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Consent Agenda
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, Interim County Administrator
FROM: Apple Martine, Director
Anna McEnery, DD & BH County Coordinator
DATE:
SUBJECT: Agenda Item —Amendment #1 to the Professional Services Agreement,
Olympic Educational School District (OESD) #114
STATEMENT OF ISSUE:
Jefferson County Public Health, (JCPH) as the fund manager of the Behavioral Health, 1/10th of 1% Sales Tax
Fund; is requesting Board approval of Amendment #1 to the Professional Services Agreement with the Olympic
Educational School District #114. Subcontractor will address the following change in their contract: When
applicable, assure that a Clinical Supervisor is available to provide weekly clinical and supervisory oversight, for
the therapists providing services in this program.
All other terms and conditions of the agreement will remain the same.
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This agreement is between Jefferson County Public Health and the Olympic Educational School District #114,
for behavioral health counseling to children and youth who are affected by mental health issues; 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; it is allocated by the BoCC with advice
from the Behavioral Health Advisory Committee. The agreement states, if the sales tax revenue decreases, the
Olympic Educational School District #114 will be contacted and the contract may be renegotiated.
RECOMMENDATION:
JCPH management requests approval of Amendment #1 to the Professional Services Agreement with Olympic
Educational School District #114.
REVIEWE BY:
zz
Mark McCauley ' County Administrator Date
Community Health
Developmental Disabilities Environmental Public Health
360-385-9400 360-385-9444
360-385-9401 (f) (f) 360-379-4487
Always working for a safer and healthier community
AD-21-068-A l
Contract Amendment#1
Between
Olympic Educational School District-#114
And
Jefferson County Public Health
Developmental Disabilities Program
WHEREAS, Olympic Educational District,(OESD)#114(Subcontractor)and Jefferson County
(County) entered into an agreement on December 1,2021 for Professional Services; in order to
provide mental health services in the Port Townsend,Chimacum, Quilcene and Brinnon School
Districts of Jefferson County, Washington;and
WHEREAS,the parties desire to amend the terms of that agreement;
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The term of the above referenced agreement ends June 30, 2023.
2. Subcontractor's will address the following change in their contract: When applicable,
assure that a Clinical Supervisor is available to provide weekly clinical and supervisory
oversight, for the therapists providing services in this program,
3. Work performed between March 1, 2022 and the execution of this Agreement that is
consistent with the provisions of this Agreement is hereby ratified.
4. All other terms and conditions of the agreement will remain the same.
Dated this day of , 2022
By:
Heidi Eisenhour, Chair
Jefferson Board of County Commissioners
By: E5-1
Gregory J. Lynch, Superintendent
OLYMPIC ESD#114
Initials:
ULI
Ey
Kristin Susan Jung Monica Tina
Schutte Lathrop Hunsaker Schulz
Amendment 1 to Professional Services Agreement:OESD—2021-2023 Page 1 of 2
AD-21-068-A 1
ATTEST:
By:
Carolyn Gallaway,Clerk of the Board
APPROVED AS TO FORM ONLY:
By: March 14,2022
Philip Hunsucker,Chief Civil Deputy Prosecuting
Attorney
Amendment 1 to Professional Services Agreement:OESD—2021-2023 Page 2 of 2
PROI/ESSIONAL SERVICES AGREEMENT FOR
Olympic Educational School District#114
THIS PROFESIONAL SERVICES AGREEMENT("this Agreement")is entered into between
the County of Jefferson, a municipal corporation("the County"),and the Olympic Educational
School District#114("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 Projects: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";Exhibit"B"and Exhibit"C"attached hereto including the provision of all labor.
3. Time for Performance. This Agreement shall commence on December 1, 2021 and
continue through June 30,2023. Work performed consistent with this Agreement
during its term,put 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$199,138 ($93,368 in 2021/2022 and$105,770 in
2022/2023),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. The County will check such invoices, 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. The County will make final payment of any balance due the Contractor of the
total contract price earned promptly upon its ascertainment and verification after
the completion of the work and submittal of reports under this Agreement and its
acceptance by the County.
d. Consultant 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.
Professional Services Agreement: OESD-2021-2023 Page 1 of 20
AD-21-068
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.
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.
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 fords 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. The Contractor shall defend,indemnify and hold the County, its
officers,officials, employees, agents and volunteers(and their marital communities)
harmless from any and all claims,injuries, damages, losses or suits including
attorney's fees, arising out of or resulting from the acts, errors or omissions of the
Contractor in performance of this Agreement, except for injuries and damages caused
by the sole negligence of the County. Should a court of competent jurisdiction
determine that this Agreement is subject to RCW 4.24.115,then, in the event of
liability for damages arising out of bodily injury to persons or damages to property
caused by or resulting from the concurrent negligence of the Contractor and the
County, its officers, officials, employees, agents and volunteers (and their marital
communities)the Contractor's liability, including the duty and cost to defend,
hereunder shall be only to the extent of the Contractor's negligence.
Professional Services Agreement: OESD#114-2021-2023 Page 2 of 20
9. It is further specifically and expressly understood that the indemnification provided
herein constitutes the Contractor's waiver of immunity under Industrial Insurance,
Title 51 RCW, solely for the purposes of this indemnification. This waiver has been
mutually negotiated by the parties. The provisions of this section shall survive the
expiration or termination of this Agreement.
10.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 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,(c)Non-
owned automobiles.
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 Liability Insurance. 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 the professional liability policy is"claims made,"then
an extended reporting period's 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 Services Agreement: OESD#114-2021-2023 Page 3 of 20
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 fmancial institution.
f. The Contractor shall furnish the County with properly executed certificates of
insurance that, at a minimum, shall include: (a)The limits of overage; (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.
g. Failure of the Contractor to take out or maintain any required insurance shall not
relieve the Contractor from any liability under this Agreement, nor shall the
insurance requirements be construed to conflict with or otherwise limit the
obligations concerning indemnification of the County.
h. 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.
i. All deductibles in the above described insurance policies shall be assumed by and
be at the sole risk of the Contractor.
j. 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.
k. 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
Professional Services Agreement: OESD#114-2021-2023 Page 4 of 20
furnish additional security covering such judgment as may be determined by the
County.
1. 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.
m. 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.
n. 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.
o. 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.
p. The Contractor's insurance shall apply separately to each insured against whom
claim is made or suit is brought, except with respect to the limits of the insurer's
liability.
q. 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.
r. 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.
s. 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.
Professional Services Agreement: OESD#114-2021-2023 Page 5 of 20
t. 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.
u. The County reserves the right to request additional insurance on an individual
basis for extra hazardous contracts and specific service agreements.
11.Worker's 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
worker's compensation and employers' 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,which
would otherwise be applicable in the case of such claim.
e. If the County incurs any costs to enforce the provisions of this subsection, all cost
and fees shall be recoverable from the Contractor.
12. 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.
Professional Services Agreement: OESD#114-2021-2023 Page 6 of 20
13. 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
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.
14. 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.
15. 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.
16. 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.
17. 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.
Professional Services Agreement: OESD#114-2021-2023 Page 7 of 20
18. 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.
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.
19.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:
Notices to the County shall be sent to the following address:
Jefferson County Public Health Department
Attn: Anna Mc Enery-DDBH County Coordinator
615 Sheridan Street
Port Townsend, WA 98368
Notices to Contractor shall be sent to the following address:
Olympic Educational School District
AU: Kristin Schutte
Student Services and Support Department
105 National Ave North
Bremerton, WA 98312
20. 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, 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.
Professional Services Agreement: OESD#114-2021-2023 Page 8 of 20
21. Modification of this Agreement. This Agreement may be amended only by written
instrument signed by both County and Contractor.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. Binding on Successors, Heirs and Assi2,ns. This Agreement shall be binding upon
and inure to the benefit of the parties' successors in interest,heirs,and assigns.
28.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.
Professional Services Agreement: OESD#114-2021-2023 Page 9 of 20
29.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.
30. 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.
31. Facsimile and Electronic Signatures. The parties agree that facsimile and electronic
signatures shall have the same force and effect as original signatures.
32. 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.
33. 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.
34. 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.
Professional Services Agreement: OESD#114-2021-2023 Page 10 of 20
DocuSign Envelope ID:A1403F11-D94C-42CD-B64F-5782558ABF87
35.Crimiaal 1. i wtt ry 3ac:k ro andCheck.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 9t$ day of December ,20 21
(SIGNATURES FOLLOW ON THE NEXT PAGE)
Professional Services Agreement: OESD#114-2021-2023 Page 11 of 20
DocuSign Envelope ID:A1403F11-094C-42CD-B64F-5782558ABF87
SIGNATURE PAGE
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Kate Chair
441141.
Brothertents Member
s; ° f!,«ap ESI)#114 Heidi Eisenhour,Member
Gregory J.Lynch,Superintendent
12/9/2021
Dateqta
DS
FL H
Kristin Susan Jung Monica Tina
Schutte Lathrop Hunsaker Schulz
Approved as to form only:
e
C December 1,2021
Philip C.Hunsucker Date
Chief Civil Deputy Prosecuting Attorney
Professional Services Agreement: OESD#114-2021-2023 Page 12 of 20
EXHIBIT A
Scope of Work
Olympic Educational School District#114
December 1,2021—June 30,2023
RESPONSIBILITIES:
The County, as administrator of the 1/10t of 1% Sales and Use Tax Funds,and agree that
Olympic Educational School District#114 will provide services to individuals as described in
this Contract. Including EXHIBIT A: Scope of Work; EXHIBIT B: Logic Model and
Performance Measures; and EXHIBIT C: Budget Sheet; and further agrees to comply with
the stipulations contained in ATTACHMENT A; attached hereto and incorporated herein.
RESPONSIBILITIES:
The Olympic Educational School District#114,(OESD) as a contracted Vendor agrees to:
1. Provide four(4)school districts with mental health, intervention and treatment services in
the schools;for children or youth grades K-12 who identify with behavioral health issues.
OESD hours will be distributed per the following:
a. One day a week at Brinnon SD during the 2021-2022 school year; and one day a
week during the 2022-2023 school year;
b. One day a week at Quilcene SD during the 2021-2022 school year; and one day a
week during the 2022-2023 school year;
c. Two days a week at Chimacum SD during the 2021-2022 school year; and one
day a week at Chimacum SD during the 2022-2023 school year;
d. Two days a week at Port Townsend SD during the 2021-2022 school year; and
one day a week at Port Townsend SD during the 2022-2023 school year.
2. 85%of that time is spent seeing students in clinical services and 15%is spent on
charting,travel or meetings.
3. Staff each site with licensed therapists who consistently work at the same site, except for
personal leave. Exceptions will be granted with the written approval of JCPH.
4. Provide the names of licensed therapists working in each school to School Districts and
JCPH.
5. Notify JCPH and the School Districts of any Counselor changes in writing, (before they
occur).
6. Notify each School District of any extended leave of absence for Counselors in writing,
(before they occur).
7. Notify the School District and the SBHC, if a Counselor is out sick and unable to make
an appointment.
Professional Services Agreement: OESD#114-2021-2023 Page 13 of 20
8. Provide background checks for all OESD employees or subcontractors working with
children or youth,who provide services under this contract. School districts 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.)
9. Upon request,provide copies of background checks&Counselor resumes to JCPH.
10. Maintain a secure and confidential records system guaranteeing HIPPA for behavioral
health and treatment services.
11.Assure that Counselors 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.
12.Assure that Counselors provide education, support,and consultation for the teachers and
staff in each School District.
13. Assure that Counselors assist teachers and staff in each School District to identify and
develop strategies to assist students with behavioral health issues.
14. Assure that a Project Supervisor is available to meet with the School Superintendents and
Principals at the Quilcene and Brinnon School Districts,as needed.
15. Assure that Counselors work collaboratively with local mental health and substance
abuse treatment agencies for identified clients.
16. Assure that Counselors provide crisis interventions and emergency response services
within the OESD's scope of practice.
17. Assure that Counselors 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.
18. Assure that Counselors provide on-going supportive counseling as needed,to all youth.
Services are not dependent on Medicaid eligibility.
19.Assure that Counselors contact parents or guardians of children or youth by following
HIPPA laws and Washington State laws concerning age of consent.
20. Assure that Counselors work with social services or other agencies as needed for dually
served children or youth with behavioral health and/or chemical dependency issues.
21. Assure that a Clinical Supervisor is available to provide weekly clinical and supervisory
oversight, for the therapists providing services in this program.
Professional Services Agreement: OESD#114-2021-2023 Page 14 of 20
22. Assure that a Clinical Supervisor or a Counselor is available to attend Clinician meetings
and quarterly SBHC Advisory meetings in Port Townsend,Chimacum and Quilcene
School Districts.
23. Assure that Counselors collaborate in regular consults with the SBHC team of health and
school professionals.
24. Assure that Counselor's offer each student an opportunity for session feedback by
providing a Miller Rating Scale.
25. Assure that Counselor's provide a new"new client sheet"for every new client to services
at each School.
26. Assure that each Counselor fills out a"visit details sheet"to collect information about the
reasons for the visit,referrals,and satisfaction with services, at every session.
27. Assure that each Counselor provides program data from the new client and visit detail
sheets,the number,types of Behavioral health issues, intervention and treatment services
provided,and will electronically upload it to the SBHC data base system.
28. Assure that an Epidemiologist of the Kitsap County Health District has continued access
to the SBHC data system.
29. Quarterly electronic reports,(created by the Public Health contracted Epidemiologist)
will be based on data provided by Counselors and will be completed by the
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.
30. The Epidemiologist of the Kitsap County Health District will generate a yearly report on
client(students and families),utilization,referrals and outcomes.
31. Upon request, additional reports of activities and services will be provided to the JCPH
Contract Representative.
32. Upon request,attend a Behavioral Health Advisory meeting once a year,to present a
progress report about the mental health services provided by the 1/10t of 1%fund.
Professional Services Agreement: OESD#114-2021-2023 Page 15 of 20
EXHIBIT B
Logic Model
School-based Mental Health Services 2021-2023
...so
Outcome
...so
Output 1) Participating
students will have
reduced mental
Beginning with.,. health and substance
Process 1) Participating use symptoms in the
student's progress classroom,in
will be monitored school,and at home.
and evidenced by
1) Eligible students in data taken at every 2) The participating
Input public schools in session. students'quality of
Jefferson County life will be improved
have access to 2) Individuals that in areas of self-
1) Eligible participants are mental health require higher level perception,family
students in Jefferson support and therapy. of treatment will be dynamics,and
County school districts referred to school involvement.
with mental health or 2) Each Student that is appropriate levels of
drug and alcohol abuse referred and eligible care. DBH,Trauma 3) The school
symptoms. for services will be Therapist,or another community will
assessed for risk Therapist in the experience
2) Mental Health factors(i.e.ACEs) community. decreased suicidality
Associated/Licensed and protective and disruptive
Therapists employed factors(i.e. 3) The Therapist,with behavior.
will be placed in each strengths/resiliency). consent,will
school district. coordinate with 4. Schools and students
3) Data will be Jefferson School will report improved
3) Mental Health gathered according Districts,School confidence in their
Therapist/Professionals to the guidelines of Based Health Clinic, ability to manage
will provide services to- Jefferson County DBH,JHC, mental health and
Port Townsend, Behavioral Health Jefferson County substance abuse
Chimacum,Quilcene, Advisory Board and Jail,Port Townsend challenges.
Brinnon,schools the Public Health Police,Safe Harbor,
Epidemiologist,and Dove House or other 5) Student participation
4) Clinical supervision will inserted into the resources. in the classroom will
be provided to school- SBHC Data System. increase.
based Mental Health
Therapist/Professionals. 4) Sessions of 30 to 45 6) There will be fewer
minutes of behavioral issues
evidenced based leading to punitive
therapy will be suspensions and
provided as needed
until symptoms
resolve.
Professional Services Agreement: OESD#114-2021-2023 Page 16 of 20
EXHIBIT C Budget Sheet
Jefferson County 1/10th of 1%Sales Tax
2021/2023 Request for Proposals
Please create a budget page for each year you are requesting funding.
The time-period is: December 6, 2021—June 17, 2022
PERSONNEL COSTS REQUESTED FROM OTHER FUNDING TOTAL
S is
SALES TAX SOURCE BUDGET
t i 8
FTE&Salaries/Benefits for each
Employee
Brinnon $500 X 1 day a week X
23 school weeks=
$11,500
Quilcene $500 X 1 day a week X
23 school weeks=
$11,500
Chimacum $500 X 2 days a week X
23 school weeks=
$23,000
Port Townsend $500 X 2 days a week X
23 school weeks=
$23,000
SUPERVISION/CLINICAL OVERSIGHT-`$12,880
4 Therapists x 23 weeks x$140 an
hour=$12,880
SUB-TOTAL PERSONNEL $81,880.00
OPERATING COSTS
Supplies/Materials-(Please Describe) $3,000 $ $
Computer/Registration Fees/Travel
Advertising
SUB-TOTAL-OPERATING COSTS $3,000
......E �..
SUB-TOTAL $84,880.00
Admin-(no more than 10%&please $8,488 $ $
describe what charges are to be
included)
$93,368 Oa $ $
Note:In-kind contributions/match are not required,however the County is interested in the total cost to provide
the service or program.
Professional Services Agreement: OESD#114-2021-2023 Page 17 of 20
EXHIBIT C Budget Sheet
Jefferson County 1/10th of 1%Sales Tax
2021/2023 Request for Proposals
Please create a budget page for each year you are requesting funding.
The time- period is September 7, 2022—June 16, 2023
REQUESTED FROM € OTHER FUNDING TOTAL
PERSONNEL COSTS SALES TAX SOURCE BUDGET
ifTE&Salaries/Benefits for each
Employee
Brinnon $500 X 1 day a week X
36 school weeks= 11.1111
( $18,000
Quilcene $500 X 1 day a week X
36 school weeks=
S18,000
Chimacum $500 X 1 day a week X
36 school weeks=
$18,000
Port Townsend $500 X 1 day a week X
36 school weeks=
$18,000
SUPERVISION/CLINICAL OVERSIGHT- $21,160
4 Therapists x 36 weeks x$140 an
hour=$21,160
SUB-TOTAL PERSONNEL $93,160.00
OPERATING COSTS
Supplies/Materials-(Please Describe) $3,000 $ $
Computer/Registration Fees/Travel
Advertising
SUB-TOTAL-OPERATING COSTS $3,000
'SUB-TOTAL $96,160.00
Admin-(no more than 10%&please $9,610 $ $
describe what charges are to be
included)
TOTAL COST $105,770.00
Total for two years:is$199,138
Professional Services Agreement: OESD#114-2021-2023 Page 18 of 20
ATTACHMENT A
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 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 1/10th 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 County reserves the 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 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 MHJSA sales tax monies as match. Following state,
federal and local guidelines for match is the responsibility of the Contractor.
Professional Services Agreement: OESD#114-2021-2023 Page 19 of 20
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: OESD#114-2021-2023 Page 20 of20