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HomeMy WebLinkAboutDoc 698 - IGA Amend - OHA FundingDeschutes 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 December 19,2011 ~: December 9, 2011 FROM: Nancy England, Contract Specialist, Deschutes County Health Services, 322-7516 TITLE OF AGENDA ITEM: Consideration of Board Signature of Document #2011-698, Amendment # 3 to Intergovernmental Financial Agreement Award #135558 between the Local Public Health Department and the Oregon Health Authority for the financing of Local Public Health Services for fiscal year 2011-2013. PUBLIC HEARING ON THIS DATE? No. BACKGROUND AND POLICY IMPLICATIONS: The Oregon Health Authority (OHA) was created by the 2009 Oregon legislature to bring most health­ related programs in the state into a Single agency to maximize its purchasing power; the Intergovernmental Agreement (#135558) outlines the services and finanCing for fiscal year 2011-2013. There are separate grants associated with individual public health programs represented in the Intergovernmental Agreement, ranging from disease prevention and maternal child health to school based health centers, women, infants and children (WIC), bioterrorism preparedness and family planning. Each grant has an associated set of Program Assurances which are the service and quality performance expectations connected with the delivery of the various components of the program itself. Amendment #3 modifies the agreement as follows: 1-Program Element #01, Accreditation Readiness -Mini Grant -$50,000 allocation funds are provided FY11-12 to be used to complete the activities required for National Accreditation. The goal of public health accreditation is to improve and protect the health of the public by advanCing the quality and performance of all health departments in the country, so that residents can feel confident that their public health department is providing the highest­ quality services possible. 2-Program Element #12, Public Health Emergency Preparedness -($13,010), amount reflects a reduction of funds for Public Health Emergency Preparedness. 3-Program Element #44, School Based Health Centers -($16,030) The FY 2012 budget assumes flat funding of the program; the reduction of funds reflects the change in funding for each sight. 4-Program Element #40, "Women, Infants and Children" (WIC), $8,970 funds represent a one-time year-end funding to agencies. The rate of the funding is $2 per assigned caseload. WIC is a free nutrition education program which provides supplemental foods to promote good health for pregnant, breastfeeding and postpartum women, infants and children up to age five. S-Program Element #47, Linking Actions for Unmet Needs in Child Health (LAUNCH) Project, $709,347, funds represents the LAUNCH Grant. The purpose of the LAUNCH project is to promote the wellness of young children, birth to eight (8) years of age. LAUNCH defines wellness as optimal functioning across all developmental domains, including physical, social, emotional, cognitive and behavioral health. 6-Program Element #48, "Teen Pregnancy Prevention", $1,236, funds are added for the Personal Responsibility Education Program (PREP) for attendance at the PREP regional training. In addition to funding, Amendment #3 modifies the description for Program Element #47, "Family Health Services -Project LAUNCH". FISCAL IMPLICATIONS: Maximum funding reimbursement for specific Program Elements for year 11-12 is $740,513. I RECOMMENDATION & ACTION REQUESTED: I Approval and signature of Document #2011-698, Amendment #3 to Intergovernmental Financial Agreement Award #135558 between the Local Public Health Dept. and the Oregon Health Authority is requested. I ATTENDANCE: Kate Moore, Program Manager DISTRIBUTION OF DOCUMENTS: E-mail Signature Page (connie.thies@state.or.us) or fax 503-373-7889 the Signature Page; f executed documents to Nancy England, Contract Specialist i 4 1 I l 1, I 1 1 1 DESCHUTES COUNTY DOCUMENT SUMMARY (NOTE: This form is required to be 8UbmitIed 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. 11 the document is to be on a Board agen(la. 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 direcUy to Legal Counsel. the County Administrator or the Commissioners. In addition to submitting this form with your documents. please submit this form eledronicaUy to the Board Secretary.) Pleese complete all sections above the OfficIal Review line. Date: I November 30, 2011 I Department: I Health Services, Public Health Division .1 Contractor/Supplier/Consultant Name: I Oregon Health Authority I Contractor Contact: I Connie Thies, Office of Contracts & Procurements I Contractor Phone #: I 503-373-7889 I Type of Document: Amendment #3 to the Intergovernmental Agreement, #135558 Goods and/or Services: The Oregon Health Authority (OHA) was created by the 2009 Oregon legislabJre to bring most health-related programs in the state into a single agency to maximize its purchasing power; the Intergovernmental Agreement (#135558) outlines the services and financing for fiscal year 2011-2013. Background & History: Through the Intergovernmental Agreement, OHA administers Federal public health grant funds, pools these funds with state funds and then allocates these to local health departments. This is the primary means by which State and Federal public health funds are delivered to the local public health authority for Deschutes County. There are separate grants associated with individual public health programs represented in the Intergovernmental Agreement, ranging from disease prevention and maternal child health to school based health centers, women, infants and children (WIC), bioterrorism preparedness and family planning. Each grant has an associated set of Program Assurances which are the service and quality performance expectations connected with the delivery of the various components of the program itself. Amendment #3 modifies the agreement as follows: 1-Program Element #01, Accreditation Readiness -Mini Grant -$50,000 allocation funds are provided FY11-12 to be used to complete the activities required for National Accreditation. The goal of public health accreditation is to improve and protect the health of the public by advancing the quality and performance of all health departments in the country, so that residents can feel confident that their public health department is providing the highest-quality services possible. 2-Program Element #12, Public Health Emergency Preparedness -($13,010). amount reflects a reduction of funds for Public Health Emergency Preparedness. 3-Program Element #44, School Based Health Centers -($16,030) The FY 2012 budget assumes flat funding of the program; the reduction of funds reflects the change in funding for each sight. 4-Program Element #40, "Women, Infants and Children" (WIC), $8,970 funds represent a one-time year-end funding to agencies. The rate of the funding is $2 per assigned caseload. WIC is a free nutrition education program which provides supplemental foods to promote good health for pregnant, breastfeeding and postpartum women, infants and children up to age five. S-Program Element #47, Linking Actions for Unmet Needs in Child Health (LAUNCH) Project, $709,347, funds represents the LAUNCH Grant The purpose of the LAUNCH project is to promote the wellness of young children, birth to eight (8) years of age. LAUNCH defines \Y8l1ness as optimal functioning across all developmental domains, including phYSical, social, emotional, cognitive and behavioral health. 6-Program Element #48, "Teen Pregnancy Prevention", $1,236, funds are added for the Personal Responsibility Education Program (PREP) for attendance at the PREP regional training. In addition to funding, Amendment #3 modifies the description for Program Element #47, "Family Health Services -Project LAUNCH", Agreement Starting Date: 1 July 1, 2011 I Ending Date: I June 30, 2013 Annual Value or Total Payment: I $740,513 FY11-12. [81 Insurance Certificate Received (check box) Insurance Expiration Date: I County is Contractor Check all that apply: D RFP, Solicitation or Bid Process D Informal quotes «$150K) [81 Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37) Funding Source: (Induded in current budget? [81 Yes D No If No, has budget amendment been submitted? DYes D No Is this a Grant Agreement providing revenue to the County? DYes [81 No Special conditions attached to this grant: Deadlines for reporting to the grantor: .....1 _---' 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#:D 11/30/2011 Departmental Contact and Title: I Nancy England, Contract Specialist Phone #: I 541-322-7516 I Department Director Approval: ~~, ~I).'/Ll\t Signature Date Distribution of Document: e-mail SignaturePage(connie.thies@state.oLus) or fax 503-373-7889 the entire Signature Page; executed documents to Nancy England, Contract Specialist Official Review: County Signature Required (check. one): III eocc 0 Department Director (if <$25K) o Administrator (if >~~5K but <~1~~r$150K, eocc Order No. ) Legal Review J~k. (~ Date /2 -\'-It Document Number :::;20:.,1=-:1:...;-6:.:98=-_______ IIWD 7hVt~ ('M LEGAL COUNSEL 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 dhsalt@State.or.us or contact the Office of Document Management at 503-378-3486, and TTY at 503-378­ 3523 Agreement #135558 THIRD AMENDMENT TO OREGON HEALTH AUTHORITY 2011-2013 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES This Third Amendment to Oregon Health Authority 2011-2013 Intergovernmental Agreement J for the Financing of Public Health Services, effective July I, 2011 (as amended the "Agreement"), is I between the State of Oregon acting by and through its Oregon Health Authority ("OHA") and Deschutes County, acting by and through its Deschutes County Health Services ("LPHA"), the entity designated, pursuant to ORS 431.375(2), as the Local Public Health Authority for Deschutes County. RECITALS WHEREAS, OHA and LPHA wish to modify the set of Program Element Descriptions set forth in Exhibit B of the Agreement and ... WHEREAS, OHA and LPHA wish to modify the Financial Assistance Award set forth in Exhibit C 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. Exhibit B. "Program Element Descriptions" is amended as follows: Program Element #47: Family Health Services ("FHS") -Project LAUNCH (Deschutes Co. only) is added as set forth in Exhibit I attached hereto and incorporated herein by this reference. Related program funding is awarded as set forth in Exhibit 2 to this Amendment. 2. Section I of Exhibit C entitled "Financial Assistance Award" of the Agreement is hereby superseded and replaced in its entirety by Exhibit 2. attached hereto and incorporated herein by this reference. Exhibit 2. must be read in conjunction with Section 4. of Exhibit C, entitled "Explanation of Financial Assistance Award" of the Agreement. 3. LPHA represents and warrants to OHA that the representations and warranties of LPHA 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. Capitalized words and phrases used but not defined herein shall have the meanings ascribed thereto in the Agreement. 2011-2013 Intergovernmental Agreement for the Financing of Public Health Services Page 1 of 8 pages 135558-3 pgm.doc Deschutes County DC -2011-698 5. Except as amended hereby, all tenns and conditions of the Agreement remain in full force and effect. 6. 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. 7. This Amendment becomes effective on the date of the last signature below. IN WITNESS WHEREOF, the parties hereto have executed this Amendment as of the dates set forth below their respective signatures. APPROVED: STATE OF OREGON ACTING BY AND THROUGH ITS OREGON HEALTH AUTHORITY (OHA) By: Name: Jean O'Connor, JD, DrPH Title: Deputy Public Health Director Date: DESCHUTES COUNTY ACTING BY AND THROUGH ITS DESCHUTES COUNTY HEALTH SERVICES (LPHA) By: Name: Title: Date: OHA OF JUSTICE -ApPROVED FOR LEGAL SUFFICIENCY Approved by D. Kevin Carlson, Senior Assistant Attorney General on October 14,2011. Copy ofapproval on file at OC&P . OFFICE OF CONTRACTS & PROCUREMENT (OC&P) By: Name: Phillip G. McCoy, OPBC Title: Contract Specialist Date: 2011-2013 Intergovernmental Agreement for the Financing of Public Health Services Page 2 of 8 pages 135558·3 pgm.doc • Deschutes County EXHIBIT 1 PROGRAM ELEMENT DESCRIPTIONS Program Element #47: Family Health Services ("FHS") -Project LAUNCH (Deschutes Co. only) 1. General Description and Purpose. a. The Substance Abuse and Mental Health Services Administration, SAMHSA has awarded funds to the State of Oregon to initialize and support specific ongoing activities related to "Linking Actions for Unmet Needs in Children's Health" (Project LAUNCH). The purpose of Project LAUNCH is to promote the wellness of young children, birth to eight years of age. Project LAUNCH defines wellness as optimal functioning across all developmental domains, including physical, social, emotional, cognitive and behavioral health. Project LAUNCH is a five year grant, from 2009-2014, with a demonstration project component in Deschutes County. b. The purpose of Oregon LAUNCH is to develop a state and local coordinated child-serving system that integrates behavioral and physical health services. Oregon LAUNCH will provide an integrated and holistic system of wellness, prevention and treatment services to assist 1,500 children, birth to eight-years of age, and their families in Deschutes County, Oregon over a five-year period. c. The funds provided under this Financial Assistance Agreement for this Program Element shall only be used, in accordance with and subject to the requirements and limitations set forth below, as supplemental funds to support Oregon LAUNCH. 2. Definitions Specific to Oregon LAUNCH. a. Early Childhood Matters -Oregon's framework for a statewide birth-through-five Early Childhood system. b. The Early Childhood Council (ECC) -This council consist of three subcommittees: • Health Matters • Early Learning Matters • Family Matters 3. Local Project LAUNCH Resources, Organizations, and Related Programs: a. Child Care Resource and Referral is the resource and referral that provides services and mental health consultation to childcare providers. b. Deschutes County Commission on Children and Families (DCCF) is a governmental agency that promotes child abuse prevention and early intervention through early childhood care, education and community partnerships. 2011-2013 Intergovernmental Agreement for the Financing of Public Health Services Page 3 of 8 pages 135558-3 pgm.doc -Deschutes County c. Deschutes County Health System -School-Based Health Centers (DCHS-SBHC) are primary care health clinics located in the elementary schools in Deschutes County. d. Family Access Network (FAN) is a local non-profit organization that provides family advocacy services in every public school to assist children and families in accessing services to meet basic needs . e. .Family Access Network Coalition (18 organizations) is a school based organization that advocates for children and families. f. Family Resource Center (FRC) is the primary local provider for parenting education. FRC currently uses: o Incredible Years (IY) o Parenting Wisely (PW) g. Healthy Beginnings is a prevention-focused program to ensure that children meet age­ appropriate developmental standards upon entering kindergarten and increase parents' skills by bringing accessible, educational, preventive screenings to children ages birth to 5 and their parents. h. Healthy Families of the High Desert is a child abuse prevention program that provides parent groups and home visitation services to first time parents. i. KIDS Center is a local organization that offers advocacy, child abuse prevention programs, medical assessments, victim counseling, family therapy, and parent training services. j. Latino Community Association is a local organization that serve as the resource for the local Hispanic community. k. Local Interagency Coordinating Council is a group of providers and families who coordinate services for children with disabilities. I. Mountain Star Family Relief Nursery is an emergency childcare and support system for families that are facing domestic violence, child abuse, and neglect. m. Neighbor Impact is the local organization that provides Head Start programs. n. Parent Child Interaction Therapy is an intervention developed to reduce child behavioral problems and risks for child abuse. o. Promoting First Relationships is an intervention model that to promote trusting and secure caregiver-child relationships and the child's healthy social emotional development. 4. Procedural and Operational Requirements. The funds provided under this Cooperative Agreement between SAMHSA, the State of Oregon Department of Human Services, and Deschutes County shall only be used to support activities related to planning, administration, operation, and delivery of services as outlined by the SAMHSA Project LAUNCH grant guidelines. 2011·2013 Intergovernmental Agreement for the Financing of Public Health Services Page 4 of 8 pages 135558·3 pgm.doc . Deschutes County a. SAMHSA Project LAUNCH -Specific Local Requirements and Timelines 1.) Create and fill the local-level position of Child Wellness Coordinator by l<ln11<"'" 2010. 2.) Convene Deschutes County Council on Young Child Wellness on a recurring basis. 3.) Develop a local level strategic plan for the LAUNCH initiative by May 17th, 2010. 4.) Implement local level changes in child wellness policy, service systems, evaluation, as indicated by the LAUNCH strategic plan throughout the 5 year grant cycle, 2009­ 2014. 5.) Participate in the Evaluation Task Force and contribute data to the Evaluation Plan on a recurring basis. 6.) Train providers on Evidence Based Program Interventions identified in the Grant: Promoting First Relationships, Parents as Teachers, Parent Child Interaction Therapy and Incredible Years throughout the 5 year grant cycle, 2009-2014. 7.) Increase early identification of development and mental health issues through comprehensive developmental assessments and referral. The School Based Health Centers will begin using these developmental assessments by March 20 IO. 8.) Integrate Parent Child Interaction Therapy into primary care in school-based health clinics and FQHC settings throughout the 5 year grant cycle, 2009-2014. 9.) Create Healthy Child Family Support Teams (HCFST) at the School Based Health Centers (SBHC). These HCFSTs will consist of a nurse practitioner, a mental health consultant and a family access network advocate, who will provide coordinated services and healthcare in a "Medical Home" model. The HCFST will provide care throughout the 5 year grant cycle, 2009-2014. 10.) Implement "Promoting First Relationships" in the Deschutes County public health nurse home visiting program by December, 2010. 11.) Expand "Parents as Teachers" into the community home visitation programs offered by Healthy Families of the High Desert throughout the 5 year grant cycle, 2009-2014. 12.) Provide parent skills training using: Incredible Years" and "Parenting Wisely" curricula by ==....=~. 13.) Work with DCHS Public Information Coordinator to create and implement a Young 1 Child Wellness campaign by December, 2011. I ! 2011·2013 Intergovernmental Agreement for the Financing of Public Health Services Page 5 of 8 pages 135558·3 pgm.doc • Deschutes County 1 b. Reporting Obligations and Periodic Reporting Requirements. In addition to the reporting obligations set forth in section 8 of Exhibit E, of this Agreement, LPHA, will submit a quarterly invoice to the DHS Contract Administrator describing work performed, time lines and budget updates on a quarterly basis during the current Agreement period. 2011-2013 Intergovernmental Agreement for the Financing of Public Health Services Page 6 of 8 pages 135558-3 pgm.doc • Deschutes County EXHIBIT 2 FINANCIAL ASSISTANCE AWARD I 1) Grantee State of Oregon Oregon Health Authority Public Health Division 2) Issue Date Name: Deschutes County Health Dept. September 22, 201'1 Street: 2577 N. E. Courtney 3} Award Period Page 1 of]; This Action AMENDMENT FY2012 City: Bend From July!, 2011 Through June 3D, 2012 State: OR lip Code: 97701 4) OHS Public Health Funds Approved Previous Increase! Grant Program Award (Decrease) Award PE 01 State Support for Public Health 177,089 ° 177,089 PE 01 Accreditation Readiness Mini Grant 0 50,000 50,000 (i) PE 03 TB Case Management 3,447 0 3,447 PE 07 HIV Prevention Services 37,696 0 37,696 HIV Prevention Block Grant Services Ryan White Title II HIV I AIDS Services PE 08 Ryan White--Case Management 72,392 0 72,392 i PE 08 Ryan White-Support Services 25.448 ° 25,448 PE 12 Pub. Health Emergency Prep::uednessl(July-Aug. 9) '14.755 0 14,755 ( b ) PE12 Pub. Health Emergency PreparednessJ{Aug 10-June30} 108,640 (13,010) 95,630 PE 13 Tobacco Prevention & Education 112,727 0 "12,727 PE 15 Healthy Communities ­Phase 2 65,000 0 65,000 PE 40 Women, Infants and Children 659,469 8,970 668,439 FAMILY HEALTH SERVICES cdghlm 5) FOOTNOTES: a) Funds will not be shifted between categories or fund types_ The same program may be funded by more than one fund type, however, federal funds may not be used as match for other federal funds ( such as Medicaid ). b) July 1 -Augllst 9th awards must be spent by 8f9l11 and a report submitted for that period c) July-September grant is $175,423 and includes $35,085 of minimum Nutritional Education and $7,586 for Breastfeeding Promotion. d) October through June grant is $493,917 and includes $98,603 of minimum Nutritional Education and for Breastfeedil1g Promotion_ e) The Fiscal Year 2012 budget assumes flat funding of the program. The final 2012 School Based Health Center budget will be determined based upon the number of certified SHBC's on July I , 2011 and the legislatively adopted budget f) S 193233 is the total Family Planning grant; $132,051 is Title X and $6'1.182 is Title V 6) Capital Outlay Requested in This Action: Prior approval is required for Capital Outlay. Capital Outlay is defined as an expenditure for equip­ ment with a purchase price in excess of $5,000 and a life expectancy greater than one year. PROG, PROGRAM ITEM DESCRIPTION COST APPROV I Ij 2011·2013 Intergovernmental Agreement for the Financing of Public Health Services Page 7 of 8 pages 135558-3 pgm.doc • Deschutes County I State of Oregon Page 2 of 2 Oregon Health Authority Public Health Division 1) Grantee 2) Issue Date This Action Name: Deschutes County Health Dept. September 22, 2011 AMENDMENT FY2012 Street: 2577 N. E. Courtney J) Award Period City: Bend From July 1, 2011 Through June 30, 2012 State: OR Zip Code: 97701 4} DHS Public Health Funds Approved Previous Increasel Grant Program Award (Decrease) Award PE 41 Family Planning Agency Grant '193,233 0 193.233 FAMILY HEALTH SERVICES (f) PE 42 MCH/Chikl & Adolescent Health ­General Fund 11,077 a 11,077 FAMILY HEALTH SERVICES I (3) PE 42 MCH-TitleV Child & Adolescent Health 17,261 0 17,261 FAMILY HEALTH SERVICES ( a ) PE 42 MCH-TitleV Flexible Funds 40.276 0 40,276 FAMILY HEALTH SERVICES ( a ) PE 42 MCHIPerinatal Health ­Genera! Fund 5,904 0 5,904 FAMILY HEALTH SERVICES ( a ) PE 42 Babies First 18,692 0 18,692 FAMILY HEALTH SERVICES PE 42 Oregon MothersCare 15,995 0 15,995 FAMILY HEALTH SERVICES PE 43 Immunization Special Payments 42,332 0 42,332 FAMtLYHEALTH SERVICES PE 44 School Based Health Centers 221,030 (16,030) 205,000 FAMILY HEALTH SERVICES (e,i) PE 47 Linking Actions for Unmet Needs in Child Health Project 0 709.347 709,347 FAMILY HEALTH SERVICES PE 48 Teen Pregnency Prevention -P. R E. P. 107,040 '1,236 108,276 FAMilY HEALTH SERVICES ( k ) TOTAL 1,949,503 740,513 2,690,016 5) FOOTNOTES: g) $12.760 represents the adjustment to the indial SFY2012 grant contract so that the total base rate per participant increases by three percent compared to SFY2011. h) $2,114 represents targeted nutrition education support for increasing consumption of fresh fruits and vegetables. iJ -$3,206 was the change in funding for each site. DS50,000 funding to be used to complete the activities described in counties approved mini grant for Accreditation Readiness. Expenditures must be tracked and reported separately. k) $1 is for attendance at the Persona! Responsibility Education Program regional training. I) $8,770 represents one-time year-end funding to local agencies to be spent by 9130/2011 The rate of the funding is $2.00 I assigned caseload. m} 5200 represents travel expense reimbursemenl to local agencies for Farmers Market local agency monitoring. 6) Capita.1 Outlay Requested in This Action: Prior approval is required for Capital Outlay. Capital Outlay is defined as an expenditure for equip­ ment with a purchase price in excess of $5,000 and a life expectancy greater than one year. PROGRAM ITEM DESCRIPTION I I PROG. COST APPROV 2011-2013 Intergovernmental Agreement for the Financing of Public Health Services Page 8 of 8 pages 135558-3 pgm.doc • Deschutes County --- 1 DESCHUTES COUNTY BEHAVIORAL HEALTH REQUEST FOR TRAINING FROM: DATE: Title of Training: Location: Dates of From To Hours of + Travel Hours: Total Training Time: Description of Plans for Travel, Lodging and Time Out of Office: ~ RESPONSIBILITY OF: (Place check in appropriate box) Associated Cost COUNTY EMPLOYEE N/A Fees Travel Lodging Meals Time Away from Work Other TOTAL How will the skills be used to improve program effectiveness, public service and evidence-based practice? As a result of the training, I will be able to: ----------------~~....... ------------­ signature Date TO BE COMPLETED BY SUPERVISOR: # of training hours approved this fiscal year: Total Cost paid county this fiscal year: Supervisor signature Date Manager signature Date Director signature (for out of state or over $500) Date j 8/4/10 http://insidedc/hea1th/Forms/Request for Training.doc i I