HomeMy WebLinkAboutJumping Mouse Chimacum School 615 Sheridan Street
Port Townsend, WA 98368
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Consent Agenda
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark Mc Cauley, County Administrator
FROM: Apple Martine, Director
Anna McEnery, DD & BH County Coordinator
DATE: ,_Jot 0
SUBJECT: Agenda Item — Professional Services Agreement, Jumping Mouse
Children's Center; July 1, 2023— June 30, 2024; $38,531.00
STATEMENT OF ISSUE:
Jefferson County Public Health, (JCPH), requests Board approval of the Professional Services Agreement with
the Jumping Mouse Children's Center. Recognizing the lack of access and resources in the rural locations of
Jefferson County; Jumping Mouse has a satellite agency located at the Chimacum School, in order to provide
long-term therapy to young children in the Chimacum School District; July 1, 2023 — June 30, 2024;
$38,531.00.
ANALYSIS/STRATEGIC GOALS/PRO'S and CONS:
This Professional Services Agreement, between Jefferson County Public Health and Jumping Mouse Children's
Center; is for clinical and care management services for up to 16 slots for children who attend school at the
Chimacum School District, along with consults, education and support with teachers and staff. This service will
include long-term therapy to children affected by and/or with risk factors for mental illness or substance abuse
at home and/or in the community. Jumping Mouse will also provide support and education to the children's
parents/caregivers through monthly meetings and on-call support.
FISCAL IMPACT/COST BENEFIT ANALYSIS :
This is County sales tax revenue, which is deposited into the 131 Fund; (1/10 of 1% Fund). The BoCC
allocates it, with input from the Behavioral Health Advisory Committee. The agreement states that funding is
subject to availability and if the County sales tax revenue decreases, the Vendor will be contacted and the
contract may be renegotiated.
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
AD-23-037
This Professional Services Agreement resulted from an RFP process; services and funding have been
recommended to the BoCC by the Behavioral Health Advisory Committee.
RECOMMENDATION:
Jefferson County Public Health, (JCPH), requests approval of the Professional Services Agreement with
Jumping Mouse Children's Center. Recognizing the lack of access and resources in the rural locations of
Jefferson County; Jumping Mouse has a satellite agency located at the Chimacum School, in order to provide
long-term therapy to young children in the Chimacum School District; July 1, 2023—June 30, 2024;
$38,531.00.
REVIEWED BY:
/ 3
Mark McCauley, Coun dministrator Dat
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Jumping Mouse Children's Center Contract No: AD-23-037
Contract For: Mental Health Therapy Services for Children at the Chimacum School District Term: July 1, 2023 to June 30, 2024
COUNTY DEPARTMENT: Public Health
Contact Person: Anna Mc Enery
Contact Phone: 360-385-9410
Contact email: amcenery@co.jefferson.wa.us
AMOUNT: $38,531.00 PROCESS: Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: $38,531.00 Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s)of Matching Funds Vendor List Bid
Fund # #131 RFP or RFQ
Munis Org/Obj 13156400 Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMP WIT C �80 AND CHAPTER 42.23 RCW.
CERTIFIED: ®■ N/A:® June 5, 2023
Signature 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: F N/A: ® June 5,2023
Signature Date
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche):
Electronically approved by Risk Management on 6/6/2023.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 6/7/2023.
County standard PSA language.
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
1
PROFESSIONAL SERVICES AGREEMENT
Between
Jefferson County
And
Jumping Mouse Children's Center/Chimacum School District Mental Health Services
THIS PROFESSIONAL SERVICES AGREEMENT("this Agreement") is entered into between the County
of Jefferson, a municipal corporation ("the County"), and Jumping Mouse Children's Center, ("the
Contractor"), in consideration of the mutual benefits,terms, and conditions specified below.
1. Project Desi ation. The Consultant is retained by the County to perform the following Project: to
provide mental health services for young children, in the Chimacum School District, (along with
support for their parents/caregivers), who have suffered trauma, including loss, abuse,neglect, and
exposure to violence, mental illness, and substance abuse; in Jefferson County, Washington.
2. Scope of Services. Contractor agrees to perform the services identified on Exhibit"A"attached
hereto including the provision of all labor.
3. Time for Performance. This Agreement shall commence on July 1, 2023 and continue through June
30, 2024. Work performed consistent with this Agreement during its term, but prior to the adoption
of this Agreement, is hereby ratified. The Contractor shall perform all services pursuant to this
Agreement as outlined in 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 on an hourly basis at the rate as
defined in Exhibit`B", attached hereto,provided that the total amount of payment to the
Contractor shall not exceed $38,531.00; without express written modification of the
Agreement signed by the County. The Contractor shall adhere to the budget amounts
pursuant to this Agreement as outlined in Exhibit`B".
b. Invoices must be submitted by the 10th of the month for the previous month's expenses.
Such invoices will be checked by the County, 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"A"of the Agreement may result in a denial of reimbursement. Invoices
not submitted within 60 days may be denied.
c. Final payment of any balance due the Contractor, of the total contract price earned, will be
made promptly upon its ascertainment and verification by the County after the completion of
the work and submittal of reports under this Agreement and its acceptance by the County.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 1 of 16
AD-23-037
d. Contractor 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.
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.
f. The County reserves first right to use as match,the Chemical Dependency or Mental Health
Treatment Sales and Use Tax, (now known as the 1/10I'of 1%Behavioral Health Sales Tax)
and the services funded by them for purposes of qualifying for additional funding and grants.
The County may allow the Contractor to use the 1/10'h of 1%Behavioral Health Sales Tax
funds as match, at the County's sole discretion. Should the County decline to use the 1/101'
of 1%Behavioral Health Sales Tax funds as match for additional funding and/or grants,then
the County may authorize the Contractor to use such funds for match(see ATTACHMENT
A).
g. Where Contractor proposes to use 1/10'h of 1%Behavioral Health Sales Tax funds for match,
Contractor shall be solely responsible for compliance with all state and federal laws and
regulations, including, but not limited to DSHS, CMS and MCSR funding rules, applicable
to the use of 1/10'h of 1% Behavioral Health Sales Tax funds as match. Contractor shall
document they have met this responsibility by submitting to the County Administrator, in
writing, their match formula, allocation plan and any other documentation required of them
pursuant to ATTACHMENT A, attached hereto and incorporated in this Agreement.
h. The County may withhold authorization to utilize the 1/10''of 1%Behavioral Health Sales
Tax funds as match. Contractor's failure to provide adequate documentation does not relieve
the Contractor of their responsibility to comply with all state and federal laws and regulations
related to match.
i. The County reserves first right to use as match the 1/IWh of 1%Behavioral Health Sales Tax
fund to the County Administrator, in writing,their match formula, allocation plan and any
other documentation required of them pursuant to ATTACHMENT A, attached hereto and
incorporated in this Agreement.
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.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 2 of 16
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 finds 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 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 this Agreement is subject to RCW 4.24.115 if liability for damages occurs 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,
shall be only for the Contractor's negligence. It is further specifically understood that the
indemnification provided 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. This section shall survive the expiration or termination of this
Agreement.
9. 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 is waived based on Jumping Mouse's
representation and warranty that it never transport's clients.
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);
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 3 of 16
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 periods 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
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
financial 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 the Agreement, nor shall the insurance requirements be
construed to conflict with or otherwise limit the obligations concerning indemnification of
the County.
h. The Contractor's insurers shall have no right of recovery or subrogation against the County
(including its employees and other agents and agencies), it being the intention of the parties
that the insurance policies,with the exception of Professional Liability Insurance, so affected
shall protect both parties and be primary coverage for all losses covered by the above
described insurance.
i. 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.
j. All deductibles in the above described insurance policies shall be assumed by and be at the
sole risk of the Contractor.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 4 of 16
k. 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.
1. Insurance companies issuing the Contractor's insurance 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 insurance policy.
in. 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 furnish additional security covering such
judgment as may be determined by the County.
n. 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.
o. 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.
p. 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.
q. 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.
r. 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.
s. 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.
t. 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.
u. 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.
v. 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.
w. The County reserves the right to request additional insurance on an individual basis for extra
hazardous contracts and specific service agreements.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 5 of 16
10. 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 employer's 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.
11. 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.
12. 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.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 6 of 16
13. 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.
14. 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.
15.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.
16.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.
17. 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.
18. 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:
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:
Jumping Mouse- Children's Center
Attn: Kimberley Gorman-Executive Director
1809 Sheridan Street
Port Townsend, WA 98368
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 7 of 16
19. 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, and 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.
20. Modification of this Agreement. This Agreement may be amended only by written instrument
signed by both County and Contractor.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. Binding on Successors, Heirs and Assigns. This Agreement shall be binding upon and inure to the
benefit of the parties' successors in interest, heirs, and assigns.
27. 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.
28.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.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 8 of 16
29. 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.
30. Facsimile and Electronic Signatures. The parties agree that facsimile and electronic signatures shall
have the same force and effect as original signatures.
31. 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.
32. 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.
33. 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.
34. Criminal History/Background Check. 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.
(SIGNATURES FOLLOW ON THE NEXT PAGE)
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 9 of 16
SIGNATURE PAGE
JEFFERSON COUNTY WASHINGTON
BOARD OF COUNTY COMMISSIONERS
u n
C��l�l►-��s Ce�t�r
ame f C tractor Greg Brotherton, Chair
Contractor Representative (Please print) Kate Dean, Member
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i ture) Heidi Eisenhour, Member
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Title
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Attest:
Carolyn Gallaway, Date
Clerk of the Board
Approved as to Form Only:
j .
June 7, 2023
Philip C. Hunsucker, Date
Chief Civil Deputy Prosecuting Attorney
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 10 of 16
Exhibit A
Scope of Work
Jumping Mouse Children's Center/Chimacum School District - Mental Health Services
RESPONSIBILITIES:
The County, as administrator of the 1/10'h of 1% Sales and Use Tax Funds, and Jumping Mouse Children's
Center agree that Jumping Mouse Children's Center will provide services to individuals as described in this
Contract, including EXHIBIT A: Scope of Work, EXHIBIT B: Fee Schedule; and EXHIBIT C; Logic
Model and Performance Measures; and further agrees to comply with the stipulations contained in
ATTACHMENT A attached hereto and incorporated herein.
The Jumping Mouse Children's Center Services agency as a contracted provider, agrees to:
1. Clinical and care management services for up to 16 children weekly using the Jumping Mouse model
of play therapy at the Chimacum School District.
2. Provide support and education to the parents/caregivers of the children covered in this contract
through monthly meetings and on-call support.
3. Work with social services or other agencies as needed for dually served families with mental health
or chemical dependency issues.
4. Provide care coordination with other involved agencies, and referrals to supportive services such as
housing, transportation and vocational services and track client involvement in recommended
services, including 12-step or comparable support.
5. Maintain a secure records system guaranteeing the confidentiality of PHI pursuant to HIPPA.
6. Bill other revenues whenever they exist.
7. Provide individual therapy, using promising and/or evidence-based models of treatment. Applicant
will identify the number of clients seen, how often each week and the number of hours per week and
per month for treatment enrollment.
8. Make referrals for mental health medication and monitoring, as needed.
9. Prepare progress reports, if needed (e.g., for care coordination purposes).
10. Provide staff including two master's level Licensed Mental Health Counselor or Licensed Mental
Health Counselor Associates, one Clinical Supervisor and support staff to include billing and
administration.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 11 of 16
11. Ensure all employees or subcontractors of the Contractor undertaking the performance of mental
health/substance abuse services under this agreement are professionally licensed or certified by the
State.
12. Complete background checks; to be redone for every employee every 3 years. The names of licensed
therapists will be given to the County.
13. Provide opportunities for regular clinical supervision and consultation for Jumping Mouse therapists
staff who are working at the Chimacum site. Provide supervision for all therapists consisting of a
minimum of one hour per week in individual consultation, one hour per week in group consultation
and three hours per month in a clinical staff meeting.
14. Provide for clerical,billing, and general office support.
15. Provide agency oversight regarding record keeping, data collection, legal and ethical issues and
standards of care are up to date and meet State of Washington standards.
16. Collect and prepare data for internal and external evaluation purposes,provide a monthly invoice to
JCPH and a quarterly data report. Provide quarterly data on client utilization, referrals, outcomes, and
any other required reporting, on a standard template provided by JCPH.
17. Provide data including:
• Number of intakes, individual sessions,psychiatric visits, and adult education visits provided.
• Age, sex, and ACE's.
• Referrals to other agencies.
• Completion and program success data.
18. Opportunities for regular clinical supervision and consultation are available for staff on a regular
basis. Supervision for all therapists, including interns and externs, consists of minimum one hour per
week in individual consultation, one hour per week in group consultation and three hours per month
in a clinical staff meeting.
19. A quarterly report of services and will be recorded on a form created or approved by the Public
Health contracted Epidemiologist.
20. Quarterly electronic reports will be sent to the Public Health contracted 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.
21. Attend and report to the Behavioral Health Advisory Committee once during the duration of this
contract period, at regularly scheduled meetings, with progress evaluation reports.
22. A copy of each electronic report will be sent to the JCPH Contract Representative.
23. Upon request, additional reports of activities and services provided,to the JCPH Contract
Representative.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 12 of 16
Exhibit B
Fee Schedule
Jumping Mouse Children's Center/Chimacum School District - Mental Health Services
July 1, 2023 —June 30, 2024
REQUESTED FROMOTHER FUNDING TOTAL
PERSONNEL COSTS •
FTE&Salaries for each Employee
(1)Therapist (22 hrs/wk) $6,276 $31,200 $37,476
(2)Therapist (22 hrs/wk) $15,150 $27,186 $42,336
(3) Clinical Supervisor(4 hrs/wk) $7,962 $7,962
(4)Site Supervision(2 hrs/wk) $4,824 $4,824
Benefits for each Employee
(1)Therapist (22 hrs/wk) $5,640 $ $5,640
(2)Therapist (22 hrs/wk) $6,312 $6,312
(3) Clinical Supervisor(4 hrs/wk) $1,152 $1,152
(4)Site Supervision(2 hrs/wk) $498 $498
SUBTOTAL $35,028 $71,172 $106,200
OPERATING COSTS
Supplies/Materials—please describe $ $
Ongoing toys and materials for therapy room
Travel-(Please describe) $ $
(5)Admin-(no more than 10%&please describe what $3,503 $1,501 $5,004
charges are to be included)
OTHER COSTS
(If Other—Please Describe) $ $ $
TOTAL COST $38,531 $72,673 $111,204
All categories will be billed as a monthly portion of total estimate.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 13 of 16
Exhibit C
Logic Model
Jumping Mouse Children's Center/Chimacum School District - Mental Health Services
July 1, 2023 —June 30, 2024
Name of Program or Service:
Jumping Mouse Children's Center—Mental health services
for Chimacum School District ...so that...
No Outcome
...so that... Output
...so that... Process Substance abuse
90%of children served will
successfully participate in and mental
Input therapy at their own pace, illness are
demonstrating: prevented in
1) Provide mental 1) increased emotional children exposed
health therapy for regulation, confidence, and to ACES.
children ages self-esteem;
1) Master-level 3-12 in East 2) reduction of developmental Current and
intern therapists Jefferson County delays and concerning future
2) Licensed, 2) Provide support behaviors; generations
certified and education for 3) increased trusting experience less
our children's relationships with significant trauma and
supervisors parents and people in their lives; and improved health
3) Administrative caregivers 4) gained coping skills in and well-being.
support staff 3) Provide support dealing with difficult
4) Facility and play and training to situations.
materials that educators and 80%of parents served
provide trust and school staff will develop:
safety in the 1) safer and more secure
therapy parental care that promotes
relationship healthy development.
5) Longterm, 2) positive relationships with
their child;
sustainable
funding 3) increased understanding
and application of effective
parenting skills; and
4) improved confidence, self-
esteem, and ability to access
support for their family when
needed.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 14 of 16
ATTACHMENT A
JEFFERSON COUNTY 1/10th of 1% BEHAVIORAL HEALTH SALES TAX FUNDING-
MATCH POLICY
Definitions:
Match: is a requirement for the grantee to provide contributions of a specified amount or percentage
to match funds provided by another grantor. Matching can be in the form of cash or in-kind
contributions.
Regulations: The specific requirements for matching funds are unique to each federal or state
program. The A-102 Common Rule provides criteria for acceptable costs and contributions in
regard to match.
Jefferson County Policy:
In 2005,the Washington State Legislature created an option for counties to raise the local sales tax by 0.1
percent, (the 1/1 Oth of 1% sales tax initiative)to augment state funding for behavioral health treatment.
Jefferson County collects and distributes the 1/10th of 1%Behavioral Health Sales Tax fund. Services
purchased by the County are allocated through a formal Request for Proposal(RFP)process, review and
contracting; staffed by Jefferson County Public Health, overseen by Jefferson County Behavioral Health
Advisory Committee and adopted by the Board of County Commissioners, (BoCC). BoCC does not assume
any fiscal responsibility/liability for any of the Contractors they contract for services with.
Jefferson County reserves the first right to use as match the 1/IOd'of 1%Behavioral Health Sales Tax funds
and the services funded by them for purposes of qualifying for additional funding and grants. County may
make available to the Contractor the 1/10t' of 1%Behavioral Health Sales Tax funds for the Contractor to
propose as match to state, federal or other entities, at the County's sole discretion. Contractor shall not use
the 1/10'h of 1%Behavioral Health Sales Tax funds for match without prior authorization by the Jefferson
County Administrator and County fiscal team. To request authorization of availability of the funds for
match, Contractor must apply to the County Administrator in writing, and include their match formula and
allocation plan and may include other documentation to support their request. The County Administrator
will authorize or deny the availability of match funds in writing within 30 days of the application.
If the County informs the Contractor of the availability of the 1/10''of 1%Behavioral Health Sales Tax
funds for match,then the Contractor shall be solely responsible for compliance with all state and federal
laws and regulations, including, but not limited to DSHS, CMS and BIRR funding rules, applicable to the
use of 1/10`h of 1%Behavioral Health Sales Tax funds as match. Following state, federal and local
guidelines for match is the responsibility of the Contractor.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 15 of 16
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 1/10th of 1%Behavioral Health Sales Tax
funding as match.
Professional Services Agreement,Jumping Mouse Children's Center/CSD-2023-2024 Page 16 of 16