HomeMy WebLinkAboutDoc 176 - IGA - CO Health Board as 190e
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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 April 6, 2011
DATE: March 28, 2011
FROM: Scott Johnson, Director, Deschutes County Health Services, 541-322-7502
TITLE OF AGENDA ITEM:
Consideration of Board Signature Document #2011-176, Intergovernmental Agreement
between Crook, Deschutes and Jefferson Counties to form the Central Oregon Health Board
as a 190 organization.
PUBLIC HEARING ON THIS DATE? No.
BACKGROUND AND POLICY IMPLICATIONS:
In the interest of improving health outcomes, increasing satisfaction with the health
systems and reducing costs (Triple Aim), Deschutes, Crook and Jefferson Counties wish
to form an intergovernmental entity referred to as the "Central Oregon Health Board"
(Board). The Board is to promote the health of the Central Oregon region and its residents.
The goal is to manage resources efficiently and effectively, in collaboration with local and
State Government, the hospital system, local providers, private insurers, health
collaboratives and most importantly our community and the people we serve.
The Board will contract and administer contracts with the State of Oregon and any other
public and private entity to provide or secure a wide range of health services including
behavioral health, physical health and public health. In addition to the administration of
contracts, the Board will:
a. Conduct a periodic regional health assessment to inform decision -makers on
such matters as planning, policy development, system design and
investments.
b. Develop and establish policies that will support Health Services on behalf of
the Central Oregon population.
c. Improve the coordination of funding for Health Services among the Parties
and relevant stakeholders. This includes establishing financial systems,
maintenance of financial reserve requirements, policies, and monitoring sub -
capitated funds of the Parties and other Health Service providers in Central
Oregon.
d. Develop and adopt a coordinated regional Health Improvement Plan to
improve collaboration among health care providers.
e. Collect and analyze health system costs and outcome data to measure the
quality and performance of the health system in order to lower costs,
increase access, improve satisfaction and increase efficiency. This includes
establishing management information systems to meet reporting
requirements.
f. Promote evidence -based practices and prevention programs, including, but
not limited to: quality assurance guidelines and oversight, utilization
management for services both inpatient and outpatient, and providing
member services including education and prevention activities.
Promote models of care that improve the provision of services for patients
among various providers so that individuals can navigate service systems
successfully. This would include the development and implementation of
processes for hearing, monitoring and resolving complaints and grievances.
h. Hiring employees to perform administrative tasks and other duties as
assigned or delegated by the Governing Board and Administrative Council.
g.
The Counties agree that through this formation of an intergovernmental entity, with the
(Board's signature and approval of Document #2011-176), the Counties will be able to
provide the best possible behavioral health, physical health and public health services to
the client population of all three Counties.
FISCAL IMPLICATIONS:
There is no fiscal impact at time of signature or change in the budget that can be identified
at this time. It is likely some grants or state contracts that are of a regional nature will be
managed through this new organization in the coming years.
RECOMMENDATION & ACTION REQUESTED:
Deschutes County Health Services recommends approval and signature of the
Intergovernmental Agreement, Document #2011-176.
ATTENDANCE: Scott Johnson, Director
DISTRIBUTION OF DOCUMENTS:
Original to Deschutes County Clerk for recording, one copy to Nancy England, Deschutes
County Health Services Department; one copy to Jefferson County; one copy to Crook
County.
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.)
Date:
Please complete all sections above the Official Review line.
March 28, 2011
Department:
Health Services
Contractor/Supplier/Consultant Name:
Contractor Contact:
Scott Johnson
Central Oregon Health Board
Contractor Phone #:
Type of Document: Intergovernmental Agreement (IGA)
541-322-7500
Goods and/or Services: This IGA shall be used to form the Central Oregon Health
Board as a 190 organization between Crook County, Deschutes County and Jefferson
County.
Background & History: Over the past eighteen (18) months, a number of health
organizations and interests in Central Oregon have been working to develop a structure
and set of functions to improve the health of people in our region and the performance
of the health care system in Crook, Deschutes and Jefferson Counties. Represented
organizations include all three (3) counties (Boards of Commissioners), Deschutes
County Health Services (DCHS), PacificSource, Accountable Behavioral Health Alliance
(ABHA), St. Charles Health System, HealthMatters, Volunteers in Medicine, Oregon
Health Authority, BestCare Treatment Services, Lutheran Community Services NW and
others.
In July of 2010, the Boards of County Commissioners (Boards) in all three (3) counties
agreed in concept that the region would benefit from a formal process for the
aforementioned groups to work together more closely in adapting to health reform
changes at the national, state and local levels. Our goal was and is to improve the
health of the region's residents, to improve the quality of care they receive and to
reduce the costs of such services (i.e. The Triple Aim). In July, the Boards charged
staff with developing recommendations to begin this change process. This work
continued under the title of the "Central Oregon Health Authority". Leadership was
provided by a Transitional Board, chaired by Commissioner Tammy Baney, and an
Administrative Council, chaired by Scott Johnson, Director of DCHS.
In September of 2010, a Memorandum of Understanding (MOU) was signed by
representatives of the Oregon Health Authority, all three (3) counties, PacificSource,
ABHA and St. Charles Health System detailing more specifically our plans and
agreements.
In addition to a number of planning efforts and actions to improve and better integrate
services, it has become clear that a more formal relationship is needed to better align
the work of the three (3) county governments, particularly as they fulfill their
3/28/2011
responsibilities as the behavioral health authority and public health authority for each
respective county. It was agreed that the organization would be referred to as the
"Central Oregon Health Board". With the assistance and approval of County Counsels,
including Mark Pilliod with Deschutes County, the attached IGA was prepared for
signature. Both the Jefferson County Board of Commissioners and the Crook County
Court have formally approved this IGA and formation of the Central Oregon Health
Board. Formation of the Central Oregon Health Board will occur with an affirmative
action by the Deschutes County Board of Commissioners.
There is no fiscal impact at time of signature or change in the budget that can be
identified at this time. It is likely some grants or state contracts that are of a regional
nature will be managed through this new organization in the coming years.
Start Date:
Signature Date
End Date:
Annual Value or Total Payment:
Upon Written Notice of Termination
No fiscal implication.
® Insurance Certificate Received (check box)
Insurance Expiration Date:
N/A
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 ® 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 #:
541-322-7502
Department Director Approval:
Scott Johnson, Director
s.23-11
Date
3/28/2011
Distribution of Document: Original to Deschutes County Clerk for recording, one
copy to Nancy England, Deschutes County Health Services Department; one copy to
Jefferson County; one copy to Crook County.
Official Review:
County Signature Required (check one): ❑ BOCC ❑ Department Director (if <$25K)
❑ Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. )
Legal Review Date
Document Number 2011-176
3/28/2011
REVIEWED
LEGAL COUNSEL
For Recording Stamp Only
CENTRAL OREGON HEALTH BOARD
INTERGOVERNMENTAL AGREEMENT
This Agreement, entered into by Deschutes, Jefferson and Crook Counties (herein collectively
referred to as "Counties" or "Parties") pursuant to ORS Chapter 190 to form an intergovernmental
entity to be referred to as the Central Oregon Health Board ("COHB" or "BOARD"). Each Party is a
political subdivision of the State of Oregon.
WHEREAS, each of the Parties to this Agreement has authority to preform the functions, duties, and
responsibilities set out in this Agreement itself or by agreement with the other Parties; and
WHEREAS, the Parties to this Agreement wish to form an intergovernmental entity to perform the
functions, duties and responsibilities set out in this Agreement in the interest of 1) furthering economy
and efficiency in the delivery of local health services, including public health and behavioral health
services, 2) collectively contracting with the State of Oregon and other public and private health
entities, 3) furthering coordination and continuity of quality health services to the residents of all three
Counties; and 4) achieving the Triple Aim: improve health outcomes, increase satisfaction with the
health systems and reduce costs.
THE PARTIES AGREE AS FOLLOWS:
1. PURPOSE: This Agreement establishes and forms a three county intergovernmental entity to
be known as the Central Oregon Health Board, hereinafter known as BOARD. The BOARD is
to promote the health of the Central Oregon region and its residents. It seeks to improve
health outcomes, increase satisfaction with our health systems and reduce cost. The goal is
to manage resources efficiently and effectively, in collaboration with local and State
Government, the hospital system, local providers, private insurers, health collaboratives and
most importantly our community and the people we serve.
2. EFFECTIVE DATE: This Agreement shall be effective when fully executed by all Parties.
3. FUNCTIONS: The BOARD will contract and administer contracts with the State of Oregon
and any other public and private entity to provide or secure a wide range of health services
including behavioral health, physical health and public health (collectively "Health Services").
In addition the BOARD will perform the following:
a. Conduct a periodic regional health assessment to inform decision -makers on such
matters as planning, policy development, system design and investments.
b. Develop and establish policies that will support Health Services on behalf of the
Central Oregon population.
c. Improve the coordination of funding for Health Services among the Parties and
relevant stakeholders. This includes establishing financial systems, maintenance of
financial reserve requirements, policies, and monitoring sub -capitated funds of the
Parties and other Health Service providers in Central Oregon.
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d. Develop and adopt a coordinated regional Health Improvement Plan to improve
collaboration among health care providers.
e. Collect and analyze health system costs and outcome data to measure the quality and
performance of the health system in order to lower costs, increase access, improve
satisfaction and increase efficiency. This includes establishing management
information systems to meet reporting requirements.
f. Promote evidence -based practices and prevention programs, including, but not limited
to: quality assurance guidelines and oversight, utilization management for services
both inpatient and outpatient, and providing member services including education and
prevention activities.
Promote models of care that improve the provision of services for patients among
various providers so that individuals can navigate service systems successfully. This
would include the development and implementation of processes for hearing,
monitoring and resolving complaints and grievances.
h. Hiring employees to perform administrative tasks and other duties as assigned or
delegated by the Governing Board and Administrative Council.
g.
4. FUNDING: The BOARD shall receive funding through contracts with the State of Oregon and
any other public or private entity and shall be fully responsible for all funding of the BOARD'S
functions, duties and responsibilities under this Agreement. Each Party to this Agreement
shall receive funding from the BOARD, and each of the Parties to this Agreement shall be fully
responsible for all funding of that Party's functions, duties and responsibilities under the
Agreement.
5. TERM: This Agreement shall be in effect for the life of the BOARD. Should any Party wish to
withdraw from the BOARD, the remaining Parties shall negotiate a new Agreement.
6. TERMINATION: This Agreement may be terminated, in writing, by mutual consent of all the
Parties, or by agreement of any two of the Parties, provided that one of those two Parties is
Deschutes County. It shall expire with no further action of any of the Parties should the
BOARD terminate or be dissolved. As the Agreement creates the BOARD, termination of the
Agreement terminates the BOARD.
7. DEBTS, LIABILITIES AND OBLIGATIONS: All debts, liabilities, and obligations of any of the
Parties shall be and shall remain debts, liabilities, and obligations of that or those Parties and
shall not become debts, liabilities, and obligations of any other Party or Parties or of the
BOARD. Debts and obligations shall remain the liabilities of the incurring Party, whether or
not that Party remains a member of the BOARD. All debts, liabilities, and obligations incurred
by or on behalf of the BOARD shall remain debts, liabilities, and obligations of the BOARD.
Notwithstanding any other provision of this Agreement, this provision shall survive termination
or dissolution of this Agreement.
8. DISSOLUTION: Upon dissolution of the BOARD, any assets, other than the reserve funds
discussed in Section 10 below, acquired by the BOARD during its existence shall be
distributed proportionate to a Party's contribution to the operating budget of the Authority
between all the Parties which are members of the BOARD at the date of dissolution. Except
as provided in Section 10, no distribution shall be made to any original Parties to this
Agreement which are no longer members at the date of dissolution. Any indebtedness of the
BOARD, outstanding at the date of dissolution, shall be satisfied before assets are distributed.
In satisfying such outstanding indebtedness, assets of the BOARD shall be applied first, and
2 of 5 - INTERGOVERNMENTAL AGREEMENT— Doc# 2011-176
only after those assets have been exhausted may the reserves discussed in Section 10,
below, be applied to the debt. Should there be sufficient assets to satisfy all debts and claims
against the BOARD, then each Party shall be entitled to a refund based upon the proportion of
the Party's funding contributions since the inception of this Agreement.
9. WITHDRAWAL: If a Party to this Agreement withdraws from this Agreement prior to
dissolution, that Party shall not be entitled to any distribution of BOARD assets or funds
except for reserves, as set out in Section 10, below. A withdrawing Party shall be entitled to a
distribution of any contribution by that Party to the reserve fund, described in Section 10, Tess
the amount needed to satisfy all outstanding claims, debts, liabilities and obligations of or
against the BOARD for or on behalf of that Party prior to or at the time of withdrawal.
10. RESERVES: The Reserves are those sums contributed after negotiation by the Parties to
cover start-up and initial administrative expenses. Reserves shall not be considered assets of
the BOARD for purposes of this Agreement. Should one of the Parties to this Agreement
withdraw from this Agreement without the remaining Parties dissolving the BOARD or upon
dissolution of the BOARD, the withdrawing Party shall be entitled to receive a proportionate
refund of its initial contribution to the reserves of the BOARD and a proportionate refund of its
enrolled population contribution under State funding made since inception of this Agreement.
This refund shall be paid from available funds, if any, and shall not, in any event, exceed the
contributions of the individual withdrawing Party. In determining available funds, a sum equal
to the amount necessary to cover any outstanding claims, debts, liabilities or obligations of or
against the BOARD for services rendered to the BOARD prior to or at the time of the
withdrawal shall be set aside before any distribution Is made.
11. GOVERNING BOARD: The BOARD shall be governed by a three-member governing board.
The governing board shall be comprised of one commissioner from each of the Boards of
Commissioners or the County Court of each County. Each commissioner shall be appointed
by his or her respective Boards of Commissioners or County Court. The governing board
shall have the following rights and responsibilities: establish overall governing guidelines,
appoint members of advisory boards, hire and evaluate the performance of the Executive
Director, appoint and oversee the Administrative council, oversee the operation of the
BOARD, and any other right or responsibility deemed necessary and appropriate. The
governing board has the authority to enact bylaws which shall govern its actions.
12. GOVERNING BOARD VOTING: Decisions of the BOARD will require a majority vote and
must include support from Deschutes County. On issues of potential disagreement, the
Governing Board may request recommendations from the Administrative Council. Under
extraordinary situations, a County representing a minority view may, with the agreement of
that County's governing body, ask for a joint meeting of the three Counties' governing bodies.
13. ADMINISTRATIVE COUNCIL: The Administrative Council ("Council") shall be comprised of
thirteen -fifteen members: (1) one behavioral health representative and (1) one public health
representative from each of the counties which are Parties to this Agreement, to be appointed
by the governing body of his/her county and (7-9) members to be appointed by the governing
board in accordance with the provisions of the adopted bylaws representing stakeholder,
hospital system, local providers, private insurers, safety net providers and other community
members as appropriate.
The Council shall have the following rights and responsibilities: recommend goals and
objectives for the BOARD; establish standards and administrative and operational policies;
assure provision of appropriate service delivery; advice on strategic and operational matters;
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develop projects and action plans in support of regional policies; develop a Health
Improvement Plan and performance outcomes and any other rights or responsibilities that are
deemed necessary by the Governing Board. The Council has the authority to enact bylaws
which shall be approved and adopted by the Governing Board and which shall govern its
actions.
14. EXECUTIVE DIRECTOR: The Governing Board shall hire an Executive Director who shall
have the following rights and responsibilities: monitor Authority activities for contract and
regulatory compliance, enter into contracts for the provision of physical health, public health,
social services and behavioral health services, oversee day-to-day operations of the BOARD;
and work with the Administrative Council to set goals and objectives for the BOARD, establish
standards and administrative policies and procedures and any other rights and responsibilities
that are deemed necessary by the Governing Board.
15. MERGER: This Agreement is intended both as the final expression of the Agreement
between the Parties with respect to the included terms and as a complete and exclusive
statement of the terms of the Agreement.
16. MODIFICATIONS: No modification of this Agreement shall be effective unless and until it is
made in writing and signed by all Parties.
17. HOLD HARMLESS: Each of the Parties shall be solely responsible for any liability incurred
by that Party. To the extent possible under the limits of the Oregon tort Claims Act, each
Party shall hold the others harmless, indemnify and defend the others' officers, agents and
employees from any and all liability, actions, claims, losses, damages, or other costs including
attorney's fees and witness costs (at both trial and appeal level, whether or not a trial or
appeal ever take place) that may be asserted by any person or entity arising from, during, or
in connection with the performance of the work described in this Agreement, except liability
arising out of the sole negligence of one or more of the other Parties or its or their employees.
If any aspect of this indemnity shall be found to be illegal or invalid for any reason whatsoever,
such illegality or invalidity shall not affect the validity of the remainder of this indemnification.
18. SEVERANCE: if any aspect of this Agreement shall be found to be illegal or invalid for any
reason whatsoever, such illegality or invalidity shall not affect the validity of the remainder of
this Agreement.
19. NONDISCRIMINATION: The Parties shall comply with all applicable federal, state, and local
laws, rules and regulations on nondiscrimination in employment because of race, color,
ancestry, national origin, religion, sex, marital status, age, medical condition or disability,
sexual orientation or any other protected status or class.
20. CONTRACT EXECUTION IN COUNTERPARTS: This Agreement shall be comprised of three
separate original documents, identical but for the signature blocks. The governing body of
each Party shall execute and date one of the separate original documents. Pursuant to
section 2, this Agreement shall be final upon the date of the last signature. Deschutes County
shall compile the three separate original documents into one document. From that time
forward, this compilation shall be considered the original Agreement. Deschutes County shall
provide a full copy of this Agreement to each of the other Parties and shall maintain the
original in its records.
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DATED this day of , 2011.
DESCHUTES COUNTY BOARD OF DIRECTORS
TAMMY BANEY, County Commissioner
ANTHONY DeBONE, County Commissioner
ALAN UNGER, County Commissioner
5 of 5 — INTERGOVERNMENTAL AGREEMENT— Doc# 2011-176