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State of Washington Department of Health Consolidated Contracts Amendment 20 - 071524
Page 1 0l 33 JEFFERSON COUNTY PUBLIC HEALTH 2022-2024 CONSOLIDATED CONTRACT CONTRACT NUMBER: CLH31013 AMENDMENT NUMBER: 20 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH", and JEFFERSON COUNTY PUBLIC HEALTH, a Local Health Jurisdiction, hereinafter referred to as "LHJ", pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, includes the following statements of work,which are incorporated by this reference and located on the DOI1 Finance SharePoint site in the Upload Center at the following URL: httns://statcofwaahsareuoint.com/sites/doh-ofsfundmgresourees/site mai_home.as e?—el:ye94688da2d94d3caBQac7ibc32c4d7c ® Adds Statements of Work for the following programs: Foundational Public Health Services (FPHS)- Effective July 1, 2024 ® Amends Statements of Work for the following programs: Executive Office of Resiliency& Health Security-WFD LHJ -Effective July I,2023 Recreational Shellfish Activities- Effective July I, 2023 Sexual & Reproductive Health Program - Effective January 1,2022 WIC Nutrition Program - Effective January 1, 2022 ❑ Deletes Statements of Work for the following programs: 2. Exhibit 13-20 Allocations, attached and incorporated by this reference,amends and replaces Exhibit B-I9 Allocations as follows: ® Increase of$1,218,566 for a revised maximum consideration of$9,416,279. ❑ Decrease of for a revised maximum consideration of No change in the maximum consideration of . Exhibit B Allocations arc attached only for informational purposes. Unless designated otherwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof. JEFFERSON COUNTY WASHINGTON STATE OF WASHINGTON BOARD OF COUNTY COMMISSIONERS DEPARTMENT OF HEALTH 07/17/2024 Kate Dean,Chair Date Date APPROVED AS 10 FORM ONLY APPROVED AS TO FORM ONLY Assistant Attorney General - July 4. 2024 Philip C. 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F.. a. :J 0 Q 0 0 d I— ` E at Q c E p u. z Lt •44. -O v tN v- ,� s- i•. • c�J O >a oo ^'+ c c i N V xi N 1 O g. 4' Q) L ea ^� . y H a. c a) y p a fl j rn y' b e Jo C T C ° i L 0 d y ca i0 " > T VI O 0 . 0 .. 0 E O 0 w cs C 0 E 04 c y saox Eli C N ~ro O I- b 8 ems_ _ CS V a. •� a) L C es a) ¢ O o. "-I a, Q ci � � em a 0� a ° v.; 0 - caG ; . ¢ c I = 3+ e_LaOCC m = I vg • vav c s S E •-v - ttl LS• o ti O Q Ep L F C y C, q pp OE •C N L C .c .cc d o os C N C 2 H Y O > C' C o0.rf ca'Q J ;7f C a•7 '�p rL .'I'i V ^' 6 .1,1 J :() V �' 'O 'a = e (j C '�^ •— c Zp > w O L 4, W x F ,Op 0 �y ei E• t � cVa '3 ,7 0 a us coA z N c O OO t O L ? ?i • sncZ " zc G -0 ta c i i c e °i - •"c u o • " o I I Z u e •a YE LL •}D - m w Ec " 2 °V c u cc = a v s I CC ia.0 regj a7 O G''C CA O �, L aG a G p- N O .c .. 00 0 3 c_ u L b_ o c`°i e C <` C Q a� E- '�= �_ a g�'" ;; V E Q H dJ oa yyqq i LO H 7 C C .0 s. cgc n C r 7 a OA I V? U a ° O u L v 0n E c `a aC1 >, > > o .y c U c z = z G — $ c v II U >•, 3 c „' ai 40 E C ? `o a f • _ •CC •` kflU ,! Ui h L ZA Aej u c L41> • O c`s. cz IL •c ii ! CU o as =. • • • • p a n p" c on 2 �. p Q L i {i O. N A. N an E C E O Page 10 of 33 The following expenses are not allowable with these funds: • Clothing(except for vests to be worn during exercises or responses). • Food or beverages. • Incentives. • Items to be given to community members(members of the public). • Salaries at a rate more than Executive Level II(Federal Pay Scale). • Vehicles(with preapproval,funds may be used to lease vehicles). Preapproval from DOH is required to use these funds for: • Contracting. • Purchasing equipment.(Equipment is a tangible item with an original per-unit cost of$5,000 or more.) • Disposition of equipment with a current value of$5,000 or more. (Equipment is a tangible item with an original per-unit cost of$5.000 or more.) • Leasing vehicles. • Out of state travel. Note: Preapproval is no longer required for paying overtime. See also DOH A19 Documentation Matrix for additional expenses that may require preapproval. BILLING All expenses on invoices must be related to statement of work tasks. Submit invoices monthly on a signed A 19 with backup documentation appropriate for risk level. DOH will provide A 19 and risk level. • If your invoice includes indirect costs,you must have an indirect rate cost agreement approved by DOH. • If you have no expenses related to this contract for a month, let your DOH Primary Point of Contact know via email. • Submit final billing within 60 days of the end of the contract period. Exhibit A, Statement of Work Page 4 of 4 Contract Number CLI131013-Amendment 20 f 0000000 OD y, I I ^ _ vi�... v^ g O i el V >, 4 . b 35G '" E o o o a as = u .L o — c,c>. a E ae. O u iti a CO un PEE 0 Ca V0 2 in L. 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L E ••E ca $ 'y/ U .y. U V E t V d 1r L l—NG �' d L i.., 'a oQ „ .0 0 0 0S. "'O G 0 e3 O - w O spC.-. a'•S tom'' a' �"" U Q� U I-. N CI� L L �•' tii CO 0 cj5X jj � Om 6t' O >,O u 4�� i, s � 7 O. u = a� .� ca O b •to •E Q u. i • U �° a>az o ; ; E � 3 a dbz a C£i a� C. v •— C >' C C t�0 y L U vvl y 'O.. MI u ri to i -0 Tu.". ACC) o o ° x 3 c 0 _ 3 v, e o a-. s E $ „ Z ciN v: E E c "� asis _ „ ob u ^ o cc 0 ?- C. f , "HI 3� • c "c1 ooy = —.., s -0ta ,, .0 e col 03 VyE0 cs � `° c o O £ .2 J 0 — v > = u C.) � C.)cs col cp y c aII GJ111tH! 43 >NnE 9a> uuHI . III W ID ;1 . 0 e. a ,a, 0 •EEE H a VR 0 s V u -0 c>3 >, a J� a' �+0 „ E. •> I a>i a•5 0 a_ v e0 5 8 0 „ R u x � 2 d L. g E U s .S v)H .o a� °� E- u, Q a Fie c w UI {j o c/a = it E O a 8 $ > 00 `v 0,, ...E. , core 's 4s 4 •0 m CC v, .5 V 3 F- rat E- < a a. • :zl = • W F- • W F • F. • < ri C vi ,G N " x u.1 Page 18 of 33 Exhibit A Statement of Work Contract Term: 2022-2024 DOH Program Name or Title: Recreational Shellfish Activities- Local Health Jurisdiction Name: Jefferson County Public Health Effective July I,2023 Contract Number: CLH31013 SOW Type: Revision Revision#(for this SOW) I Funding Source Federal Compliance Type of Payment ❑ Federal<Select One; (check if applicable) Reimbursement Period of Performance: July I,2023 through December 31,2024 ®State ❑ FFA 1'A(Transparency Act) El Fixed Price ❑Other ❑Research&Development Statement of N'\ork Purpose: The purpose of this statement of work(SOW)is to provide funds for shellfish harvesting safety. Revision Purpose: The purpose of this revision is to add funds for biotoxin monitoring. Master Assistance BARS Allocation Index Listing Revenue LH.I Funding Period Current Change Total DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation REC. SHELLFISH!BIOTOXIN 26402600 N/A 334.04.93 07/01/23 12/31/24 11,100 3,000 14,100 0 0 0 _ 0 0 0 0 0 0 0 0 0 0 0 0 TOTALS j 11,100 3,000 14,100 Task Activity Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount Biotoxin Monitoring Submit annual report on DOH approved Email Report to DOH by S44488$/3,600 • Collect monitoring samples on schedule according to format of activities for the year, including February 15,2024 Department of Health(DOH) Biotoxin Monitoring Plan, the number of sites monitored and samples coordinate deviations from the schedule with DOH, notify collected, and number and names of (See Special Instructions DOH in advance if samples cannot be collected. beaches posted with signs. below.) • Conduct emergency biotoxin sampling when needed. • Post!remove recreational shellfish warning and/or classification signs on beaches and restock cages as needed. • Issue biotoxin news releases during biotoxin closures in Jefferson County. • This task may also include recruiting,training,and coordination of volunteers,and fuel reimbursement funds for volunteer biotoxin monitoring. Exhibit A. Statement of Work Page 1 of 2 Contract Number CLH31013-Amendment 20 . c 4 t c k Co) 6 2 2 ^ .... § \ - � f & 0 & w = - a ■ 2 - 3 > _ ,f 7 / C / ) § .0 C k $ § I. _ § 2 = % R ' 2 % n % tC 2 2 ( k 0 , O e ' a - \ o 40 - B \ . g 2 k \ tt O - © w � �2 0 % § c \ A § 0 k a ƒ � ' / 7 2E E £ � 7 / : 2 - k � c � > 2 b - j U J $ o § _ \ % 2 / \ x ? � \ = \ $ , c ■ 2 \ k % . 2 § / t TI 2 � — ) c @ ° , 00k 2 ._ 7 a. \ � / / § � 2 5 k / / © 7 / 3 2 = _ � ... § 3 § k $ , _ f g \ \ 3 o _ gf f •0 2 -0 i o . 2 g e � § 7 B - 2 £ \ 5 / \ > 0) � § / 0 \ 5 � c c ■ 2 Co § k 5 k ( '© � � S - •® �▪ � % 2 2 \ E k c t c . = . - / / f 7 E t ._ _ _ 22 � 2 �7 / { , ( * k ƒ � k - 22 f 2 ( g 2 g k 0) a+ • i 7 ° r 7 - / � � � = � \ a \ \ / CL _8 0 0 2 .U 2 2 % CC / \ = 71) � \ \ � �\ k - _ c0 * J6 § / ; % £ qL. ) % E 2 Con o . , I. R 2 « % 4 • k E r E E © 0 o _ 2 k a I. i k : ] c = _ ƒ ® * § o f t • & Ifi° E u ¢ ~ EA in 0. 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'- e = u •U , F tn N OG C -di N N N N r•, M Tr .!/ .od E a c ivi� iyiyt� �lirt� -, _ � i H � t P - 000000 E 3 .OaC A . '3 - E c _ j1 00 0000o y - oC 00 ,1°„ O. y C .� v c - a u N N t- L. v, C f V V C p C LT. V) 0 C V N 0) �. Gi O' N N O' N 0+ N O! +ie eY C Q C K ^ M - a Q 44 O en M en Ti ri e-1 Ti en M Ti en 4.0f F. ^_ N w v. 6� L - .-. W Re J M M M M M M M M U. °� 7 G O 0 L O L 0 OG ° u c O >-. w a - co b a) °f N E 2 X •�, _-1 E C_ N N < N _< N Q v y y u .}- V N• = Q .� Z Zcc ZcZ � Z ems X� v L �� I,. 0 N w O - 0 0 0 c 0 u '- O 7 7 C O ,' L -1 CI CI N N to N — N - e, c y • v 0- c oA Lc, a+ ,i . 0 0 0 0 0 0 0 0 a ca is I-- 4 fr, O ��c In f y M el .. M el el M M a. N G = •E a N G . r,.% 2222222 N N • --... �r, 3 T o '. �- U e en * 69 > N 3 � a 3 I. cc " ! sH g N N L - A I. 3 0A ...= y V N _ W j vL SLo oc : H 0 y .l Lt • y-.. < ` 7a � vsa . 2 re • It N O <e eo 0 E w x v: �' v a pp.. `v = u . a� w F y aXi ? `' n � � a� C g1 M cO > _ A va Lr: - y °' f G ce r- Ili et s 44�- v b H n H e H I v: d,= Q u t. les • ..7 L ` 0 tt ca - y = a ^L '0 v _ .0 R s =Li. L X Z o i.y n. _ a, a a es. aCU te+ x E o4) 0 e C, 3 ,0 0 �a E Y. ms- o Wiz . y.� �_� a � E: e o 7 > E L = c 3 v ou ` eEc Ce eEo °G °� C° ac, N I. O Q-• G L. C h Q o1j 6 LL 44 Li q� W ...4 0 0 a � 3 o 0 5 e e. o �.. XXIssX csQa wmg' � C: ate; ` y y `. �' p y v '. °' °' °' 2 X awe 0=C o` = O. C o = c - e. (0 v •= = 44) - 44) G :tl rJ: w V; .0 a' V) a. E--' - y �j is emu,, u C U N N N M e•1 -7 "t v1 . Q N > (0 "0 eV tY N N f-I N N N v 3 � •v y w w O Le- } � � ic}c. c}L } Q W a cu0. s ti tr0 C G v: = cs. V: U. cn la. C-n E- i . — 0 -pp el 70 Z. .. �� ° - '= 5 E v `° � -° v - ca _ `" E °o E-: c E � 1 d o , E c e I > ero , o o a ST ° co j T • C � col O 'y _ vaON C E .04 ay c a ` = H A a .0 -0 O C >o . ag > p ua ..0 F 0 f.. • ti U G.� Fa u a .,na E 'C E H Qt -0 — a a a era CI a et) a B O s-• N a0'v > ohE �' L .0 E = a ea - -. -_ C �. e� ea y r •= eZa . _ tE Q 7 y a3 'EL a . .y = u) ,_ tn�+ 2 0 a _ w c c r L nO ! _ a E a Os O �. H u V s °a JZ C CO 6 c u U c a a E .S , r3 a > c = . J o .5aeoUyes ¢ Q -osseo0 — Ecs = Qu >. . sY0= 3 - $ Aa30 y' gO c > 0 0 w 0 a. es v, • o • U L 2 2 u a Q 0 _ 1. u .8 :° .ota z itiLin 'C. c N O = y r = 0- , . 0 O 6 0 L L < c .o < < L a y lc rs t a yc e4 a g O y •u c ..0 ° ? O ° CZ H ►• s.. F u T G G. G �' '� 'v: 0" ea 7 C. 40.06 es th o a �' w eo • .E to u c; 8 y V •U E to 2 OL co o E c � E u 2 2cc .= v> 5 .c +V+ i C011 j5, •yj. d "0 T C C cno 0 •v' e,a F o e -c h b u o E E •v u X . x r, �>,70 c y v a o _ cl- "O ' C N > •J O u y 2 0 u 0 e e `C a. re b • ea a = ay o co � F3 � •v E3 � y i.. U -u a s a a s U cd R v -0 .0 0 a ee E '> i s c -`0 .. eaC — a ;7. Q - a -to � v] L,i a 2 L •ea E •� c L'J.. Y 2 0 a O .�.. O 8 O 'C c Y/ . a sl L� Q .0 0 CI eC o E- -o - co 'O V: > ;n ea Q ° • • • • • • • teec o � y by a, CC m c a .n h t5. -o c e to _ OE o � > c 1 a is m c _a O a anuyL CU> fC ° a� F bQ u _ F F o aU >' = yO tu h 4 L • .+ \ 0 F A 22a a cc a e .2 e. � c5E7 ••_ 2 'ro ,.,g � a y t v. ce E 'o � w E • =°e ` 1 E � c• c U a '„ y c ° ; � � ., ,o CZ € ° ,-• $ - - CO ' v we ` > � = � ' � c3 � 2 � wQ so ov , c � c � -Ea o E :m o to aFa 1- co • c2` 3 r°o u a •E yO OG E G. L..� ... a Iv a7.4' C e F l O _ ` J ,� ^ ' ° c � > ^° ai c : • yaZEwe V. '° c =ai «F mp a _ bC . F e e w > >. • C O.'. q b4 7 .a . • : V rT., a �' n 'V C • aa a • < an � a ( ye.. a . 7 ` „ a = «+ Z H Q kiE4 ' ° ixr -80 G s y e S .E. vc E Ox' ' E v n r b ° c M E t' a 17 Et ta _`'- A : c ,c = E — ; U¢ u v P. 0 Q E u w— E =-, > e 'ti x E u Ci: E c. �, ,o c E 5 p — c >, ,. a y c e 1- a .a 2 T a :n o ;r ° a :, ce > c e o 0 c, c a T .0 •� a5 o0 v c °-' a .c L � %' :° U ,o E .. E -5 E e. os °>,•_ i '0C >, e'e -E o G. , e` 2 O: U .c 7 c a cc C a h — c-i e~i -4 s ac Li 3 z L W F r :i Page 22 of 33 Task Activity Deliverables/Outcomes Due Date/Time Payment Information Frame and/or Amount • Teens source,plus one, • People who are uninsured or underinsured, whichever is less. and/or low-income(at or below 250%of the Payment will be Rural poverty tine) The I5t of the calculated byR&E • Rural communities • Hispanic following month. provided by DOH(see • Black, Indigenous, People of Color CVR data submitted to DOH data contractor(Ahlers& Within thirty(30)days Reporting Extra efforts should be made to provide information Associates)electronically in a format compatible with of receiving Requirements table). and services to people who intersect with multiple Ahlers software. error/rejection report priority population categories. or request from DOI I All services must be • Data for each month Sexual and billed within 60 days of Provide all services in accordance with: Reproductive Health the budget period, with • DOH SRHP&Title X Manual • Corrected CVR data data manager. the exception of the December billing that is • Other state and federal requirements due within 45 days to • Reporting Requirements(see below) meet federal reporting D. Collect,maintain,and provide data about each As needed to keep requirements. family planning clinic visit as defined in the Email briefly describing change. information current. SRH CVR Manual. 1. Maintain a computer system that includes safety precautions against loss of information. 2. Ensure data entry personnel protect confidentiality of CVR data. 3. Have ability to retrieve all information for auditing and monitoring by DOH or its designee. E. Notify DOH contract manager of all: • Key staff and organizational changes. • Proposed clinic site additions.New clinic sites must be approved by DOH before offering services supported by SRHP/Title X funding. • Expected clinic site closures. Note: DOH may,at its sole discretion,recalculate LIIJ's funding allocation if it closes a clinic site. • Any other change that might affect LHJ's ability to provide the sexual and reproductive services described in this SOW. Exhibit A,Statement of Work Page 3 of 7 Contract Number CLII31013-Amendment 20 0 C ON 0 CO c PI E O fl 0 E C IS E N ♦r 0 t.1 a'V .O d• E c Co i en a x U .. ca .c C 4.. Go � � = o E E c to .0 _ 7 c c ea es "0 -0y 7 O 0 4� 7 c Cr. °° v •^ ,� O 0 c o o c Lr. M 7 ate, u «., T. Q u U 0 o yea >, en °' y .. € EE v 0. '0 Z N Crv4° c JD °' .0 v C EA 'j 0 '1. 70 V �, :' .0 .coo isv J ta '7 ..� "' > L •"0' a 7 A 11111111 r 0C' c >• , •. V b a' O O .0 4•0Jp IGaaa _ cti = � •oV ai` 0c�' ° +' v ::. •fl ;; CO .0 .0 cci 't w '� — 0 O .VM. V L C O G. V 0 7 C ,AU a) a' .O .0 OA vvoi c Yy. -a O aCi u c .. •c V y = _ V C tun E O C H ' > H ,N 0 L 'L C C ! N t7 V •O to R = :66 C R 'n O • V 3 L 13 ! r1trb to `��' O oa.0 ¢ O L 'd v °' _ av,' 4V3114jIVHU1 ! id 0 OA mu ° ° ¢ C e�ca CL c .V. OD >, as U °�' 0 0 .o ;b °' s 0 ` • es � � u u ° u ea en !, a' 3 v .c L O — a.. O 0 L y O L.L. 0 ° b •_ C N = 0 a' a' Vl •0 L t•-• .-• •-• c ~ e«: C N •'CI c yr +, .c at � en q,,, 4,,, � � c = " 37 C C s.. V to y .. 0 e3 c 4-. "O Z= C .- E c E m c c o o c3 c c o - = 3 0 o c .- ^ 0 L M c S oo cn :. 00.; e7 o en L ++ v L O .0 _ 4. UUCCODU O � '� u 3 — = a' 5 c V] k, o S � a I M a�ci 1) as °' s 0 o i = p0 8 = V � 7. o � .... u C '= x x 2 z F O2 td .0 ci •c 6 t.•: E 'z U o.olt .1 to 0 •v .� - in .= H " 0E-" o E � . $ QmUO [i ^ 2 < m ° x °' O C 7 o 0 e � 0 0 a 3 0 u TAc w Lcc = '> 'vv e� ..c° •- iijlfl ct C ° C E = 2 z o vi 0 Q' o s O i. CT � 3sIt ° '�° 2 , _6soC � . /E 4- v > .. ho a e O. a aui 0. c s 0`. >CIE E .. x1:4 g .. . a, xcu • ' $cri _ •> C = � r enO _ u .. c u 7; y = Co. Y Q 0 4 % N .E o E E o Oil a —' i E 0 L C V t F Page 24 of 33 Task Due Date/Time Payment Information Activity Deliverables/Outcomes Frame and/or Amount c. LHJ must not implement a revised fee schedule until it has been approved in writing by DOH. d. Income conversion tables must be updated annually and approved by DOH Information related to current Community Outreach Plan: LHJ's community outreach plan follows a 5-year cycle. This process must include the following steps: A. Utilize the state level priority populations,county level demographic data,and agency profile to identify unmet need in the community served. B. Determine objectives and activities to expand sexual and reproductive health to reach populations in need of services in the community served. C. Measure completion of the objectives and activities. 2. Progress Updates This information must be reported using the template During quarterly or format provided by DOH. It will include information check ins and as Summary of ongoing activities related to the about contractor's work during current and past requested by DOH SRH Program. SOWs: It informs quality improvement of the A. Community education and outreach strategies and Washington State SRH Network. activities and a discussion of their etTectiveness. B. Staff training. 3. Family Planning Annual Report(FPAR) Organization-level data on clinical services emailed to Data to he collected DOH SRH data manager annually through the Information DOH is requesting to develop trend end of the grant data. All information is for the calendar year Number of: (2027). (January through December).The subsequent A. Pap tests with an ASC or higher result agreements sent to the agency will request that B. Pap tests with an HSIL or higher result these data be collected and reported on within C. HIV Positive confidential tests the statement of work period of performance. D. HIV Anonymous tests E. FTE required to provide sexual and reproductive health services: • Physicians • Physician assistants+nurse practitioners+ certified nurse midwives • Registered nurses with expanded scope of practice who are trained and permitted by state specific regulations to perform all aspects of the physical assessment. Financial data emailed to DOH Contract Manager R&E showing Other Revenue through the end of the grant as described below. Exhibit A, Statement of Work Page 5 of 7 Contract Number CLH31013-Amendment 20 ie o ; e < 0 M E o >. 72. o B u6 .. c L.', L et st) t te . < N V = >. y. 0 cn — a E a . E g — cI x LI 0 0 -0 E b O L = d o _E V I. F.. ,... r E.-. 0 E F u y k t 0 g `� s 0,0 z c 1° aci v 5 ti cua, be z L C N EL. o •r. �i J ? '� J = A Q w CL.7 •3 = •U •O H 'C J p J L V to = i,cA6= . C v V .40 w3o � ►. cn CA .� 8gcr a: yy .0va..ph — A C. II c c C C w a F. -p p.,, 7 — '') c L = = 6o a - N 0 N VL .8 C 61 y i v c .y C • teaa o 'cN a.osgy S o = :: — yp u - g GC ° NI CI o m a° > 3F CC at 06 eos r • s cv e: o 3UE I1Ifl o b `� 4i :: « o40E °vc Ii C N W G C p u x I illcv a -4 y :e E ; s E a $ c eo ` 0.`i e U c ° •° re eD c i 3 C� o' °- a -- w s •3 , > i7E ? > .0 _ °e' w o c u s°. 3 v u e 3 = 0 7 V pr Ca N E E u v) 0 04 0 3 c� 17, o• .a EpG tdw 3 ; 6 .= U y =L. `o itia a C.Y cv co L v �° w I. a E o Q •v = P' . v a id a •a c' 'r w v `o H -, .> s C .= a 3 a � � w c � co .0 .0, ° :: 3 � °L' ��y �= 3 c °u' � � � w � Y o ^A O • a/ C t"if h O y y L QO `v CSC Gal A > L. H ou i «. z'0 P. L 0 3 E < ti Id o 0 w n a c o?3 >, o o 3 aei e y _ 3 . p OD vs OL a ... co e c cg a, u E . tb 3x 4. b U aEiT0 .. er E . _ vcE u VC 44 5' 4,' € = Q - U 1" tr) < w E °L' c .� u [iC cve c •• �x •VI ao h .0 w . , 0. CT >, t s . 3 E v a. 'E > V °) cn a U C z ¢ — c O a+ 0 e u L •Q m — �' cs Q p cn ce U .. 3 v, e U Cn Q 'v F u — c o Q ` E • fa. • .0,U_ c • Lz E 31 w 0 QcCU L o >u c QLi drI Ld ° w w °� 4. O -0 ii gan O L 1 cy = ° cc H O - , _ L = .0 u y u OS tfi G, C w ea, _ u CC 10 T. :: -0 0 y ca e v E g .= y 3 3 he es •V3 `, O vi C. O ea C •� Q Y CJ i C = .O F. V Q: E u w s_ 2 as v c o — as L e u 3 in t• a a °' U L 3 N •C in s ao s)C Q •C C Uf = es g E Q 6! 4) o c en rnco t u a 4 c en C L. � se t u . C: > N c c = O C 0 M :4 a Z u c a) C u aci 4 c es c-i Q c.. 0 o 00 c c...) c u v, Lc w c se c o o it e... o. N V C I a C W u C a C 2 Pc 6)A u N V o a) i WI O en R 3 eel c V. z' a• E Q v C a O ce c 13 >, O 2 17 d r oA • v (,) `� p D4 is C v; C. V Y G C O se .J C 0!) V "a iog 'C ca M C vi y N 00 1... O te 7 O, C O .O. > v ad cu vies c. u 0 ✓1 .G > en cx i -T3 a t ao - — ! cc p, y O C .� a `� '� • c7 O OL E y c-A se o C �l YO d " C >. V L 4 •- _ C O ✓+v Cl. — O . C Q O i °) a) O •,.. cC v O N = 04 , C 4 O ,� N 7 V_ V y :n V O 6) M a) v' a N .G>' c c.. 0 a, y o •c 0 $ pp E -0 c c o •d Cr M t C N y G .J .d V A V C V IiV.. V ; a O v7C V rt >, V V _ t V Q Cd C tV-. .q :... :n c) C .D j N 4) - E 'i > v u v C . H .O. V• ... e° •(. 0T7 .0. € V •c N N = Q CR L .0 N > 72 O E Y cC N O Ncc u E a) '0' i C O >' R -E R V i :J N j L lE 3 ¢ C) N O > o c C o o — 3 CC o ►. :� a v V y .0 E c� 0 E co es u a O v w • H o y e0A >' pOIlIHU . 0 CN•> W J 7 " .1a� o o N - o = on Le vc 4. ar O •V IIUHIIIU d L C O O a a >, N d Q `Qn. E Cc% WH1 ill v Oo > ca _ y = f c4 �° '� Z v o .'CE 2 0 0 0 o U .t c• e 0 > p 1 ctn a. e e g c co ego ' C bA �) • • • C C. . N •• • • • • .] E ."'i, u.) _ti .. J C C se COcn c/) Q Q1— O x 0 r V7 W Page 27 of 33 Exhibit A Statement of Work Contract Term: 2022-2024 DOH Program Name or Title: WIC Nutrition Program -Effective January I,2022 I.ncal I Ie.ilth .Iurimdiction Name: Jefferson County Public Health Contract Number: CLH31013 SOW Type: Revision Revision#(for this SOW) 11 Funding Source Federal Compliance Type of Payment ® Federal Subrecipient (check if applicable) ® Reimbursement Period of Performance: January I.2022 through December 3 I.2024 El State El FFATA(Transparency Act) El Fixed Price ❑Other ❑ Research&Development Statement of Work Purpose: The purpose is to provide Women,Infants,and Children(WIC)Nutrition Program services by following WIC federal regulations,WIC state office policies and procedures,WIC directives,and other rules. Refer to the Program Specific Requirements section of this document. Revision Purpose: To add FFY24 USDA WIC CLIENT SVS CONTRACTS funds. Master Assistance BARS Allocation Index Listing Revenue LIIJ Funding Period Current Change Total DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation FFY22 USDA WIC CLIENT SVS CONTRACTS 76101234 10.557 333.10.55 07/01/22 09/30/22 86,376 0 86,376 FFY23 USDA WIC CLIENT SVS CONTRACTS 76101244 10.557 333.10.55 10/01/22 09/30/23 132,338 0 132,338 FFY22 USDA BFPC PROG MGMT 76214231 10.557 333.10.55 01/01/22 09/30/24 43,389 0 43389 FFY22 USDA FMNP PROG MGMT 76540237 10.572 333.10.57 05/01/22 09/30/22 516 0 516 FFY23 USDA BFPC PROG MGMT 76214241 10.557 333.10.55 10'01/22 12/31/24 37,651 0 37,651 FFY23 USDA WIC PROG MGMT CSS 76101242 10.557 333.10.55 01/01/23 09/3023 2,800 0 2,800 FFY24 USDA WIC CLIENT SVS CONTRACTS 7610124B 10.557 333.10.55 10'01/23 09/30/24 155,011 743 155,754 FFY23 USDA FMNP MGMT 76540248 10.572 333.10.57 06/01/23 09/30/23 496 0 1 496 FFY24 USDA BFPC PROG MGMT 7621424A 10.557 333.10.55 10/01/23 09/30/24 37,651 0 37,651 FFY25 USDA WIC CLIENT SVS CONTRACTS 76101251 10.557 333.10.55 10/01/24 12/3124 26,268 0 26,268 FFY24 USDA FMNP MGMT 76540241 10.572 333.10.57 05/01/24 09/30/24 496 0 496 0 0 0 TOTALS 522,992 743 523,735 Task Payment # Activity Deliverables/Outcomes Due Date/Time Frame Information and/or Amount See"Billing 1 WIC Nutrition Program Requirements" below. I.I Outcomes based on monthly participation Authorized participating Maintain authorized participating caseload at 100%based on data from state WIC caseload management caseload for January 2022 quarterly average as determined from monthly caseload reports. through December 2024= management reports generated at state WIC office. 250 Exhibit A, Statement of Work Page I of 7 Contract Number CLI-131013-Amendment 20 .Q 7 p 7 a v . E u t C° a = . 'y 4c 3 4+ neei E .° o . •F> e N > vN E o. E Q CJ M .� Q' p I-. aI- f^ g > ' Q, o • 0. o 00 ° Ca = 0. •v 0.. c -0 n 0 .0 - 2 ar c N II N N N M {.) E ism O f?N N M 0,1 O >,O O CVL.N CV CV i 33 CM 4' E.N N 0 N O O o �`°r N C N �'� C — N M N CU Li. •p O CNI .a L NrnO Nam_ p .3 en p = M O .: raj a N c� s II N .3 O Orn o c C c O O, r,y e L E L p L E .o " r� ea ." es aE+ °, uc o� L c a °u — E E u E '" c v r CNN r ,. U _ J U v fl u ,� V = 'O ;a 10 1.4 3 •yN L 34- 7 `° L 3 3 3 3 '0 b 'n 01 sq u N -O E es aQ 0 0 .0 3 -0Z ( � J NM ,r ` >+ `° � � >,� aa? 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WA 98368 l f n www.JeffersonCountyPublicHealth.org U` Consent Agenda Public Heal JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Mark McCauley, County Administrator FROM: Apple Martine, JCPH Director Veronica Shaw, JCPH Deputy Director DATE: J L I( r , ?CZ SUBJECT: Agenda Item — Consolidated Contracts Amendment #20 with the Department of Health; January 1, 2022 — December 31, 2024; additional $1,218,566 for a total of $9,416,279 STATEMENT OF ISSUE: Jefferson County Public Health (JCPH) requests Board approval of Consolidated Contract Amendment #20 between JCPH and State of Washington Department of Health (DOH); January 1, 2022 — December 31, 2024; additional $1,218,566 for a total of $9,416,279. ANALYSIS/STRATEGIC GOALS/PROS and CONS: The purpose of this agreement is to provide public health services to the people of Washington State. This Amendment adds and/or amends statements of work (SOW) and funding for the following programs: • Executive Office of Resiliency & Health Security; revision extends period of performance and adds additional due date for data collection. • Foundational Public Health Services (FPHS) funds governmental public health system; adds new SOW and funds to build FPHS system's capacity and increase the availability of FPHS services statewide (funding of $1,166,500). • Recreational Shellfish Activities; this revision adds funds for biotin monitoring (additional $3,000). • Sexual & Reproductive Health Program; adds funds for period 7/1/2024 — 12/31/2024 (additional $48,323) • WIC Nutritional Program; provides additional funds (additional $743) FISCAL IMPACT/COST BENEFIT ANALYSIS : Total consideration for this Contract Amendment is an increase of $1,218,566 for a total of $9,416,279. The Consolidated Contract is funded by DOH, and comprises both Federal and State funds. Community Health Developmental Disabilities Environmental Public healtt 360-385-9400 360-385-9444 360 385-9401 III (f) 360-3/9.4487 Always working for a safer and healthier community RECOMMENDATION: JCPH Management recommends BoCC approval of Consolidated Contract Amendment #20; January 1 2022 — December 31, 2024; additional S1,218,566 for a total of S9,416,279. REVIEWED BY: / -4..._z_.,.....6 -is 74 -9/0 Mark McCauley, County ministrator Date Community Health Environmental PJblic Health Developmental Disabilities 360-385-9444 360-385-9400 Always working for a safer and healthier community (fl 360-379-4487 360 385 9401 (') CONTRACT REVIEW FORM I Clear Form I (INSTRUCTIONS ARE ON THE NEXT PAGE) CONTRACT WITH: Stale of WA Dept of Health Contract No: CC-22-002-A20 Contract For: Consolidated Contracts, Amendment 20 "fern: /11/2022 - 12/31/2024 COUNTY DEPARTMENT: Public Health _ Contact Person: Veronica Shaw Contact Phone: x 409 Contact email: veronica@co.jefferson.wa.us AMOUNT: Additional$1,218,566 for a total of$9,416,279 PROCESS: ✓ Exempt from Bid Process Revenue: $1,218,566 Cooperative Purchase Expenditure: Competitive Sealed Bid Matching Funds Required: — Small Works Roster Sources(s) of Matching Funds ,,.— Vendor List Bid Fund # 127 RFP or RFQ Munis Org/Obj 12756220 Other: APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFIES COMM F.W Ii 55. AND CHAPTER 42.23 RCW. CERTIFIED: ® N/A: June 26,2024 Signature Date STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE COUNTY (CONTRACTOR) HAS NOT B N DEBA ED BY ANY FEDERAL, STATE, OR LOCAL AGENCY. CERTIFIED: fl N/A: ❑ June 26,2024 Signature Date STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche): Electronically approved by Risk Management on 7/3/2024. Amendment to a state contract. Cannot change. STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche): Electronically approved as to form by PAO on 7/4/2024. State language - cannot change. Contract amendment. 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