Total BH Court YTD Expended $0.00 Total BH Court Remaining $ 8of13 EXHIBIT C: JEFFERSON CO 1/101h of 1% Behavioral Health Sales Tax; (Fund 131) SPREADSHEET BEHAVIORAL HEALTH COURT-2022 BEHAVIORAL HEALTH COURT TOTAL AWARD: $ 50,000.00 Month of Vendor Svc Date Paid Amount Description/Service Total BH Court YTD Expended $0.00 Total BH Court Remaining $ 9of13 EXHIBIT D Fee Schedule 2021 PERSONNEL COSTS Requested from Other Funding SALES TAX Source Total Budget FTE & Salaries for each Employee (The court $0.00 In kind administrator and probation clerk Il does case management for MHC in order to save funds previously used in this category and have them go towards participants) 0 OPERATING COSTS Transitional Housing (2 rooms at the Old Alcohol $27,500 None $27,500 Plant @ $1,250 per room per month) Assessments- (pays for jail assessments and $1,500.00 none $1,500.00 participants with no insurance -- $100 x 15 assessments) Incentives (3 weeks in a row of compliance $1,500.00 Sometimes BHC gets $1,500.00 participants get an incentive -- $10 per 3-week donations from the compliance, $75 for graduates0 community churches and NAMI. UA- District Ct (additional random I-JA's to $3,500.00 None $3,500.00 ensure compliance and instant strips.) Cost is minimum $17.50 per test, approx. 230 tests per year. Training (Costs for sending two team members to $500.00 None $500.00 one training) Peer Reimbursement (gas cards to take $1,750.00 In kind $1,750.00 participants to appointments, meetings, pick up from jail etc.) Our peer member donates at least 10 hours per week to this program with no other Supplies/Materials (handbook, certificates and $300.00 None $300.00 graduation coins Travel (bus, taxi, and gas cards) $750.00 None $750.00 Education (registration fees, books, seminar costs, $3,000.00 None $3,000.00 program enrollment for participants) Jail Alternatives - (Soberlink, EHM costs to keep $2,700.00 None $2,700.00 participants out of Jail Admin- (10% of the amount asked for $2,000.00 None $2,000.00 administration) Emergency Financial Needs (participants cost for $2,000.00 None $2,000.00 emergency housing, expenses, other fees/program costs -- $200 x 20 participants Technology (phone bills for court and participants, $3,000.00 None $3,000.00 zoom costs, tablets) to borrow or for education etc. TOTAL COSTS $50,000.00 $0.00 $50,000.00 10 of 13 EXHIBIT D Fee Schedule 2022 PERSONNEL COSTS Requested from Other Funding Total Budget SALES TAX Source FTE & Salaries for each Employee (The court $0.00 In kind administrator and probation clerk Il does case management for MHC in order to save funds previously used in this category and have them go towards participants) 0 OPERATING COSTS Transitional Housing (2 rooms at the Old Alcohol $27,500 None $27,500 Plant @ $1,250 per room per month) Assessments- (pays for jail assessments and $1,500.00 none $1,500.00 participants with no insurance -- $100 x 15 assessments) Incentives (3 weeks in a row of compliance $1,500.00 Sometimes BHC gets $1,500.00 participants get an incentive -- $10 per 3-week donations from the compliance, $75 for graduates0 community churches and NAMI. UA- District Ct (additional random I-JA's to $3,500.00 None $3,500.00 ensure compliance and instant strips.) Cost is minimum $17.50 per test, approx. 230 tests per year. Training (Costs for sending two team members to $500.00 None $500.00 one training) Peer Reimbursement (gas cards to take $1,750.00 In kind $1,750.00 participants to appointments, meetings, pick up from jail etc.) Our peer member donates at least 10 hours per week to this program with no other Supplies/Materials (handbook, certificates and $300.00 None $300.00 graduation coins Travel (bus, taxi, and gas cards) $750.00 None $750.00 Education (registration fees, books, seminar costs, $3,000.00 None $3,000.00 program enrollment for participants) Jail Alternatives - (Soberlink, EHM costs to keep $2,700.00 None $2,700.00 participants out of Jail Admin- (10% of the amount asked for $2,000.00 None $2,000.00 administration) Emergency Financial Needs (participants cost for $2,000.00 None $2,000.00 emergency housing, expenses, other fees/program costs -- $200 x 20 participants Technology (phone bills for court and participants, $3,000.00 None $3,000.00 zoom costs, tablets) to borrow or for education etc. TOTAL COSTS $50,000.00 $0.00 $50,000.00 11 of 13 ATTACHMENT A JEFFERSON COUNTY 1/10th of 1% BEHAVIORAL HEALTH SALES 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/loth of 1% sales tax initiative) to augment state funding for behavioral health treatment. Jefferson County collects and distributes the 1/101h of 1% Behavioral Health Sales Tax fund. 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 Behavioral Health 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 1/10th of 1% Behavioral Health Sales 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 1/loth of 1% Behavioral Health Sales 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 the 1/1 oth of 1 % Behavioral Health Sales 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 the 1/101h of 1% Behavioral Health Sales 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 1/101h of 1% Behavioral Health Sales Tax funds as match. Following state, federal and local guidelines for match is the responsibility of the Contractor. 12 of 13 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 1/101h of 1% Behavioral Health Sales Tax fund 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 1/loth of 1% Behavioral Health Sales Tax funding as match. 13 of 13