HomeMy WebLinkAboutWashington State Health Care Authority, Amendment No. 2 - 121922F)n Q- 1-?1 I f M t I')- - 1 q- ,�
CONTRACT
HCA Contract No.: K4880
Washington State
AMENDMENT for 1
Amendment No.: 2
Health Care uthority
Residential Substance
Abuse Treatment in
Prisons and Jails
THIS AMENDMENT TO THE CONTRACT is between the Washington State Health Care Authority and the party
whose name appears below, and is effective as of the date set forth below.
CONTRACTOR NAME
CONTRACTOR doing business as (DBA)
Jefferson, County of
Jefferson County Jail
CONTRACTOR ADDRESS
CONTRACTOR CONTRACT MANAGER
79 Elkins Road
Name: David Fortino
Port Hadlock, WA 98339-9700
Email: dfortino6d�co.iefferson.,,dia,us
AMENDMENT START DATE
CONTRACT END DATE
October 1, 2022
September 30, 2023
Prior Maximum Contract Amount
Amount of Increase
Total Maximum Compensation
$292,000
$146,731
$438,731
WHEREAS, HCA and Contractor previously entered into a Contract for Residential Substance Abuse Treatment
in Prisons and Jails, and;
WHEREAS, HCA determined that the federal grant funding sources for the original contract and Amendment 1
were misidentified, and;
WHEREAS, HCA and Contractor wish to amend the Contract pursuant to Section 4.3 to add funding, time and
deliverables for federal fiscal year 2023, and to correct grant reporting errors;
NOW THEREFORE, the parties agree the Contract is amended as follows:
1. The end date is extended to September 30, 2023.
2. Maximum Compensation is increased by $146,731 from $292,000 to $438,731.
3. Schedule A, Statement of Work, Section 3, Reporting Requirements, is hereby replaced as follows:
3. REPORTING REQUIREMENTS
3.1. Program Plan Report. Contractor will provide report to HCA Contract Manager for
approval. Report will include, but not limited to, the following:
3.1.1. Current staffing/hiring;
3.1.2. Purchase of program supplies;
3.1.3. Status of subcontracts or Memorandums of Understanding (MOU);
3.1.4. Other components, as approved by HCA Contract Manager.
3.2. Quarterly Reports
3.2.1. HCA Contract Manager will provide Contractor with report template within 10 days
of contract execution.
Washington State Page 1 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
3.2.2. Contractor will use template to complete reports and provide to HCA Contract
Manager for approval.
3.2.3. Contractor will comply with the following DOJ/BJA reporting requirements in
collaboration with the HCA DBHR.
1. No personal identifiable information;
2. Numbers served/completing the program are required;
3. Recidivism data, to include probation violation and new arrest convictions;
4. HCA will report this information to the DOJ/BJA as part of the reporting
requirements of the grant.
3.2.4. Reporting Requirements. The following is a list of required report components, in
accordance with the federal Bureau of Justice Assistance (BJA) all of which are
elaborated on in Attachment 7, Quarterly Report Template.
Average treatment cost per individual who receives program services.
2. Average length of stay in the program for incarcerated individuals completing
the program.
3. Number of participants carried over from the previous reporting period and
number of new participants.
4. The number of participants who successfully completed the program and
number of participants who were terminated or dropped out.
5. The number of new treatment beds and the percentage of them funded with
DOJ grant.
6. The number of days of residential treatment provided.
7. The number of participants completing the program who passed drug -testing.
8. The number of participants who were screened or enrolled in Medicaid.
9. Criminal recidivism of participants who successfully completed the program.
10. Criminal recidivism of participants who were unsuccessfully discharged from
the program.
3.2.5. Narrative. Narrative program analysis/evaluation reports responding to the
following questions:
Is this treatment program linked to other programs (such as drug courts,
community intervention, aftercare, etc?) If yes, please indicate name(s) of
other programs.
2. What were your accomplishments?
3. Is there any assistance that DSHS can provide to address any of the
problems/barriers you have identified here?
4. Are you on track to conduct your program as described in your plan? (Please
answer "Yes" or "No". If "No", please explain.)
Washington State Page 2 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
VUI.U'314ji t cf f vafu�m I V . uJ —jr-4c-Duf ✓-YDc.i-nvou-vn l ivow , i vl
4. Schedule A, Statement of Work, Section 4, Deliverable, subsection (a) Jefferson County, is amended as
follows:
#
Description
Date Range
Due Date
Rate
Max
Payment
1
Program
Up to 45 calendar
$24,731 per
$24,731
Plan Report
days following the
report
execution of the
x 1 report
contract
2
Quarterly
; Q 1: 10/1 /2022-12/31 /2022
59' day of each month
$30,500 per
$122,000
Reports
I Q2: 1 /1 /2023-3131 /2023
following the end of
report
each quarter
x 4 reports
Q3: 4/1 /2023-6/30/2023
Q4: 7/1 /2023-9/30/2023
Maximum Compensation for HCA Contract K4880, 10/1/2022 — 9/30/2023
$146, 731
5. Attachment 3, Federal Subaward Identification, is attached to replace Attachment 3 from the original
Contract, and is incorporated herein.
6. Attachment 3.1, Federal Subaward Identification, is attached to replace Attachment 3.1, from Amendment
1, and is incorporated herein.
7. Attachment 4, Substance Abuse and Mental Health Services Administration (SAMHSA) Award Terms, is
hereby removed.
8. Attachment 5, Federal Subaward Identification is hereby added, and incorporated herein.
9. Attachment 6, DOJ Award Terms, is hereby added, and incorporated herein.
10. Attachment 7, Quarterly Report Template, is hereby added, and incorporated herein.
11. This Amendment will be effective October 1, 2022 ("Effective Date").
12. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Contract.
13. All other terms and conditions of the Contract remain unchanged and in full force and effect.
The parties signing below warrant that they have read and understand this Amendment and have authority to
execute the Amendment. This Amendment will be binding on HCA only upon signature by both parties.
n
CONT ACTOR SI NATURE
PRINTED NAME AND TITLE
DATE SIGNED
`
T
Heidi Eisenhour, Chair
Jefferson County Board Commissioners
2 1�ZZ
of
HCA SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
achelle Amerine
sbw�
-4.
Contracts Administrator
12/3/2022
Approved as to form, only:
+ December 13, 2022
Philip C. Hunsucker DATE
Chief Civil Deputy Prosecuting Attorney
Washington State Page 3 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 3 - Federal Subaward Identification
K4880
US Department of Justice, Office of
1.
Federal Awarding Agency
Justice Programs, Bureau of Justice
Assistance
2.
Federal Award Identification Number (FAIN)
2017-RT-BX-4027
3.
Federal Award Date
September 28, 2019
4.
Assistance Listing Number and Title
16.593 Residential Substance Abuse
Treatment
5.
Is the Award for Research and Development?
❑ Yes ® No
Keri Waterland, assistant director
WA State Health Care Authority
6.
Contact Information for HCA's Awarding Official
Division of Behavioral Health and
Recovery
keri.waterl and =b-% hca.wa.gov
360-725-5252
7.
Subrecipient name (as it appears in SAM.gov)
Jefferson, County of
8.
Subrecipient's Unique Entity Identifier (UEI)
LP11B7JKFN38
9.
Total amount of Federal Award
$161,062
WA State Opioid and Overdose
10.
Subaward Project Description
Treatment Court Response Plan: Equity
in Training and Treatment
11.
Primary Place of Performance
98339-9700
12.
Subaward Period of Performance
January 28, 2021 - September 30, 2021
13
Amount of Federal Funds Obligated by this
$37,904
Action
14.
Total Amount of Federal Funds Obligated by
$37,904
HCA to the Subrecipient, including this Action
15.
Indirect Cost Rate for the Federal Award
10%
(including if the de minimis rate is charged)
Washington State Page 4 of 22 Substance Abuse Treatment Services
Health Care Authority FICA Contract No. K4880-2
Attachment 3
US Department of Justice, Office of
1.
Federal Awarding Agency
Justice Programs, Bureau of Justice
Assistance
2.
Federal Award Identification Number (FAIN)
2018-J2-BX-4017
3.
Federal Award Date
September 28, 2019
4.
Assistance Listing Number and Title
16.593 Residential Substance Abuse
Treatment
5.
Is the Award for Research and Development?
❑ Yes ® No
Keri Waterland, assistant director
WA State Health Care Authority
6.
Contact Information for HCA's Awarding Official
Division of Behavioral Health and
Recovery
keri.w tearla.nd a hca,wa.gov
360-725-5252
7.
Subrecipient name (as it appears in SAM.gov)
Jefferson, County of
8.
Subrecipient's Unique Entity Identifier (UEI)
LP11 B7JKFN38
9.
Total amount of Federal Award
$406,597
WA State Opioid and Overdose
10.
Subaward Project Description
Treatment Court Response Plan: Equity
in Training and Treatment
11.
Primary Place of Performance
98339-9700
12.
Subaward Period of Performance
January 28, 2021 - September 30, 2021
13
Amount of Federal Funds Obligated by this
$108,096
Action
14.
Total Amount of Federal Funds Obligated by
$108,096
HCA to the Subrecipient, including this Action
15.
Indirect Cost Rate for the Federal Award
°
10%
(including if the de minimis rate is charged)
Washington State Page 5 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 3
Attachment 3.1 - Federal Subaward Identification
K4880-1
US Department of Justice, Office of
1.
Federal Awarding Agency
Justice Programs, Bureau of Justice
Assistance
2.
Federal Award Identification Number (FAIN)
2018-J2-BX-4017
3.
Federal Award Date
9-28-2019
4.
Assistance Listing Number and Title
16.593 Residential Substance Abuse
Treatment
5.
Is the Award for Research and Development?
❑ Yes ® No
Keri Waterland, assistant director
WA State Health Care Authority
6.
Contact Information for HCA's Awarding Official
Division of Behavioral Health and
Recovery
keri_Water1a_nd. hca.wa.C-ov
360-725-5252
7.
Subrecipient name (as it appears in SAM.gov)
Jefferson, County of
8.
Subrecipient's Unique Entity Identifier (UEI)
LP11 B7JKFN38
9.
Total amount of Federal Award
$406,597
WA State Opioid and Overdose
10.
Subaward Project Description
Treatment Court Response Plan: Equity
in Training and Treatment
11.
Primary Place of Performance
Zip + 4 from GSR
12.
Subaward Period of Performance
January 28, 2021 - September 30, 2022
13.
Amount of Federal Funds Obligated by this
$146,000
Action
14.
Total Amount of Federal Funds Obligated by
$254,096
HCA to the Subrecipient, including this Action
15.
Indirect Cost Rate for the Federal Award
o
10%
(including if the de minimis rate is charged)
Washington State Page 6 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 3.1
Attachment 5 - Federal Subaward Identification
K4880-2
US Department of Justice, Office of
1.
Federal Awarding Agency
Justice Programs, Bureau of Justice
Assistance
2.
Federal Award Identification Number (FAIN)
2019-J2-BX-0022
3.
Federal Award Date
9-28-2019
4.
Assistance Listing Number and Title
16.593 Residential Substance Abuse
Treatment
5.
Is the Award for Research and Development?
❑ Yes ® No
Keri Waterland, assistant director
WA State Health Care Authority
6.
Contact Information for HCA's Awarding Official
Division of Behavioral Health and
Recovery
keri.waterland «_hca.wa.gov
360-725-5252
7.
Subrecipient name (as it appears in SAM.gov)
Jefferson, County of
8.
Subrecipient's Unique Entity Identifier (UEI)
LP11B7JKFN38
WA State Opioid and Overdose
9.
Subaward Project Description
Treatment Court Response Plan:
Equity in Training and Treatment
10.
Primary Place of Performance
Zip + 4 from GSR
11.
Subaward Period of Performance
January 28, 2021 - September 30,
2023
12
Amount of Federal Funds Obligated by this
$146,731
Action
13.
Total Amount of Federal Funds Obligated by
$146,731
HCA to the Subrecipient, including this Action
14.
Indirect Cost Rate for the Federal Award
°
10%
(including if the de minimis rate is charged)
This Contract is subject to 2 CFR Chapter 1, Part 170 Reporting Sub -Award and Executive Compensation Information. The
authorized representative for the Subrecipient identified above must answer the questions below. If you have questions or
need assistance, please contact su r i�itntmonitgring a ha.wa.aov.
1. Did the Subrecipient receive (1) 80% or more of its annual gross revenue from federal contracts, subcontracts,
grants, loans, subgrants, and/or cooperative agreements; and (2) $25,000,000 or more in annual gross revenues
from federal contracts, subcontracts, grants, loans, subgrants, and/or cooperative agreements?
❑ YES ❑ NO
Washington State Page 7 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 5
2. Does the public have access to information about the compensation of the executives in your business or
organization through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15
U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986?
❑ YES ❑ NO
Washington State Page 8 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 5
ATTACHMENT 6 — Office of Justice Programs (OJP) Award Terms
Applicability of Part 200 Uniform Requirements
The Uniform Administrative Requirements, Cost Principles, and Audit Requirements in 2 C.F.R. Part 200,
as adopted and supplemented by DOJ in 2 C.F.R. Part 2800 (together, the "Part 200 Uniform
Requirements") apply to this FY 2021 award from OJP.
The Part 200 Uniform Requirements were first adopted by DOJ on December 26, 2014. If this FY 2021
award supplements funds previously awarded by OJP under the same award number (e.g., funds awarded
during or before December 2014), the Part 200 Uniform Requirements apply with respect to all funds under
that award number (regardless of the award date, and regardless of whether derived from the initial award
or a supplemental award) that are obligated on or after the acceptance date of this FY 2021 award.
For more information and resources on the Part 200 Uniform Requirements as they relate to OJP awards
and subawards ("subgrants"), see the OJP website at
https://ojp.gov/funding/Part200UniformRequirements.htm.
Record retention and access: Records pertinent to the award that the recipient (and any subrecipient
("subgrantee") at any tier) must retain -- typically for a period of 3 years from the date of submission of the
final expenditure report (SF 425), unless a different retention period applies -- and to which the recipient
(and any subrecipient ("subgrantee") at any tier) must provide access, include performance measurement
information, in addition to the financial records, supporting documents, statistical records, and other
pertinent records indicated at 2 C.F.R. 200.333.
In the event that an award -related question arises from documents or other materials prepared or
distributed by OJP that may appear to conflict with, or differ in some way from, the provisions of the Part
200 Uniform Requirements, the recipient is to contact OJP promptly for clarification.
2. Requirement to report actual or imminent breach of personally identifiable information (PII)
The subrecipient must have written procedures in place to respond in the event of an actual or imminent
"breach" (OMB M-17-12) if it -- (1) creates, collects, uses, processes, stores, maintains, disseminates,
discloses, or disposes of "Personally Identifiable Information (PII)" (2 CFR 200.1) within the scope of an
OJP grant -funded program or activity, or (2) uses or operates a "Federal information system" (OMB
Circular A-130). The recipient's breach procedures must include a requirement to report actual or imminent
breach of PII to an OJP Program Manager no later than 24 hours after an occurrence of an actual breach,
or the detection of an imminent breach.
3. Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.F.R. Part 38
The subrecipient must comply with all applicable requirements of 28 C.F.R. Part 38 (as may be applicable
from time to time), specifically including any applicable requirements regarding written notice to program
beneficiaries and prospective program beneficiaries.
Currently, among other things, 28 C.F.R. Part 38 includes rules that prohibit specific forms of discrimination
Washington State Page 9 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
on the basis of religion, a religious belief, a refusal to hold a religious belief, or refusal to attend or
participate in a religious practice. Part 38, currently, also sets out rules and requirements that pertain to
recipient and subrecipient organizations that engage in or conduct explicitly religious activities, as well as
rules and requirements that pertain to recipients and subrecipients that are faith -based or religious
organizations.
The text of 28 C.F.R. Part 38 is available via the Electronic Code of Federal Regulations (currently
accessible at https://wwvv.ecfr.gov/cgi-bin/ECFR?page=browse), by browsing to Title 28-Judicial
Administration, Chapter 1, Part 38, under e-CFR "current" data.
4. Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.F.R. Part 42
The subrecipient must comply with all applicable requirements of 28 C.F.R. Part 42, specifically including
any applicable requirements in Subpart E of 28 C.F.R. Part 42 that relate to an equal employment
opportunity program.
5. Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.F.R. Part 54
The subrecipient must comply with all applicable requirements of 28 C.F.R. Part 54, which relates to
nondiscrimination on the basis of sex in certain "education programs."
6. Compliance with 41 U.S.C. 4712 (including prohibitions on reprisal; notice to employees)
The subrecipient must comply with, and is subject to, all applicable provisions of 41 U.S.C. 4712, including
all applicable provisions that prohibit, under specified circumstances, discrimination against an employee
as reprisal for the employee's disclosure of information related to gross mismanagement of a federal grant,
a gross waste of federal funds, an abuse of authority relating to a federal grant, a substantial and specific
danger to public health or safety, or a violation of law, rule, or regulation related to a federal grant.
The subrecipient also must inform its employees, in writing (and in the predominant native language of the
workforce), of employee rights and remedies under 41 U.S.C. 4712.
Should a question arise as to the applicability of the provisions of 41 U.S.C. 4712 to this award, the
recipient is to contact the DOJ awarding agency (OJP or OVW, as appropriate) for guidance.
Compliance with applicable rules regarding approval, planning, and reporting of conferences, meetings,
trainings, and other events
The subrecipient must comply with all applicable laws, regulations, policies, and official DOJ guidance
(including specific cost limits, prior approval and reporting requirements, where applicable) governing the
use of federal funds for expenses related to conferences (as that term is defined by DOJ), including the
provision of food and/or beverages at such conferences, and costs of attendance at such conferences.
Information on the pertinent DOJ definition of conferences and the rules applicable to this award appears in
the DOJ Grants Financial Guide (currently, as section 3.10 of "Postaward Requirements" in the "DOJ
Grants Financial Guide").
Washington State Page 10 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
8. Requirement for data on performance and effectiveness under the award
The subrecipient must collect and maintain data that measure the performance and effectiveness of work
under this award. The data must be provided to OJP in the manner (including within the timeframes)
specified by OJP in the program solicitation or other applicable written guidance. Data collection supports
compliance with the Government Performance and Results Act (GPRA) and the GPRA Modernization Act
of 2010, and other applicable laws.
9. Requirements related to "de minimis" indirect cost rate
A subrecipient that is eligible under the Part 200 Uniform Requirements and other applicable law to use the
"de minimis" indirect cost rate described in 2 C.F.R. 200.414(f), and that elects to use the "de minimis"
indirect cost rate, must advise OJP in writing of both its eligibility and its election, and must comply with all
associated requirements in the Part 200 Uniform Requirements. The "de minimis" rate may be applied only
to modified total direct costs (MTDC) as defined by the Part 200 Uniform Requirements.
10. Determination of suitability to interact with participating minors
SCOPE. This condition applies to this award if it is indicated -- in the application for the award (as approved
by DOJ)(or in the application for any subaward, at any tier), the DOJ funding announcement (solicitation),
or an associated federal statute -- that a purpose of some or all of the activities to be carried out under the
award is to benefit a set of individuals under 18 years of age.
The subrecipient at any tier, must make determinations of suitability before certain individuals may interact
with participating minors. This requirement applies regardless of an individual's employment status.
The details of this requirement are posted on the OJP web site at https://ojp.gov/funding/Explore/Interact-
Minors.htm (Award condition: Determination of suitability required, in advance, for certain individuals who
may interact with participating minors), and are incorporated by reference here.
11. Compliance with DOJ Grants Financial Guide
References to the DOJ Grants Financial Guide are to the DOJ Grants Financial Guide as posted on the
OJP website (currently, the "DOJ Grants Financial Guide" available at
https://ojp.gov/financialguide/DOJ/index.htm), including any updated version that may be posted during the
period of performance. The recipient agrees to comply with the DOJ Grants Financial Guide.
12. Encouragement of policies to ban text messaging while driving
Pursuant to Executive Order 13513, "Federal Leadership on Reducing Text Messaging While Driving," 74
Fed. Reg. 51225 (October 1, 2009), DOJ encourages subrecipients to adopt and enforce policies banning
employees from text messaging while driving any vehicle during the course of performing work funded by
this award, and to establish workplace safety policies and conduct education, awareness, and other
outreach to decrease crashes caused by distracted drivers.
13. Compliance with general appropriations -law restrictions on the use of federal funds (FY 2021)
Washington State Page 11 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
The subrecipient must comply with all applicable restrictions on the use of federal funds set out in federal
appropriations statutes. Pertinent restrictions, including from various "general provisions" in the
Consolidated Appropriations Act, 2021, are set out at
https://ojp.gov/funding/Explore/FY21AppropriationsRestrictions.htm, and are incorporated by reference
here.
Should a question arise as to whether a particular use of federal funds would or might fall within the scope
of an appropriations -law restriction, the subrecipient is to contact OJP for guidance, and may not proceed
without the express prior written approval of OJP.
14. Potential imposition of additional requirements
The subrecipient agrees to comply with any additional requirements that may be imposed by the DOJ
awarding agency (OJP or OVW, as appropriate) during the period of performance for this award, if the
recipient is designated as "high -risk" for purposes of the DOJ high -risk grantee list.
15. Employment eligibility verification for hiring under the award
15.1 The subrecipient must --
A. Ensure that, as part of the hiring process for any position within the United States that is or will
be funded (in whole or in part) with award funds, the recipient (or any subrecipient) properly
verifies the employment eligibility of the individual who is being hired, consistent with the provisions
of 8 U.S.C. 1324a(a)(1).
B. Notify all persons associated with the subrecipient who are or will be involved in activities
under this award of both--
(1) this award requirement for verification of employment eligibility, and
(2) the associated provisions in 8 U.S.C. 1324a(a)(1) that, generally speaking, make it
unlawful, in the United States, to hire (or recruit for employment) certain aliens.
C. Provide training (to the extent necessary) to those persons required by this condition to be
notified of the award requirement for employment eligibility verification and of the associated
provisions of 8 U.S.C. 1324a(a)(1).
D. As part of the recordkeeping for the award (including pursuant to the Part 200 Uniform
Requirements), maintain records of all employment eligibility verifications pertinent to compliance
with this award condition in accordance with Form 1-9 record retention requirements, as well as
records of all pertinent notifications and trainings.
15.2 Monitoring.
The recipient's monitoring responsibilities include monitoring of subrecipient compliance with this
condition.
Washington State Page 12 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
15.3 Allowable costs
To the extent that such costs are not reimbursed under any other federal program, award funds
may be obligated for the reasonable, necessary, and allocable costs (if any) of actions designed to
ensure compliance with this condition.
15.4 Rules of construction
A. Staff involved in the hiring process
For purposes of this condition. persons "who are or will be involved in activities under this
award" specifically includes (without limitation) any and all subrecipient officials or other staff
who are or will be involved in the hiring process with respect to a position that is or will be
funded (in whole or in part) with award funds.
B. Employment eligibility confirmation with E-Verify
For purposes of satisfying the requirement of this condition regarding verification of
employment eligibility, the subrecipient may choose to participate in, and use, E-Verify
(www.e-verify.gov), provided an appropriate person authorized to act on behalf of the recipient
(or subrecipient) uses E-Verify (and follows the proper E-Verify procedures, including in the
event of a "Tentative Nonconfirmation" or a "Final Nonconfirmation") to confirm employment
eligibility for each hiring for a position in the United States that is or will be funded (in whole or
in part) with award funds.
C. "United States" specifically includes the District of Columbia, Puerto Rico, Guam, the Virgin
Islands of the United States, and the Commonwealth of the Northern Mariana Islands.
D. Nothing in this condition shall be understood to authorize or require any recipient, any
subrecipient at any tier, or any person or other entity, to violate any federal law, including any
applicable civil rights or nondiscrimination law.
E. Nothing in this condition, including in paragraph 4.B., shall be understood to relieve any
recipient, any subrecipient at any tier, or any person or other entity, of any obligation
otherwise imposed by law, including 8 U.S.C. 1324a(a)(1).
Questions about E-Verify should be directed to DHS. For more information about E-Verify visit
the E-Verify website (https,//www.e-verify.gov/) or email E-Verify at E-Verify@dhs.gov. E-
Verify employer agents can email E-Verify at E-VerifyEmployerAgent@dhs.gov.
Questions about the meaning or scope of this condition should be directed to OJP, before
award acceptance.
16. Restrictions and certifications regarding non -disclosure agreements and related matters
No subrecipient under this award, or entity that receives a procurement contract or subcontract with any
funds under this award, may require any employee or contractor to sign an internal confidentiality
agreement or statement that prohibits or otherwise restricts, or purports to prohibit or restrict, the reporting
Washington State Page 13 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
(in accordance with law) of waste, fraud, or abuse to an investigative or law enforcement representative of
a federal department or agency authorized to receive such information.
The foregoing is not intended, and shall not be understood by the agency making this award, to contravene
requirements applicable to Standard Form 312 (which relates to classified information), Form 4414 (which
relates to sensitive compartmented information), or any other form issued by a federal department or
agency governing the nondisclosure of classified information.
17. Reclassification of various statutory provisions to a new Title 34 of the United States Code
On September 1, 2017, various statutory provisions previously codified elsewhere in the U.S. Code were
editorially reclassified (that is, moved and renumbered) to a new Title 34, entitled "Crime Control and Law
Enforcement." The reclassification encompassed a number of statutory provisions pertinent to OJP awards
(that is, OJP grants and cooperative agreements), including many provisions previously codified in Title 42
of the U.S. Code.
Effective as of September 1, 2017, any reference in this award document to a statutory provision that has
been reclassified to the new Title 34 of the U.S. Code is to be read as a reference to that statutory
provision as reclassified to Title 34. This rule of construction specifically includes references set out in
award conditions, references set out in material incorporated by reference through award conditions, and
references set out in other award requirements.
18. OJP Training Guiding Principles
Any training or training materials that the subrecipient \ at any tier -- develops or delivers with OJP award
funds must adhere to the OJP Training Guiding Principles for Grantees and Subgrantees, available at
https://ojp.gov/funding/Implement/TrainingPrinciplesForGrantees-Subgrantees.htm.
19. All subawards ("subgrants") must have specific federal authorization
The subrecipient must comply with all applicable requirements for authorization of any subaward.
The details of the requirement for authorization of any subaward are posted on the OJP web site at
https://ojp.gov/funding/Explore/SubawardAuthorization.htm (Award condition: All subawards ("subgrants")
must have specific federal authorization), and are incorporated by reference here.
20. Restrictions on "lobbying"
In general, as a matter of federal law, federal funds awarded by OJP may not be used by the subrecipient
either directly or indirectly, to support or oppose the enactment, repeal, modification, or adoption of any
law, regulation, or policy, at any level of government. See 18 U.S.C. 1913. (There may be exceptions if an
applicable federal statute specifically authorizes certain activities that otherwise would be barred by law.)
Another federal law generally prohibits federal funds awarded by OJP from being used by the subrecipient
to pay any person to influence (or attempt to influence) a federal agency, a Member of Congress, or
Congress (or an official or employee of any of them) with respect to the awarding of a federal grant or
cooperative agreement, subgrant, contract, subcontract, or loan, or with respect to actions such as
Washington State Page 14 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
renewing, extending, or modifying any such award. See 31 U.S.C. 1352. Certain exceptions to this law
apply, including an exception that applies to Indian tribes and tribal organizations.
Should any question arise as to whether a particular use of federal funds by a subrecipient would or might
fall within the scope of these prohibitions, the recipient is to contact OJP for guidance, and may not
proceed without the express prior written approval of OJP.
21. Specific post -award approval required to use a noncompetitive approach in any procurement contract that
would exceed $250,000
The subrecipient must comply with all applicable requirements to obtain specific advance approval to use a
noncompetitive approach in any procurement contract that would exceed the Simplified Acquisition
Threshold (currently, $250,000). This condition applies to agreements that -- for purposes of federal grants
administrative requirements -- OJP considers a procurement "contract" (and therefore does not consider a
subaward).
The details of the requirement for advance approval to use a noncompetitive approach in a procurement
contract under an OJP award are posted on the OJP web site at
https://ojp.gov/funding/Explore/NoncompetitiveProcurement.htm (Award condition: Specific post -award
approval required to use a noncompetitive approach in a procurement contract (if contract would exceed
$250,000)), and are incorporated by reference here.
22. Requirements pertaining to prohibited conduct related to trafficking in persons (including reporting
requirements and OJP authority to terminate award)
The subrecipient must comply with all applicable requirements (including requirements to report
allegations) pertaining to prohibited conduct related to the trafficking of persons, whether on the part of
recipients, subrecipients ("subgrantees"), or individuals defined (for purposes of this condition) as
"employees" of the recipient or of any subrecipient.
The details of the recipient's obligations related to prohibited conduct related to trafficking in persons are
posted on the OJP web site at https://ojp.gov/funding/Explore/ProhibitedConduct-Trafficking.htm (Award
condition: Prohibited conduct by recipients and subrecipients related to trafficking in persons (including
reporting requirements and OJP authority to terminate award)), and are incorporated by reference here.
23. Requirement to report potentially duplicative funding
If the recipient currently has other active awards of federal funds, or if the recipient receives any other
award of federal funds during the period of performance for this award, the recipient promptly must
determine whether funds from any of those other federal awards have been, are being, or are to be used
(in whole or in part) for one or more of the identical cost items for which funds are provided under this
award. If so, the recipient must promptly notify the DOJ awarding agency (OJP or OVW, as appropriate) in
writing of the potential duplication, and, if so requested by the DOJ awarding agency, must seek a budget -
modification or change -of -project -scope Grant Award Modification (GAM) to eliminate any inappropriate
duplication of funding.
Washington State Page 15 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
24. Reporting potential fraud, waste, and abuse, and similar misconduct
The subrecipients must promptly refer to the DOJ Office of the Inspector General (OIG) any credible
evidence that a principal, employee, agent, subrecipient, contractor, subcontractor, or other person has, in
connection with funds under this award-- (1) submitted a claim that violates the False Claims Act; or (2)
committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or
similar misconduct.
Potential fraud, waste, abuse, or misconduct involving or relating to funds under this award should be
reported to the OIG by--(1) online submission accessible via the OIG webpage at
https://oig.justice.gov/hotline/contact-grants.htm (select "Submit Report Online"); (2) mail directed to: U.S.
Department of Justice, Office of the Inspector General, Investigations Division, ATTN: Grantee Reporting,
950 Pennsylvania Ave., NW, Washington, DC 20530; and/or (3) by facsimile directed to the DOJ OIG
Investigations Division (Attn: Grantee Reporting) at (202) 616-9881 (fax).
Additional information is available from the DOJ OIG website at https://oig.justice.gov/hotline.
25. The grantee agrees to comply with the applicable requirements of 28 C.F.R. Part 38, the Department of
Justice regulation governing "Equal Treatment for Faith Based Organizations" (the "Equal Treatment
Regulation"). The Equal Treatment Regulation provides in part that Department of Justice grant awards of
direct funding may not be used to fund any inherently religious activities, such as worship, religious
instruction, or prose lytization. Recipients of direct grants may still engage in inherently religious activities,
but such activities must be separate in time or place from the Department of Justice funded program, and
participation in such activities by individuals receiving services from the grantee or a sub -grantee must be
voluntary. The Equal Treatment Regulation also makes clear that organizations participating in programs
directly funded by the Department of Justice are not permitted to discriminate in the provision of services
on the basis of a beneficiary's religion. Notwithstanding any other term or condition of this award, faith -
based organizations may, in some circumstances, consider religion as a basis for employment. See
http://www.ojp.gov/about/ocr/equal—fbo.htm.
26. Limit on use of grant funds for grantees' employees' salaries
With respect to this award, federal funds may not be used to pay cash compensation (salary plus bonuses)
to any employee of the award recipient at a rate that exceeds 110% of the maximum annual salary payable
to a member of the federal government's Senior Executive Service (SES) at an agency with a Certified
SES Performance Appraisal System for that year. (An award recipient may compensate an employee at a
higher rate, provided the amount in excess of this compensation limitation is paid with non-federal funds.)
This limitation on compensation rates allowable under this award may be waived on an individual basis at
the discretion of the OJP official indicated in the program announcement under which this award is made.
27. Regarding medication -assisted treatment (MAT), the award recipient understands and agrees to the
following: 1) all clients in a BJA-funded drug court have a right to access MAT under the care and
prescription of a physician to the extent MAT is clinically indicated; 2) BJA-funded drug courts must not
deny any eligible client enrollment to the drug court program because of their use of FDA -approved
medications for the treatment of substance abuse; 3) MAT must be permitted to be continued for as long as
the prescriber determines that the FDA -approved medication is clinically beneficial; 4) while under no
Washington State Page 16 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
circumstances can a BJA-funded drug court program deny access to MAT under the care and prescription
of a physician when it is clinically indicated, a judge retains judicial discretion to mitigate/reduce the risk of
abuse, misuse, or diversion of these medications; and 5) federal funds shall not be used to support
activities that violate the Controlled Substances Act, 21 U.S.C. 801-904.
28. All BJA-funded adult drug courts must be operated based on the 10 key components for drug courts, which
are found in BJA's and National Association of Drug Court Professional's (NADCP) publication: Defining
Drug Courts: The Key Components at https://www.ncjrs.gov/pdffilesl/bja/205621.pdf. During the grant
period of performance, if BJA concludes that a funded drug court is not conforming to the 10 key
components, it retains the right to place the award recipient on a corrective action plan to bring the drug
court into conformance. Continued failure to maintain conformance to the key components may result in a
hold placed on award funds or suspension/termination of the grant award agreement.
Washington State Page 17 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 6
ATTACHMENT 7
Quarterly Report Template
Program Characteristics
— Program Characteristics
4. DoesYour RSAT orogram use evidence -based treatment services
A. Select Yes or No
B. If yes, please describe the evidence -based treatment services.
Cognitive -Behavioral Therapy
Yes
S. Phase enter the number of treatment staff who work directly with articipants in the RSAT program When ?nswerinq A,
Dlease Count all treatment staff regardless of funding source.
A. Number of treatment staff
B. Of those reported in W, how many are paid for at least partially
using BJA program funds, including matching funds?
6. Please enter the amount of funds from all sources (in dollars) spent in your RSAT program during the reporting period for
the following areas:
Funds spent during Quarter B]A Funds Non-67A Funds (All Other sources)
Personnel
Fringe benefits
Supplies
Equipment
Contract/consultant fees
Construction
Indirect costs
Other
Jail -Based Programs Jul -Aug 2021
— laic -Based Programs
7. During the reporting period using BJA program funds including matching funds did you Day for training for treatment staff to
be cross trained in the Jail -based portion of the RSAT program?
A. Select Yes or No (Yes/No) Yes r' No
8. Please enter the number of treatment staff members who were cross trained in the Jail -based portion of the RSAT program
A Number of treatment staff cross trained (numeric)
t
9. During the reporting period, using BJA program funds including matching funds did you pay for training for custody staff to be
cross trained in the Jail -based portion of the RSATprogram�
Washington State Page 20 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 7
A. Select Yes
or
1 Elease enter the number b" of _MAY '* staff members . were cross trained in .Jail -based pQrbgp of thg 8SAI • •g
Numberof .•Cross
I— Risk Assessment and Treatment Planning
those ♦ • entered the Jail -based portion of '_ • 1• • , ll durinci • - reporting period, please enter / number of jail�
based participants who were administered a risk and/or needs assessment.
I
A.
Number of Jail -based participants administered a risk and needs
assessment (numeric)
12.
Please
name the risk assessment instrument(s) that is used to assess risk/need,
A.
Risk assessment instruments used:
Ohio Risk/Needs Assessment
e
j 13.
Of
those who entered the Jail -based portion of the RSAT orograrn during the reporting period.glease enter the number of such
i
individuals
who were identified as having high criminoaenic risks and/or high sub_sUnce abuse treatment needs
A.
Number of Jail -based participants with high criminogenic
risks/needs(numeric)
14.
Of
those who entered the Jail -based portion of the RSAT program during the reporting period, please enter the number with
an
individualized substance abuse treatment IR an
A.
Number of Jail -based participants with an individualized treatment ._
plan (numeric)
�— Number of Participants Receiving Services
15.
Please
enter the total number of Jail -based parti igants enrolled in the RSATTrogram as of the last day of the reoortina
A.
Total number of Jail -based participants enrolled as of the last day of
the reporting period (numeric)
j 16.
Please
enter the number of NEW Jail -based participants admitted during the reporting period,
A.
Number of NEW Jail -based participants admitted (numeric)
— Services
Provided
17.
Please
enter the number of Jail -based participants who were provided services during the reporting period with BJA program
funds
A.
including matchinQ funds through the following treatment components:
Substance abuse and treatment services (numeric)
B.
Cognitive and behavioral services (cognitive behavioral services
include interventions that address criminal thinking and antisocial
behavior) (numeric)
C
Employment services (numeric)
D.
Housing services (numeric)
E.
Mental health services (numeric)
F.
Other services (numeric)
Washington State Page 21 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 7
G.
Please explain other services
III
18.
Please
enter the number of Jail -based participants who were provided with transitional planning services with BJA
program
funds including matching funds during the reporting l2eriod.
A.
Number of Jail -based participants receiving transitional planning
services (numeric)
— Medication Assisted Treatment (RSAT)
19.
If your
treatment program includes medication assisted treatment which of the following medications are you utilizing?
Cheek
all that aooly.
A.
We do not provide MAT (Skip next question)
I—
B.
We do not have access to MAT (Skip next question)
r
C.
Naltrexone (Vivitrol®, depot naltrexone)
D.
Buprenorphine or Buprenorphine/Naloxone (Bup/NX) (Suboxone®,)
r
E.
Methadone
(--
20.
Of
the total participants enrolled in Your grogram how many were deemed eligible for medication -assisted treatment
and of
those
eligible how many received MAT during the reporting riod?
A.
Individuals Eligible for MAT: (numeric)
B.
Individuals receiving at least one treatment: (numeric)
— Program
completion
21.
Please
enter the number of participants who success U111 completed all requirements of the Jail -based portion of your
RSAT i
grogram
during the reporting geriod.
A.
Number of Jail -based successful completers (numeric)
22.
Of those Jail -based participants who successfully completed all grogram requirements, please enter the number who
were released to the community during the reporting period.
A.
Number of Jail -based successful completers released to the
community (numeric)
B.
Of those reported in 'A', how many individuals were released under
correctional supervision. (numeric)
C.
Of the number of successful completers released to the community,
how many individuals were referred to an aftercare program.
Aftercare programs are defined in 42 U.S.C. 3796ff-1(c) (numeric)
23.
Of those
Jail -based program completers released to the community. Tease enter the number with a continuity of care
f
arranaement
or reentry or transitional plan.
A.
Number of Sail -based successful completers with confirmed continuity
of care arrangements (numeric) 1______.___�
24.
Please
enter the number of individuals who did not complete the Jail based gortion of the RSAT program for the categories
below.
Jail -based Incompletes Number
Washington State Page 22 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 7
Number of participants no longer in the program due
to termination for a new charge
Number of participants no longer in the program due to release
or transfer to another correctional facility
Number of participants no longer in the program due
to death or serious illness
Number of participants no longer in the program due to voluntary
drop out
Number of participants no longer in the program due to failure to
meet program requirements
Number of participants no longer in the program due to violation
of institutional rules
Number of participants who did not complete the program
for other reasons
Please specify other reasons
25. Of Jail -based participants who left the RSAT program successfully, please enter the number who completed the gram
during the following timeframes.
A. 0 to 3 months (numeric)
B. 4 to 6 months (numeric)
C. 7 to 9 months (numeric)
D. 10 months or more (numeric)
26. Of those Jail -based participants who left the RSAT program unsuccessfully or did not complete the programs please enter
the number who left the program during the following timeframes
A. 0 to 3 months (numeric)��
B. 4 to 6 months (numeric) r�
C. 7 to 9 months (numeric) F
D. 10 months or more (numeric) -
— Alcohol and substance Involvement
27. Please enter the number of Jail -based participants who were administered an alcohol/drug test (e.g.. urinalysis test) before
admission into your RSAT program
A. Number of Jail -based participants tested before admission
28. Of those enrolled in the Jail -based portion of the RSAT program please enter the total number of participants tested for
alcohol or illegal substances during the reporting period
A. Total number of Jail -based participants tested for alcohol or illegal substances
Washington State Page 23 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 7
29. Qf_ftse, enroilgd in the Jail -based portion of the RSAT program— please enter ,the njmber of participants who tested po itive
fgr th_ e p_r en e of al gh or illegal sub noes during the reporting period
A. Number of Jail -based participants who tested positive for alcohol or illegal substances
30, During the reporting period, please enter the number of participants who were administered an_alcohol/dru4 test e. .
urinalysis testy within 30 d yss_after successfully completing_vour residential drug treatment program and are still under
supervision of the -pro gram.
A. Number of Jail -based participants tested after program completion
B. Of that number, how many tested positive for alcohol or illegal substances after program completion
Washington State Page 24 of 22 Substance Abuse Treatment Services
Health Care Authority HCA Contract No. K4880-2
Attachment 7
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, County Administrator
FROM: David Fortino
DATE: December 19, 2022
SUBJECT: Amendment to HCA Grant Contract for the Residential Substance Abuse
Treatment Program.
STATEMENT OF ISSUE:
This Amendment to the HCA grant contract for Residential Substance Abuse Treatment will allow work to
continue that has helped address behavioral health and substance use disorders among the inmate population
of the Jefferson County Jail.
ANALYSIS:
This contract continues the Residential Substance Abuse Treatment program at the Jefferson County Jail that
provides an opportunity for incarcerated individuals in our community to engage in inpatient treatment
services locally, and gain a head start on their road to recovery. Additionally, this program enhances existing
Substance Use Disorder (SUD) services, such as Relapse Prevention and Substance Use Disorder
Assessments, as well as Behavioral Health Services.
FISCAL IMPACT:
The HCA Grant Contract Provides $146.000 along with $50,000 in matching county funds.
RECOMMENDATION:
It is recommended that the board approve this contract and sub -recipient agreement.
County Administrator Date
CONTRACT REVIEW FORM
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITIL Washington State Health Care
=
(Name of Contractor/Consultant) t. ontract No.
COUNTY DEPARTMENT:
Contact Person: David Fortino
Contact Phone: 360-344-9743
Contact email: dfortino cDco.iefferson.wa.us
AMOUNT: $146,000
Revenue:
Expenditure:
Matching Funds Required:
Sources(s) of Matching Funds
$146,000
$50,000
MH Mileage fund
PROCESS:
Exempt from Bid Process
Cooperative Purchase
Competitive Sealed Bid
Small Works Roster
Vendor List Bid
x RFP or RFQ
Other:
APPROVAL STEPS:
STEP l: DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: � N/A: ,rrr� /1 7 d .
Signa ate
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: 5011 N/A: _ 4 e.
SigR6ture Date
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche):
Electronically approved by Risk Management on 12/14/2022.
STEP 4: PROSECUTING ATTORNEY REVIEW (will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 12/13/2022.
(1) State language - cannot change.
(2) Please correct signature page next time to County standard (BoCC
signature with PAO signature line) before submitting contract.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
�06f: aQ fI15
a fud
DocuSign Envelope ID: 7 BF24D5-OCB6-433F-97DE-6AD72331EBOD
Washington State ;;
CONTRACT
HCA Contract No.: K4880
}
Health Care !'_Ulhorlty
AMENDMENT
Amendment No.: 01
THIS AMENDMENT TO THE CONTRACT is between the Washington State Health Care Authority and the party
whose name appears below, and is effective as of the date set forth below.
CONTRACTOR NAME
CONTRACTOR doing business as (DBA)
Jefferson County Jail
I
CONTRACTOR ADDRESS
CONTRACTOR CONTRACT MANAGER
79 Elkins Road
Name: David Fortino
Port Hadlock, WA 98339
Email: dfortino(a)co.iefferson.wa.us
AMENDMENT START DATE
AMENDMENT END DATE
CONTRACT END DATE
October 1, 2021
September 30, 2022
September 30, 2022
PRIOR MAXIMUM CONTRACT AMOUNT
AMOUNT OF INCREASE
TOTAL MAXIMUM COMPENSATION
$146,000.
$146,000.
$292,000.
WHEREAS, HCA and Contractor previously entered into an Agreement for Residential Substance Abuse
Treatment (RSAT) for incarcerated individuals, and;
WHEREAS, HCA and Contractor wish to amend the Agreement pursuant to Section 4.3, Amendments, to extend
the Agreement term and increase Total Maximum Compensation;
NOW THEREFORE, the parties agree the Agreement is amended as follows:
1. The HCA Contract Manager indicated on the Contract Cover Page is updated as follows:
HCA PROGRAM
Department of Behavioral Health and Recovery
HCA DIVISION/SECTION
Adult Substance Use Disorder
HCA CONTACT NAME AND TITLE
HCA CONTACT ADDRESS
Health Care Authority
Kimberly Wright, Medical Program Specialist 3
626 8th Avenue SE
PO Box 42730
Olympia, WA 98504-2730
HCA CONTACT TELEPHONE
HCA CONTACT E-MAIL ADDRESS
(360) 725-9992
kimberly.wri-ght@hcawa.gov
All internal references are updated accordingly.
2. Section 3.2, Term, subsection 3.2.1 is amended to read as follows:
3.2.1 The initial term of the Contract will commence on the date of last signature, whichever is later, and
continue through September 30, 2022, unless terminated sooner as provided herein.
3. Section 3.3, Compensation, subsection 3.3.1 is amended to read as follows:
HCA Contract No, K4880-01 Page 1 of 7
DocuSign Envelope ID: 748F24D5-OC86-433F-97DE-6AD72331EBOD
3.3.1 The Maximum Compensation payable to Contractor for the performance of all things necessary
for or incidental to the performance of work as set forth in Schedule A: Statement of Work is
$292,000., and includes any allowable expenses.
4. Attachment 1, Federal Compliance, Certifications, and Assurances, Section I, Federal Compliance, new
subsections c. and d. are added as follows:
c. Source of Funds SAMHSA: This Contract is being funded partially or in full through Cooperative
Contract numbers 2017RTBX4027 and 2018J2BX4017, the full and complete terms and provisions
of which are hereby incorporated into this Contract. Federal funds to support this Contract are
identified by the Catalog of Federal Domestic Assistance (CFDA) number 16.593 in the amount of
$146,000, The Contractor or Subrecipient is responsible for tracking and reporting the cumulative
amount expended under HCA Contract K4880-01.
Period of Availability of Funds October 1, 2021-September 30, 2022: Pursuant to 45 C.F.R. § 92.23,
Contractor or Subrecipient may charge to the award only costs resulting from obligations of the
funding period specified in 2017RTBX4027 and 2018J2BX4017 unless carryover of unobligated
balances is permitted, in which case the carryover balances may be charged for costs resulting from
obligations of the subsequent funding period. All obligations incurred under the award must be
liquidated no later than 90 days after the end of the funding period.
5. A new Attachment 3.1, Federal Award Identification for Subrecipients, is attached hereto and
incorporated therein. All internal references are updated accordingly.
6. Section 3.4.4, Substance Abuse and Mental Health Services Administration (SAMHSA) Award Terms, is
deleted in its entirety.
7. A new Attachment 4, Substance Abuse and Mental Health Services Administration (SAMHSA) Award
Terms, is attached hereto and incorporated therein. All internal references are updated accordingly.
8. Section 3.8, Incorporation of Documents and Order of Precedence, is amended to read as follows:
3.8 INCORPORATION OF DOCUMENTS AND ORDER OF PRECEDENCE
Each of the documents listed below is by this reference incorporated into this Contract. In the
event of an inconsistency, the inconsistency will be resolved in the following order of precedence:
3.8.1 Applicable Federal and State of Washington statutes and regulations;
3.8.2 Recitals
3.8.3 Special Terms and Conditions;
3.8.4 General Terms and Conditions;
3.8.5
Attachment 1:
Federal Compliance, Certifications and Assurances;
3.8.6
Attachment 2:
Federal Funding Accountability and Transparency Act Data Collection
Form;
3.8.7
Attachment 3:
Federal Award Identification for Subrecipients (FATS);
3.8.8
Attachment 4:
Substance Abuse and Mental Health Services Administration (SAMHSA)
Award Terms
3.8.9
Schedule A(s):
Statement(s) of Work;
3.8.10 Any other provision, term or material incorporated herein by reference or otherwise
incorporated.
HCA Contract No. K4880-01 Page 2 of 7
00cuSign Envelope ID:748F2405-DCB8433F-97DE-6AD72331 EBOD
9. This Amendment will be effective October 1, 2021, ("Effective Date").
10. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Agreement.
11. All other terms and conditions of the Agreement remain unchanged and in full force and effect.
The parties signing below warrant that they have read and understand this Amendment and have authority to
execute the Amendment. This Amendment will be binding on HCA only upon signature by both parties.
CONTRACTORSI RE
PRINTED NAME AND TITLE
DATE SIGNED
Kate Dean,
���/S/
Chair, Board of County Commissioners
MGA SIGNATI
PRINTED NAME ANO I I(LE
DATE SIGNED
...�•w•�.
Rachelle Amerine
a�
Contracts Administrator
10/28/2021
Approved as to Form Only
November 1, 2021
Philip C. Hunsucker Date
Chief Civil Deputy Prosecuting Attorney
HCA Contract No, K4880-01 Page 3 of 7
DocuSign Envelope ID: 748F24D5-OC86-433F-97DE-6AD72331EBOD
Attachment 3.1
Federal Award Identification for Subrecipients (reference 2 CFR 200.331)
Residential Substance Abuse Treatment for State Prisoners
(i)
Subrecipient name (which must match the name
Jefferson County Jail
associated with its unique entity identifier);
(ii)
Subrecipient's unique entity identifier; (DUNS)
6194374
(iii)
Federal Award Identification Number (FAIN);
2017RTBX4027
2018J2BX4017
(iv)
Federal Award Date (see §200.39 Federal award
09/28/19
date);
(v)
Subaward Period of Performance Start and End
10/1/2021-9/30/2022
Date;
$146,000.
(vi) Amount of Federal Funds Obligated by this
action;
(vii)
Total Amount of Federal Funds Obligated to the
$292 000
subrecipient;
(xiii)
Total Amount of the Federal Award;
2017 - $161,0622018
- $406,597
(ix)
Federal award project description, as required to
Residential Substance Abuse Treatment for
be responsive to the Federal Funding
State Prisoners
Accountability and Transparency Act (FFATA);
SAMHSA
(x)
Name of Federal awarding agency, pass -through
WA State Health Care Authority
entity, and contact information for awarding
Keri Waterland, Assistant Director DBHR
official,
626 8th Ave SE; Olympia, WA 98504-5330
Keri.waterlandC-Mca. wa, qov
(A)
CFDA Number and Name; the pass -through
entity must identify the dollar amount made
16.593
available under each Federal award and the
CFDA number at time of disbursement;
(xii) Identification of whether the award is R&D; and
❑ Yes ® No
(xiii)
Indirect cost rate for the Federal award (including
if the de minimis rate is charged per §200.414
de minimus (10%)
Indirect (FBA) costs).
HCA Contract No. K4880-01 Page 4 of 7
DocuSign Envelope ID: 748F24D5-OCB6-433F-97DE-6AD72331EBOD
Attachment 4
Substance Abuse and Mental Health Services Administration (SAMHSA) Award Terms
By drawing or otherwise obtaining funds as a subawardee or contractor of a non-federal entity drawing or otherwise
obtaining funds from SAMHSA, a branch of the United States Department of Health and Human Services (HHS), you agree
to the following pass -through terms and conditions.
Name
Language
Acceptance of the
This Subaward is subject to the SAMHSA Fiscal Year 2021 — Award Standard Terms, included
Terms of an Award
directly, or incorporated by reference on the Notice of Award (NoA) support the grant.
Non -Supplanting
Federal award funds must supplement, not supplant, nonfederal funds. All recipients who
receive awards under programs that prohibit supplanting by law must ensure that federal funds
do not supplant funds that have been budgeted for the same purpose through non-federal
sources. Applicants or award recipients may be required to demonstrate and document that a
reduction in non-federal resources occurred for reasons other than the receipt of expected
receipt of federal funds.
Block grant funds (SABG and MHBG) will not be used to supplant state funding of alcohol and
other drug prevention programs. See 45 CFR § 98.123
Unallowable Costs
All costs incurred prior to the award issue date and costs not consistent with the funding
opportunity, 45 CFR Part 75, and the HHS Grants Policy Statement, are not allowable under
this subaward.
Marijuana Restrictions
Grant funds may not be used, directly or indirectly, to purchase, prescribe, or provide
marijuana treatment using marijuana. Treatment in this context includes the treatment or opioid
use disorder. Grant funds also cannot be provided to any individual who or organization that
provides or permits marijuana use for the purposes of treating substance use or mental
disorders. See, e.g., 45 CFR 75.300(a); 21 USC 812(c)(10) and 841. This prohibition does not
apply to those providing such treatment in the context of clinical research permitted by the DEA
and under an FDA -approved investigational new drug application where the article being
evaluated is marijuana or a constituent thereof that is otherwise a banned controlled
substances under the federal law.
Executive Pay
The Consolidated Appropriations Act, 2021 (Public Law 116-260), signed into law on
December 27, 2020 restricts the amount of direct salary to Executive Level II of the Federal
Executive Pay scale. Effective January 3, 2021, the salary limitation for Executive Level II is
$199,300.
Promotional Items
SAMHSA grant funds may not be used for Promotional Items. Promotional Items include but
are not limited to: Clothing and commemorative items such as pens, mugs/cups, folders/folios,
lanyards, and conference bags.
Acknowledgment of
When a conference is funded by a grant or cooperative agreement, the recipient must include
Federal Funding at
the following statement in all conference materials (including promotional materials, agenda,
Conferences and
and internet sites):
Meetings
Funding for this conference was made possible 9in part) by (insert grant or cooperative
agreement award number) from SAMHSA. The views expressed in written conference
materials or publications and by speakers and moderators do not necessarily reflect the official
policies of the Department of Health and Human Services; nor does mention of trade names,
commercial practices, or organizations imply endorsements by the U.S. Government.
Rights in Data and
As applicable, recipients agree to the requirements for intellectual property, rights in data,
Publications
access to research data, publications, and sharing research tools, and intangible property and
copyrights as described in 45 CFR 75.322 and the HHS Grants Policy Statement.
HCA may copyright any work that is subject to copyright and was developed, or for which
ownership was acquired, under a Federal Award. SAMHSA reserves a royalty -free,
nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work for Federal
i
purposes, and to authorize others to do so.
HCA Contract No. K4880-01 Page 6 of 7
DocuSign Envelope ID: 748F2405-OC86-433F-97DE-6AD72331EBOD
Mandatory Disclosures
Consistent with 45 CFR 75,113, Subrecipients must disclose, in a timely manner, in writing to
HCA and the HHS Office of Inspector General (OIG), all information related to violations, or
suspected violations, of Federal criminal law involving fraud, bribery, or gratuity violations
potentially affecting the Federal award. Disclosures must be sent in writing to HCA and the
HHS OIG at the following addresses:
U.S. Department of Health and Human Services
Office of Inspector General
ATTN. Mandatory Grant Disclosures, Intake Coordinator
330 Independence Avenue, SW, Cohen Building Room 5527
Washington DC 20201
Fax: (202) 205-0604 (include "Mandatory Grant Disclosures" in subject line or email)
_MandatorvGranteeDisclosure_s oighhs.go_v
Failure to make required disclosures can result in any of the remedies described in 45 CFR
75.371 remedies for noncompliance, including suspension or debarment (See 2 CFR parts 180
& 376 and 31 USC 3321)
Lobbying Restrictions
Per 45 CFR §75.215, Subrecipients are subject to the restrictions on lobbying as set forth in 45
CFR part 93.
U.S.C. > Title 18 > Part I > Chapter 93 > Section 1913, No part of the money appropriated by
any enactment of Congress shall, in the absence of express authorization by Congress, be
used directly or indirectly to pay for any personal service, advertisement, telegram, telephone,
letter, printed or written matter, or other device, intended or designed to influence in any
manner a Member of Congress, a jurisdiction, or an official of any government, to favor, adopt,
or oppose, by vote or otherwise, any legislation, law, ratification, policy, or appropriation,
whether before or after the introduction of any bill, measure, or resolution proposing such
legislation, law, ratification, policy, or appropriation: but this shall not prevent officers or
employees of the United States or of its departments or agencies from communicating to any
such Member or official, at his/her request, or to Congress or such official, through the proper
official channels, requests for any legislation, law, ratification, policy, or appropriations which
they deem necessary for the efficient conduct of the public business, or from making any
communication whose prohibition by this section might, in the opinion of the Attorney General,
violate the Constitution or interfere with the conduct of foreign policy, counter -intelligence,
intelligence, or national security activities.
Violations of this section shall constitute as a violation of section 1352 (a) of Title 31.
Drug Free Workplace
The Drug -Free Workplace Act of 1988 (41 U.S.C. § 701 et seq.) requires that all organizations
receiving grants from any Federal agency agree to maintain a drug -free workplace. By signing
this Contract, you agree that the grantee will provide a drug -free workplace and will comply
with the requirement to notify NIH if an employee is convicted of violating a criminal drug
statute. Failure to comply with these requirements may be cause for debarment. Government
wide requirements for Drug -Free Workplace for Financial Assistance are found in 2 CFR part
182; HHS implementing regulations are set forth in 2 CFR part 382.400. All recipients of NIH
grant funds must comply with the requirements in Subpart B (or Subpart C if the recipient is an
individual) of part 382.
Trafficking Victims
The Trafficking Victims Protection Act of 2000 authorizes termination of financial assistance
Protection Act of 2000
provided to a private entity, without penalty to the Federal government, if the recipient or
(22 USC 7104(G)), as
subrecipient engages in certain activities related to trafficking in persons.
amended, and 2 CFR
SAMHSA or HCA may unilaterally terminate this award, without penalty, if a private entity
Part 175
recipient, or a private entity subrecipient, or their employees: a) Engage in severe forms of
trafficking in persons during the period of time that the award is in effect; b) Procure a
commercial sex act during the period of time that the award is in effect; or, c) Use forced labor
in the performance of the award or subawards under the award.
The text of the full award term is available at 2 C.F.R. § 175.15(b). See
http llwww.gp_oyov/fdSVs/pkg/CFR-2012-title2-voll/pdf/CFR-2012-title2-volt-sec175-15 pdf
Confidentiality of
The regulations (42 CFR 2) are applicable to any information about alcohol and other drug
Alcohol and Drug
abuse patients obtained by a "program" (42 CFR 2.11), if the program is federally assisted in
Abuse Patient Records
any manner (42 CFR 2.12b). Accordingly, all project patient records are confidential and may
HCA Contract No. K4880-01 Page 6 of 7
DocuSign Envelope ID: 748F24D5-OCB6-433F-97DE-6AD72331EBOD
be disclosed and used only in accordance with 42 CFR Part 2. The Subrecipient is responsible
for assuring compliance with these regulations and principles, including responsibility for
assuring the security and confidentiality of all electronically transmitted patient material.
Healthy People 2020
Healthy People 2020 is a national initiative led by HHS that set priorities for all SAMHSA
programs. The initiative has two major goals: (1) increase the quality and years of a healthy
life; and (2) eliminate our country's health disparities. The program consists of 28 focus areas
and 467 objectives. SAMHSA has actively participated in the work groups of all the focus areas
and is committed to the achievement of the Healthy People 2020 goals. Healthy People 2010
and the conceptual framework for the forthcoming Healthy People 2020 process can be found
online at: https/lwww.healthypeople.gov/
Accessibility Provisions
Recipients of Federal financial assistance (FFA) from HHS must administer their programs in
compliance with Federal civil rights law. This means that recipients of HHS funds must ensure
equal access to their programs without regard to a person's race, color, national origin,
disability, age, and in some circumstances, sex and religion. This includes ensuring your
programs are accessible to persons with limited English proficiency.
The HHS Office for Civil Rights also provides guidance on complying with civil rights laws
enforced by HHS. Please see:
httpl/www hhs.gov/ocr/civilrights/understanding/section1557/index.html.
Recipients of FFA also have specific legal obligations for serving qualified individuals with
disabilities. Please see- http://www hhs.gov/ocr/civilrights/understanding/disability/index.htnil.
Please contact the HHS Office for Civil Rights for more information about obligations and
prohibitions under Federal civil rights laws at https:/twww.hhs.gov/civil- rights/index.html or call
1-800-368-1019 or TDD 1-800- 537-7697.
Also note that it is an HHS Departmental goal to ensure access to quality, culturally competent
care, including long-term services and supports, for vulnerable populations. For further
guidance on providing culturally and linguistically appropriate services, recipients should review
the National Standards for Culturally and Linguistically Appropriate Services in Health and
Health Care at https://minorityheaith.hhs.gov/omh/browse.aspx?lvl=1&Mid=6.
Legislative Mandates
Certain statutory provisions under P.L. 115-245, Department of Defense and Labor, Health and
Human Services, and Education Appropriations Act, 2019, Division B, Title V, Title II, General
Provisions limit the use of funds on SAMHSA grants, cooperative agreements, and contract
awards. Such provisions are subject to change annually based on specific appropriation
language that restricts the use of grant funds. The full text of P.L. 115-245 is available at
https://www.congress.gov/bill/115th-congress/housebill/6157/text? Format=txt.
Ad Hoc Submissions
Throughout the project period, SAMHSA may determine that a grant requires submission of
additional information beyond the standard deliverables. This information may include, but is
not limited to, the following:
• Payroll
• Purchase orders
• Contract documentation
• Proof of project implementation
HCA Contract No. K4880-01 Page 7 of 7
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, Interim County Administrator
FROM: David Fortino
DATE: November 15, 2021
SUBJECT: Amendment to HCA Grant Contract for Residential Substance Abuse Treatment
Program.
STATEMENT OF ISSUE:
This Amendment to the HCA grant contract for Residential Substance Abuse Treatment to continue the
work that has helped to address the behavioral health and substance use disorder among the inmate
population of the Jefferson County Jail,
ANALYSIS:
This contract continues the Residential Substance Abuse Treatment program at the Jefferson County Jail that
provide an opportunity for incarcerated individuals in our community to engage in inpatient treatment
services locally, and gain a head start on their road to recovery. Additionally, this program enhance existing
Substance Use Disorder (SUD) services, such as Relapse Prevention and Substance Use Disorder
Assessments, as well as Behavioral Health Services.
FISCAL IMPACT:
The HCA Grant Contract Provides $146,000 along with $50,000 in matching county funds.
RECOMMENDATION:
It is recommended that the board approves this contract and sub -recipient agreement.
REVIEWED BY:
Mark McCauley, Werim County Administra D to
CONTRACT REVIEW FORM
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Washington State Health Care Authority k4880
Name ofCont ractor/Consultant Contract No.
COUNTY DEPARTMENT:
Contact Person: David Fortino
Contact Phone: 360-344-9743
Contact email: dfortino(fto.iefferson.wa.us
AMOUNT: $146.000
Revenue:
Expenditure:
Matching Funds Required:
Sources(s) of Matching Funds
$146,000
$50,000
MH Mileage fund
PROCESS:
Exempt from Bid Process
Cooperative Purchase
Competitive Sealed Bid
Small Works Roster
Vendor List Bid
x RFP or RFQ
Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: 0 N/A:-�•-»ram-i _ // /�jb91
ignature ' Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: Q N/A: F-1
ignature Date
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche):
Electronically approved by Risk Management on 11/112021.
State language.
STEP 4: PROSECUTING ATTORNEY REVIEW (will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 11/9/2021.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL