HomeMy WebLinkAboutDoc 709 - Health Services AmendmentDeschutes 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
DATE: December 15,2011
FROM: Nancy England, Contract Specialist, Deschutes County Health Services, 322-7516
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2011-709, Amendment #5 to the Intergovernmental Financial
Agreement Award #134309 between Deschutes County Health Services, Behavioral Health Division and the
Oregon Health Authority.
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. OHA is at the forefront of lowering and containing costs, improving
quality and increasing access to health care in order to improve the lifelong health of Oregonians. In the public
sector, OHA will consolidate most of the state's health care programs, including Addictions & Mental Health
Services (AMH), Public Health, the Oregon Health Plan (OHP), HealthyKids Connect, employee benefits and
public-private partnerships. This will give the state greater purchasing and market power to begin tackling issues
with costs, quality, lack of preventive care and health care access. In both the public and the private sector, OHA
will be working to fundamentally improve how health care is delivered and paid for. OHA will also be working to
reduce health disparities and to broaden the state's public health focus.
The 2011-2013 Intergovernmental Agreement for the Financing of Community Addictions and Mental Health
Services sets the dollar amounts and guidelines for Deschutes County Health Services to provide or
coordinate provision of behavioral health as well as alcohol, other drug and problem gambling prevention
and treatment services for the next two years.
Amendment #5 adjusts the funding to the 2011-2013 financial assistance award for mental health services to
reflect changes in the re-allocation process for October 2011.
1-Service Element #20, Non-Residential Adult Mental Health Services -$354,106.
2-Service Element #22, Child & Adolescent Mental Health Services -$2,710.
3-Service Element #25, Community Crisis -Adult & Child -$44,998.
FISCAL IMPLICATIONS:
Maximum Compensation is $401,814.
RECOMMENDATION &ACTION REQUESTED:
Approval and signature of Document #2011-709, Amendment #5 to the Intergovernmental Financial Agreement
Award #134309 between Deschutes County Health Services, Behavioral Health and the Oregon Health Authority
is requested.
ATTENDANCE: Lori Hill, Program Manager
DISTRIBUTION OF DOCUMENTS:
Fax or E-mail the signature page and completed, Signed "Document Return Statement" to Tami Goertzen;
tami.j.goertzen@state.or.us or (503) 373-7365, fully executed original to County Clerk and copy to Nancy
England.
DESCHUTES COUNTY DOCUMENT SUMMARY
(NOTE: This form is required to be submitted with ALL contracta 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 Direetor. If the document is to be on a Board
agenda, the Agenda Request Form is also required. If this form 18 not included with the document, the document will be returned to
the Department Please eubmit documents to the Board Secretary for tracking purpoees, and not direcUy to Legal Counsel, the
County Administrator or the Commissioners. In addition to submitting thl8 form with your documents, please submit thl8 form
eIeotronically to the Board Secratary.)
Please complete aU sections above the OfficIal Review line.
Date: 1 December 12,2011 1
Department: I Health Services, Behavioral Health I
Contractor/Supplier/Consultant Name: 1 Oregon Health Authority
Contractor Contact: 1 April Barrett 1 Contractor Phone #: I 503-945-5821
Type of Document: Amendment #5 to #134309
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 Oregon Health
Authority (OHA) and DCHS provides the financing for mental health and addidion services and
sets forth the guidelines for DCHS to provide or coordinate provision of mental health services
to individuals.
Amendment #5 adjusts the funding to the 2011-2013 financial assistance award for mental
health services to reflect changes in the re-allocation process for Odober 2011.
1Service Element #20, Non-Residential Adult Mental Health Services -$354,106.
2Service Element #22, Child & Adolescent Mental Health Services -$2,710.
3Service Element #25, Community Crisis -Adult &Child -$44,998.
Agreement Starting Date: 1 July 01, 2011 I Ending Date: 1 June 30,2013 1
Annual Value or Total Payment: I Maximum Compensation is $401,814.1
1:81 Insurance Certificate Received (check box)
Insurance Expiration Date: 1 County is Contrador
Check all that apply: o RFP, Solicitation or Bid Process
D Informal quotes «$150K)
1:81 Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37) ,
Funding Source: (Included in current budget? 0 Yes [8l No
If No, has budget amendment been submitted? [8l Yes D No
Is this a Grant Agreement providing revenue to the County? 0 Yes IZI No
Special conditions attached to this grant:
Deadlines for reporting to the grantor:
If a new FTE will be hired with grant funds, confinn 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
Contact infonnation for the person responsible for grant compliance: Name:
Phone#:D
Departmental Contact and Title: I Nancy England , Contract Specialist I
Phone #: I 541-322-7516 I ~
Department Director APproval:,£.y-~lCIl'uluL \2. 13.\I
Signatu Date
Distribution of Document: Fax or E-mail the signature page and completed, signed
"Document Return Statement" to Tami Goertzen; tami.j.goertzen@state.or.us or (503) 373
7365, fully executed copy to Nancy England .
Official Review:
County Signature Required (check one): IfJ SOCC 0 Department Director (if <$25K)
; if >$150K, SOCC Order No. _____)
Legal Review Date
Document Numt>t.r: "1=O~II:....-'1.:...;OS:.=-________
C 201 -?Or
I
ADMINISTRATIVE SERVICES DIVISION
Office of Contracts and Procurement
John A Kitzhaber, MD, Governor 250 Winter St NE, Room 306
Salem, OR 97301
Voice: (503) 945-5818
FAX: (503) 378-4324
DOCUMENT RETURN STATEMENT
Re: Amendment #05 to Agreement #134309 hereinafter referred to as "Document."
Please complete the following statement and return it along with the completed signature page and the
Contractor Data and Certification page and/or Contractor Tax Identification Information form (if
applicable ).
Important: If you have any questions or find errors in the above referenced Document, please contact
the contract specialist, April D. Barrett at (503) 945-5821.
(Name) (Title)
received a copy of the above referenced Document, between the State of Oregon, acting by and through
its Oregon Health Authority, and Deschutes County, bye-mail from Tami Goertzen on November 18,
2011.
On _________7 I signed the electronically transmitted Document without
(Date)
change. I am returning the completed signature page and Contractor Data and Certification page and/or
Contractor Tax Identification Information form (if applicable) with this Document Return Statement.
(Authorizing Signature) (Date)
ADMINISTRATIVE SERVICES DIVISION
of Human Services Office of Contracts and Procurement Authority
)tQt12,,,,m,", ] [ealth
John A. Kilzhaber, MD, Governor 250 Winter St NE, Room 306
Salem, OR 97301
Voice: (503) 945-5818
FAX: (503) 378-4324
DATE: November 18,2011
TO: Scott Johnson, Director
Deschutes County
RE: Amendment #05 to the
2011-2013 Intergovernmental Agreement for the Financing
of Community Addictions and Mental Health Services Agreement #134309
Enclosed is an amendment to the Agreement.
NOTE: Payment for amendments returned to OHA by the 3 rd 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 the "Document Return
Statement".
• E-mail or Fax only the signature page of the amendment and the completed, signed
"Document Return Statement" to tami. j.goertzen@state.or.us or 503-373-7365.
Following receipt by aHA of your signed amendment, OHA will route its copy of amendment to
the official( s) who is/are authorized to execute the amendment. Once the amendment is signed
OHA 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
Attachment( s)
ADMINISTRATIVE SERVICES DIVISION ][enlthOffice of Contracts and Procurement Authority
John A. Kitzhaber, MD, Governor 250 Winter St NE, Room 306
Salem, OR 97301
In compliance with the Americans with Disabilities Act, this Voice: (503) 945-5818
document is available in altemate fOlmats such as Braille, FAX: (503) 378·4324
large print, audio recordings, Web-based communications
and other electronic fOlmats. To request an alternate format, please send an e
mall to dhsalt@state.or.us or call 503-378-3486 (voice) or 503-378-3523
(TTY) to arrange for the alternative format.
FIFTH AMENDMENT TO
OREGON HEALTH AUTHORITY
2011-2013 INTERGOVERNMENTAL AGREEMENT FOR THE
FINANCING OF COMMUNITY ADDICTIONS AND MENTAL HEALTH
SERVICES AGREEMENT #134309
Tbis Fifth Amendment to Oregon Health Authority 2011-2013 Intergovernmental
Agreement for the Financing of Community Addictions and Mental Health Services dated as· of
July 1,2011 (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 Oregon Health Authority
("OHA") and Deschutes County ("County").
\,
RECITALS
\VHEREAS, OHA and County wish to modify 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. The financial and service infOlmation in the Financial Assistance Award are hereby
amended as described in Exbibit 1 attached hereto and incorporated herein by this
reference : Exhibit I must be read in conjunction with the portion of Exbibit C of the
Agreement that describes the effect of au amendment of the financial and service
infOlmation.
2. Capitalized words and phrases lIsed but not defined herein shall have the meanings
ascribed thereto in the Agreement.
DC . 2 0 11 -7 'S
3. County represents and wan-ants to Department that the representations and wan-anties of
County set forth in section 4 of Exhibit F of the Agreement are true and correct on the
date hereof with the same effect as ifmade on the date hereof.
4. Except as amended hereby, all temlS and conditions of the Agreement remain in full
force and effect.
5. This Amendment may be executed in any number of counterpa11s, all of which when
taken together shall constitute one agreement binding on all parties, notwithstanding that
an pm1ies are not signatories to the same counterpart. Each copy ofthis Amendment so
executed shall constitute an original.
IN W1TNESS WHEREOF, the parties hereto have executed this amendment as of the dates set
forth below their respective signatures.
Deschutes County
By:
Authorized Signature Title Date
State of Oregon acting by and through its Oregon Health Authority
By:
SteHa Transue Date
Administrator, Office of Contracts and Procurement
Document date: 11/18/2011 Amendment #05 Page 2
Reference #006
Exllibit 1 to the 5th Amendment to
Oregon Health Authority
2011··2013 Intergovernmental Agreement for the
Financing of Community Addictions and Mental Health Services Agreement #134309
Document date: 1111812011 Amendment #05 Page 3
Reference #006
OREGON HEALTH AUTHORITY
I!.inancial Assistance Award Amendment (FAAA)
2011-2013
CONTRACTOR: DESCHUTES COUNTY
D~TE; 11/17/2011
Contract#:
Reference#:
134309
006
.MENTAL HEALTH SERVICES
SECTION: 1
SERVICE REQUIREMENTS MEET EXHIBIT B AND, IF INDICATED, EXHIBIT B-2
Part
Start/End
Dates
CPMS
Name
Approved
service Funds
Approved
Start-up
Servo
Units
Unit
Type
EXHIB 82
Codes
Spec
Condit
A
SElt 20 NON-RESIDENTIAL ADULT
7/2011-6/2012 N/A
SUBTOTAL SEIt 20
MH SERV
$354,106
$354,106
$0
$0
O. NA N/A M0114 1
A
SEIt 22 CHILD & ADOLES
7/2011-6/2012 N/A
SUBTOTAL SEn 22
MH SERVICES
$2,710
$2,710
$0
$0
O. NA N/A M0114 1
A
SEn 2S COMM CRISIS
7/20116/2012 N/A
SUBTOTAL SE#
TOTAL SECTION 1
-ADULT
25
& CHILD
$44,998
$44,998
$401,814
$0
$0
$0
O. NA N/A MOl14 2
TOTAL AUTHORIZED FOR MENTAL HEALTH SERVICES $401,814
TOTAL AUTHORIZED FOR THIS FAAA: $401,814
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
CONTRACTOR: DESCHUTES COUNTY Contract#: 134309
DATE: 11/17/2011 REF#: 006
REASON FOR F'AAA (for information only) ;
The 2011-2013 Financial Assistance Award (FAA) for Mental Health Services
(MHS) is revised to reflect changes in the Re-allocation process for
October 2011.
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.
M0114 1 The funds are for Re-allocation services.
~10114 2 A) These funds are for Re-allocation services. B) These funds are
for Community Crisis services.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
*********************
CONTRACTOR: DESCHUTES COUNTY
DATE: 11/17/2011
CURRENT
SE# DESCRIPTION APPROVED
FAAA Totals
Part A
2011-2013
INFORMATION ONLY
CURRENT
PENDING
1 LOCAL ADMIN MENTAL HEALTH SVCS $246,168 $206,000
TOTAL SE# 1 $246,168 $206,000
20 NON-RESIDENTIAL ADULT MH SERV $367,261 $84,264
20 NON-RESIDENTIAL ADULT MH SERV $302,152 $0
TOTAL SE# 20 $669,413 $84,264
22 CHILD & ADOLES MH SERVICES $198,106 $16,100
TOTAL SE# 22 $198,106 $16,100
24 REGIONAL ACUTE PSYCH INPATIENT $530,700 $0
24 REGIONAL ACUTE PSYCH INPATIENT $821,002 $29,779
TOTAL SE# 24 $1,351,702 $29,779
25 COMM CRISIS -ADULT & CHILD $356,297
TOTAL SE# 25 $356,297
26 NON-RESIDENTIAL YOUTH DESIGNAT $414,933
TOTAL SE# 26 $414,933
28 RESIDENTIAL TREATMENT SERVICES $907,999
$33,474
$33,474
$0
$0
$120,252
*********************
CONTRACT#: 134309
REF#: 006
PROPOSED REVISED
CHANGE TOTAL
$0 $452,168
$0 $452,168
$354,J.06 $805,631
$0 $302,152
$354,106 $1,107,783
$2,710 $216,916
$2,710 $216,916
$0 $530,700
$0 $850,781
$0 $1,381,481
$44,.998 $434,769
$44,998 $434,769
$0 $414,933
$0 $414,933
$0 $1,028,251
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Part A
2011-2013
********************* INFORMATION ONLY *********************
CONTRACTOR:
DATE:
DESCHUTES COUNTY
11/17/2011
CONTRACT#:
REF#:
134309
006
SE# DESCRIPTION
CURRENT
APPROVED
CURRENT
PENDING
PROPOSED
CHANGE
REVISED
TOTAL
28 RESIDENTIAL TREATMENT SERVICES $638,989 $36,000 $0 $674,989
TOTAL SE# 28 $1,546,988 $156,252 $0 $1,703,240
30 PSRB TMNT & SUPERVISION $37,055 $52,936 $0 $89,991
TOTAL SE# 30 $37,055 $52,936 $0 $89,991
35 OLDER/DISABLED ADULT ME SVCS $9,367 $0 $0 $9,367
TOTAL SE# 35 $9,367 $0 $0 $9,367
38 SUPPORTED EMPLOYMENT SERVCS $93,593 $0 $0 $93,593
TOT.l\,L SE# 38 $93,593 $0 $0 $93,593
39 CSS-HOMELESS $66,365 $0 $0 $66,365
TOTAL SE# 39 $66,365 $0 $0 $66,365
201 NON-RES DESIGNATED SVCS MRS $13,020 $65,211 $0 $78,291
TOTAL SE# 201 $13,020 $65,271 $0 $78,291
$5,003,007 $644,076 $401,814 $6,048,897
NOTE: The am01.mts in the "REVISED TOTAL" column include am01.mts reported in the "CURRENT PENDING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Part B
2011-2013
********************* INFORMATION ONLY *********************
CONTRACTOR: DESCHUTES COUNTY CONTRACT#: 134309
DATE: 11/17/2011 REF#: 006
CURRENT CURRENT PROPOSED REVISED
SE# DESCRIPTION APPROVED PENDING CHANGE TOTAL
20 NON-RESIDENTIAL ADULT MH SERV $65,302 $0 $0 $65,302
20 NON-RESIDENTIAL ADULT MH SERV $471,723 $0 $0 $471,723
TOTAL SE# 20 $537,025 $0 $0 $537,025
22 CHILD & ADOLES MH SERVICES $61,145 $0 $0 $61,145
TOTAL SE#: 22 $61,145 $0 $0 $61,145
28 RESIDENTIAL TREATMENT SERVICES $1,152,000 $0 $0 $1,152,000
28 RESIDENTIAL TREATMENT SERVICES $728,933 $0 $0 $728,933
TOTAL SE# 28
31 ENHANCED CARE
TOTAL SE# 31
34 ADULT FOSTER
TOTAL SE# 34
36 PASARR MHS
TOTAL SE# 36
SERVICES
CARE MHS
$1,880,933 $0 $0 $1,880,933
$219,095 $0 $0 $219,095
$219,095 $0 $0 $219,095
$320,697 $0 $0 $320,697
$320,697 $0 $0 $320,697
$10,036 $0 $0 $10,036
$10,036 $0 $0 $10,036
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" column
that 'have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
*********************
FAAA Totals
Pa·rt B
2011-2013
INFORMATION ONLY *********************
CONTRACTOR:
DATE:
DESCHUTES COUNTY
11/17/2011
CONTRACT#: 134309
REF#: 006
SE# DESCRIPTION
CURRENT
APPROVED
CURRENT
PENDING
PROPOSED
CHANGE
REVISED
TOTAL
$3,028,931 $0 $0 $3,028,931
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FP~~.)
FAAA Totals
Summary
2011-2013
********************* INFORMATION ONLY *********************
CONTRACTOR: DESCHUTES COUNTY CONTRACT#: 134309
DATE: 11/17/2011 REF#: 006
CURRENT CURRENT PROPOSED REVISED
SE# DESCRIPTION APPROVED PENDING CHANGE TOTAL
1 LOCAL ADMIN MENTAL HEALTH SVCS $246,168 $206,000 $0 $452,168
TOTAL SE# 1 $246, H8 $206,000 $0 $452,168
20 NON-RESIDENTIAL ADULT MH SERV $432,563 $84,264 $354,106 $870,933
20 NON-RESIDENTIAL ADULT MH SERV $773,875 $0 $0 $773,875
TOTAL SE# 20 $1,206,438 $84,264 $354,106 $1,644,808
22 CHILD & ADOLES MH SERVICES $61,145 $0 $0 $61,145
22 CHILD & ADOLES MH SERVICES $198,106 $16,100 $2,710 $216,916
TOTAL SE# 22 $259,251 $16,100 $2,710 $278,061
24 REGIONAL ACUTE PSYCH INPATIENT $530,700 $0 $0 $530,700
24 REGIONAL ACUTE PSYCH INPATIENT $821,002 $29,779 $0 $850,781
TOTAL SE# 24 $1,351,702 $29,779 $0 $1,381,481
25 COMM CRISIS -ADULT & CHILD $356,297 $33,474 $44,998 $434,769
TOTAL SE# . 25 $356,297 $33,474 $44,998 $434,769
26 NON-RESIDE~~IAL YOUTH DESIGNAT $414,933 $0 $0 $414,933
TOTAL SE# 26 $414,933 $0 $0 $414,933
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CtrR.~ENT PENDING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEALTH AUTHORITY
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Summary
2011-2013
********************* INFORMATION ONLY *********************
CONTRACTOR: DESCHUTES COUNTY CONTRACT4/;: 134309
DATE: 11/17/2011 REF#: 006
CURRENT CURRENT PROPOSED REVISED
SE# DESCRIPTION APPROVED PENDING CHANGE TOTAL
28 RESIDENTIAL TREATMENT SERVICES $2,059,999 $120,252 $0 $2,1.80,25J.
28 RESIDENTIAL TREATMENT SERVICES $1,367,922 $36,000 $0 $1,403,922
TOTAL SE# 28 $3,427,921 $156,252 $0 $3,584,173
30 PSRB TMNT & SUPERVISION $37,055 $52,936 $0 $89,991
TOTAL SE# 30 $37,055 $52,936 $0 $89,991
31 ENHJU~CED CARE SERVICES $219,095 $0 $0 $219,095
TOT)l..L SE# 31 $219,095 $0 $0 $219,095
34 ADULT FOSTER CARE MHS $320,697 $0 $0 $320,697
TOTAL SE4/; 34 $320,697 $0 $0 $320,697
35 OLDER/DISABLED ADULT MH SVCS $9,367 $0 $0 $9,367
TOTAL SE4/; 35 $9,367 $0 $0 $9,367
36 PASARR MHS $10,036 $0 $0 $10,036
TOTAL SE4/; 36 $10,036 $0 $0 $10,036
38 SUPPORTED EMPLOYMENT SERVCS $93,593 $0 $0 $93,593
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PENDING" column
that have not yet been accepted/approved. Therefore, these amounts may change.
OREGON HEP~TH AUTHORITY
Financial Assistance Award Amendment (FAP_~)
FAAA Totals
Summary
2011.-2013
********************* INFORMATION ONLY *********************
CONTRACTOR: DESCHUTES COUNTY CONTRACT#: 134309
DATE: 11/17/2011 REF#.: 006
CURRENT CURRENT PROPOSED REVISED
SE# DESCRIPTION APPROVED PENDING CHANGE TOTAL
TOTAL SE# 38 $93,593 $0 $0 $93,593
39 eSS-HOMELESS $66',365 $0 $0 $66,365
TOTAL SE# 39 $66',365 $0 $0 $66,365
201 NON~RES DESIGNATED SVCS MHS $13,020 $65,271 $0 $78,291
TOTAL SE# 201 $13,020 $65,271 $0 $78,291
CONTRACT TOTAL $8,031,938 $6'44,076 $401,814 $9,077,828
NOTE: The amounts in the "REVISED TOTAL" column include amounts reported in the "CURRENT PEND1.NG" column
that have not yet been accepted/approved. Therefore, these amounts may