HomeMy WebLinkAboutDoc 529 - Amend IGA - My Future-My Choice--------
Deschutes 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 October 8, 2014
DATE: October 1, 2014
FROM: Nancy Mooney, Contract Specialist, Deschutes County Health Services, 322-7516
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2014-529, Amendment #1 to Intergovernmental Financial
Agreement Award #142671 between the Local Public Health Department and the Oregon Department of Human
Services for the financing of the My Future, My Choice Program.
PUBLIC HEARING ON THIS DATE? No.
BACKGROUND AND POLICY IMPLICAonONS:
The Department of Human Service (DHS) has developed the My Future, My Choice curriculum to support the
efforts in educating young people to learn how to handle social pressure and peer pressure in regards to
making positive choices about sexual behavior that could potentially lead to life-long consequences.
The purpose of Agreement #142671 is to provide services, which include a comprehensive sexuality
education curriculum. This program provides age-appropriate sexuality education as an integral part of the
health education course. My Future-My Choice goals is to provide middle school students with tools to resist
social and peer pressure to become sexually involved before they are ready. Amendment #1 to the Agreement
extends the term of the program for another school year and provides additional funding.
FISCAL IMPLICATIONS:
Maximum compensation for July 1,2014 through June 30, 2015 is $85,000, This brings the total contract amount
to $170,000.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature of Document #2014-529, Amendment #1 is requested.
ATIENDANCE: Kathy Christensen, Program Supervisor
DISTRIBUTION OF DOCUMENTS:
1. Agency Data and Certification on page 4
2. Entire contract
3. Insurance documents
4. Scan items 1-3 and e-mail tOlyndell.b.troxell@state.or.us.
5. Original documents to Nancy Mooney, Deschutes County Health Services.
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: September 24, 2014 I 1
Department: 1 Health Services, Health Department .1
Contractor/Supplier/Consultant Name: I Oregon State Department of Human Services I
Contractor Contact: Lyn Troxell, OfFice of Contracts & Procurements 11
Contractor Phone #: 1 503-945-6692 1
Type of Document: Amendment #1 to Intergovernmental Agreement
Goods and/or Services: The Department of Human Service (DHS) has developed the
My Future, My Choice curriculum to support the efforts in educating young people to
learn how to handle social pressure and peer pressure in regards to making positive
choices about sexual behavior that could potentially lead to life-Ion~ consequences.
Background & History: The purpose of this Agreement is to provide services which
include a comprehensive sexuality education curriculum. This program provides age
appropriate sexuality education as an integral part of the health education course. My
Future-My Choice goals is to provide middle school students with tools to resist social
and peer pressure to become sexually involved before they are ready.
Agreement Starting Date: I July 1, 2013 I Ending Date: I June 30, 2015
Annual Value or Total Payment: I Maximum compensation for July 1, 2014 throughl
pune 30, 2015 is $85,000. 1
Check all that apply:
D RFP, Solicitation or Bid Process
D Informal quotes «$150K)
l'g] Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37)
Funding Source: (Included in current budget? l'g] Yes D No
If No, has budget amendment been submitted? DYes D No
9/2412014
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: D
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
Contact information for the person responsible for grant compliance: Name:
Phone #:
Distribution of Document: Please e-mail the following:
1. Agency Data and Certification on page 4
2. Entire contract
3. Insurance documents
4. Scan items 1-3 and e-mail tOlyndell.b.troxell@state.or.us.
5. Original documents to Nancy Mooney, Deschutes County Health Services.
Department Director Approval: ~~
Signature
D
Official Review:
County Signature Required (check one): ~ SOCC 0 Department Director (if <$25K)
o Administrator (if >$25K but <$150K; if >$150K, SOCC Order No. )
Legal Review 'QY \[\J\..; Date!() - \ - \ Y
Document Number =20=-1.:.-4-,--=52=9~_______
9/2412014
-
)tOHS
Oregon Department
of Human Services
Grant Agreement Number 142671
AMENDMENT TO
STATE OF OREGON
INTERGOVERNMENTAL GRANT AGREEMENT
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 .publicationreguest@state.or.us or call 503-378-3486 (voice) or 503-378-3523 (TTY) to arrange
for the alternative format.
This is amendment number 01 to Agreement Number 142671 between the State of Oregon, acting
by and through its Department of Human Services, hereinafter referred to as "DHS" and
Deschutes County Health Department
577 NE Courtney Drive
Bend, Oregon 97701
Telephone: 541-322-7426
E-mail address: scottj@deschutes.org
hereinafter referred to as "Recipient."
1. Upon signature by all applicable parties, this amendment shall be effective on July 1,2014,
regardless of the date it is actually signed by all parties.
2. The Agreement is hereby amended as follows :
a. Section 1, Effective Date and Duration, is amended as follows: language to be
deleted or replaced is struck through; new language is underlined and bold.
1. Effective Date and Duration
This Agreement shall become effective on July 1, 2013 when signed by all
parties. Unless extended or terminated earlier in accordance with its terms,
this Agreement shall terminate on June 30, 2014 June 30, 2015. Agreement
termination or expiration shall not extinguish or prejudice DHS' right to
enforce this Agreement with respect to any default by Recipient that has not
been cured.
DC -2 0 1 4 -5 ~ ~
b. Section 3, Grant Reimbursement Generally, paragraph a, is deleted in its entirety and
restated with the following:
In accordance with the terms and conditions of this Agreement, DHS shall reimburse
Recipient up to a maximum not-to-exceed amount for specific Program allowable
costs as stated in Exhibit A, Part 3, incurred within the effective dates for funding as
follows:
Funding and Effective Dates Not-to-Exceed Amount
. July 1,2013 June 30, 2014 $82,085
PUlY 1,2014 June 30, 2015. $85,000
c. Exhibit A, Part 2, Program Description, paragraph 6.b.(5), is amended as follows:
new language is underlined and bold.
(5) Ensure required school participation data is reported to DHS no later than
April 10, 2014, June 10, 2014, April 10, 2015 AND June 10, 2015.
d. Exhibit A, Part 2, Program Description, paragraph 7.a.(3), is amended as follows:
new language is underlined and bold.
(3) Reporting shall occur not later than April 10, 2014, July 10, 2014, April
10,2015 AND June 10,2015.
3. Certification
a. The Recipient acknowledges that the Oregon False Claims Act, ORS 180.750 to
180.785, applies to any "claim" (as defined by ORS 180.750) that is made by (or
caused by) the Recipient and that pertains to this Agreement or to the project for
which the Agreement work is being performed. The Recipient certifies that no claim
described in the previous sentence is or will be a "false claim" (as defined by ORS
180.750) or an act prohibited by ORS 180.755. Recipient further acknowledges that
in addition to the remedies under this Agreement, if it makes (or causes to be made) a
false claim or performs (or causes to be performed) an act prohibited under the
Oregon False Claims Act, the Oregon Attorney General may enforce the liabilities
and penalties provided by the Oregon False Claims Act against the Recipient.
Without limiting the generality of the foregoing, by signature on this Agreement, the
Recipient hereby certifies that:
(1) Under penalty of perjury the undersigned is authorized to act on behalf of
Recipient and that Recipient is, to the best of the undersigned's knowledge,
not in violation of any Oregon Tax Laws. For purposes of this certification,
"Oregon Tax Laws" means a state tax imposed by ORS 320.005 to 320.150
and 403.200 to 403.250 and ORS chapters 118,314,316,317,318,321 and
323 and the elderly rental assistance program under ORS 310.630 to 310.706
and local taxes administered by the Department of Revenue under ORS
305.620;
142671-1 jmb Page 2 of 4
DHS IGA Amendment Updated: 01.10.14
(2) The infonnation shown in Recipient Data and Certification, of original
Agreement or as amended is Recipient's true, accurate and correct
infonnation;
(3) To the best of the undersigned's knowledge, Recipient has not discriminated
against and will not discriminate against minority, women or emerging small
business enterprises certified under ORS 200.055 in obtaining any required
subcontracts;
(4) Recipient and Recipient's employees and agents are not included on the list
titled "Specially Designated Nationals and Blocked Persons" maintained by
the Office of Foreign Assets Control of the United States Department of the
Treasury and currently found at:
http://www.treas.gov/offices/enforcement/ofaclsdnltllsdn.pdf;
(5) Recipient is not listed on the non-procurement portion of the General Service
Administration's "List of Parties Excluded from Federal procurement or
Nonprocurement Programs" found at:
https://www.sam.gov/portaVpubliclSAMI; and
(6) Recipient is not subject to backup withholding because:
(a) Recipient is exempt from backup withholding;
(b) Recipient has not been notified by the IRS that Recipient is subject to
backup withholding as a result of a failure to report all interest or
dividends; or
(c) The IRS has notified Recipient that Recipient is no longer subject to
backup withholding.
b. Recipient is required to provide its Federal Employer Identification Number (FEIN).
By Recipient's signature on this Agreement, Recipient hereby certifies that the FEIN
provided to DHS is true and accurate. If this infonnation changes, Recipient is also
required to provide DHS with the new FEIN within 10 days.
c. Except as expressly amended above, all other tenns and conditions ofthe original
Agreement and any previous amendments are still in full force and effect. Recipient
certifies that the representations, warranties and certifications contained in the
original Agreement are true and correct as of the effective date of this amendment
and with the same effect as though made at the time of this amendment.
142671·1 jmb Page 3 of4
DRS IGA Amendment Updated: 01.10.14
4. Recipient Data. Recipient shall provide current infonnation as required below. This
infonnation is requested pursuant to OARS 305.385 and OAR 125-246-0330(1).
PLEASE PRINT OR TYPE THE FOLLOWING INFORMATION
Recipient Name (exactly as filed with the IRS): J)e sc..h uies ColAaty
Street address: 1300 NW Wa.// Si-("~±
City, state, zip code: 13ecd
I
0 fQ:r:::101
Email address: Oare'1 mco("',t6 I 62 ~(chuiC$..o:q
Telephone: (Stj ( ) 222 -IS! ~ I Facsimile: (SL!i) 32-"2.--TsL,s
Federal Employer Identification Number: _2.1.::.'3::...--.::;:;&;..;;.C;_()...::.).;...,..?r::;......;<j....~~____________
Proof of Insurance:
Workers' Compensation Insurance Company: -'"':x-=-==CLI+'----.-'-l,n'--'-='5>..."lA.Y"1~rd=___________
Policy #: ,,10 Expiration Date: -I-M",+/~.4I---__
Recipient shall provide proof of Insurance upon request by DHS or DHS designee.
5. Signatures
RECIPIENT: YOU WILL NOT BE PAID FOR SERVICES RENDERED PRIOR TO
NECESSARY STATE APPROVALS
Deschutes County Health Department
By: Tammy Baney, Chair
Deschutes County Board ofCommiss:G;::~~~
Authorized Signature Title Date
State of Oregon acting by and through its Department of Human Services
By:
Authorized Signature Title Date
Approved for Legal Sufficiency
Authorized Signature Title Date
Office of Contracts and Procurement
Jewelee Bell, Contract Specialist Date
142671-1 jmb Page 4 of4
DHS IGA Amendment Updated: 01.10.14
Certificate of Self-Insurance
This is to certify that Deschutes County, Oregon is a self-insured entity
pursuant to ORS 30.282 and has established a self-insured fund against liability
and property damage arising out of any tort claims against its programs, officers,
agents, employees and volunteers acting within the scope of their employment.
This coverage is applicable under any Deschutes County agreement.
Deschutes County's self-insured retention is one million dollars. A policy
purchased through Starr Indemnity & Liability Company provides excess liability
coverage for claims in excess of one million dollars, with a cap of ten million
dollars.
Please refer inquiries to:
Deschutes County Risk Management
Erik Kropp, Risk Manager (541) 388-6584
Laurie Smith, Claims Coordinator (541) 385-1749
1300 NW Wall St., Ste. 200, Bend, OR 97701
Effective Date 7/19/14, no expiration
Department of Administrative Services
Erik Kropp, Deputy County Administrator
1300 MN Wall St, Suite 200 • Bend. Oregon 97701
(541) 388-6584. FAX (541) 385-3202
www.deschutes.or.us
July 18,2014
To whom it may concern:
The purpose of this letter is to certify that Deschutes County, Oregon, is and has been since at
least 1990, a self-insured entity pursuant to ORS 30.282. Deschutes County has established a
self-insurance fund for liability arising out of any tort claims against any of its programs,
officers, agents, employees and volunteers acting within the scope oftheir employment during
this period. This coverage is applicable under any Deschutes County agreement.
Please call me at 541-388-6584 should you have any questions or need additional information.
Sincerely,
~Jt,qp
Erik Kropp
Deputy County AdministratorlRisk Manager
Enhancing the Lives of Citizens by Delivering Quality Services in a Cost-Effective Manner