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Home My WebLink AboutSignature Authorization - CCFwicA,0Es 67 Deschutes County Board of Commissioner'; 1300 NW Wall St., Suite 200, Bend, OR 97701 -196(1 (541) 388 -6570 - Fax (541) 385 -3202 - www.deschutes.org AGENDA REQUEST & STAFF REPORT For Board Business Meeting of February 11, 2009 Please see directions for completing this document on the next page. DATE: January 30, 2009 FROM: Debi Harr Commission on Children & Families 330 -4692 TITLE OF AGENDA ITEM: Consideration of Chair and County Administrator signatures on Document No. 2009 -041, the Oregon Commission on Children & Families signature authorization form for 2009. PUBLIC HEARING ON THIS DATE? No BACKGROUND AND POLICY IMPLICATIONS: Each year, the Oregon Commission on Children & Families requires an updated form with the new Board of County Commissioners Chair's signature for budget documents, reports, and funding requsts. FISCAL IMPLICATIONS: None RECOMMENDATION & ACTION REQUESTED: Approval and signature of the Oregon Commission on Children & Families signature authorization form. ATTENDANCE: Debi Harr DISTRIBUTION OF DOCUMENTS: Two originals to be returned to Debi Harr at the Commission on Children & Families, 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 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. January 30, 2009 Contractor /Supplier /Consultant Name: Contractor Contact: (503) 378 -5125 Type of Document: Sandra Flickinger Department: CCF Oregon Commission on Children & Families Signature authorization form Contractor Phone #: This is a form updating the authorization for budgeting, funds Goods and/or Services: requests, and reports for Deschutes County Commission on Children & Families with the new chairperson for the Board of County Commissioners for 2009. Background & History: This is a standard form that is updated every new year. Agreement Starting Date: 31, 2009 January 1, 2009 Annual Value or Total Payment: 0 Ending Date: ❑ Insurance Certificate Received (check box) Insurance Expiration Date: N /AI December 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: Quarterly - 45 days after the end of the quarter. 1/30/204 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 El No Contact information for the person responsible for grant compliance: Name: Saraceno Phone #: 317 -3178 Departmental Contact and Title: Phone #: 330 -4692 Department Director Approval: Debi Harr, Financial Analyst Hillary) //30/02 DDaate Distribution of Document: Please return two originals to Debi Harr at the Commission on Children & Families, 1130 NW Harriman, Ste. A, Bend, OR 97701 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 2009 -041 1/30/2009+: ■,APO ONCy /` IT. 41097. CA ,ao 4.3 POLICY AND PROCEDURE MANUAL OCCF State of Oregon Subject: County Authorized Signatures Policy /Procedure Number: CTY -010 Effective Date: Revised June 1, 2008 Approval: 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 locale 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 • Must be approved by Chair of Local Commission Oregon Commission on Children & Families: Authorized Signatures (Revised) 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 Commission, or a delegated signer Oregon Commission on Children & Families: Authorized Signatures (Revised) 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. Oregon Commission on Children & Families: Authorized Signatures (Revised) Oregon Commission on Children and Families Signature Authorization Form County Date The undersigned individual is hereby authorized to approve legal and reporting documents. Chair, Board of County Commissioners (Signature) Printed Name The undersigned Individual is hereby authorized to approve legal documents on behalf of the Board of County Commissioners (BOCC). Other Delegate I Dave Kanner Printed Name County Administrator Title The undersigned individual is hereby authorized to approve comprehensive plan and updates and budget distributions. Chair, Local Commission on Children & Families (Signature) eA) �iJDsv2 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 Ear i •s Satements, and Medicaid Reinvestment Plan reports and reporting documents. terv() irector, Lo • -I Commission on Children & Families (Signature) /7/11, _S.-547m-r,c-70/) Printed Nam 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. Other Delegate (Signature) Printed Name