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HomeMy WebLinkAboutDoc 536 - OR CCF Signature AuthorizationDeschutes 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 August 31, 2011 Please see directions for completing this document on the next page. DATE: August 17,2011 FROM: Debi Harr CFC (541) 330-4692 TITLE OF AGENDA ITEM: Consideration of Board signature on Document # 2011-536, Oregon Commission on Children & Families signature authorization form. PUBLIC HEARING ON THIS DATE? No BACKGROUND AND POLICY IMPLICATIONS: At the beginning of each biennium, Oregon Commission on Children & Families policy requires a signature authorization form to approve budget documents, reports and funds requests. The form requires the signature of the Chair of the Board of County Commissioners, the County Administrator, the Chair of the local Children & Families Commission, the Director of the Children & Families Commission, and the Financial Analyst of the Children & Families Commission. FISCAL IMPLICATIONS: None RECOMMENDATION & ACTION REQUESTED: Approval and signature of the Chair of the Board of County Commissioners, and the County Administrator on Document # 2011-536. ATTENDANCE: Debi Harr DISTRIBUTION OF DOCUMENTS: Return the original document to Debi Harr at the Children & Families Commission, 1130 NW Harriman, Ste. A, Bend OR 97701. 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 retumed 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: ~ugust 10, 2011. Department: ICFC! Contractor/Supplier/Consultant Name: IOregon Commission on Children & Familieij Contractor Contact: ISandra Flickingerl Contractor Phone #: 50337 Type of Document: Signature Authorization form Goods and/or Services: According to Oregon Commission on Children & Families policy, local Commissions must submit a signature authorization form for quarterly reports, funds requests and budget documents. Background & History: This authorization form needs to be filled out at the beginning of each biennium, or any time there is a change in leadership. Agreement Starting Date: puly 1,20111 Ending Date: IJune 30, 201~ Annual Value or Total Payment: IIQI o Insurance Certificate Receiied (CieCk box) Insurance Expiration Date: Check all that apply: o RFP, Solicitation or Bid Process o Informal quotes «$150K) [2J Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37) Funding Source: (Included in current budget? 0 Yes [2J No If No, has budget amendment been submitted? 0 Yes 0 No Is this a Grant Agreement providing revenue to the County? 0 Yes [2J 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 8/10/2011 Contact information for the person responsible for grant compliance: Name: Hilla Saraceno Phone #: i317-317 Departmental Contact and Title: Debi Harr, Financial Analyst Phone #: (541) 330-4692 Department Director Approval: Distribution of Document: Return original document to Debi Harr at CFC, 1130 NW Harriman, Ste A, Bend, OR 97701 Official Review: County Signature Required (check one): 0 BOee 0 Department Director (if <$25K) ~' Administrator (if >$25K but <$150K; if >$150K, BOCe Order No. _____) Legal Review ~fi-M Date If I? (( Document Number 2011-536 8/1012011 POLICY AND PROCEDURE MANUAL • •OCCF SUft of Or~gon Subject: County Authorized Signatures Policy/Procedure Number: CTY -010 Effective Date: Revised June 1, 2008 Purpose: This policy establishes an authorized signature sheet for local commissions to notify the State Office of their authorized signatories. This provides internal control when implementing the budgeting, releasing, and reporting of state funds for both county and state. References: This policy and procedure is in accordance with OCCF Administrative Rule 423­ 010-0021 through 423-010-0027. Policy: Local commissions shall have on file with the State Commission on Children and Families a complete signature authorization form. Any change in signatory due to a change in leadership requires a new form, which should be completed immediately by the local commission. The authorization form will be on file at the State Office to verify approval has been given by authorized signatories. Local commissions provide several different documents to the State Office. The State Office implemented a web based reporting database which requires electronic submission of reporting documents and request for funds. Individuals who submit quarterly reporting documents and funds requests should not be the same individual who approves those quarterly reports. The local commission shall have in place written internal controls on how the approval and submission of reports and reporting documents is separated. The following is a summary of documents and authorities that must approve, sign and/or submit them. The State Office will verify the authorized approval, signature and/or submittal name upon receipt of these documents. If the name is not included on the authorization form, the local commission will be notified. The local commission will need to provide an updated authorization form with the new authorization(s) or submit a revised document with an authorized signature. Legal Documents Comprehensive Plan and Update • Must be approved by Chair of Board of County Commissioners; and Oregon Commission on Children & Families: Authorized Signatures (Revised) Oregon Commission on Children and Families Signature Authorization Form Desch u fe s County The undersigned individual is hereby authorized to approve legal and reporting documents. Chair, Board of County Commissioners (Signature) -rAm Wf ~ r3{(1f e j Printed Name The undersigned Individual is hereby authorized to approve legal documents on behalf of the Board of County Commissioners (BOCC). Other Delegate (Signature) DAIle, fA VIner Printed Name The undersigned individual is hereb thorized to approve comprehensive plan and updates and budget distributions. I Chair, Local Co on Children & Families (Signature) kblUIlttt DAVi dSfJl1 Printed Name The undersigned individual is hereby authorized to approve reporting documents including budget distribution (less than 5% change), request for funds, expenditure, carry-over, Healthy Start Medicaid Earnings Statements, and Medicaid Reinvestment Plan reports and reporting documents. Director, Loc Commission on Children & Families (Signature) !-Ii l/aY'1j 5tt Vt1 cen 0 Printed Name The undersigned individual is hereby authorized to electronically submit prior approved reporting documents including budget distribution (less than 5% change), request for funds, expenditure, leverage, outcome, and monitoring reports and reporting documents. r;:3241, ~ Other Delegate (Signature) Deb', HaY'v Printed Name -f~EVIEVif~ J) ~~, t~ LEGAL COUNSEL DC -2 0 11 - S 3 6 Debi Harr From: Hillary Saraceno Sent: Friday, July 22, 2011 10:52 AM To: Debi Harr; Sarah Johnson; Jessica Kelly Subject: FW: County Policies link on website FYI. In partnership ­ r-lillar.lj Saraceno, Director Children & Families Commission 541 317-3178 office Our Vision: Healthy Children, Strong Families, Supportive Communities From: Brenda Brooks [mailto:brenda.brooks@occf.state.or.us] Sent: Friday, July 22,201110:45 AM Subject: County Polides link on website Dear Local Commission Directors: We want you to know that we have added a website link dedicated to county policies. It is located in the left­ hand column of the home page of our website: http://www.oregon.gov/OCCF/.Click on the link that says County Policies. This section will eventually replace the former First Class Policy and Procedures folder. This section will house county-related policies and will be updated when policies are revised. At this time the section includes the County Authorized Signatures page. If you have not updated this form, please download a copy and return it to Sandra Flickinger as soon as possible. Sandra can be reached at Sandra.A.Flickinger@state.or.us, or you can call her at 503-378-5125. Regards, Brenda Brenda Brooks Communications Coordinator Oregon Commission on Children and Families 530 Center St. NE, Suite 100 Salem, OR 97301 503-378-5129 brenda. brooks@state.or.us 1 Oregon Commission on Children & Families: Authorized Signatures (Revised) • Must be approved by Chair of Local Commission Intergovernmental Grant Agreements/Amendments • Must be signed by Chair of Board of County Commissioners or other delegate Medicaid Agreement • Must be signed by Chair of Board of County Commissioners or other delegate Initial Budget Distribution • Must be approved by Chair of Board of County Commissioners; and • Must be approved by Chair of Local Commission Reporting Documents Quarterly Budget Distribution • Must be approved by Chair of Board of County Commissioners if the total available budget is being increased or decreased by five percent (5%) or more; otherwise • Must be approved by Chair of Local Commission, Director of Local Commission, or a delegated signer • Must be submitted electronically by Chair of Local Commission, Director of Local Commission, or a delegated signer Request for Funds • Must be approved by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer • Must be submitted electronically by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer Quarterly Expenditure Report • Must be approved by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer • Must be submitted electronically by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer Bi-Annual Monitoring, Outcomes, and Leveraged Resources Reports • Must be approved by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer • Must be submitted electronically by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer Carry-over Fiscal Report • Must be signed by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer Healthy Start Medicaid Earnings Statement • Must be signed by Chair of Board of County Commissioners, Director of Local Oregon Commission on Children & Families: Authorized Signatures (Revised) Commission, or a delegated signer Medicaid Reinvestment Plan • Must be signed by Chair of Board of County Commissioners, Director of Local Commission, or a delegated signer Procedure: • State Office: will provide the local commission with a Signature Authorization Form. • Local Commission: will provide the State Office with original current signatures on the Authorized Signatures Form by mail. • State Office: will receive and retain the form for verification. For legal documents, the Board of County Commissioner (BOCC) may delegate signature authority to another designee. The BOCC must supply the State Commission with signed documentation designating the authorized signer. When changes occur with the local commission authorized signatures it will be the local commission's responsibility to submit an updated Signature Authorization Form.