HomeMy WebLinkAboutOrdinance 013 - IGA - CO Health BoardDeschutes County Board of Commissioners
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AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of April 6, 2011
DATE: March 29, 2011
FROM: Scott Johnson, Director, Deschutes County Health Services, 541-322-7502
TITLE OF AGENDA ITEM:
Consideration of First and Second readings by Title Only, and Adoption, by Emergency, of
Ordinance 2011-013 Amending Deschutes County Code 2.60, ratifying an Intergovernmental
Agreement establishing the Central Oregon Health Board as an Intergovernmental Entity.
PUBLIC HEARING ON THIS DATE? No.
BACKGROUND AND POLICY IMPLICATIONS:
Over the past eighteen (18) months, a number of health organizations, including public and
private health and behavioral health care providers in Central Oregon have been working
to develop a new organization whose task it would be 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 the interest of improving health outcomes, increasing satisfaction with the health
systems and reducing costs (Triple Aim), representatives of Deschutes, Crook and
Jefferson Counties have proposed creating an intergovernmental entity by means of an
Intergovernmental Agreement (IGA) to be known as the "Central Oregon Health Board"
(Board). The principal goal of the Board would be to promote the health of the Central
Oregon region and its residents. Included with this goal would be the efficient and
effective management of health care resources in collaboration with local and State
Govemment, the hospital system, local providers, private insurers, and most importantly
our community and the people we serve. The Board would contract and administer
contracts with the State of Oregon and other public and private entities to provide or
secure a wide range of health services including behavioral health, physical health and
public health.
Deschutes County Health Services has proposed approval and signature of the "Central
Oregon Health Board" Intergovernmental Agreement, Document #2011-176 as an agenda
item for the Board meeting, April 6, 2011. ORS 190.085 requires that local govemments
ratify the creation of intergovemmental entities through IGA's via ordinances prior to the
effective date of such agreements; therefore Deschutes County Health Services
recommends approval of the first reading of Ordinance No. 2011-013 on April 6, 2011 and
approval of the second reading April 20, 2011 and adoption of the Ordinance, with it taking
immediate effect by declaring an emergency.
FISCAL IMPLICATIONS:
Since this action only creates the structure of an organization, there is no fiscal impact at
this time. It is likely that in the future some grants or state contracts that are of a regional
nature will be managed through this new organization.
RECOMMENDATION & ACTION REQUESTED:
Deschutes County Health Services recommends the Board conduct the First by title only at
this meeting and the Second reading by title only and adoption of Ordinance 2011-013 at the
meeting of April 20 or a near future meeting.
ATTENDANCE: Scott Johnson, Director
DISTRIBUTION OF DOCUMENTS:
Nancy England, Deschutes County Health Services Department.
REVIEWED
CODE REVIEW COMMITTEE
For Recording Stamp Only
BEFORE THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON
An Ordinance Amending Deschutes County Code
2.60, Ratifying an Intergovernmental Agreement
Establishing the Central Oregon Health Board as
an Intergovernmental Entity and Declaring an
Emergency.
ORDINANCE NO. 2011-013
WHEREAS, the public health service providers in Crook, Jefferson and Deschutes Counties
("Parties")find that it is their mutual self interest, as well as the best interest of the public to fully integrate the
management, delivery, and oversight of the provision of local health services, including public health and
behavioral health services; and,
WHEREAS, the Parties have entered into an intergovernmental agreement, whose purpose it is to
establish an intergovernmental entity, which would enable the Parties to collectively contract with the State
of Oregon and other public and private healthcare providers; further the coordination and continuity of quality
health services to the residents of all three counties; and seek to achieve the Triple Aim of improving health
outcomes, increase satisfaction with the healthcare delivery systems and reduce costs; and,
WHEREAS, the Board of County Commissioners ("Board") agrees that the intergovernmental
agreement (IGA) as recommended by the Director of the Health Department is in the best interest of the County;
and,
WHEREAS, ORS 190.085 requires local governments to ratify the creation of
intergovernmental entities through intergovernmental agreements via ordinances prior to the effective
date of such agreements; now, therefore,
THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON, ORDAINS
as follows:
Section 1. The Board hereby declares its intent to create an intergovernmental entity by
intergovernmental agreement (IGA) with the Crook County and Jefferson County.
Section 2. The intergovernmental entity shall be known as the Central Oregon Health Board.
Section 3. The IGA, attached as Exhibit A and incorporated by reference, describes the powers, duties
and functions of the Central Oregon Health Board, and is hereby ratified.
Section 4. According to the terms of the IGA, the Central Oregon Health Board shall be
formed and the IGA effective upon the ratification of that IGA by the Board, the Crook County Court
and the Jefferson County Board of Commissioners.
///
PAGE 1 OF 2 - ORDINANCE NO. 2011-013 (04/06/2011)
Section 5. AMENDMENT. DCC 2.60 is amended to read as described in Exhibit "B," attached hereto
and by this reference incorporated herein, with new language underlined and language to be deleted in
stfikethceugh.
Section 6. EMERGENCY. This Ordinance being necessary for the immediate preservation of the
public peace, health and safety, an emergency is declared to exist, and this Ordinance takes effect on its passage.
DATED this day of , 2011.
BOARD OF COUNTY COMMISSIONERS
OF DESCHUTES COUNTY, OREGON
TAMMY BANEY, Chair
TONY DEBONE, Commissioner
ALAN UNGER, Commissioner
Date of 1d Reading: day of , 2011.
Date of 2°d Reading: day of , 2011.
Record of Adoption Vote
Commissioner Yes No Abstained Excused
Tammy Baney
Tony DeBone
Alan Unger
Effective date: day of , 2011.
ATTEST:
Recording Secretary
PAGE 2 OF 2 - ORDINANCE NO. 2011-013 (04/06/2011)
REVIEWED
LEGAL COUNSEL
For Recording Stamp Only
EXHIBIT A
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.
1 of 5 - INTERGOVERNMENTAL AGREEMENT— Doc# 2011-176
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, less
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;
3 Of 5 — INTERGOVERNMENTAL AGREEMENT — Doc# 201 1 -1 76
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.
4 of 5 — INTERGOVERNMENTAL AGREEMENT— Doc# 2011-176
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
EXHIBIT B
Chapter 2.60. INTERGOVERNMENTAL ENTITIES
2.60.010. Purpose.
2.60.020. Definition -Intergovernmental Entity.
2.60.030. Accountable Behavioral Health Affiance.
2.60.040. Central Oregon Law Enforcement Services.
2.60.050 Central Oreeon Health Board
2.60.010. Purpose.
The purpose of DCC 2.60 is to ratify the creation of intergovernmental entities through intergovernmental
agreements pursuant to ORS 190.085.
(Ord. 97-039 §1, 1997)
2.60.020. Definition -Intergovernmental Entity.
For purposes of DCC 2.60, "intergovernmental entity" shall mean an entity created through an
intergovernmental agreement pursuant to ORS 190 governed by a board or commission appointed by,
responsible to, and acting on behalf of the parties to the intergovernmental agreement.
(Ord. 97-039 §1, 1997)
2.60.030. Accountable Behavioral Health Alliance.
A. Deschutes County ratifies the creation of the Accountable Behavioral Health Alliance (Alliance).
B. The Alliance shall have the power to enter into contracts, provide mental health services under the
Oregon Health Plan, provide behavioral health services as a unified entity, and provide all
administrative services necessary for the provision of these services.
(Ord. 97-039 §1, 1997)
2.60.040. Central Oregon Law Enforcement Services.
A. Deschutes County ratifies the creation of Central Oregon Law Enforcement Services (COLES).
B. COLES shall have the power to enter into contracts, provide agreed upon law enforcement services as
a unified entity and provide all administrative and support services necessary for the provision of these
services.
(Ord. 99-002 *1, 1999)
2.60.050. Bend Metropolitan Planning Organization.
A. Deschutes County ratifies the creation of the Bend Metropolitan Planning Organization (BMPO).
B. The BMPO shall have the power to enter into contract, incur debt, own property and provide all
administrative and support services necessary for the provision of transportation planning services for
the Bend Metropolitan Area.
(Ord. 2002-034 *5, 2002)
Chapter 2.60 1 (04/2011)
2.60.060 Central Oregon Health Board
A. Deschutes County ratifies the creation of the Central Oregon Health Board.
B. The Central Oregon Health Board shall have the power to enter into contracts. provide health and
behavioral health care services as a unified entity and provide all administrative and support
services necessary for the provision of such services for the residents of Deschutes. Crook and
Jefferson counties.
(Ordinance No. 2011-013, §3, 2011)
Chapter 2.60 2 (04/2011)