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HomeMy WebLinkAboutDoc 008 - Amend DHS Behav Health AgrmtDeschutes 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 5, 2011 DATE: December 29, 2010 FROM: Lori Hill, Adult Treatment Program Manager, Deschutes County Health Services, 541-322-7535. TITLE OF AGENDA ITEM: Consideration of Board Signature of Document #2011-008, Amendment #47 to the 2009-2011 State Intergovernmental Agreement for the financing of mental health, developmental disability and addiction services, State Agreement #127295. PUBLIC HEARING ON THIS DATE? No. BACKGROUND AND POLICY IMPLICATIONS: The 2009-2011 Intergovernmental Agreement for the financing of mental health, developmental disability and addiction services sets forth the dollar amounts and guidelines for Deschutes County Health Services (DCHS) to provide or coordinate provision of mental health and developmental disability treatment services to individuals, as well as alcohol, other drug and problem gambling prevention and treatment services for the 2009-2011 biennium. Amendment #127295-47 modifies funding for the following service elements: 1) Service element #20 — Non -Residential Adult Mental Health Services - $5,047; funds are removed for rehabilitative services for one client at Edgecliff Residential Treatment Home. 2) Service element #24 — Regional Acute Psychiatric Inpatient Services - $529,250; funds are awarded for two beds. 3) Service element #28 — $0; Limitation is decreased and funds are awarded for service payment for one client at Edgecliff Residential Treatment Home. 4) Service element #201 — Non -Residential Adult Mental Health Services - $7,069; funds are awarded for rehabilitative services, room & board for one client at Edgecliff Residential Treatment Home. FISCAL IMPLICATIONS: Maximum Compensation is $532,272. RECOMMENDATION & ACTION REQUESTED: Behavioral Health recommends approval. ATTENDANCE: Nancy England, Contract Specialist DISTRIBUTION OF DOCUMENTS: Fax the documents to April D. Barret at (503) 378-4324, and fully executed copy to Nancy England, Contract Specialist, Behavioral Health Department. April Barrett , 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 wIl 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 Comrnissioners. In addition to submitting this form with your documents, please submit this form electronically to the Board Secretary.) Date: Please complete alt sections above the Offclal Review line. December 17, 2010 Department: Health Services, Behavioral Health Contractor/Supplier/Consultant Name: Contractor Contact: Type of Document: Amendment Oregon Department of Human Services Contractor Phone #: 503-945-5821 Goods and/or Services: 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. Background & History: The intergovemmental agreement between the Department of Human Services and DCHS provides the financing for mental health, developmental disability and addiction services and sets forth the guidelines for DCHS to provide or coordinate provision of mental health and developmental disability services to individuals. Amendment #47 to the agreement modifies funding for the following service elements: 1) Service element #20 — Non -Residential Adult Mental Health Services - $5,047, funds are removed for rehabilitative services for one client at Edgediff Residential Treatment Home. 2) Service element #24 — Regional Acute Psychiatric Inpatient Services - $529,250, funds are awarded for two beds. 3) Service element #28 — $0, Limitation is decreased and funds are awarded for service payment for one client a Edgecliff Residential Treatment Home. 4) Service element #201 — Non -Residential Adult Mental Health Services - $7,069, funds are awarded for rehabilitative services, room & board for one client at Edgecliff Residential Treatment Home. Agreement Starting Date: July 01, 2010 Annual Value or Total Payment: Ending Date: June 30, 2011 Maximum Compensation is $531,272 ® Insurance Certificate Received (check box) Insurance Expiration Date: County is Contractor Check all that apply: ❑ RFP, Solicitation or Bid Process ❑ Informal quotes (<$150K) ® Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37) Funding Source: (Included in current budget? ® Yes ❑ No If No, has budget amendment been submitted? ❑ Yes 0 No Is this a Grant Agreement providing revenue to the County? ❑ 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: ❑ Yes ❑ No Contact information for the person responsible for grant compliance: Name: Phone #: Departmental Contact and Title: Phone #: 541-322-7516 Nancy England, Contract Specialist Department Director Approval:Oi iwr- C1I Signature 2-2-7-o 1p Date Distribution of Document: Fax to April D. Barrett at (503) 373-7365, fully executed copy to Nancy England, Behavioral Health Department, (541) 322-7565. Official Review: County Signature Required (check one): BOCC 0 Department Director (if <$25K) ❑ Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. Legal Review Date Document Number: 2010-735 -?3—/o 12/17/2010 Oregon Theodore R. Kulongoski, Governor DATE: December 9, 2010 TO: Scott Johnson, Director Deschutes County Department of Human Services Administrative Services Office of Contracts & Procurement 250 Winter Street NE, 3rd Floor Salem, OR 97301-1080 (DHS RE: Amendment #47 to the 2009-2011 Intergovernmental Agreement for the Financing of Mental Health, Developmental Disability, and Addiction Services Agreement #127295 Enclosed is an amendment to the Agreement. NOTE: Payment for amendments returned to DHS by the 3rd 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 if the amendment is more than 10 pages the "Fax Back Statement. • Fax the entire amendment to DHS at 503-373-7365. If amendment is more than 10 pages fax only the signature page of the amendment and the completed, signed "Fax Back Statement" to DHS at the number above. Following receipt by DHS of your signed amendment, DHS will route its copy of amendment to the official(s) who is/are authorized to execute the amendment. Once the amendment is signed DHS will scan the Amendment and transmit to the appropriate County official. If you have questions regarding this financial assistance award, please contact Sheryl Derting, Mental Health & Addiction Services, at (503) 945-6263 or April D. Barrett at (503) 945-5821. Sincerely, April D. Barrett, OPBC Contracts Specialist Enclosure "Assisting People to Become Independent, Healthy and Safe" An Equal Opportunity Employer Oregon Theodore R. Kulongoski, Govemor FAX BACK STATEMENT Department of Human Services Administrative Services Division Office of Contracts & Procurement 250 Winter Street NE, 3rd Floor Salem, OR 97301 )(DHS Please complete the following statement and return it along with the completed signature page. If any changes are made to the Amendment, please return the Amendment in its entirety. Thank you. I (Name) (Title) received a copy of Amendment #47 to Agreement #127295, between the State of Oregon, acting by and through the Department of Human Services and Deschutes County, from Tami Goertzen on December 9, 2010. On , I signed the printed form of the Amendment without change (Date) from the electronically transmitted document. A copy of the signature page pertaining to the above listed Amendment containing my signature is included with this facsimile transmission. (Signature) (Date) After all parties have signed, you will receive a copy of the Amendment for your records. If you have any questions, please call April D. Barrett at (503) 945-5821. Attachment(s) "Assisting People to Become Independent, Healthy and Safe" An Equal Opportunity Employer Oregon -1.85_9 Theodore R. Kulongoski, Governor Department of Human Services Administrative Services Office of Contracts & Procurement 250 Winter Street NE, 3rd Floor Salem, OR 97301 (503) 945-5818 Fax: (503) 378-4324 )(DHS In compliance with the Americans with Disabilities Act, this document is available in alternate formats such as Braille, large print, audiotape, oral presentation and electronic format. To request an alternate format, please send an e-mail to DHS.Forms@state.or.us or contact the Office of Document Management at (503) 378-3523, and TTY at 503-378-3523. FORTY-SEVENTH AMENDMENT TO DEPARTMENT OF HUMAN SERVICES 2009-2011 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF MENTAL HEALTH, DEVELOPMENTAL DISABILITY AND ADDICTION SERVICES AGREEMENT #127295 This Forty -Seventh Amendment to Department of Human Services 2009- 2011 Intergovernmental Agreement for the Financing of Mental Health, Developmental Disability and Addiction Services dated as of July 1, 2009 (as amended, the "Agreement"), is entered into, as of the date of the last signature hereto, by and between the State of Oregon acting by and through its Department of Human Services ("Department" or "DHS") and Deschutes County ("County"). RECITALS WHEREAS, the Department and County wish to modify the Financial Assistance Award set forth in Exhibit C-1 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. The financial and service information in the Financial Assistance Award 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 of Exhibit C-1 of the Agreement that describes the effect of an amendment of the financial and service information. "Assisting People to Become Independent, Healthy and An Equal Opportunity Employer DC -2011 008 2. Capitalized words and phrases used but not defined herein shall have the meanings ascribed thereto in the Agreement. 3. County represents and warrants to Department that the representations and warranties of County set forth in section 2 of Exhibit E of the Agreement are true 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 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. IN WITNESS WHEREOF, the parties hereto have executed this amendment as of the dates set forth below their respective signatures. STATE OF OREGON ACTING BY AND THROUGH ITS DEPARTMENT OF HUMAN SERVICES By: Date: Name: Stella Transue Title: Administrator, DHS Office of Contracts & Procurement Deschutes County By: Date: Name: Title: Document date: 12/9/2010 Amendment #47 Page 2 Reference #042 Exhibit 1 to the 47th Amendment to Department of Human Services 2009-2011 Intergovernmental Agreement for the Financing of Mental Health, Developmental Disability and Addiction Services Agreement #127295 Document date: 12/9/2010 Reference 1/042 Amendment #47 Page 3 DEPARTMENT OF HUMAN SERVICES Financial Assistance Award Amendment (FAAA) 2009-2011 CONTRACTOR: DESCHUTES COUNTY Contract#: 127295 DATE: 12/08/2010 Reference#: 042 MENTAL HEALTH SERVICES SECTION: 1 SERVICE REQUIREMENTS MEET EXHIBIT B AND, IF INDICATED, EXHIBIT B-2 Start/End CPMS Part Dates Name Approved Service Funds SE# 20 NON-RESIDENTIAL ADULT MH SERV B 10/2010- 1/2011 N/A SUBTOTAL SE# 20 - $5,047 Approved Serv. Unit EXHIB B2 Spec Start-up Units Type Codes Cond# $0 -8. SLT N/A - $5,047 $O SE# 24 REGIONAL ACUTE PSYCH INPATIENT A 7/2010- 6/2011 N/A $529,250 $O 730. CSD N/A SUBTOTAL SE# 24 $529,250 $0 SE# 28 RESIDENTIAL TREATMENT SERVICES A 10/2010- 1/2011 ONZEDR-860130 B 10/2010- 1/2011 N/A SUBTOTAL SE# 28 $9,000 $0 4. SLT N/A M0518 1 - $9,000 $0 -4. SLT N/A $0 $0 SE# 201 NON -RES DESIGNATED SVCS MHS A 10/2010- 1/2011 ONZEDR-860130 $7,069 $0 0. NA N/A SUBTOTAL SE# 201 $7,069 $0 TOTAL SECTION 1 $531,272 $0 TOTAL AUTHORIZED FOR MENTAL HEALTH SERVICES $531,272 TOTAL AUTHORIZED FOR THIS FAAA: $531,272 DEPARTMENT OF HUMAN SERVICES Financial Assistance Award Amendment (FAAA) CONTRACTOR: DESCHUTES COUNTY Contract#: 127295 DATE: 12/08/2010 REASON FOR FAAA (for information only): REF#: 042 Non -Residential Adult Mental Health (General) (MHS 20) funds are removed for rehabilitative services for one client at Edgecliff RTH, LOI #09-11-2643. Regional Acute Psychiatric Inpatient Services (MHS 24) funds are awarded for two beds, LOI #09-11-2664. Residential Treatment Services (MHS 28) limitation is decreased and funds are awarded for service payment for one client at Edgecliff RTH, LOI #09-11-2643. Non -Residential Adult Mental Health Services (Designated) (MHS 201) funds are awarded for rehabilitative services, room & board and PIF for one client at Edgecliff RTH, LOI #09-11-2643. The following 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 Award. M0518 1 MHS 28 Rate: For services delivered to individuals during a particular month, Department will provide financial assistance at the rate of $3,000 per month per individual. 1) W tn crt crt U q H u 040�a O it Z •d H ni •.i A U •r1 EL, w 2009-2011 In CI mit co r 4k H it Ei it 0 * U it it it 0 0 ° it it it it it it it it it kg) kg) N Ui H co In w 5 H m co o W N rn rn co O rI PROPOSED H o O 0 in- ill ih 0 ri o CO - N r to N th A CO to N CO o 0 W CO CO W R: O py p4 m o 0 J a N M M U W co o H r C i? , i? H i? DESCRIPTION W U) $1,999,044 0 $1,998,773 O O O N N CO co tlt ri to W W t.o o r r m m o r r m to W to W H H H r N N W o O co di rn di di M N ko H o o In N CO Vt dl co m H co to to o r r r r ih to Wo in - V} i- ih 0 0 O CO - 0 ri H N t? 4.(1- 0 0 i/} in- 0 ? 0 0 O N w �o to r to lD N W 0 o m d• O 0 N N to to to C- O} CO- AA- M a a w wH DI in M Fi Fi al a H z Z H H H H N xx rwn 0 0 ri4 iii H H HDI w EWi w w W (� g g A A 1-1 H O �YY N w w w N N z z Pd M P, A 00 000 V x U1 W W Z Z z 0 W G� 0 0 o H N H Vt d' N N N 0 N O N N H T 0 $2,253,922 TOTAL SE# 0 0 0 th 0 0 0 th 0 0 � Hl �4 rn 0 0 0 E N 0 E in- p, rd v t 013 ro o cwo) 41 • 0 N o O U }� aa rd O N H 1� Pi 41) W rn WHW nS z a W 0 0A H 4i N a •O Ul Ul f: 1i Fi RI E rd pH .0.0 a m o z CO CO W ri In 1, ON m o r r ON ,-i H r to N W w w c rt r H cr dt W N 0 CO r r LI- N W i? sh CO- DI U A H H M W W 0 tri u0 til H Q w w 1=4 r4 Hrn r$ co H H U N co W N N E DI A H � H H co rn 0 uwi W W 0 a W TOTAL CO W N TOTAL SE# Pi; En E 0 ro H ani a F, E N }ril 441 oI1F: Nn N N H 4 aH ca A -�t 2009-2011 H W g0 41 * 0 A k 0 W C7 0 °a 00 0 � a z 0 Na o 0 a H Ei 0 DESCRIPTION 0 tR 0 0 0 VI- 0 {r1- 0 t/} 0 if w d' t0 a d' w o o N m r) co o H H m m to r r H H N r Ol Ol to co co N N o o H H r; H H o o H H in in 0) t? t? H H H H tn- VI- o { trr to +A N ih tR 0 in - 0 0 0 in - 0 0 in - 0 0 0 0 0 m Lo 0 N t/} Lo 0 to 0 r N d1 d' l0 l0 d. W u) u) H r) r) o o H H H H r r N H H N r u) N [0 o o N r o o r H H o o H in- t/} H H H H tr} A ul in- V} (0- tri 0 0 0) Ch H aW A 0 A 41 r4 i-1 W �q H FC o 0 w H in W co m rn w rn A en H el E m \ El IX 41 4t it qQ [0 41 A 0) o (0 u1) 0)) A 0 (0 0 w H ut H � E -i m E -i H r) O r) 0m O m 0El E-1 o TOTAL SE# OR 0) NON -RES DESIGNATED SVCS T TOTAL SE# 201 0 U C7 W a �Z as P a) U g a) U Id 0 E N b cu a 0 o O) ol x g4J 0 b v ,11H a N 0 0 0, a El 40 o a) H a A a) W U U) PI 5 a) 4-5 0 0 N A 0 2009-2011 A �l w inm O O 0 0 N N w d N N r ul N W o u) N m m m m m m m m N r m al dt U] H i0 m al N N H H al m m rl o O co N 0 H O I-- H O O O N N 0 0 l0 l0 ,--1 H 0 0 H N W m l0 ON N N d' d' 01 01 d' d' N N V) H 14 r1 HN r--1 H m al d' d' to l0 i/} of d' in in- in- i/i in- in- in- in- in in in - CI i/} Hw U i< �a 0 A w U C7 0 Oa U a 0 caw 0 0 it it 1t ♦e 0 U 0 vi H HoN CO U o cal N 171 \ x w A O 0 0 in i!} 0 i!} 0 0 0 0 i/} 0 0 d•01 LD O O O O N N d' d' N O0 O m m m 0 m m of m m r r 10 d' 0 N N H H m m m m O O a O in 1.0 N N m m 1.0 1D H r -t 0 O M l0 0 N N d• d' rl rl d' d' N N U ri H N r 1 H m Cr) d' d' kr) to in- in - in. in- in- ininin- in. in- in -in. in - DESCRIPTION C4 a GI 0 U U Vi W 0 £ H 0) PI in H H w H W U1 �� PIH 0) a 0 ain PI PI A A a H 0 H m H H o N H o0 H 0 d• (i kr) W W N L N W N U til w m m El H 07, 07. 0 a Z P ?Li 0 o H N H CO H H H d' H l0 N N O N O N O m O m O ri T T T T T TOTAL SE# O $2,465,884 2 ri 0 U C7 z AHq W a z w U 1 91 ret N TS J1 w 0 1�-1 O 0, rd v N V r ,.1 0 0 arw 40 01 ri N fU,' H .arm • G r�1 0 0 0 ti H t3 0 0 H a+ W U CO U H r1 01 0 IX 00)0) 1J 0 tri 1., 0 al N id H w 0H zz rn W E O 'd • a- Ci r• d rd P U 4 N o G a ra w z4-) ri ▪ 4 ari • rd A U 0 ro a 2009-2011 toN W a, m a d. Ul N CO CO c 0 H O N 'a H in Li.) N W d, qN H N H H 0 O 0 U 0 Ul H w N m U 0 Ul H a w O 4 • Ca z 0 U PROPOSED 0 0 0 0 a o, o, rn m W(x �j co co in ul •41 ag U W H rl V v - DESCRIPTION PROJECTS H H U n H W M Cn 0 P4 w ro 0 0 r♦ to - 0 0 0 0 ri 0 0 N r♦ 0 0 0 0 ri cn W M o 0 0 N N z 0 0 rn rn M N ri "REVISED T it w � 4' -I) i< a + w 9 + U 1 a vwird 0 to 4 n3 H o H x U H It N H U 0 g 0 m m o 0 a) N f� H N W 7i 7, •rl H Z N N •F H •k it rl 4, a q UUj f0 it �t ri •N W x 4, 4, 4, 4, 4, 4, 4, 4, Q l0 O r M 0 0 0 O N N m CO Hlfl-41 10 ry w W co to 0 Ol l0 to O r r m Ol O O O OS o) d0 V) H CO ri m 0 N to 01 tn to r4 ri H r r d• to NO H O . . . . . . . . . . r > H Ol ON 0 0 N O N CO w M w dt M N t0 rl N W N W m m N O N W N m ' -41m r to co co H N N H to t0 O r r r r L? d• to W. (/)-.V} (f)- in- . . _ ri N ri rl N rf r-1 {J (1)- 114 . CONTRACT#: W W a H DESCRIPTION w U) o H in- N in - N r "r 0 0 0 in- in - 0 0 0 0 0 0 0 W to N N 0 0 W m m 0 0 0 O N to o O r m <D N to r CO Ol O r N l0 Ol N t0 O\ CO W d. N O N Ol sr N t0 Ol O\ N 0 N N N CO rl N N H to t0 to r . in- 4 H N ri i a a a W W W m W co cnu) PI CO HH Fri PI Q p 0) U) a H H H w w QRI E -t H H a a III CI) Ge)F4 A A A Q Q H H H 0 N U) U) U) N '8 (4 N cxa' A A O Z fIt ll a a 41: H 41 0 0 0 0 U) x u) 'Ti z z U U (x 0 0 0 H N N H d1 W N N N 0 N N 0 N N INPATIENT $2,253,922 0 0 0 yr 0 0 0 0 in - SERVICES SERVICES REGIONAL ACUTE PSYCH 0 0 $1,556,405 H H U) H H N IX N Za 'Zi N U WQ WA �t H H 0 m a a toE-. m m N 0 N N TOTAL SE# TOTAL SE# SUPERVISION 48 pH a 0 "REVISED CO N W O\ d' En H N 0 H O N > H N W H a H S4 U W * a * z * a * * O U S4 * * U * 0 * N 0 * W E * 0'0 * H v * HE.7 a >I M M CO CI 0 P tic 1) 1y O H U W N H a N H o r t 00 VI r0 W N A Ul H g * a0 W Ed it IT A0 * u ili 4 n5 * 0 * •ri * S4 it it it it * it * * it * 0 CO H H M CO U O H� w A E-1 O U DESCRIPTION W N N d' O d' at d' N N al O\ lO al al al ON L} O1 m m N N al O\ 00 lO al O\ m CO N N 0 0 0 CO H H1 l0 l0 H H CO OD 0 0 to ,n N co m m d' d' H H N N d W 00 tI} d' d' lO W -Ur ill t - CO -H H H Or CO- Or Or Or 0 0 0 th 0 0 0 0 O 0 0 th 0 O th 0 th O CO - 0 O th 0 Or CO- 0 th W N N d' O d' d' d' N N O\ O\ 11 O\ O\ al ON t/} 01 m m N N 01 al CO \O O\ O\ CO m N N 0 0 CO CO H HI \O l0 r -I H 00 CO O O ,n In N co m m d' d' H H N N d• d' CO -CO- d' d' l0 \0 Or L} Or in- H H -4 CO- ill th CO- Or CO- Or En U W E W N to H d H 0 W r4 DI ril (n 0 0 u A a W as FWl w HH o A H 0 0 d' H InEn En X to U N H m W m S4 W m A M m W m H H aEn >1A E.1 En En Qa Q `� 0 m w Ht E -i d' d' E+ (0 N to EH N m 0 m m O m 0 m O m H TOTAL SE# T T T TOTAL SE# SUPPORTED EMPLOYMENT SERVCS 0 H m 0 z H W * C4 * z * 0 q w * 0 U' * U 0 * J-) it 0 it co N k CO 5 0 2S w q wH � 'CI 0ri) 2 RI H 4 T-1 o ff U a W U H E N H .0 ni co Nrti Wz Inw z El n it Pi H Q •r1 it 0 0 ♦< rd it 0 it •r1 * W it it DESCRIPTION O H ri O1 O1 N O O m M O H H lf) In r -I H r -I V} 44- (0- V} Vf 0 Vf O O O O O rn w O N l0 O N 0 O V} CO r -I r -I ri ri ri N N O O N 0 010 10 OJ H r1 W W H r-1 H Li -VI- VI- }V} V} V} CSS -HOMELESS m W 0 NON -RES DESIGNATED SVCS 0 N TOTAL SE# 201 $9,692,903 N N 0 $9,160,954 0 0 0 U � "REVISED TOTAL" column The amounts in the