HomeMy WebLinkAboutDoc 025 - IGA - MH Services with OHADeschutes County Board of Commissioners
1300 NW Wall S1., 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 #2014-025, Amendment to the Intergovernmental Financial
Agreement Award #141408 between Deschutes County Health Services, Behavioral Health Division and the
Oregon Health Authority for the finanCing of Community Addictions and Mental Health Services for year 2013
2015.
PUBLIC HEARING ON THIS DATE? No.
BACKGROUND AND POLICY IMPLICATIONS:
Deschutes County Health Services (DCHS) provides or coordinates the provision of mental health and
developmental disability treatment services to individuals; services may include alcohol and drug treatment,
problem gambling prevention treatment services, transportation services, housing services and the provision of
peer resources.
The intergovernmental agreement between the Oregon Health Authority (OHA) and DCHS provides the
financing for mental health and addiction services and sets forth the guidelines for DCHS to provide or
coordinate provision of mental health services to individuals. Amendment #6 modifies funds to match the
Governor's 2013-2015 budget. The General Funds are to be extended through June 30,2014 using the same
rate methodology that is currently applied. Payment of funds is subject to Legislative approval of the Oregon
Health Authority's 2013-2015 budget.
Amendment #6 modifies funding for the following service elements:
1. Service Element #1, Local Admin Mental Health Services -$171,367. The financial assistance subject to
this service element is awarded for local administration of services in the Mental Health Services program
area. These funds are for services at: 12th Street Residential Treatment Home; Deschutes Recovery
Center Secure Residential Treatment Facility; Edgecliff Residential Treatment Home; and Hosmer
Residential Treatment Home.
2. Service Element #20, Non-Residential Adult Mental Health Services -$160,091. These funds are for rental
assistance and treatment services at the above-mentioned locations.
3. Service Element #28, Residential Treatment Services -$797,319. These funds are for services delivered to
individuals during a particular month. Oregon Health Authority will provide financial assistance at the rate of
$5,319.91 per month per individual at the 12th Street Residential Treatment Home and Deschutes
Recovery Center Secure Residential Treatment Facility locations. Oregon Health Authority will provide
financial assistance at the rate of $4,729.16 per month per individual for Deschutes Recovery Center
Secure Residential Treatment Facility location and $5,329.91 per month per individual at the Edgecliff
Residential Treatment Home.
FISCAL IMPLICATIONS:
Funding reimbursementfor FY 13-15 is estimated to be $1,128,777.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature of Document #2014-025, Amendment #6 to Intergovernmental Financial Agreement Award
#141408 between Deschutes County Health Services, Behavioral Health and the Oregon Health Authority is
requested.
ATTENDANCE: Lori Hill, Adult Treatment Program Manager
DISTRIBUTION OF DOCUMENTS: Fax or E-mail the signature page and completed, signed "Document Return
Statement" and the signature page to Tami Goertzen; tami.j.goertzen@state.or.us or (503) 373-7365, fully
executed copy to Nancy Mooney.
DESCHUTES COUNTY DOCUMENT SUMMARY
(NOTE: This fonn 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 Fonn is also required. If this fonn 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 fonn with your documents, please submit this fonn
electronically to the Board Secretary.)
Please complete all sections above the Official Review line.
Date: I January 13, 2014
Department: I Health Services, Behavioral Health I
Contractor/Supplier/Consultant Name: I Oregon Health Authority
Contractor Contact: I Tami Goertzen I Contractor Phone #: I 503-373-7365
Type of Document: Amendment #6 to #141408
Goods and/or Services: Amendment #6 modifies funds to match the Governor's 2013-2015
budget. The General Funds are to be extended through June 30, 2014 using the same rate
methodology that is currently applied. Payment of funds is subject to Legislative approval of the
Oregon Health Authority's 2013-2015 budget.
Background & History: Deschutes County Health Services (DCHS) provides or coordinates
the provision of mental health and developmental disability treatment services to individuals;
services may include alcohol and drug treatment, problem gambling prevention treatment
services, transportation services, housing services and the provision of peer resources.
The intergovernmental agreement between the Oregon Health Authority (OHA) and DCHS
provides the financing for mental health and addiction services and sets forth the guidelines for
DCHS to provide or coordinate provision of mental health services to individuals.
Amendment #6 modifies funding for the following service elements:
1. Service Element #1, Local Admin Mental Health Services -$171.367. The financial
assistance subject to this service element is awarded for local administration of services in
the Mental Health Services program area. These funds are for services at 12th Street
Residential Treatment Home; Deschutes Recovery Center Secure Residential Treatment
Facility; Edgecliff Residential Treatment Home; and Hosmer Residential Treatment Home.
2. Service Element #20. Non-Residential Adult Mental Health Services -$160,091. These
funds are for rental assistance and treatment services at the above mentioned locations.
3. Service Element #28, Residential Treatment Services -$797,319. These funds are for
services delivered to individuals during a particular month. Oregon Health Authority will
provide financial assistance at the rate of $5,319.91 per month per individual at the 12th
Street Residential Treatment Home and Deschutes Recovery Center Secure Residential
Treatment Facility locations. Oregon Health Authority will provide financial assistance at the
rate of $4,729.16 per month per individual for Deschutes Recovery Center Secure
Residential Treatment Facility location and $5,329.91 per month per individual at the
Edgecliff Residential Treatment Home.
1113/2014
Agreement Starting Date: 1 July 01, 2013 1 Ending Date: 1 June 30, 2015 1
Annual Value: 1 Amendment #6 modifies funding by $1,128,777.1
Check all that apply: o RFP, Solicitation or Bid Process o Informal quotes «$150K)
~ Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37)
Funding Source: (Included in current budget? 0 Yes ~ No
If No, has budget amendment been submitted? 0 Yes ~ No
Is this a Grant Agreement providing revenue to the County? 0 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: 0 Yes 0 No
Contact information for the person responsible for grant compliance: Name:
Phone#:C
Departmental Contact and Title: 1 Nancy Mooney, Contract Specialist 1
Phone #: 1 541-322-7516 1
Deputy Director Approval:
Department Director Approval:
Distribution of Document: Fax or E-mail t e signature page and completed, signed
"Document Return Statement" and the signature page to Tami Goertzen;
tami.j.goertzen@state.or.us or (503) 373-7365, fully executed copy to Nancy Mooney.
Date
ll414
Date
Official Review:
County Signature Required (check one): ~ BOCC 0 Department Director (if <$25K)
o Administrator ut <$150K; if >$150K, BOCC Order No. ____-'
Legal Review Date I ~ I 7 -I <I
Document Number: ::.20,..,1.:...4:....-0=2=5:...-____
1113/2014
ADMINISTRATIVE SERVICES DIVISION)tQ!j~'tm'"t ] [ealth
of Human Services Office of Contracts and Procurement Authority
John A. Kitzhaber, MD, Governor 250 Winter St NE, Room 306
Salem, OR 97301
Voice: (503) 945-5818
FAX: (503) 378-4324
DATE: December 18, 2013
TO: Scott Johnson, Director
Deschutes County
RE: Amendment #06 to the
2013-2015 Intergovernmental Agreement for the Financing
of Community Addictions and Mental Health Services Agreement #141408
Enclosed is an amendment to the Agreement.
NOTE: Payment for amendments returned to OHA by the 3 rd Friday of every
month are more likely to be in the following month's allotment or electronic
fund transfer.
The instructions for processing this amendment are as follows:
• Open and print the electronic file containing the amendment for signature by the
appropriate authorized County Official(s).
• Obtain the authorized signature(s) on the amendment and the "Document Return
Statement" .
• E-mail or Fax only the signature page of the amendment and the completed, signed
"Document Return Statement" to tami.j.goertzen@state.or.us or 503-373-7365.
Following receipt by OHA of your signed amendment, OHA will route its copy of amendment to
the official(s) who is/are authorized to execute the amendment. Once the amendment is signed
OHA will scan the amendment and transmit to the appropriate County official.
If you have questions regarding this financial assistance award, please contact Carmen
Armendariz, Addictions and Mental Health Services, at (503) 945-8995 or April D. Barrett,
Office of Contracts and Procurement, at (503) 945-5821.
Sincerely,
April D. Barrett, OPBC
Contracts Specialist
Attachment( s)
I
)tQtt~"tm'"t ADMINISTRATIVE SERVICES DIVISION ] [erL'50alth
of Human Services Office of Contracts and Procurement Authority
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 Infonnation fonn (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 Infonnation fonn (if applicable) with this Document Return Statement.
(Authorizing Signature) (Date)
ADMINISTRATIVE SERVICES DIVISION.)fQt!~'"m..t
or ~uman Services Office of Contracts and Procurement
John A. Kllzhaber, MD, Governor 250 Winter St NE, Room 306
Salem, OR 97301
Voice: (503) 945·5818
In compliance with the Americans with Disabilities Act, this • J
FAX: (503) 378·4324 .
document is available in alternate fOlmats 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.publicationl'equest@state.or.us or call 503-378-3486 (voice) or 503
378-3523 (TTY) to arrange for the alternative format.
SIXTH AMENDMENT TO .
OREGON HEALTH AUTHORITY
2013-2015 INTERGOVERNMENTAL A(J~EEMENT FOR THE
FINANCING OF COMMUNITY ADDICTIONS AND MENTAL HEALTH
SERVICES AGREEMENT #141408 .
This Sixth Amendment to Oregon Health Atithority 2013·2015 Intergovernmental
Agreement for the Financing of Community Addictions and Mental Health SerVices dated as of
July 1, 2013(as amended, the "Agreemenf'), is entered into, as ofthe date of the last signature
hereto, by and between the State of Oregon acting by and through its Oregon Health Authority
("OHA") and Deschutes County ("County"). ..
RECITALS
WHEREAS, OHA and County wish to modifY the Financial Assistance Award set forth
in Exhibit D-l of the Agreement. .... .....
NOW, THEREFORE, in consideration of the premises, covenants and agreements
contained herein and other good and valuable consideration the receipt arid sufficiency of which
is hereby acknowledged, the parties her~to agree as follows:" .
. AGREEMENT
1. The financial and service information in the Financial Assistance A ward. are hereby
amended as described in Exhibit 1 attached hereto and incorporated herein by this
reference. Exhibit 1 must be read in conjunction with the portion ofExhibit D·1 of the
Agreement that describes the effect'of an amendment of the financial and service
information. . .
2. Capitalized words and phrases used but not defined herein shall have the meanings
ascribed thereto in the Agreement.
~lmJ-
LEGAL COUNSEL
DC -20 1 4 - 0 25
3. . County represents and W8lTants to OHA that the representations and warranties of County
set forth in section 4 of Exhibit G of the Agreement are hue and correct on the date
hereof with the same effect as if made on the date hereof.
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 munber 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 ·cOlmterpart. Each copy of this Amendment so
executed shall constitute an original.
IN WITNESS WHEREOF, the parties hereto have executed this amendment as of the dates set
fmih below their respective signatures.
Deschutes County
By:
Authorized Signatme Title Date
State of Oregon acting by and through its Oregon Health Autbority
By:
~-------------------------------------------Authorized Signature Title Date
Docmnent date: 12118120 13 Amendment # 06 Page 2
ReferenceW 003
Exhibit 1 to the 6th Amendment to
Oregon Health Authority
2013~2015 Intergovernmental Agreement for the
Financing of Commnnity Addictions and Mental Health Services Agreement #141408
Document date: 12/1812013 Amendment # 06 Page 3
Reference # 003
obligation, after the termination, to payor disburse to County
financial assistance subject to this special condition. S) These
funds are for services at Hosmer RTH.
MOO66 5 These funds are for Rental Assistance.
MOO66 6 These funds
SRTF.
are for Rent Subsidy at Deschutes Recovery Center
MOO66 7 These funds are for Treatment Services.
MOO66 8 These funds are for Rent Subsidy at 12th Street RTH.
MOO66 9 These funds are for Rent Subsidy at Edgecliff RTH.
MOO66 10 These funds are for Rent Subsidy at Hosmer RTH.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
2013-2015
CONTRACTOR: DESCHUTES COUNTY Contract#: 141408
DATE: 12/18/2013 Reference#: 006
MENTAL HEALTH SERVICES
SECTION: 1
SERVICE REQUIREMENTS MEET EXHIBIT B AND, IF INDICATED, EXHIBIT B-2
Start/End Client Approved Approved Servo Unit EXHIB B2 Spec
Part Dates Code Service Funds start-up units Type Codes Cond#
SE# 1 LOCAL ADMIN MENTAL HEALTH SVCS
A 1/2014-6/2014 N/A $24,960 $0 O. NA N/A M0066 1
A 1/2014 6/2014 N/A $103,000 $0 O. NA N/A M0066 2
A 1/2014-6/2014 N/A $24,960 $0 O. NA N/A M0066 3
A 1/2014-6/2014 N/A $18,447 $0 O. NA N/A M0066 4
SUBTOTAL SE# 1 $171,367 $0
SE# 20 NON-RESIDENTIAL ADULT MH SERV
A 1/2014-6/2014 N/A $582 $0 O. NA N/A M0066 5
A 1/2014-6/2014 HOMARY-500609 $8,433 $0 O. NA N/A M0066 7
A 1/2014-6/2014 N/A $85,018 $0 96. SLT N/A M0066 6
A 1/2014-6/2014 N/A $28,296 $0 30. SLT N/A M0066 8
A 1/2014-6/2014 N/A $28,296 $0 30. SLT N/A M0066 9
.i A 1/2014-6/2014 N/A $9,466 $0 30. SLT N/A M0066 10
SUBTOTAL SE# 20 $160,091 $0
SE# 28 RESIDENTIAL TREATMENT SERVICES
A 1/2014 -6/2014 HOMARY-500609 $24,126 $0 6. SLT 28A M0066 12
A 1/2014-6/2014 N/A $453,999 $0 96. SLT 28A M0066 13
A 1/2014 6/2014 N/A $159,597 $0 30. SLT N/A M0066 11
A 1/2014-6/2014 N/A $159,597 $0 30. SLT N/A M0066 14
SUBTOTAL SE# 28 $797,319 $0
TOTAL SECTION 1 $1,128,777 $0
TOTAL AUTHORIZED FOR MENTAL HEALTH SERVICES $1,128,777
TOTAL AUTHORIZED FOR THIS FAAA: $1,128,777
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
CONTRACTOR: DESCHUTES COUNTY
DATE: 12/18/2013
Contract#:
REF#:
141408
006
REASON FOR FAAA (for information only) :
The Financial Assistance Award (FAA) is for Mental Health Services
Adjustment to Base within the Governor's 2013-2015 Balanced Budget (GBB).
The General Funds in contract are to be extended through June 30, 2014
using the same rate methodology that is currently applied. Payment of funds
in this FAA is subject to Legislative approval of the Oregon Health
Authority's 2013-2015 Budget.
The fo110\'ling special condition(s) apply to funds as indicated by the
special condition number in column 9. Each special condition set forth
below may be qualified by a full description in the Financial Assistance
A\-/ard.
M0066 1 A} Local Administration -Mental Health Services (MHS Ol)
Financial Assistance Associated with Specific program Area: The
financial assistance subject to this special condition is awarded
for local administration of services in the Mental Health
Services Program Area. If County terminates its obligation to
include this Program Area under this Agreement, OHA shall have no
obligation, after the termination, to payor disburse to County
financial assistance subject to this special condition. B) These
funds are for services at 12th Street RTH.
M0066 2 A) Local Administration Mental Health Services (MHS 01)
Financial Assistance Associated with Specific Program Area: The
financial assistance subject to this special condition is a\'/arded
for local administration of services in the Mental Health
Services Program Area. If County terminates its obligation to
include this Program Area under this Agreement, OHA shall have no
obligation, after the termination, to payor disburse to County
financial assistance subject to this special condition. B} These
funds are for services at Deschutes Recovery Center SRTF.
M0066 3 A) Local Administration -Mental Health Services (MBS 01)
Financial Assistance Associated with Specific Program Area: The
financial assistance subject to this special condition is a\'larded
for local administration of services in the Mental Health
Services Program Area. If County terminates ita obligation to
include this Program Area under this Agreement, OHA shall have no
obligation, after the termination, to payor disburse to County
financial assistance subject to this special condition. B) These
funds are for services at Edgecliff RTH.
M0066 4 A) Local Administration Mental Health Services (MHS 01)
Financial Assistance Associated "lith Specific Program Area: The
financial assistance subject to this special condition is a\'larded
for local administration of services in the Mental Health
Services Program Area. If County terminates its obligation to
include this program Area under this Agreement, OHA shall have no
M0066 11 A) MHS 28 Rate: For services delivered to individuals during a
particular month l OHA will provide financial assistance at the
rate of $5,319.91 per month per individual. B) These funds are
for 12th Street RTH.
M0066 12 A) MHS 28 Rate: For services delivered to individuals during a
particular month, OHA will provide financial assistance at the
rate of $4 /021 per month per individual. B} These funds are for
Deschutes Recovery center SRTF.
M0066 13 A) MHS 28 Rate: For services delivered to individuals during a
particular month l OHA will provide financial assistance at the
rate of $4,729.16 per month per individual. B) These funds are
for Deschutes Recovery Center SRTF.
M0066 14 A) MHS 28 Rate: For services delivered to individuals during a
particular month, OHA will provide financial assistance at the
rate of $5 / 329.91 per month per individual. B) These funds are
for Ed~ecliff RTH.
CONTRACTOR: DESCHUTES COUNTY
DATE: 12/18/2013
SE# DESCRIPTION
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Part A
2013-2015
********************* INFORMATION ONLY *********************
CONTRACT#: l41408
REF#: 006
CURRENT CURRENT PROPOSED REVISED
APPROVED PENDING CHANGE TOTAL
1 LOCAL ADMIN MENTAL HEALTH SVCS
TOTAL SE# 1
20 NON-RESIDENTIAL ADULT MH SERV
20 NON-RESIDENTIAL ADULT MH SERV
TOTAL SE# 20
28 RESIDENTIAL TREATMENT SERVICES
28 RESIDBNTIAL TREATMENT SERVICES
$171,366 $0 $171,366 $342,732
$171,366 $0 $171,366 $342,732
$9,015 $0 $9,015 $18,030
$151,076 $0 $151,076 $302,152
$160,091 $0 $160,091 $320,182
$478,125 $0 $478,125 $956,250
$319,495 -$300 $319,l95 $638,390
TOTAL SE# 28 $79',620 -$300 $797,320 $1,594,640
35 OLDER/DISABLED ADULT MH SVCS $18,734 $0 $0 $18,734
TOTAL SB# 35
39 CSS-HOMELESS
TOTAL SE# 39
$18,734 $0 $0 $18,734
$94,000 $0 $0 $94,000
$94,000 $0 $0 $94,000
$1,241,811 -$300 $1,128,777 $2,370,288
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" 'column
that have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Part B
2013-2015
********************* INFORMATION ONLY *********************
CONTRACTOR: DESCHUTES COUNTY CONTRACT#: 141408
DATE: 12/18/2013 REF#: 006
CURRENT CURRENT PROPOSED REVISED
SE# DESCRIPTION APPROVED PENDING CHANGE TOTAL
20 NON-RESIDENTIAL ADULT MH SERV $443,833 $0 $0 $443,833
20 NON-RESIDENTIAL ADULT MH SERV $235,861 $0 $0 $235,861
TOTAL SE# 20 $679,694 $0 $0 $679,694
22 CHILD & ADOLES MH SERVICES $122,290 $0 $0 $122,290
TOTAL SE# 22 $122,290 $0 $0 $122,290
2~ RESIDENTIAL TREATMENT SERVICES $576,000 $0 $0 $576,000
:28 RESIDENTIAL TREATMENT SERVICES $364,466 $0 $0 $364,466
TOTAL SE# 28 $940,466 $0 $0 $940,466
31 ENHANCED CARE SERVICES $109,248 $0 $0 $109,248
TOTAL SE# 31 $109,248 $0 $0 $109,248
34 ADULT FOSTER CARE MRS $160,349 $0 . $0 $160,349
TOTAL SE# 34 $160,349 $0 $0 $160,349
36 PASARR MHS $20,072 $0 $0 $20,072
TOTAL SE# 36 $20,072 $0 $0 $20,072
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance, Award Amendment (FAAA)
*********************
FAAA Totals
Part B
20B-201S
rNFORMATION ONLY *********************
CONTRACTOR:
DATE:
DESCHUTES COUNTY
12/1B/2013
CONTRACT#: 141408
REF#: 006
SE# DESCRIPTION
CURRENT
APPROVED
CURRENT
PENDING
PROPOSED
CHANGE
REVISED
TOTAL
$2 / 032 / 119 $0 $0 $2,032,119
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" column
that have not yet been accepted/approved. Therefore 1 these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Summary
2013-2015
********************* INFORMATION ONLY *********************
CONTRACTOR: DESCHUTES COUNTY CONTRACT#: 141408
DATE: 12/18/2013 REF#: 006
CURRENT CURRENT PROPOSED REVISED
SE#: DESCRIPTION APPROVED PENDING CHANGE TOTAL
1 LOCAL ADMIN MENTAL HEALTH SVCS $171,366 $0 $171,366 $342,732
TOTAL SE# 1 $171,366 $0 $171,366 $342,732
20 NON-RESIDENTIAL ADULT MH SERV $452,848 $0 $9,015 $461,863
20 NON-RESIDENTIAL ADULT MH SERV $386,937 $0 $151,076 $538,013
TOTAL SE#: 20 $839,785 $0 $160,091 $999,876
22 CHILD & ADDLES MH SERVICES $122,290 $0 $0 $122,290
TOTAL SE# 22 $122,290 $0 $0 $122,290
28 RESIDENTIAL TREATMENT SERVICES $1,054,125 $0 $478,125 $1,532,250
28 RESIDENTIAL TREATMENT SERVICES $683,962 -$300 $319,195 $1,002,856
TOTAL SE# 28 $1,738,086 -$300 $797,320 $2,535,106
31 ENHANCED CARE SERVICES $109,248 $0 $0 $109,248
TOTAL SE#: 31 $109,248 $0 $0 $109,248
34 ADULT FOSTER CARE MHS $160,349 $0 $0 $160,349
TOTAL SE#: 34 $160,349 $0 $0 $160,349
35 OLDER/DISABLED ADULT MH SVCS $18,734 $0 $0 $18,734
NOTE: The amounts in t,he '''REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
mP\G\#4.¢4LQU [4 ; k#Ut4dii44iiil4i;;g;:QMS, ;,!U¥J(J flJ;t. QQ W oaw .,""'**''*¥')6#MiR, ...... ;. %,t(1M10;ssn M!&!.II!\M9i$,M!i1 .ii4iiM'*"5ii;;aGjK~.'*"Aj r;z;p ,IW4JHt(liiryar .... "1"*"""111·"""'.,3'*"",,.,,1''';;_ ,W'
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAM)
FAM Totals
Summary
2013-2015
********************* INFORMATION ONLY *********************
CONTRACTOR:
DATE:
DESCHUTES COUNTY
12/18/2013
SE# DESCRIPTION
CURRENT
APPROVED
CURRENT
PENDING
CONTRACT#':
PROPOSED
CHANGE
REF#':
141408
006
REVISED
TOTAL
TOTAL SE# 35
36 PASARR MHS
TOTAL SE# 36
39 CSS-HOMELESS
TOTAL SE# 39
CONTRACT TOTAL
$18,734
$20,072
$20,072
$94,000
$94,000
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$3,273,930 -$300 $1,128,777
$18,734
$20,072
$20,072
$94,000
$94,000
$4,402,407
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT P~~ING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
Nancy Mooney 2011-02S
From: Lori Hill
Sent: Thursday, January 09,2014 11:31 AM
To: Nancy Mooney
Cc: Sharon Hatcher
Subject: RE: I have amendment's #4, #5 & #6--pending approval. see attached. Thank you!
Amendment #6 is approved for signature. The state will send a future amendment to make needed minor
adjustments. Lori
From: Nancy Mooney
sent: Friday, January 03, 2014 4:07 PM
To: Lori Hill
Cc: Sharon Hatcher
Subject: I have amendment's #4, #5 & #6-~pending approval. see attached. Thank you!
Importance: High
Nancy Mooney
ContractlCredentialing Specialist
Deschutes County Health Services
2577 NE Courtney Drive
Bend, OR 97701
Phone: 541-322-7516
Fax: 541-322-7565
Business Hours:
Monday -Thursday 9AM to 6PM
Friday BAM to SPM
1