HomeMy WebLinkAboutIGA Amend - Mental Health SvcsDeschutes County Board of Commissioners
1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 - Fax (541) 385-3202 - www.deschutes.orp.
AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of January 30, 2008
Please see directions for completing this document on the next page.
DATE: January 22, 2008
FROM: Sherri Pinner, Deschutes County Mental Health (DCMH) Phone #322-7509
TITLE OF AGENDA ITEM:
Consideration and signature of document #2008-029, an amendment to an intergovernmental agrees vent
with the Oregon Department of Human Services for mental health, developmental disability, and
addiction services.
PUBLIC HEARING ON THIS DATE? no.
BACKGROUND AND POLICY IMPLICATIONS:
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 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 monitorin ; of
contracts and subcontracts and documentation of service delivery in compliance with state and federal
requirements for the 2007-2009 biennium.
FISCAL IMPLICATIONS:
The fiscal implication is $176,098 in revenue from the Oregon Department of Human Services for the
2007-2009 biennium. This revenue is not included in the current budget and a budget amendment will
be submitted to the Finance Dept.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature of document #2008-029.
ATTENDANCE: Sherri Pinner
DISTRIBUTION OF DOCUMENTS:
Fax to April D. Barrett at (503) 378-4324, and fully executed copy to Loretta Gertsch, Mental He lth
Department, (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 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 15, 2007
Contact Person:
Sherri Pinner
Contractor/Supplier/Consultant Name:
Department:
Mental Health Dept.
Phone #:
322-7509
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
Annual Value or Total Payment:
2007-2009 biennium.
Ending Date:
6/30/2009
Increases contract revenue by $176,098 for the
® Insurance Certificate Received (check box)
Insurance Expiration Date:
Check all that apply:
RFP, Solicitation or Bid Process
Informal quotes (<$150K)
] Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37)
N/A County is Contractor
11
11
Funding Source: (Included in current budget? 1 1 Yes ® No
If No, has budget amendment been submitted? ® Yes ] No
1/24/200h
Departmental Contact: 'Sherri Pinner Phone #:
Title:
Business / Operations Manager
Department Director Approval:
Signature
322-7509
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
1/24/2003
Oregon
Theodore R. Kulongoski, Governor
DATE: January 10, 2008
TO:
Scott Johnson, Director
Deschutes County
Department of Human Services
Administrative Services
Office of Contracts & Procurement
500 Summer Street NE, E-03
Salem, OR 97301-1080
(503) 945-5818
Purchasing Fax: (503) 373-7365
Contracts Fax: (503) 373-7889
TTY (503) 947-5330
)(DHS
RE: Amendment #15 to the
2007-2009 Intergovernmental Agreement for the Financing
of Mental Health, Developmental Disability, and Addiction
Services Agreement #119929
Enclosed is an amendment to the Agreement.
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 "Fax Back
Statement.
• Fax the amendment and "Fax Back Statement" to DHS at 503-373-7889 or
503-378-4324.
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
Stanislav Leaderman, Mental Health & Addiction Services, at (503) 945-5879 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
Oregon
Theodore R. Kulongoski, Governor
Department of Human Services
Administrative Services
Office of Contracts & Procurement
500 Summer Street NE, E-03
In compliance with the Americans with Disabilities Act, this Salem, OR 97301-1080
document is available in alternate formats such as Braille, (503) 945-5818
large print, audio tape, oral presentation, and electronic Purchasing Fax: (503) 373-7365
format. To request an alternate format call the State of Contracts Fax: (503) 373-7889
Oregon, Department of Human Services, Office of Forms TTY (503) 947-5330
and Document Management at (503) 373-0333.
FIFTEENTH AMENDMENT TO
DEPARTMENT OF HUMAN SERVICES
2007-2009 INTERGOVERNMENTAL AGREEMENT FOR THE
FINANCING OF MENTAL HEALTH, DEVELOPMENTAL DISABILITY
AND ADDICTION SERVICES AGREEMENT #119929
Y(DHS
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 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"
An Equal Opportunity Employer
DC_2OO —Os'9
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: Jeremy Emerson
Title: Administrator, DHS Office of Contracts & Procurement
Deschutes County
By:
Name:
Date:
Title:
Document date: 01/10/2008 Amendment #15 - Revised Page 2
Reference 4018
Exhibit 1 to the 15th Amendment to
Department of Human Services
2007-2009 Intergovernmental Agreement for the
Financing of Mental Health, Developmental Disability
And Addiction Services Agreement #119929
Document date: 01/10/2008 Amendment #15 - Revised Page 3
Reference #018
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
2007-2009
CONTRACTOR: DESCHUTES COUNTY Contract#: 119929
DATE: 01/23/2008 Reference#: 018
LOCAL ADMINISTRATION
SECTION: 1
SERVICE REQUIREMENTS MEET EXHIBIT B AND, IF INDICATED, EXHIBIT D
Start/End CPMS
Part Dates Name
Approved
Service Funds
Approved Serv. Unit EXHIB D Spec
Start-up Units Type Codes Cond#
SE# 1 LOCAL ADMINISTRATION HEALTH SV
A 7/2007- 6/2008 N/A $88,049 $0 0. NA N/A M0191 1
A 7/2008- 6/2009 N/A $88,049 $0 0. NA N/A M0191 1
SUBTOTAL SE# 1
TOTAL SECTION 1
$176,098 $0
$176,098 $0
TOTAL AUTHORIZED FOR LOCAL ADMINISTRATION $176,098
TOTAL AUTHORIZED FOR THIS FAAA: $176,098
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
CONTRACTOR: DESCHUTES COUNTY Contract##: 119929
DATE: 01/23/2008
REASON FOR FAAA (for information only):
Local Administration (MHLA01) funds are awarded for the 07-09 Biennium.
REF#: 018
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.
M0191 1 The financial assistance subject to this special condition is
awarded for local administration of services in the Mental Health
Services Program Area. If County terminates its obligation to
include this Program Area in its CMHP, Department shall have no
obligation, after the termination, to pay or diburse to County
financial assistance subject to this special condition.
DHS, Addictions and Mental Health Division, Evidence -Based Practices Unit
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01/23/2008
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Oregon Department
of Human Services
Office of Contracts & Procurement
500 Summer St. NE, E-03
Salem, OR 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. If any changes are made to the Amendment, please return the
Amendment in its entirety. Thank you.
I
(Name) (Title)
received a copy of Amendment #15 to Agreement #119929, between
the State of Oregon, acting by and through the Department of Human Services and
Deschutes County, from Connie Thies on January 10, 2008.
On , I signed the printed form of the Amendment without change
(Date)
from the electronically transmitted document.
A copy of the signature page pertaining to the above listed Amendment containing
my signature is included with this facsimile transmission.
(Signature) (Date)
After all parties have signed, you will receive a copy of the Amendment for your
records. If you have any questions, please call April D. Barrett at (503) 945-5821.
Enclosure(s)
Fax Back Statement.doc Revised: May 16, 2005
