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Consent Agenda
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Vicki Kirkpatrick, Director, JCPH
Apple Martine, Community Health Director, JCPH
DATE:
SUBJECT: Agenda —Addendum B to Memorandum of Understanding with
UPSTREAM; December 20, 2018 — December 20, 2023
STATEMENT OF ISSUE:
Jefferson County Public Health requests approval of Addendum B Prime the Pump Schedule to the
Memorandum of Understanding (MOU) with UPSTREAM for the purchase of Long Acting reversible
Contraceptive Devices (LARCs), equipment, and technical services; December 20, 2018 - December 20, 2023.
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
JCPH has been selected as one of four family planning programs forming the latest cohort of Washington
participating clinics to receive TA/QI services from UPSTREAM. It is an opportunity that will provide for
improvements around goals of cost savings, client service enhancement, and inventory management to ensure
timely access to contraceptive methods. Addendum A Partnership Schedule more explicitly stated milestones
and incentive payments that JCPH was eligible for under the original MOU with Upstream. Addendum B Prime
the Pump Schedule, and the corresponding Small Funding Request application attached here, more explicitly
states milestones and incentive payments that JCPH is now eligible for under the original MOU and Addendum
A with Upstream.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
The services provided to the Family Planning program is provided at no cost to JCPH, will provide for quality
improvement and, assuming JCPH Family Planning program meets milestones, will provide incentive funds that
can be used to stabilize inventory and improve access.
RECOMMENDATIONS: JCPH management requests approval of Addendum B Prime the Pump Schedule to
the Memorandum of Understanding with UPSTREAM for the purchase of Long Acting reversible Contraceptive
Devices (LARCs), equipment, and technical services; December 20, 2018 - December 20, 2023.
RE :
hi ip Morley, Co dministrator-------j 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
upstream
ADDENDUM B
PRIME THE PUMP SCHEDULE
TO
MEMORANDUM OF UNDERSTANDING
THIS PRIME THE PUMP SCHEDULE ("PIP Schedule") is entered into between Upstream USA, Inc.
("Upstream")and Jefferson County Public Health ("Organization") and is made a part of and is subject to the
terms of the Memorandum of Understanding entered into between Upstream and Organization dated
12/20/2018("MOU").
Purpose
The purpose of this PTP Schedule is to provide the means by which the Organization can purchase an initial
stock of Long Acting Reversible Contraceptive Devices("LARCs"),enabling the Organization to provide same-
day access to all methods of contraception, including those that require a procedure from a mid-level provider.
1. PTP Content:
Upstream and Organization agree to engage in Upstream's Prime the Pump program,which will include
the following content and activities,as further described herein:
• LARC inventory
• Evidence of contraceptive purchases
• Technical assistance in stocking and sustaining all contraceptive methods and billing&coding
• Prime the Pump funds
2. Obligations of Organization:
a) Initial LARC Inventory. Organization shall use all of the PTP Funds, as defined in Section
3(a),for the purchase of initial inventory of LARCs. Organization shall maintain sufficient inventory of LARCs
to provide these methods to patients during one healthcare visit without the need to schedule a second visit.
Organization shall use payor reimbursements for LARCs to purchase replacement stock, initiating
Organization's ability to keep steady stock on its health centers' shelves without further PTP funding.
Organization shall submit invoices of purchases every thirty(30)days starting thirty (30)days after PTP Start
Date as delineated in Section 2(c)below.
b) Organization Charges. Organization will still charge and be solely responsible for the
collection or reimbursement fees for any care provided to patients. The PTP Funds shall not be used to pay or
reimburse for any other services, including tests.
c) Invoices. Organization shall submit invoices of purchases within thirty(30)days of PTP Start
Date, as defined in Section 4(a), showing proof of purchase of LARCs(including copper IUDs, hormonal IUDs,
and contraceptive implants).
d) Method Tracking System. Organization shall implement a tracking system to collect, track,
and study data on LARCs stocking and reimbursement. Organization can use its own tools and resources or
utilize Upstream's templates for method inventory tracking and technical assistance guidance.
e) Technical Assistance. Organization agrees to work with Upstream's Quality Improvement
Advisor on ongoing technical assistance related to stocking contraceptive methods and/or billing, coding and
reimbursement procedures, as needed. At the discretion of Upstream and Organization, technical assistance
may also include ad hoc support provided by a third-party expert on billing, coding, and reimbursement,which
upstream
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may require review of billing and coding documentation and the Or nization's method inventory tracking
system.
3. Upstream Obligations:
a) LARC Inventory Funding. Upstream will provide funding in the amount of$4,822.42 ("PTP
Funds") to Organization within fifteen (15) days of execution of this PTP Schedule by Organization and
Upstream. Organization will have until 07/11/2021 ("PTP Spend Deadline")to spend PTP Funds.
b) Unspent Funds. Organization shall pay back to Upstream any unspent funding ("Unspent
Funds") provided to Organization by Upstream in relation to this PIP Schedule, including any addenda or
amendments thereto, within fifteen (15) days of receipt of a notice of termination or by PTP End Date.
Organization shall also pay back to Upstream any Unspent Funds provided to Organization by Upstream in
relation to this PTP Schedule within fifteen (15) days of receipt of notice from Upstream, if Organization does
not spend any PTP Funds over the course of six(6) consecutive months. Unspent Funds are defined as the
calculated difference between the total amount reflected by the device distributor invoices provided by
Organization up until PTP Spend Deadline and the total PTP Funds paid to Organization by Upstream.
4. Term and Termination of PTP Schedule:
a) The term of this PTP Schedule shall be from 01/11/2021 ("PTP Start Date")through 12/20/2023
("PTP End Date") (collectively, the "PTP Term"), unless the MOU is terminated earlier in which case this DU
Schedule shall terminate the date the MOU terminates.
b) Either party may terminate this PTP Schedule for any reason with or without cause at any time
by giving thirty (30) days' prior written notice to the other party. Upon receipt of such notice, each party will
inform the other party of the extent to which obligations were completed and each party will take steps to wind
down their obligations in an orderly fashion during the notice period.
c) If this PTP Schedule is terminated prior to the PTP End Date,Upstream shall have no obligation
to pay any PTP Funds which would otherwise be paid after the effective date of termination of this PTP
Schedule.
5. Miscellaneous Provisions.
a) Each of the persons signing below on behalf of a party represents and warrants that he or she
has full requisite power and authority to execute and deliver this PTP Schedule on behalf of the party for whom
he or she is signing and to bind such party to the terms and conditions of this PTP Schedule.
b) This PTP Schedule may be executed in counterparts, each of which shall be deemed an
original and may be executed and delivered by a digitized transmission of a counterpart signature page.
IN WITNESS WHEREOF,the parties have executed this PTP Schedule as of the date first above written.
UPSTREAM USA,INC.: JEFFERSON COUNTY PUBLIC HEALTH:
(Signature) (Signature)
Name: Chelsea Waliser Name: Kate Dean
Title: Executive Director, Upstream Washington Title: Chair,Jefferson County Board of Commissioners
Date: Date:
Agprlrredas too i I VA9A9
UU�� Date:Philip C. Hunsucker,Chief Civil Deputy Prosecutingey
Jefferson County Prosecuting Attorney's Office
upstream
JCPH Small Funding Requests
Use this grant application for amounts less than$5000 and submit to Q►Leadership
Process:
1. Please reference the workflow for grants here and guidelines for PTP and AMU Funding for
Agency Partners.
2. Plan for 1-2 weeks for written and/or verbal bilateral(back and forth)discussions,ideally also
time at a check-in meeting.
3. Use this form to formally submit your proposal to QI Leadership.
4. Once approved,submit to contracts in Conga;if it is a non-traditional grant,you may need to work
directly with contracts to develop.
Requested amount: $4,822.42
Submitted by:Noemi LaChapelle on December 3,2020
Approved by:Adrianne Moore on 12/16/2020, DQI
Concurred by: Frances Placide 12/16/2020, WDP
Description (the why):
• JCPH is located in Port Townsend, WA.They have 1 main site and 3 school
based sites in Chimacum, Port Townsend and Quilcene. The clinics provide
services similar to Planned Parenthood including birth control information and
methods,exams,Pap smears,pregnancy tests and referrals,and sexually
transmitted disease (STD) information and testing. The Quilcene SBHC was
approved shortly before COVID-19 pandemic.
• Problem statement- Due to COVID JCPH redistributed all birth control that was
placed in SBHCs to the main site. The Quilcene SBHC is now ready to open and
JCPH had to stock the entire inventory.JCPH used General funds from
Washington DOH Sexual and Reproductive Health Program to cover the funds
and would be grateful to receive a reimbursement of these funds so they can
reallocate those funds back to general funds from DOH.
• Overview of grant
O JCPH will provide invoices for the cost to stock Quilcene clinic to meet
initial PAR(to'prime the pump').This stock will enable easy access to
adolescents in a more remote area of Jefferson County.
o JCPH will use these funds to purchase a refrigerator to store NuvaRing at
Quilcene and Chimacum SBHCs and will provide Upstream with invoices.
Upstream USA
upstream
School Based Health Centers at Chimacum and Quilcene provide critical
access for our more remote south county teens. Refrigeration will give
these adolescents access to another type of birth control.
• % of WRA at Quilcene: approximately 75
• Responsible parties
o Noemi LaChapelle and Livia Romero will support logistics of contracting,
releasing the grant dollars, and collecting invoices and writing up the final
report.
O Kelly VonVolkli will support the inventory/PAR level area of this grant;
Susan O'Brien will support the refrigeration area of this grant,and Apple
Martine, Community Health Director, will oversee the process.
• Risks
o Too much inventory.This is mitigated by the new PAR levels set by the
agency based on average use.
Budget details(the what):
QUIL
265 #PER BOX TOTAL BOXES $$per box $$TOTAL
R,&S
AUBRA 12 3 4 $4.50 $18.00
CHATEAL 24 3 8 $4.50 $36.00
CLOTRIMAZOLE 2 1 2 $4.20 $8.40
DEPO 25 25 1 $235.20 $235.20
ELLA 20 1 20 $8.95 $179.00
JUNEL 6 0 $3.32 $0.00
KARIVA 6 0 $11.78 $0.00
NORA-BE 12 6 2 $3.33 $6.66
NUVARING 15 3 5 $77.73 $388.65
SPRINTEC 24 3 8 $2.26 $18.08
TRI-LO SPRINTEC 12 3 4 $2.40 $9.60
XULANE 48 3 16 $25.90 $414.40
PLAN B 5 1 5 $3.64 $18.20
NEXPLANON 2 1 2 $399.00 $798.00
MIRENA 3 5 1 $249.00 $249.00
KYLEENA 2 5 1 $249.00 $249.00
PARAGARD 4 1 4 $244.73 $978.92
ACYCLOVIR 400 MG#30 2 $7.00 $7.00
METRONIDAZOLE#14 2 $8.63 $8.63
Upstream USA
upstream
REFRIGERATOR FOR
NUVARING
(QUILCENE/CHIMACUM
)refrigerator 2 $599.99 $1,199.98
TOTAL $4,822.52
Upstream USA