HomeMy WebLinkAboutAmend IGA - State DHS - Mental HealthDeschutes 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 February 27, 2008
Please see directions for completing this document on the next page.
DATE: February 8, 2008
FROM: Loretta Gertsch Department: Deschutes County Mental Health (DCMH) Phone #322-
7510
TITLE OF AGENDA ITEM:
Consideration and signature of document #2008-088, an amendment to an intergovernmental agreement
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 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 # 119929-24 increases the
existing financial service award for the 2007-2009 biennium cost of living adjustment (COLA).
Amendment #119929-24 includes revisions for the following service elements:
1. Service element #20 - Non-residential Adult Mental Health Services - increase of $29,787 for tI e
2007-2009 biennium cost of living adjustment.
2. Service element #22 - Child and Adolescent Mental Health Services - increase of $15,320 for the
2007-2009 biennium cost of living adjustment.
3. Service element #24 - Regional Acute Psychiatric Inpatient Services - increase of $59,547 for the
2007-2009 biennium cost of living adjustment.
4. Service element #25 - Community Crisis Services for Adults and Children - increase of $18,997 for
the 2007-2009 biennium cost of living adjustment.
5. Service element #28 - Residential Treatment Services - increase of $32,268 for the 2007-2009
biennium cost of living adjustment.
6. Service element #30 - Supervision Services for Persons Under the Jurisdiction of the Psychiatric
Security Review Board - increase of $3,553 for the 2007-2009 biennium cost of living adjustment.
7. Service element #31 - Enhanced Care Services - increase of $9,670 for the 2007-2009 biennium cost
of living adjustment.
8. Service element #34 - Adult Foster Care Services - increase of $17,619 for the 2007-2009 biennium
cost of living adjustment.
9. Service element #35 - Older/Disabled Adult Mental Health Services - increase of $570 for the 2007-
2009 biennium cost of living adjustment.
10. Service element #36 - Pre -admission Screening and Resident Review Services - increase of $6 [ 1
for the 2007-2009 biennium cost of living adjustment.
11. Service element #201 - Non-residential Adult Mental Health Designated Services - increase of
$2,840 for the 2007-2009 biennium cost of living adjustment.
FISCAL IMPLICATIONS:
The fiscal implication is $190,782 in revenue from the Oregon Department of Human Services for tie
2007-2009 biennium. This revenue is included in the current budget.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature of document #2008-088.
ATTENDANCE: Sherri Pinner
DISTRIBUTION OF DOCUMENTS:
Fax to April D. Barrett at (503) 378-4324, and fully executed copy to Loretta Gertsch, Mental Health
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.
February 8, 2008
Contact Person:
Loretta Gertsch
Contractor/Supplier/Consultant Name:
Department:
Mental Health Dept.
Phone #:
322-7510
Oregon Department of Human Services
Goods and/or Services: Consideration and signature of document #2008-088, an
intergovernmental agreement, #119929-24, 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 #119929-24
increases the existing financial service award for the 2007-2009 biennium cost of living
adjustment (COLA).
Amendment #119929-24 includes revisions for the following service elements:
1. Service element #20 - Non-residential Adult Mental Health Services - increase of
$29,787 for the 2007-2009 biennium cost of living adjustment.
2. Service element #22 - Child and Adolescent Mental Health Services - increase of
$15,320 for the 2007-2009 biennium cost of living adjustment.
3. Service element #24 - Regional Acute Psychiatric Inpatient Services - increase of
$59,547 for the 2007-2009 biennium cost of living adjustment.
4. Service element #25 - Community Crisis Services for Adults and Children - increase
of $18,997 for the 2007-2009 biennium cost of living adjustment.
5. Service element #28 - Residential Treatment Services - increase of $32,268 for the
2007-2009 biennium cost of living adjustment.
6. Service element #30 - Supervision Services for Persons Under the Jurisdiction of the
Psychiatric Security Review Board - increase of $3,553 for the 2007-2009 biennium cost
of living adjustment.
7. Service element #31 - Enhanced Care Services - increase of $9,670 for the 2007-
2009 biennium cost of living adjustment.
2/8/2008
8. Service element #34 - Adult Foster Care Services - increase of $17,619 for the 2007-
2009 biennium cost of living adjustment.
9. Service element #35 - Older/Disabled Adult Mental Health Services - increase of
$570 for the 2007-2009 biennium cost of living adjustment.
10. Service element #36 - Pre -admission Screening and Resident Review Services -
increase of $611 for the 2007-2009 biennium cost of living adjustment.
11. Service element #201 - Non-residential Adult Mental Health Designated Services -
increase of $2,840 for the 2007-2009 biennium cost of living adjustment.
Agreement Starting Date:
7/1/2007
Annual Value or Total Payment:
2007-2009 biennium.
Ending Date:
6/30/2009
Increases contract revenue by $190,782 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
Funding Source: (Included in current budget? r/ Yes ❑ No
If No, has budget amendment been submitted? ❑ Yes ❑ No
Departmental Contact:
Title:
Loretta Gertsch
'Accounting Technician
Department Director Approval:
Phone #:
322-7510
2•IZ.g
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): El BOCC D Department Director (if <$25K)
❑ Administrator (if >$25K but <$150K; if >$150K, BOCC Order No.
Legal Review Date
Document Number
2/8/2008
REVI
f '
ED
LEGAL COUNSEL
For Recording Stamp Only
BEFORE THE BOARD OF COUNTY COMMISSIONERS
FOR DESCHUTES COUNTY, OREGON
A Resolution Appointing a Financial
Assistance Administrator for the 2007-2009
Intergovernmental Agreement for Financing
of Community Mental Health, Developmental
Disability and Addiction Services, and
Authorizing the Director of Mental Health
and the County Administrator to Approve
Certain Amendments to such Contract
RESOLUTION NO. 2007-107
WHEREAS, the State of Oregon acting by and through the Department of Human Services and
Deschutes County, acting through the Department of Mental Health have entered into an
intergovernmental agreement for the funding and performance of mental health, development
disability and addiction services and such agreement requires that the County appoint a Financial
Assistance Administrator; and
WHEREAS, the Financial Assistance Administrator should be a person knowledgeable about the
available mental health services and capable of dealing with a large volume of transactions in a timely
manner; now therefore:
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES
COUNTY, OREGON, as follows:
Section 1. Scott Johnson, the Director of the Deschutes County Mental Health Department, is duly
appointed as the Deschutes County Financial Assistance Administrator with respect to that
certain 2007-2009 Intergovernmental Agreement for the Financing of Community Mental
Health, Developmental Disability and Addiction Services (herein "DHS Agreement
No.119929"). Such appointment shall continue in effect so long as Scott Johnson is an
employee of Deschutes County and until a successor is appointed.
Section 2. The Financial Assistance Administrator is authorized to perform the functions of such
appointment as set forth in DHS Agreement No. 1 19929, except with respect to contract
amendments which exceed a dollar amount of $50,000, in which event such amendments
are subject to approval by the County Administrator for amendments which are less than
$150,000. Amendments to DHS Agreement No. 119929 which exceed $150,000 shall be
subject to prior approval by the Board.
Resolution No. 2007-107 Page 1 of 2
Section 3. All contract amendments shall be in accordance with the approved Deschutes County
budget.
Section 4. This resolution shall take effect on July 1, 2007.
-l4)
DATED this.611b day of,ltxrf e 2007.
THE BOARD OF COUNTY COMMISSIONERS FOR
DESCHUTES COUNTY, OREGON
MC AE D C air
�Y,
ENNIS R. LUKE, Commissioner
ATTEST: TAMMY BANEY, Commissioner
(&//1/LW-L (8
Recording Secretary
Resolution No. 2007-107 Page 2 of
Oregon
Theodore R. Kulongoski, Governor
DATE: February 6, 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 #24 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
2_06g - Duk
Oregon
Theodore R. Kulongoski, Governor
Department of Human Services
Administrative Services
Office of Contracts & Procurement
500 Summer. Street NE, E-01
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.
TWENTY-FOURTH AMENDMENT TO
DEPARTMENT OF IlUMAN SERVICES
2007-2009 INTERGOVERNMENTAL AGREEMENT FOR THE
FINANCING OF MENTAL HEALTH, DEVELOPMENTAL DISABILITY
AND ADDICTION SERVICES AGREEMENT #119929
YODH
This Twenty -Fourth 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
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: 02/06/2008 Amendment #24 Page 2
Reference #021
Exhibit 1 to the 24th 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: 0210612008 Amendment #24 Page 3
Reference #021
DEPARIMENI OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
2007-2009
CONIRACTOR: DESCHUTES COUNIY Contract#: 119929
DATE: 02/05/2008 Reference#: 021
MENTAL HEALTH SERVICES
SECIION: 1
SERVICE REQUIREMENTS MEET EXHIBII B AND, IF INDICATED, EXHIBIT D
Start/End CPMS Approved Approved Serv, Unit EXHIB D Spec
Part Dates Name Service Funds Start-up Units Iype Codes Cond#
SE# 20 NON-RESIDENTIAL ADULT MH SERV
A 7/2007- 6/2008 N/A $8,544 $0 0. NA N/A
A 7/2008- 6/2009 N/A $17,268 $0 0.. NA N/A
B 7/2007- 6/2008 N/A $1,316 $0 0.. NA N/A
B 7/2008- 6/2009 N/A $2,659 $0 0,. NA N/A
SUBTOTAL SE# 20
$29,787 $0
SE# 22 CHILD & ADDLES MH SERVICES
A 7/2007- 6/2008 N/A $3,839 $0 0. NA N/A
A 7/2008- 6/2009 N/A $7,760 $0 0. NA N/A
B 7/2007- 6/2008 N/A $1,232 $0 0.. SLT 22A
B 7/2008- 6/2009 N/A $2,489 $0 0. SLT 22A
SUBIOTAL SE# 22
$15,320 $0
SE# 24 REGIONAL ACUTE PSYCH INPATIENT
A 7/2007- 6/2008 N/A $19,801 $0 0.. NA N/A
A 7/2008- 6/2009 N/A $39,746 $0 0.. NA N/A
SUBTOTAL SE# 24
$59,547 $0
SE# 25 COMM CRISIS - ADULT & CHILD
A 7/2007- 6/2008 N/A $6,288 $0 0.. NA N/A
A 7/2008- 6/2009 N/A $12,709 $0 0, NA N/A
SUBTOTAL SE# 25
$18,997 $0
$E# 28 RESIDENTIAL IREATMENT SERVICES
B 7/2007- 6/2008 N/A $10,681 $0 0, SLT N/A
B 7/2008- 6/2009 N/A $21,587 $0 0, SLT N/A
SUBTOTAL SE# 28
$32,268 $0
CONTRACTOR: DESCHUIES COUNTY Contract#: 119929
DATE: 02/05/2008 Reference#: 021
MENTAL HEALTH SERVICES
SECTION: 1
SERVICE REQUIREMENTS MEET EXHIBIT B AND, IF INDICAIED, EXHIBIT D
Start/End
Part Dates
CPMS
Name
Approved
Service Funds
SE# 30 PSRB IMNI & SUPERVISION
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2007-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
7/2008-
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2008
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
6/2009
ALSOHN-710719
OYEHOM-480408
ARINDR-710205
ASORAN-810809
ATSICH-571212
LAKANI-661008
RASOBE-650925
RAVARY-560312
OWENDR-720924
OPEAME-661204
MOOHAR-620521
ARINDR-710205
LAKANI-661008
MOOHAR-620521
ASORAN-810809
AISICH-571212
OYEHOM-480408
RASOBE-650925
RAVARY-560312
OWENDR-720924
ALSOHN-710719
OPEAME-661204
ALSOHN-710719
OYEHOM-480408
ARINDR-710205
ASORAN-810809
AISICH-571212
LAKANI-661008
RASOBE-650925
RAVARY-560312
OWENDR-720924
OPEAME-661204
MOOHAR-620521
ARINDR-710205
LAKANI-661008
MOOHAR-620521
ASORAN-810809
ATSICH-571212
OYEHOM-480408
RASOBE-650925
RAVARY-560312
OWENDR-720924
ALSOHN-710719
OPEAME-661204
Approved Serv. Unit. EXHIB D Spec
Start-up Units Type Codes Cond#
$5,185 $0 1 SLT N/A
$5,185 $0 1. SLT N/A
$5,185 $0 1.. SLT N/A
$5,185 $0 1,. SLT N/A
$5,185 $0 1.. SLT N/A
$5,185 $0 1. SLT N/A
$5,185 $0 1., SLT N/A
$5,185 $0 1. SLI N/A
$5,185 $0 1. SLT N/A
$5,185 $0 1. SLT N/A
$5,185 $0 1. SLT N/A
- $5,078 $0 -1. SLT N/A
-$5,078 $0 -1. SLT N/A
-$5,078 $0 -1. SLT N/A
-$5,078 $0 -1,. SLT N/A
-$5,078 $0 -1. SLT N/A
-$5,078 $0 -1, SLT N/A
- $5,078 $0 -1., SLI N/A
-$5,078 $0 -1, SLT N/A
-$5,078 $0 -1. SLT N/A
-$5,078 $0 -1.. SLI N/A
-$5,078 $0 -1, SLT N/A
$5,294 $0 1. SLT N/A
$5,294 $0 1.. SLT N/A
$5,294 $0 1,. SLI N/A
$5,294 $0. 1.. SLT N/A
$5,294 $0 1, SLT N/A
$5,294 $0 1, SLI N/A
$5,294 $0 1. SLT N/A
$5,294 $0 1. SLT N/A
$5,294 $0 1. SLT N/A
$5,294 $0 1., SLT N/A
$5,294 $0 1.. SLT N/A
-$5,078 $0 -1. SLT N/A
- $5,078 $0 -1 SLT N/A
-$5,078 $0 -1. SLT N/A
- $5,078 $0 -1.. SLT N/A
-$5,078 $0 -1. SLI N/A
-$5,078 $0 -1.. SLT N/A
- $5,078 $0 -1. SLT N/A
- $5,078 $0 -1. SLT N/A
- $5,078 $0 -1.. SLI N/A
- $5,078 $0 -1.. SLT N/A
-$5,078 $0 -1.. SLT N/A
M0070 1
M0070 1
M0070 1
M0070 1
M0070 1
M0070 1
M0070 1
M0070 1
M0070 1
M0070 1
M0070 1
M0070 2
M0070
M0070 2
M0070 2
M0070 2
M0070 2
M0070 <
M0070 2
M0070 2
M0070 2
M0070 2
CONTRACTOR: DESCHUTES COUNTY Contract#: 119929
DAIE: 02/05/2008 Reference#: 021
MENIAL HEALIH SERVICES
SECTION: 1
SERVICE REQUIREMENTS MEET EXHIBIT B AND, IF INDICATED, EXHIBIT D
Start/End CPMS Approved Approved Sery., Unit EXHIB D Spec
Part Dates Name Service Funds Start-up Units Type Codes Cond#
SUBTOTAL SE# 30
SE# 31 ENHANCED CARE SERVICES
B 7/2007- 6/2008 N/A
B 7/2008- 6/2009 N/A
SUBIOZAL SE# 31
SE# 34 ADULT FOSTER CARE MHS
$3,553 $0
$3,206
$6,464
$0 0. SLT N/A
$0 0.. SLT N/A
$9,670 $0
B 7/2007- 6/2008 N/A $151,880 $0 0. NA N/A
B 7/2007- 6/2008 N/A -$146,048 $0 -1. SLT N/A
B 7/2008- 6/2009 N/A $157,835 $0 0. NA N/A
B 7/2008- 6/2009 N/A -$146,048 $0 -1. SLI N/A
SUBIOIAL SE# 34
$17,619 $0
SE# 35 OLDER/DISABLED ADULT MH SVCS
A 7/2007- 6/2008 N/A
A 7/2008- 6/2009 N/A
SUBTOTAL SE# 35
SE# 36 PASARR MHS
B 7/2007- 6/2008 N/A
B 7/2008- 6/2009 N/A
SUBTOTAL SE# 36
$189
$381
$0 0. NA 35A
$0 0. NA 35A
$570 $0
$202 $0 0. NA N/A
$409 $0 0 NA N/A
$611 $0
SE# 201 NON -RES DESIGNATED SVCS MHS
A 7/2007- 6/2008 ASORAN-810809 $424 $0 0.. NA N/A
A 7/2007- 6/2008 ANTULI-740811 $516 $0 0 NA N/A
A 7/2008- 6/2009 ASORAN-810809 $857 $0 0 NA N/A
A 7/2008- 6/2009 ANIULI-740811 $1,043 $0 0. NA N/A
SUBTOTAL SE# 201
$2,840 $0
CONTRACTOR: DESCHUIES COUNTY Contract#: 119929
DAIE: 02/05/2008 Reference#: 021
MENTAL HEALTH SERVICES
SECTION: 1
SERVICE REQUIREMENTS MEET EXHIBII B AND, IF INDICATED, EXHIBIT D
Start/End CPMS
Part Dates Name
TOIAL SECTION 1
Approved
Service Funds
Approved Serv. Unit EXHIB D Spec
Start-up Units Type Codes Cond#
$190,782 $0
TOIAL AUTHORIZED FOR MENTAL HEALIB SERVICES $190,782
TOTAL AUTHORIZED FOR THIS FAAA: $190,782
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment. (FAAA)
CONTRACTOR: DESCHUIES COUNIY Contract#: 119929.
DATE: 02/05/2008 REF#: 021
REASON FOR FAAA (for information only):
Financial Assistance Award (FAA) for the 2007-2009 Biennium Cost Of Living
Adjustment (COLA)
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.
M0070 1 This special condition replaces the rate portion of special
condition M0000-2, M0055-1 as follows: MHS 30 Rate: For services
delivered to individuals during a particular month, Department
will provide financial assistance at the rate of $432..06 per
month per individual.
M0070 2 This special condition replaces the rate portion of special
condition M0000-2, M0055-1 as follows: MHS 30 Rate: For services
delivered to individuals during a particular month, Department
will provide financial assistance at the rate of $441..13 per
month per individual..
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N N 01 01 N N CO CO
rl H 01 01 tilt d• O1 C<+
co co 111 in U) to O1 C11
Ln to H H m of m co
N N H *-I in in Hi *-I
iR VI-
O
10-
DESCRIPTION
w
W
W
a
q0
Cn
0
0
O
$1,048,482
O
0
O
;/t
a .it a
W co co
d' d' 0
U) iD 0
CO N 0
tzr
i!} i?
SERVICES
O
$1,100,084
O
lh
O
O
U)
0
t/Y
0
t11
O
lh
N N l0 l0 N N O
co CO H rI N N 0
N N N N O1 al O
CO CO r+ -1 r- N o
H H H -1 H H rf1
N N H H ill- th 10
-
Art VI- VI-
U H
t
a Q
W
0 (1)
H
0 N d' H til 0 H rf)
N ' N Z N U N _ m ra rn
0
w H w 0 w X w w A w
al x U] a 0 0 En U1 (1) a Cn
0
F N F 0 E 0 H In H
0 N 0N 0 N 0 C0 0 M 0
P
0
CSS -HOMELESS
rl
0
U
z
H
z
z
U
V U
Cfl
'0 4.1
CU 0
4.3
LI O
to
9
2
m
0 0
U 001
a
H �
oar
H
P1
0 a)
W U
to
it
W P
a w
a)
tea)
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CO 0
4-)
v
0 al
aj rt
H u
Therefore, these
H
°z
w E
U '0
Ha
rq
al
rti-3d
SC E-+ 0 RS
0 a
rdx
N
A
U
td
2007-2009
ON H W
N N U] F
O 0 H O
CS) 7 N
H W
H R'
H G4
u4 IX
0 A W
0 W U'
� a x
0
� fx
a
zz
O Paoo
z C.)al
0
H
H
W 0
� � a
u
E-+
0
U
up 0
o
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A �
in
U 0
",-
14 N
A 0
lx W
O
N
O
U
DESCRIPTION
o N r• r-
0 ui N
0 ri H r-
0 k. W m
to H H l0
L?in-
H H N
r.)
0
VI
H
N
H
0 N N
0 cr m
0 0 0
0 N N
to H H
t!} H H
rn
TOTAL SE#
NON -RES DESIGNATED SVCS
rl
0
4
W
W
H E+ IWt
0 0 0
N E"r Z
0
CriH
$3,645,562
2
H
0
U
L7
z
a
a•
a)
U
(I)rd
0 E
b
g
o
o aaS
N
1_)
-00
a)
H a)
0 F
r{
0 •
H
0 0
U -+
= Rt
F -0
0 a)
H a�
A
W U
N
H td
W
N
a)
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0
ui
0 a)
7
O0 al
rd
H +-)
4J
W O
U
a
W
t0 H
ro
4 F N
W RI
U
O 0
F jJ
z N
4
ars
ro
Q -ri
ro
k:
2007-2009
rn ri W I< VD L <m+1 cm+1 0 r0 -I rr-I
N N CO F N N 0 0 if) Ill 10
al O H O
a1 > F 01 al H H H H 01
H a 4 H r r V TN oiD-
CONTRACT#:
W
PROPOSED
0
ER:
U a
N
dl
m
0
N
0
ifr
N
m
0
[-1 Q a)c0 N N
?r [0 00 H H
O N N m M
v a H , ,
(n- 4O-
DESCRIPTION
TOTAL SE#
CHILD & ADOLES MH SERVICES
N
TOTAL SE#
0
0
0
ACUTE PSYCH INPATIENT
O
$1,049,516
0
$1,017,248
0
$1,017,248
m m -I H o In
sr sr r :1t sr Io
01 01 O 1 O a0
sr sr m M 01
H H [- N r1
m m u1 in i/t
0
CO
0\
0
0
b
l0
0\
0
0 0
O
1-1
O
L7
)43
Hl
1-1
N
+/t U o
U
rti
II
0
rct
0
N 4-I
zf N
ri Q1
U 4
F
0 N
r1
O O
U S•I
04
a
(TS
z:f
a1
a�
U
U
ro
a�
a�
al
4.-),
-ri 11
N
o
J
al
4 4
rct
c14 F t)
a
ko
m 0
M M \a ID N 7)
N N N at N I+1
N N m 0 d) N
ui ICI r1 0.1 In ini
0 0 ko o\ In H
M m N N to :/t
N CO 0
N W m W W m
sr
14 U
it
0 Z F F
w coi w x w q�
co W N Z I Q Q
Tr E -i m
N 0 N O m
T
TOTAL
TOTAL SE#
"REVISED TOTAL"
Ly
W E
U b
Hw
N N
rd
4.3 EQ
F 4-3
al rd
P4
U
F
Z
•rl
N
a H
w �
A •�
U
a
w
2007-2009
m,, W
N N CO H
m o H O
m > F
H W
HI o4
4t It
iz+
W
# g R;
# R:
F
# z
# 0 A w
# U W 0
#
4 0
0
4 c)
# LL
4
4
4
#
4
4
4
o a z
z U a
0
0
fi
DESCRIPTION
(41
W
N
$2,139,797
"CURRENT PENDING" column
Therefore,
The amounts in the "REVISED TOTAL"
W
H
°z
A 7 iD 10 m m 1.o
a, r -I W FC to to M CO .-i
N N CO El 1!1 Ul 0 0 r -I
A CO H O
01 'J F co rn r1 CO 01
ri W 0 0 N 01 H
H a N N H H. W
CONTRACT#:
0
0
co
o
W o
Zo
• N
A 0
a W
O E-,
A
H
O
U
PROPOSED
ri H
$1,601,141
ri 0 0 1fl m o o M
d4 CO CO
r -I n n N U1 N N 01
ri n n 01 01 In U1 d'
o ri "l Tr dr H ri r1
W N n 0 0 r -I H "1
H H H
W W H 01 0 N n COCO 03 00
00 CO N 01 N dr dI 01 01 6D ID
N n n to r'1 Ill 611 01 01 N N
01 01 "1 H in 01 01 CO CO N N
N N :h H H lfl U1 H H N1 r'l
in- tn. in- vs- 4 4.11- Lr Lr t? irt
0
ilk
0
0 0
0
F, A 0 0 N d, 10
r�, C• n H Cl 01
W n n 1+1 Vr C`
C4 O
W n n H m 0
U Ww H H H b+ W
DESCRIPTION
1)
ilk in -
a
al
`0 w w
E 0 U
H a P4
ca co
frl EA
H io En
W W
Q• a
H • O N
to N ca L! N
W
ask A A
O N x
Z U U
N 0 N N
E1
TOTAL SE#
$1,100,084
REGIONAL ACUTE PSYCH INPATIENT
0
0
Cr N N
w CO m
0 n r-
0
0 m CO
0 ri ri
ri n r -
r -V
TOTAL SE#
TOTAL SE#
0
$1,017,248
TREATMENT SERVICES
0
$1,017,248
CI
N
TOTAL SE#
0
Ln
M
0
0
z
0
U
w
o a
trl
U 0
+ N U
rt
• E
co
'd 11
N.#
4-) 0
?a O
0 0
+i 0044
Biz
u v
w
4
O
rd
v
r-1
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0.
rd
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a
A v
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H E.)
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aa)
01
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0
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0)
0 ; >
O rd
U • rt t.)
Id
H E.
"1 00
PSRB TMNT & SUPERVISION.
0
rr1
O
M
TOTAL SE#
SERVICES
Therefore,
H rr,
U W
4
4
i< H
it z
4 0 A 14
4 U W 0
4 CA
+ O
44
CL
+ U
• p;
4 Cl
W 4
...
4
.0 4
0) a) 4.
t0U 4
W 4 z W HH
rn
o, tF0 W
3 111 o O
Z
x v [0 (ONH
�Oi ( 0 o 0
7.
ti) • 4
NH
Q
a 4 W O
Ai ri 4 0:
A *Ai
v U g
0 4
IIS 4
A 4
ri 4
r4 +
4
4
it
it
4
it
4
O
U
w
W o
W o
5N
x �n
U 0
W N
O o
O H
FC
0
C.)
DESCRIPTION
W
0)
M H rl 0 N N In In O O N N l0
d• d4 ill- .4 444 Vr kr. 10 0 0 in in H
O1 0 t 0 In In CO CO 0 0 H rl O1
V' M M CO CO 01 O1 O O In 4.0 CO
H N r H H ra H In In H H ri
M Il) In Ll- in- in t? in- i? H H Vt
ill- ill- ill- ill- in
i?
0
0 0
in in
0
O
0
0
O
4
0)
r
N
r-1
(+) I.0 10 N N N di W 0 O N N
r- N in N r N In In 0 o 4 d'
N M 0 dl O1 01 N N 0 0 0 0
In M N In r r N O1' O 0 N N
0 In Cn In ri r-1 rl rl In In H H
('R N N In ill- in- in ill- ill- in- rl H
in. in in- i? i? int
CA Cn
W as
U U
• x
41 H EW
co Cn
M W W M
• g
LA
OM
TOTAL SE#
OLDER/DISABLED ADULT
0)
co
u) W
M7� M
co W u)
el l0 E
O M 0
CSS -HOMELESS
m
M
0)
M
TOTAL SE#
NON -RES DESIGNATED SVCS
0
N
TOTAL SE# 201
N
r
r
O
01
rl
$5,785,359
ENT PENDING" column
a)
b1
0
115U
N
O
fctW
4-3
a)
O
w
a)
0 N
O 0
U 3i
P.
w
a)
a
a)
U
U
0
a)
a)
a)
Ul0 i• t
C;
b 0
• nJ
.4
in the "REVISED TOTAL"
YID
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 #24 to Agreement #119929, between
the State of Oregon, acting by and through the Department of Human Services and
Deschutes County, from Connie Thies on February 6, 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