HomeMy WebLinkAboutDoc 021 - IGA - Health Svcs with OHADeschutes County Board of Commissioners
1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 -Fax (541) 385-3202 -www.deschutes.org
AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of January 29, 2014
DATE: January 22,2014
FROM: Nancy Mooney, Contract Specialist, Deschutes County Health Services, 322-7516
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2014-021, Amendment #4 to Intergovernmental Financial
Agreement Award #142008 between the Local Public Health Department and the Oregon Health Authority for the
financing of Local Public Health Services for fiscal year 2013-2015.
PUBLIC HEARING ON THIS DATE? No.
BACKGROUND AND POLICY IMPLICATIONS:
OHA is at the forefront of lowering and containing costs, improving quality and increasing access to health care
The Oregon Health Authority (OHA) was created by the 2009 Oregon legislature to bring most health-related
programs in the state into a single agency to maximize its purchasing power; the amendment to
Intergovernmental Agreement (#142008) outlines the services and financing for fiscal year 2013-2014.
There are separate grants associated with individual public health programs represented in the
Intergovernmental Agreement, ranging from disease prevention and maternal child health to school based
health centers, women, infants and children (WIC), bioterrorism preparedness and family planning. Each grant
has an associated set of Program Assurances that are the service and quality performance expectations
connected with the delivery of the various components of the program itself.
Amendment #4 award funding to Program Element #44, School Based Health Centers $816,830, for counties
with more than one certified School Based Health Center to increase mental health capacity and support
mental health projects during the 2013-2015 biennium.
In addition, funds are awarded to Program Element #12, Public Health Emergency Preparedness as a Mini
Grant, $27,000, award to develop and exercise a medical surge plan that will culminate in a regional full-scale
exercise in June 2014.
FISCAL IMPLICATIONS:
Maximum funding reimbursement for this Amendment is $843,830
RECOMMENDATION & ACTION REQUESTED:
Approval and Signature of Document #2014-021, Amendment #4 to Intergovernmental Financial Agreement Award
#142008 between the Local Public Health Dept. and the Oregon Health Authority is requested.
ATTENDANCE: Linda Webb, Clinical Program Supervisor
DISTRIBUTION OF DOCUMENTS:
Please fax or e-mail entire amendment to Connie Thies; e-mail: connie.thies@state.or.us, Fax 503-373-7889.
Please return executed documents to Nancy Mooney, Contract Specialist
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DESCHUTES COUNTY DOCUMENT SUMMARY
(NOTE: This form is required to be submitted with ALL contracts and other agreements, regardless of whether the document is to be
on a Board agenda or can be signed by the County Administrator or Department Director. If the document is to be on a Board
agenda, the Agenda Request Form is also required. If this form is not included with the document, the document will be returned to
the Department. Please submit documents to the Board Secretary for tracking purposes, and not directly to Legal Counsel, the
County Administrator or the Commissioners. In addition to submitting this form with your documents, please submit this form
electronically to the Board Secretary,)
Please complete all sections above the Official Review line.
Date: Ranuary 9,2014 1
Department: 1 Health Services, Public Health Division .1
Contractor/Supplier/Consultant Name: I Oregon Health Authority I
Contractor Contact: 1 Connie Thies, Office of Contracts & Procurements I
Contractor Phone #: 1 503-373-7889 1
Type of Document: Amendment #4 to Intergovernmental Agreement #142008
Goods and/or Services: This amendment is awarding funding to the School Based Health
Center Program and for a Public Health Emergency Preparedness Mini-Grant.
Background & History: The Oregon Health Authority (aHA) was created by the 2009
Oregon legislature to bring most health-related programs in the state into a single agency
to maximize its purchasing power; the amendment to Intergovernmental Agreement
(#142008) outlines the services and financing for fiscal year 2013-2014.
There are separate grants associated with individual public health programs
represented in the Intergovernmental Agreement, ranging from disease prevention and
maternal child health to school based health centers, women, infants and children
(WIC), bioterrorism preparedness and family planning. Each grant has an associated
set of Program Assurances which are the service and quality performance expectations
connected with the delivery of the various components of the program itself.
Amendment #4 award funding to Program Element #44, School Based Health Centers
$816,830, for counties with more than one certified School Based Health Center to
increase mental health capacity and support mental health projects during the 2013
2015 biennium. Funds are awarded to Program Element #12, Public Health Emergency
Preparedness as a Mini-Grant award to develop and exercise a medical surge plan
which will culminate in a regional full scale exercise in June 2014.
Agreement Starting Date: I July 1, 2013 I Ending Date: I June 3D, 2015
Annual Value or Total Payment: 1 Total amount of amendment is $843,830.
I
119/2014
1
I Check all that apply:
D RFP, Solicitation or Bid Process
D Informal quotes «$150K)
~ Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37)
Funding Source: (Included in current budget? ~ Yes D No
If No, has budget amendment been submitted? DYes D No
Is this a Grant Agreement providing revenue to the County? D Yes ~ No
Special conditions attached to this grant:
Deadlines for reporting to the grantor:
'------'
If a new FTE will be hired with grant funds, confirm that Personnel has been notified that
it is a grant-funded pOSition so that this will be noted in the offer letter: DYes D No
I Contact information for the person responsible for grant compliance: Name:
Phone#:D
I Departmental Contact and Title: I Nancy Mooney, Contract Specialist
Phone #: I 541-322-7516 I
1
Department Director Approval: __ I \ 0 l ~
Date
Distribution of Document: Please fax or e-mail
e-mail: connie.thies@state.or.us, Fax 503-373-7889. Please return executed
documents to Nancy Mooney, Contract Specialist
Official Review:
County Signature Required (check one): 00 BOCC 0 Department Director (if <$25K)
o Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. ____-1)
Legal Review Date /-17~ 11W (lfodJ
Document Number =20.:..1-,-4'--..wO~'2..."",-,I,--_____
--:__=+-+.>L----
ntire amendment to Connie Thies;
1/9/2014
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PUBLIC HEALTH DIVISION
Adolescent, Genetics and Reproductive Health Section ~alth
-----t\uthorityJohn A. Kilzhaber, MD. Governor (J, t: /Ztfe
800 NE Oregon St., Suite 805L'r\ddPortland, OR 97232ShEr("1December 20, 2013 Voice: (971) 673-0249
';1U1ty FAX: (971) 673-0250
Scott Johnson, Director TTY: (971) 673-0372
Deschutes County Health Services
2577 NE Courtney Dr.
Bend, OR 9770 I
Dear Mr. Johnson,
The School-Based Health Center (SBHC) State Program Office (SPO) is pleased
to announce the successful award of SBHC mental health expansion funds to
Deschutes County Health Services in the amount of $846,830 to increase mental
health capacity and support mental health projects during the 2013-2015
biennium.
Deschutes County Health Services will receive a contract amendment under
Program Element 44 for the purpose of supporting the mental health expansion
grant activities in the school-based health centers in your county. In the meantime,
here are the program highlights ofthe agreement:
Expectations
A. Award monies must be used to support mental health capacity within the
school-based health center system by adding mental health staff and
expanding current mental health staff hours, with the ability to collect and
report on mental health encounter visits.
B. Award monies must also be used to support mental health projects within
the school-based health center system and help the SBHC integrate physical
and mental health, specifically: (1) Implementation ofa Mental Health
Screening Tool or Framework; (2) Implementation ofa Youth Advisory
Committee and Mental Health Research Project; and (3) Integration ofa
Data Capturing System.
C. Awardees will be expected to provide services that are culturally and
linguistically appropriate to their target population.
D. Awardees will be expected to track data related to mental health encounters
as outlined in the SBHC Certification standards. SBHC Certification
standards are available at www.healthoregon.orglsbhc.
E. Awardees will be expected to create and implement an evaluation plan for
their projects in collaboration with the sPa. The evaluation plan will
include the creation of a logic model, projected output and outcomes, and
measurement of these outputs and outcomes. Technical assistance
throughout this process will be available.
F. Awardees will be expected to participate in monthly check-in meetings (via
phone or email) with the spa and submit 1-2 mid-project reports and a
final project report, as determined by the evaluation plan. Guidance will be
given on expected report content.
Funds
Funds for this project must be spent by June 30, 2015. The maximum amount of
the contract amendment will be $846,830. Any unspent grant funds during FY14
may be rolled over into FY15. Grantees are expected to provide services during
entire project period ending June 30, 2015. Future funding is unknown at this time
and will be determined by the legislative adopted budget and evaluation outcomes.
Reporting Requirements
You will be required to submit 1-2 mid-project reports, depending upon project
goals. Reporting requirements and due dates will be determined by the evaluation
plan timeline which will be developed in February 2014. Grantees will be
required to submit mental health encounter data to spa three times during the
contract period (July 15,2014, January 15,2015 and July 15,2015). Grantees will
also provide a final report that includes qualitative and quantitative data as part of
the evaluation plan. Final reports are due no later than July 15,2015.
Technical Assistance
The SBHC State Program Office will provide on-going technical assistance in
your efforts to increase mental health capacity, collect mental health encounter
data, and create an evaluation plan and final report. An initial check-in call will be
held in February to review grant expectations and to develop a workplan and
evaluation strategy. spa will contact the individual grantees by January 15,2014
to set up a February call.
In the meantime, we recommend grantees and community partners visit the SBHC
State Program website for more information about SBHCs in Oregon:
www.healthoregon.org/sbhc
Kate O'Donnell, SBHC Systems Development Specialist, will be your primary
contact at the State. She may be reached at 971.673.1054 or via e-mail at
kathryn.m.odonnell@state.or.us.
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Thank you for your commitment to expand the provision of mental health services
I to children and youth in your community. The staff of the SBHC State Program
Office looks forward to working with you and your county in promoting health
and mental health care access to youth in our schools.
I Sincerely,
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ica E.A. Duke, MPH
tescent and School Health Manager
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Kathryn O'Donnell, MPH
SBHC Systems Development
Specialist
Nancy Mooney p?010-0 2 1
From:
Sent:
To:
Thomas Kuhn
Tuesday, December 31, 2013 3:05 PM
Nancy Mooney
Subject: RE: Amendment #4 to OHA contract #142008. ready for signature approval
Hi Nancy,
I affirm that I have read Amendment #4 in its entirety, that we can accept/accomplish the required
work and that signing this document is recommended. Changes in this contract which affect my
program areas include:
-PE 12 PHEP mini-grants -Received an increase of $27,000 to develop and exercise a medical surge
plan which will culminate in a regional full scale regional exercise in June 2014
I've read the document and approve the Statement of Work as it is set forth in this agreement.
Sincerely,
Tom Kuhn, M.S.Ed.
Deschutes County Health Services
Community Health Program Manager
2577 NE Courtney Dr.
Bend, OR 97701
Ph:(541) 322-7410
Fax: (541) 322-7465 \ thomask@deschutes.org
-----Original Message----
From: Nancy Mooney
Sent: Monday, December 30,2013 12:08 PM
To: Kate Moore; Thomas Kuhn
Subject: Amendment #4 to OHA contract #142008, ready for signature approval
Tom/Kate,
Please provide your affirmation that you have read this document in its entirety, that we can
accept/accomplish the Statement of Work and that signing this document is recommended.
Please note upon e-mailing your consent for signature that you're confirming you've read the
document and reviewed/approved the Statement of Work as it is set forth in the document.
Thank you,
Nancy Mooney
Contract Specialist
Phone: 541-322-7516
Fax: 541-322-7565
Nancy Mooney
From: Linda Webb
Sent: Monday, January 06, 2014 11:18 AM
To: Nancy Mooney
Subject: RE: Amendment to OHA contract 142008-4 is ready for approval
I have read the attached document and verify our intention to accomplish the statement of work.
recommend this document be signed.
Linda Webb RN
SBHC Supervisor
Deschutes County Health Department
541 322-7405
lindaw@deschutes.org
-----Original Message----
From: Nancy Mooney
Sent: Monday, January 06, 2014 10:32 AM
To: Linda Webb
Subject: FW: Amendment to OHA contract 142008-4 is ready for approval
Importance: High
Linda,
Would you be comfortable approving this amendment for the SBHC portion of this amendment? If so,
please provide your affirmation that you have read this document in its entirety, that we can
accept/accomplish the Statement of Work and that signing this document is recommended.
Please note upon e-mailing your consent for signature that you're confirming you've read the
document and reviewed/approved the Statement of Work as it is set forth in the document.
Thank you,
Nancy Mooney
Contract Specialist
Phone: 541-322-7516
Fax: 541-322-7565
Deschutes County Health Services
2577 NE Courtney Drive
Bend, OR 97701
-----Original Message----
From: THIES Connie [mailto:connie.thies@state.oLus]
Sent: Monday, December 30, 2013 11 :41 AM
To: Nancy Mooney; Scott Johnson; Sherri Pinner
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ADMINISTRATIVE SERVICES DIVISION)tQtj~'tm'''t
of Human Services Office of Contracts and Procurement
John A. Kitzhaber, MD, Governor 250 Winter St NE, Room 306
Salem, OR 97301
Voice: (503) 945-5818
FAX: (503) 378-4324
DOCUMENT RETURN STATEMENT
Re: Amendment #06 to Agreement #141408 hereinafter referred to as "Document."
Please complete the following statement and return it along with the completed signature page and the
Contractor Data and Certification page and/or Contractor Tax Identification Information form (if
applicable ).
Important: If you have any questions or find errors in the above referenced Document, please contact
the contract specialist, April D. Barrett at (503) 945-5821.
(Name) (Title)
received a copy of the above referenced Document, between the State of Oregon, acting by and through
its Oregon Health Authority, and Deschutes County, bye-mail from Tami Goertzen on December 18,
2013.
On _________, I signed the electronically transmitted Document without
(Date)
change. I am returning the completed signature page and Contractor Data and Certification page and/or
Contractor Tax Identification Information form (if applicable) with this Document Return Statement.
(Date)
1~:.t:rlJ
\ LEGAL COUNSEL e~lth
-----Authority
Agreement #142008
FOURTH AMENDMENT TO OREGON HEALTH AUTHORITY
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE
FINANCING OF PUBLIC HEALTH SERVICES
In compliance with the Americans with Disabilities Act, this document is available in
alternate formats such as Braille, large print, audio recordings, Web-based
communications and other electronic formats. To request an alternate format, please
send an e-mail to dhs-oha.publicationrequest@State.or.us or call 503-378-3486 (voice)
or 503-378-3523 (TTY) to arrange for the alternative format.
This Fourth Amendment to Oregon Health Authority 2013-2015 Intergovernmental Agreement
for the Financing of Public Health Services, effective July I, 2013 (as amended the "Agreement"), is
between the State of Oregon acting by and through its Oregon Health Authority ("OHA") and
Deschutes County, acting by and through its Deschutes County Health Services ("LPHA"), the entity
designated, pursuant to ORS 431.375(2), as the Local Public Health Authority for Deschutes County.
RECITALS
WHEREAS, OHA and LPHA wish to modify the Financial Assistance Award set forth in
Exhibit C of the Agreement.
NOW, THEREFORE, in consideration of the premises, covenants and agreements contained
herein and other good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, the parties hereto agree as follows.
AGREEMENT
1. Section I of Exhibit C entitled "Financial Assistance Award" of the Agreement is hereby
superseded and replaced in its entirety by Exhibit I attached hereto and incorporated herein by
this reference. Exhibit I must be read in conjunction with Section 4 of Exhibit C, entitled
"Explanation of Financial Assistance Award" of the Agreement.
2. LPHA represents and warrants to OHA that the representations and warranties of LPHA set
forth in Section 2 of Exhibit E of the Agreement are true and correct on the date hereof with the
same effect as ifmade on the date hereof.
3. Capitalized words and phrases used but not defined herein shall have the meanings ascribed
thereto in the Agreement.
2013-2015 AGREEMENT FOR THE .'INANCING OF PUBLIC HEALTH SERVICES PAGE 1 OF 6 PAGES
142008-4 PGM.DOC -DESCHUTES COl'NTY
DC -20 1 4 - 0 2 1
4. Except as amended hereby, all terms and conditions of the Agreement remain in full force and
effect.
5. This Amendment may be executed in any number of counterparts, all of which when taken
together shall constitute one agreement binding on all parties, notwithstanding that all parties
are not signatories to the same counterpart. Each copy of this Amendment so executed shall
constitute an original.
6. This Amendment becomes effective on the date of the last signature below.
THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK
2013-2015 AGREEME~T FOR THE FINANCIr\G OF PUBLIC HEALTH SERVICES PAGE 2 OF 6 PAGES
142008-4 PGM.DOC -DESCHUTES COUNTY
IN WITNESS WHEREOF, the parties hereto have executed this Amendment as of the dates set
forth below their respective signatures.
7. Signatures.
STATE OF OREGON ACTING BY AND THROUGH ITS OREGON HEALTH AUTHORITY (OHA)
By:
Name: Bobby L. Green, Sr.
Title: Interim Deputy Public Health Director
Date:
DESCHUTES COUNTY ACTING BY AND THROUGH ITS DESCHUTES COUNTY HEALTH SERVICES
(LPHA)
By:
Name:
Title:
Date:
DEPARTMENT OF JUSTICE ApPROVED FOR LEGAL SUFFICIENCY
Approved by D. Kevin Carlson, Senior Assistant Attorney General on May 21, 2013. Copy of
approval onfile at aHA, OC&P.
REVIEWED:
OFFICE OF CONTRACTS & PROCUREMENT
By:
Name: Phillip G. McCoy, OPBC, OCAC
Title: Contract Specialist
Date:
2013-2015 AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 3 OF 6 PAGES
142008-4 PGM.DOC -DESCHUTES COUNTY
EXHIBIT 1
FINANCIAL ASSISTANCE AWARD
1) Grantee
State of Oregon
oregon Health AU1hority
Public Health Division
2) Issue Da1e
Name: Deschutes County Health Dept December 17. 2013
Street: 2577 N. E. courtney 3) Award Period
Page 1 of 3
This Action
AMENDMENT
FY20'14
City: Bend From July 1,2013 Through June 30, 2014
State: OR Zip Code: 97701
4) DHS Public Health Funds Approved
Previous Increasel Grant
Program Award (DecreaSe) Award
PE 01 State Support for PubliC Health 177.353 0 177,353
( a )
PE 03 TB Case r...1anagement '1.216 0 1,216
PE 07 HIV Prevention Services 29,874 0 29.874
HIV Prevention Block Grant Services
Ryan White Tille II HIV I AIDS Services
PE 08 Ryan White--Case Management 76.282 a 76,282
PE 08 Ryan Whlte--Support Services 26,786 0 26,786
PE12 Public Health Emergency Prepareoness 109.421 a 109,421
!PE 12 P.H.E.P Mini Grants 0 27.000 27,000
!
iPE 13 Tobacco Prevention &Education 132,932 0 '132,932
PE 15 Healthy Communities Phase II 81,250 0 81,250
w.en, InfanlS and ChiiOren 656,452 0 656,452
FAI\·1ILY HEALTH SERVICES (cdjK)
C --PEER Counseling 44.100 0 44,100
FAMIL Y HEAL TH SERVICES (Q,h)
5) FOOTNOTES:
a) Based on the certified population estimate of July 1, 20'12. Prepareo by the Portland State
University Population Research center.
b) Funds will not be shifted between categories or fund types. The same program may be funded
by more than one fund type, however, federal funds may not be used as match for other
federal funds ( such as Medicaid ).
c) July -September grant is $176,056 ; and includes $35.211 of minimum Nutrition Education: and
S7,817 for Breastfeeoing Promotion,
d) October-June grant is $480,396 ; and includes $96,079 of minimum Nutrition Education amount
and $23,451 for Breastfeeding Promollon_
e) Please note that Chlamydia and High Cost Contraceptives funds have been folded into
the Title X funds and are no longer a separate line Item. n Immunization SpeCial Payments are funded by State General Fund and matched dollar for
dollar with Medicaid.
6) Capital Outlay Requested in This Action:
Prior approval is required for Capital Outlay. Capital Outlay is defined as an expenditure for equip
ment with a purcllase price in excess of $5,000 and a life expectancy greater than one year.
PROGRAM ITEM DESCRIPTION
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PROG.
COST APPROV
PAGE 4 OF 6 PAGES 20ll-2ots AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES
142008-4 PGM.DOC -DESCHUTES COUNTY
State of Oregon Page 2 of 3
Oregon Health Authority
Public Health Division
1) Grantee 2) Issue Date This Action
Name: Deschutes County Health Dept December 17, 2013 AMENDMENT
FY20t4
Street 2577 N. E. Courtney 3) Award Period
City: Bend From JUly 1,2013 Through June 30. 2014
State: OR Zl~Code: 97701
14) DHS Public Health Funds Approved
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Program
PE 41 Family Planning Agency Grant
FAMILY HEALTH SERVICES
PE 42 MCH/Child & Adolescent Health -General Fund
FAMILY HEALTH SERVICES
PE 42 MCH-TitieV --Child & Adolescent Health
FAMILY HEALTH SERVICES
PE 42 MCH-TrtleV Flexible Funds
FAMIL Y HEAL TH SERVICES
PE 42 "'·1CHfPennatal Health --General Fund
FAMILY HEALTH SERVICES
PE 42 Babies First
FAMILY HEALTH SERVICES
!PE 42 Oregon MothersCare
I FAMilY HEALTH SERVICES
! PE 43 ImmuniZation Special Payments
FAMILY HEALTH SERVICES
PE 43 Immunization Conference Travel
FAMILY HEALTH SERVICES
PE 44 School Based Health Centers
FAMilY HEALTH SERVICES
PE 47 Linking Actions for Unmet Needs in Child Health Project
FAMILY HEAL TH SERVICES
PE 48 Teen Pregnency Prevention - P R. E. P
FAMILY HEALTH SERVICES
5) FOOTNOTES:
Previous
Award
173.888
11,323
17,860
41,675
6.035
19,"106
20.153
39.871
600
295,000
65'1,054
105,080
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(ncreasel Grant
(Decrease) Award
0 173.888
(e,m)
0 11.323
( b)
0 17,860
( b )
0 41,675
( b )
0 6,035
( b )
0 19,106
20,1530
39,8710
(ft
0 600
1,111,830
( I,n )
0
816,830
651,054
( j )
0 '105,080
g) $11.025 is the July through September funding to local agenCies.
h) $33,075 shows October. 2013 through June 30th, 2014 funding portion to local agencies
i) $162.764 is for July 1. 2013 to September 30,2013 period,
j) $14.749 represents year-end one time funding at $350 per assigned caseload.
k) 51,175 Represents fresh Fruits and Veggies grant to local agencies in State Fiscal Year 2014.
I) Funding formula base increase ($'12.000 per SBHC) for counties with more than one certified
SBHC. due to passing of HB2445.
m) -$15,499 Award reduction due to sequestration cuK
n) $30,000 School Based Health Clinic planning grant to support local School Based Health Cltnic
planning grant activities.
I 6) Capital Outlay Requested in This Action:
Prior approval is reqUired for Capital Outlay. Capital Outlay is defined as an expenditure for equip
ment With a purchase price in excess of $5.000 and a life expectancy greater than one year
1 I PROG.
PROGRAM ITEM DESCRIPTION COST APPROV
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2013-2015 AGREEMENT FOR THE FINANCING OF PlJBLlC HEALTH SERVICES PAGE SOF6 PAGES
142008-4 PGM.DOC -DESCH liTES COUNTY I
State of Oregon Page 3 of 3
Oregon Health Authority
Public Health Division
1} Grantee 2) Issue Date This Action
Name: Deschutes County Health Dept December 17,2013 AMENDMENT
FY2014
iStreet: 2577 N. E. Courtney 3) Award Period
City Bend From July 1,2013 Through June 30, 2014
State: OR ZIP Code: 97701
4) DHS Public Health Funds Approved
Previous Increasel Grant
Program Award (Decrease) Award
PE 50 Safe Drinking Water Program 93,863 0 93,863
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TOTAL 2,811,'174 843,830 3,655,004
5) FOOTNOTES:
I 6) Capital Outtay Requested in This Action:
Plior approval is required for Capital Outlay. Capital Outlay is defined as an expenditure for equip
ment With a purchase price in excess of $5.000 and a life expectancy greater than one year
PROGRAM ITEM DESCRIPTION
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PROG.
COST APPROV
2013-2015 AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 6 OF 6 PAGES
142008-4 PGM.DOC -DESCHUTES COUNTY