HomeMy WebLinkAboutIGA Amendment - DHS - Mental HealthI)cschutes County Hoard of ('ommissioner
1')00 N\V' \fall St., Suite 200, I3cnd, Ok 7701-190(
(54.1) 3titi-0570 - I°ax (541) 385-32(12 - vvwv\.descltutes.ors
AGENDA REQKKFS & STAFF REPORT
For Board Business Meeting of .January 23, 2008
Please ,see directions for completing this document on the next page.
DA'Z'E: January 15, 20(18
FROM: Sherri Pinner Department: Deschutes County Mental health (1)CMI I) Phone //322-7500
TIME OF AGENDA ITEI\l:
Consideration and signature of document /120(18-029, an amendment to an intergovernmental agrccin nt
with the Oregon 1)cpartment of 1-1aman Services for mental health, developmental disability, and
addiction services.
PU131 1C HEARING: ()N '1'IIIS DA'T'E? no.
BA('KCROUND AND POLI('Y I1\II l l('ATI(INS:
'l'hc 2007-00 lntcrgoverunaental Agreement for the Financing of Mental Health, Developmental
Disability, and Addiction Services agreement sets lorth the dollar amounts and guidelines for i)CM11 o
provide or coordinate provision 01naenta1 health and developmental disability treatment services to
indiv ideals, as spell as alcohol, other drug and problem gambling prevention and ireatmen1 services fo
the 2007-2000 biennium. Amendment /J110020-15 increases funding for Service element Id)1 - Local
Administration Health Services.
Amendment /11 1 0020-1 5 includes revisions for the following service element:
I . Service clement /101 - Local Administration I Ical(h Services - increase o1$170,008 for planning an.1
resource development, coordination of Mental Health Program services, negotiation and monitoring of
contracts and subcontracts and documentation of service delivery in compliance with stale and federal
requirements for the 2007-2000 biennium.
FISCAL, IMPLICATIONS:
The fiscal implication is 8170,098 in revenue (iom the Oregon Department of Etonian Services for the
2007-2000 biennium. This revenue is no( included in (he current budget and a budget amendment will
be submitted to the Finance Dept.
RECO1\1 \1I NDATION & AC'I'ION REQUESTED:
Approval and signature of document/12008-020
.AT'IFNDAN('E:
oi umcnt/12008-(I20
.1'1"IFNDANCE: Scott Johnson
DISTRIBUTION OF DOCUMENTS:
Fax to April D. Barrett at (503) 378-4324, and Cully executed copy to Loretta Gcrtsch, Mental 1lcalt
1)cpartmcnt, (541) 322-7565.
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 he 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.)
Please complete all sections above the Official Review line.
Date: January 15, 2007
Contact Person: 'Sherri Pinner{ Phone #: 322-75091
Department: [Mental Health Dept
Contractor/Supplier/Consultant Name:
Oregon Department of Human Services
Goods and/or Services: Consideration and signature of document #2008-029, an
intergovernmental agreement, #119929-15, with the Oregon Department of Human
Services for mental health, developmental disability, and addiction services.
Background & History: The 2007-09 Intergovernmental Agreement for the Financing
of Mental Health, Developmental Disability, and Addiction Services agreement sets forth
the dollar amounts and guidelines for Deschutes County Mental Health (DCMH) 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 2007-2009 biennium. Amendment #119929-15
increases funding for Service element #01 - Local Administration Health Services.
Amendment #119929-15 includes revisions for the following service element:
1. Service element #01 - Local Administration Health Services - increase of $176,098
for planning and resource development, coordination of Mental Health Program
services, negotiation and monitoring of contracts and subcontracts and documentation
of service delivery in compliance with state and federal requirements for the 2007-2009
biennium.
Agreement Starting Date: [7/1/2007 Ending Date: 6/30/2009
Annual Value or Total Payment: llncreases contract revenue by $176,098 for the
12007-2009 biennium.
x
Insurance Certificate Received (check box)
Insurance Expiration Date: [N/A County is Contractor
Check all that apply:
RFP, Solicitation or Bid Process
Informal quotes (<$150K)
Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37)
II
II
II
Funding Source: (Included in current budget? Li Yes V No
If No, has budget amendment been submitted? N Yes I No
1/ 15/2008
Departmental Contact: [Sherri Pinned Phone #: [322=75091
Title: [Business / Operations Manager
Department Director Approval: �, ?- 1/15t�
Signature Date
Distribution of Document: Fax to April D. Barrett at (503) 378-4324, and fully
executed copy to Loretta Gertsch, Mental Health Department, (541) 322-7565.
Include complete information if document is to be mailed.
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 2W-OZei
1/1 -1, -)ft;
0
uregon
)hq9 1hcoJuic R l nlunuu,til.i. (iovcrnor
1)Ai'1January 10, 2008
10:
Scott Johnson, Director
Deschutes County
Department of Human Ser Vices
Administrative Sc -vices
(Vice o/ C'otulruc i s c�, ) roc rri' 'mod
500 Su 111 mer Strecl Nl 1 1'1-0 3
Salem, Ok 97301 .1080
(503) 945 5818
Purchasing Fax: (503) 37 3 7365
Contracts Fax: (50 3) 373 7889
TIN (503)947 5330
1Z1:: Amendment #15 to the
2007-2009 Intergovernmental Agreement for the Financing
of Mental Health, Developmental Disability, and Addiction
Services Agreement #119929
1 nclosed k an amendment to the Agreement.
The instructions for processing this amendment are as follows:
• Open and print the electronic lilt containing the amendment for signature by
the appropriate authorized County Official(s).
• Obtain the authorized signature(s) on the Amendment and the "Fax Rack
Statement.
• Fax the amendment and "Fax Back Statement" to I)11S at 503-373-7889 or
503-378-4324.
Following receipt by DHS of your signed amendment, DI -IS will route its copy of
amendment to the official(s) who is/are authorized to execute the amendment.
Once the antendnment is signed I_)I-RS will scan the Amendment and transmit to the
appropriate County official.
11vou have questions regarding this financial assistance award, please contact
Stanislav Leaderman, Mental Health & Addiction Services, at (503) 945-5879 or
April D. Barrett at (503) 945-5821.
Sincerely.
April 1). Barrett, ()PBC
Contracts Specialist
lInclosure
1 v islir>� 1'c'nj)lc' 10 Bc'c'nalc Trrc/c'lkc'ncic/Tl, llcallha' and Sufi' "
An Equal Opportunity f,:naplover
f3
clJre giii. Department of 11uman Service ;
Administrative Service ;
I lieodoro KnlorToski, Governor Office of (ontraCtS (c: Pi OC!li
500 Summcl Sttect NF, F-0
fn compliance with the Americans with 1)isabilities Act, this Salem, OR 97301-100
document is available in alternate formats such as Braille, (503) 945-5S1/
large pt int, audio tape, oral presentation, and electronic Purchasing Fax: (503) 373-736f
format. To request an alternate format call the State of Contracts Fax: (503) 373-788
Oregon, Department of I luman Services, Office of Forms TTY (503) 947-53'3(
and Document Management at (503) 373-0333
FIF'LLENf1f AMENDMENT TO
DEPARTMEN1 01 HUMAN SERVICES
2007-2009 INTERGOVERNMENTAL NTAL AGREEMENT FOR TI1L
FINANCING OF MENTAL HEALTH, DEVELOPMENTAL DISABILI"FY
AND ADDICTION SERVICES AGREEMENT 11119929
).(DH
This Fifteenth Amendment to Department of Human Services 2007-2009
Intergovernmental Agreement for the Financing of Mental Health, Developmental
Disability and Addiction Services as amended, 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 Set vices ("Department" or "DHS") and Deschutes County
("County")
RECITALS
WEIl RLAS, the Department and County wish to modify the Financial
Assistance Award set forth in Exhibit C-1 of the Agreement.
NOW, TIIEREFORE, 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:
AORFt MENT
1 The Financial and service inhotmation in the Financial Assistance Award ale
hereby amended as described in Exhibit 1 attached hereto and incorporated
herein by this reference Exhibit 1 Aust he teal 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
".f.e,�Lstin�r PcoplC to Becon/c huicpcn fent, 11e i/iity and Sa/�e
An Equal Opportunity Hnploycr
Exhibit 1 to the 15t11 Amendment to
Department of Human Services
2007-2009 Intergovernmental Agreement for the
Financing of Mental Ilealth, Developmental Disability
And Addiction Services Agreement #119929
f)ocumcnl dale:: 0 i 1(J 20(S
Refs rc is f!0 1
nmcn�lmcnl if 1 5 Pa}�e l
DEFARIMENT CI. HUMAN SERVICES
l',Hnancial Assistance Awayd Amendment (VAAA)
L'ONTPI,CP-)P. 101PC;-IUTES COUNIY
DATF: 91799/2008
1. IJNICN C)0 'AAA (for information cinly;:
Con rartil
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Or0gon I)01mil men!
01 I lumen Sorviro"5
Office of Contracts & Procurement
500 Summer St. N I .. 1':-03
Salem, OIZ 97301-1080
Phone: (503) 945-5818
Fax: (503) 378-4324
Alternate Fax: (503) 373-7889
TTY: (503) 947-5330
FAX BACK STATEMENT
Please complete the following statement and return It along with the completed
signature page. 1 r any changes are Illa(Ie to the Amendment, please return the
Amendment in its entirety. Thank you.
(Name) (Title)
received a copy of Amendment I1 1 5 to Agreement #119929, between
the State of Oregon, acting by and through the Department of Human Services and
Deschutes County, from Connie '[hies on January 10, 2008.
On
, 1 signed the printed limn of the Amendment without change
(Date)
from the electronically transmitted document.
A copy of the signature page pertaining to the above listed Amendment containing
lily signature is included With this facsimile transmission.
(Signature) ( Date)
After all parties have signed, you wi11 receive a copy of the Amendment. lin' your
records. 1f you have any questions, please call April D. Barrett at (503) 045-5821.
hnclosure(s)
01 "s1