HomeMy WebLinkAboutDoc 494 - Amend MH Agrmt - StateDeschutes 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 26, 2009
DATE: August 17, 2009
FROM: Lori Hill, Adult Treatment Program Manager, Deschutes County Health Services,
541- 322 -7535
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2009 -494, Amendment #3 to the 2009 -2011
Intergovernmental Agreement for the financing of mental health, developmental disability and
addiction services, Agreement #127295.
PUBLIC HEARING ON THIS DATE? No.
BACKGROVND AND P9LICY IMPLICATIONS:
The 2009 -2011 Intergovernmental Agreement for the financing of mental health,
developmental disability and addiction services sets forth the dollar amounts and
guidelines for Deschutes County Health Services (DCHS) to provide or coordinate
provision of mental health and developmental disability treatment services to individuals,
as well as alcohol, other drug and problem gambling prevention and treatment services for
the 2009 -2011 biennium. Amendment #127295 -3 awards funding for service element 24 —
Regional Acute Psychiatric Inpatient Services — for two beds. For service delivered to
individuals during a particular day, DHS will provide financial assistance at the rate of $725
per day per individual.
FISCAL IMPLICATIONS
Increases 2009 -11 Intergovernmental Agreement contract revenue by $529,250 due to the fact that it
was not included in the original contract.
J ECOMMENDATION & ACTION BEOUESTED:
Mental Health recommends approval.
ATTENDANCE: Nancy England, Contract Specialist
DISTRIBUTION OF DOC)MENTS:
Fax the documents to April D. Barret at (503) 378 -4324, and fully executed copy to Nancy England,
Contract Specialist, Mental Health Department.
DESCHUTESCOUNTY 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.
August 5, 2009
Department:
Health Services, Adult Treatment
Contractor /Supplier /Consultant Name:
Contractor Contact:
Joan Wan
Type of Document: Amendment
Oregon Department of Human Services
Contractor Phone #:
503 - 947 -5395
Goods and/or Services: Consideration and signature of document #2009 -494,
Amendment #3 to the 2009 -2011 Intergovernmental Agreement for the financing of
mental health, developmental disability and addiction services, Agreement #127295.
Background & History: The 2009 -2011 Intergovernmental Agreement for the
financing of mental health, developmental disability and addiction services sets forth the
dollar amounts and guidelines for Deschutes County Health Services (DCHS) to provide
or coordinate provision of mental health and developmental disability treatment services
to individuals, as well as alcohol, other drug and problem gambling prevention and
treatment services for the 2009 -2011 biennium.
Amendment #127295 -3 awards funding for service element 24.
1. Service element #24 — Regional Acute Psychiatric Inpatient Services — $529,250
of funds are awarded for two beds. For service delivered to individuals during a
particular day, DHS will provide financial assistance at the rate of $725 per day
per individual.
Agreement Starting Date:
July 01, 2009
Annual Value or Total Payment:
Ending Date:
June 30, 2010
Award funds of $529,250.
® Insurance Certificate Received (check box)
Insurance Expiration Date:
County is Contractor
Check all that apply:
❑ RFP, Solicitation or Bid Process
❑ Informal quotes (4150K)
® Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37)
8/5/200'
Funding Source: (Included in current budget? ❑ Yes ® No
If No, has budget amendment been submitted? ® Yes ❑ No
Is thls a Grant Agreement providing revenue to the County? ❑ Yes ® 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: ❑ Yes ❑ No
Contact information for the person responsible for grant compliance: Name:
Phone #:
Departmental Contact and Title:
Phone #:
541 -322 -7516
Department Director Approval:
Nancy England, Contract Specialist
x.15
Date
Distribution of Document: Fax to April D. Barrett at (503) 378 -4324, fully executed
copy to Nancy England, Mental Health Department, (541) 322 -7565.
Official Review:
County Signature Required (check one): 121BOCC ❑ Department Director (if <$25K)
❑ Administrator (if >$25K but <$150K; i >$150K, BOCC Order No.
Legal Review ?'I 1,' IA \ 0°1
Document Number: 2009 -494
8/5/200!
regon
Theodore R. Kulongoski, Governor
Department of Human Services
Administrative Services
Office of Contracts & Procurement
500 Summer Street NE, E -03
Salem, OR 97301 -1080
(503) 945 -5818
Fax: (503) 378 -4324
TTY: (503) 947 -5330
)DHS
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
DHS.Foims @state.or.us or contact the Office of Document
Management at (503) 378 -3523, and TTY at 503- 378 -3523.
THIRD AMENDMENT TO
DEPARTMENT OF HUMAN SERVICES
2009 -2011 INTERGOVERNMENTAL AGREEMENT FOR THE
FINANCING OF MENTAL HEALTH, DEVELOPMENTAL DISABILITY
AND ADDICTION SERVICES AGREEMENT #127295
This Third Amendment to Department of Human Services 2009 -2011
Intergovernmental Agreement for the Financing of Mental Health, Developmental
Disability and Addiction Services dated as of July 1, 2009 (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 Department of Human
Services ( "Department" or "DHS ") and Deschutes County ( "County ").
RECITALS
WHEREAS, the Department and County wish to modify the Financial Assistance
Award set forth in Exhibit C -1 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 information in the Financial Assistance Award are
hereby amended as described in Exhibit 1 attached hereto and incorporated
herein by this reference. Exhibit 1 must be read in conjunction with the
portion of Exhibit C -1 of the Agreement that describes the effect of an
amendment of the financial and service information.
"Assisting People to Become Independent, Healthy and Safe"
LEGAL COUNSEL
/-) An Equal Opportunity Employer
Qc -2009 -4914
Oregon
Theodore R. Kulongoski, Governor
DATE:
TO:
RE:
August 4, 2009
Scott Johnson, Director
Deschutes County
Department of Human Services
Administrative Services
Office of Contracts & Procurement
500 Summer Street NF, E -03
Salem, OR 97301 -1080
(503) 945 -5818
Purchasing Fax: (503) 373-7365
Contracts Fax: (503) 373-7889
TTY (503) 947 -5330
Amendment #03 to the
2009 -2011 Intergovernmental Agreement for the Financing
of Mental Health, Developmental Disability, and Addiction
Services Agreement #127295
Enclosed is an amendment to the Agreement.
)r)Hs
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 if the amendment
is more than 10 pages the "Fax Back Statement.
• Fax the entire amendment to DHS at 503- 373 -7889 or 503- 378 -4324. If
amendment is more than 10 pages fax only the signature page of the
amendment and the completed, signed "Fax Back Statement" to DHS at the
number above.
Following receipt by DHS of your signed amendment, DHS will route its copy of
amendment to the official(s) who is /are authorized to execute the amendment.
Once the amendment is signed DHS will scan the Amendment and transmit to the
appropriate County official.
If you have questions regarding this financial assistance award, please contact Joan
Wan, Mental Health & Addiction Services, at (503) 947 -5395 or April D. Barrett
at (503) 945 -5821.
Sincerely,
April D. Barrett, OPBC
Contracts Specialist
Enclosure
"Assisting People to Become Independent, Healthy and Safe"
An Equal Opportunity Employer
2. Capitalized words and phrases used but not defined herein shall have the
meanings ascribed thereto in the Agreement.
3, County represents and warrants to Department that the representations and
warranties of County 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. Except as amended hereby, all terms and conditions of the Agreement
remain in full force and effect.
5. 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.
IN WITNESS WHEREOF, the parties hereto have executed this amendment as of
the dates set forth below their respective signatures.
STATE OF OREGON ACTING BY.AND THROUGH
ITS DEPARTMENT OF HUMAN SERVICES
By: Date:
Name: Stella Transue
Title: Administrator, DHS Office of Contracts & Procurement
Deschutes County
By: Date:
Name:_ Tammy Baney, Chair
Deschutes County Board of
Commissioners
Title:
Document date: 08/04/2009 Amendment 403 Page 2
Reference 4006
Exhibit 1 to the 3rd Amendment to
Department of Human Services
2009 -2011 Intergovernmental Agreement for the
Financing of Mental Health, Developmental Disability
and Addiction Services Agreement #127295
Document date: 08/04/2009 Amendment #03 Page 3
Reference #006
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
2009 -2011
CONTRACTOR: DESCHUTES COUNTY Contract #: 127295
DATE: 08/04/2009 Reference #: 006
MENTAL HEALTH SERVICES
SECTION: 1
SERVICE REQUIREMENTS MEET EXHIBIT B AND, IF INDICATED, EXHIBIT B -2
Start /End CPMS
Part Dates Name
Approved
Service Funds
Approved Serv. Unit EXHIB B2 Spec
Start -up Units Type Codes Cond#
SE# 24 REGIONAL ACUTE PSYCH INPATIENT
A 7/2009- 6/2010 N/A $529,250 $0 8760. CSD N/A M0044 1
SUBTOTAL 5E# 24 $529,250 $0
TOTAL SECTION 1 $529,250 $0
TOTAL AUTHORIZED FOR MENTAL HEALTH SERVICES $529,250
TOTAL AUTHORIZED FOR THIS FAAA: $529,250
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
CONTRACTOR: DESCHUTES COUNTY Contract #: 127295
DATE: 08/04/2009 REF #: 006
REASON FOR FAAA (for information only):
Regional Acute Psychiatric Inpatient Services (MHS 24) funds are awarded
for two beds.
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.
M0044 1 MHS 24 Rate: For services delivered to individuals during a
particular day, Department will provide financial assistance at
the rate of $725.00 per day per individual.
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Part A
2009 -2011
* * * * * * * * * * * * * * * * * * * ** INFORMATION ONLY * * * * * * * * * * * * * * * * * * * **
CONTRACTOR: DESCHUTES COUNTY CONTRACT #: 127295
DATE: 08/04/2009
SE# DESCRIPTION
REF #: 006
CURRENT CURRENT PROPOSED REVISED
APPROVED PENDING CHANGE TOTAL
20 NON - RESIDENTIAL ADULT MH SERV $829,866 $0 $0 $829,866
20 NON - RESIDENTIAL ADULT MH SERV $1,079,870 $0 $0 $1,079,870
20 NON - RESIDENTIAL ADULT MH SERV $37,864 $0 $0 $37,864
TOTAL SE# 20 $1,947,600 $0 $0 $1,947,600
22 CHILD & ADOLES MH SERVICES $496,140 $0 $0 $496,140
TOTAL SE# 22 $496,140 $0 $0 $496,140
24 REGIONAL ACUTE PSYCH INPATIENT $0 $0 $529,250 $529,250
24 REGIONAL ACUTE PSYCH INPATIENT $1,731,340 $0 $0 $1,731,340
TOTAL, SE# 24 $1,731,340 $0 $529,250 $2,260,590
25 COMM CRISIS - ADULT & CHILD $744,198 $0 $0 $744,198
TOTAL SE# 25 $744,198 $0 $0 $744,198
28 RESIDENTIAL TREATMENT SERVICES $147,574 $0 $0 $147,574
TOTAL SE# 28 $147,574 $0 $0 $147,574
30 PSRB TMNT & SUPERVISION $84,696 $0 $0 $84,696
TOTAL SE# 30 $84,696 $0 $0 $84,696
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 amourtt ma; charge.
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Part A
2009 -2011
* * * * * * * * * * * * * * * * * * * ** INFORMATION ONLY * * * * * * * * * * * * * * * * * * * **
CONTRACTOR: DESCHUTES COUNTY CONTRACT #: 127295
DATE: 08/04/2009
SE# DESCRIPTION
34 ADULT FOSTER CARE MHS
TOTAL SE# 34
35 OLDER /DISABLED ADULT MH SVCS
TOTAL SE# 35
38 SUPPORTED EMPLOYMENT SERVCS
TOTAL SE# 38
201 NON -RES DESIGNATED SVCS MHS
TOTAL SE# 201
REF #: 006
CURRENT CURRENT PROPOSED REVISED
APPROVED PENDING CHANGE TOTAL
$200,980
$200,980
$18,734
$18,734
$298,584
$298,584
$43,526
$43,526
$5,713,372
$0
$0
$0
$0
- $111,398
- $111,398
$0
$0
- $111,398
$0 $200,980
$0 $200,980
$0 $18,734
$0 $18,734
$0 $187,186
$0 $187,186
$0 $43,526
$0 $43,526
$529,250 $6,131,224
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.
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Part B
2009 -2011
t******* * ** * * *** ** * ** INFORMATION ONLY * * * * * * * * * * * * * * * * *'t * **
CONTRACTOR: DESCHUTES COUNTY CONTRACT #: 127295
DATE: 08/04/2009
SE# DESCRIPTION
REF #: 006
CURRENT CURRENT PROPOSED REVISED
APPROVED PENDING CHANGE TOTAL
20 NON - RESIDENTIAL ADULT MH SERV $130,604 $0 $0 $130,604
TOTAL SE# 20 $130,604 $0 $0 $130,604
22 CHILD & ADOLES MH SERVICES $122,290 $0 $0 $122,290
TOTAL SE# 22 $122,290 $0 $0 $122,290
28 RESIDENTIAL TREATMENT SERVICES $737,866 $0 $0 $737,866
TOTAL SE# 28 $737,866 $0 $0 $737,866
31 ENHANCED CARE SERVICES $436,992 $0 $0 $436,992
TOTAL SE# 31 $436,992 $0 $0 $436,992
34 ADULT FOSTER CARE MHS $641,394 $0 $0 $641,394
TOTAL SE# 34 $641,394 $0 $0 $641,394
36 PASARR MHS $20,072 $0 $0 $20,072
TOTAL SE# 36 $20,072 $0 $0 $20,072
$2,089,218 $0 $0 $2,089,218
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.
DEPARTMENT OP HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Summary
2009 -2011
** *** * * * * * * * * * * * * * * ** INFORMATION ONLY * * * * * * * ** * * * * * * * * * * **
CONTRACTOR: DESCHUTES COUNTY CONTRACT #: 127295
DATE: 08/04/2009
SE# DESCRIPTION
20 NON - RESIDENTIAL ADULT MH SERV
20 NON - RESIDENTIAL ADULT MH SERV
20 NON - RESIDENTIAL ADULT MH SERV
TOTAL SE# 20
22 CHILD & ADOLES MH SERVICES
22 CHILD & ADOLES MH SERVICES
TOTAL SE# 22
24 REGIONAL ACUTE PSYCH INPATIENT
24 REGIONAL ACUTE PSYCH INPATIENT
TOTAL SE# 24
25 COMM CRISIS - ADULT & CHILD
TOTAL SE# 25
28 RESIDENTIAL TREATMENT SERVICES
TOTAL SE# 28
30 PSRB TMNT & SUPERVISION
REF #: 006
CURRENT CURRENT PROPOSED REVISED
APPROVED PENDING CHANGE TOTAL
$829,866 $0 $0 $829,866
$1,210,474 $0 $0 $1,210,474
$37,864 $0 $0 $37,864
$2,078,204 $o $o $2,078,204
$122,290 $0 $0 $122,290
$496,140 $0 $0 $496,140
$618,430 $0 $0 $618,430
$0 $0 $529,250 $529,250
$1,731,340 $0. $0 $1,731,340
$1,731,340 $0 $529,250 $2,260,590
$744,198 $0 $0 $744,198
$744,198 $0 $0 $744,198
$885,440 $0 $0 $885,440
$885,440 $0 $0 $885,440
$84,696 $0 $0 $84,696
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.
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Summary
2009 -2011
* * * * * * * * * * * * * * * * * * * ** INFORMATION ONLY' * * * * * * * * * *'*w * * * * * * * **
CONTRACTOR: DESCHUTES COUNTY CONTRACT #: 127295
DATE: 08/04/2009
REF #: 006
CURRENT CURRENT PROPOSED REVISED
SE# DESCRIPTION APPROVED PENDING CHANGE TOTAL
TOTAL SE# 30 $84,696 $0 $0 $84,696
31 ENHANCED CARE SERVICES $436,992 $0 $0 $436,992
TOTAL SE# 31 $436,992 $0 $0 $436,992
34 ADULT FOSTER CARE MHS $641,394 $0 $0 $641,394
34 ADULT FOSTER CARE MHS $200,980 $0 $0 $200,980
TOTAL SE# 34 $842,374 $0 $0 $842,374
35 OLDER /DISABLED ADULT MH SVCS $18,734 $0 $0 $18,734
TOTAL SE# 35 $18,734 $0 $0 $18,734
36 PASARR MHS $20,072 $0 $0 $20,072
TOTAL SE# 36 $20,072 $0 $0 $20,072
38 SUPPORTED EMPLOYMENT SERVCS $298,584 - $111,398 $0 $187,186
TOTAL SE# 38 $298,584 - $111,398 $0 $187,186
201 NON -RES DESIGNATED SVCS MHS $43,526 $0 $0 $43,526
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.
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
FAAA Totals
Summary
2009 -2011
* * * * * * * * * * * * * * * * * * * ** INFORMATION ONLY * * * * * * * * * * * * * * * * * * * **
CONTRACTOR: DESCHUTES COUNTY CONTRACT #: 127295
DATE: 08/04/2009
SE# DESCRIPTION
TOTAL SE# 201
CONTRACT TOTAL
REF #: 006
CURRENT CURRENT PROPOSED REVISED
APPROVED PENDING CHANGE TOTAL
$43,526 $0 $0 $43,526
$7,802,590 - $111,398
$529,250 $8,220,442
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.