HomeMy WebLinkAboutMental Health IGA - Amend DHS AgrmtDeschutes 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 June 25, 2008
DATE: June 18, 2008
FROM: Sherri Pinner Department: Deschutes County Mental Health (DCMH) Phone #322-75( 9
TITLE OF AGENDA ITEM:
Consideration and signature of document #2008-322, 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 #119929-36 revises the
awarded funds for a specific individual for a specific period of time.
Amendment #119929-36 includes revisions for the following service elements:
1. Service element #20 - Non -Residential Adult Mental Health Services - increase of $4,207 for rent
subsidy at Hosmer House.
2. Service element #34 - Adult Foster Care Mental Health Services - increase of
$172,374 for foster care services. The majority of these monies are sent directly to our foster care
service providers from the Oregon Department of Human Services.
3. Service element #201 - Non-residential Designated Services, Mental Health Services
decrease of $24,431 - removed from Golden Eagle AFH and awarded to Hosmer House. These monies
pass through DCMH to the foster care service providers.
FISCAL IMPLICATIONS:
The fiscal implication is $152,150 in revenue from the Oregon Department of Human Services for the
2007-2009 biennium. This revenue is included in the current budget.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature of document #2008-322.
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: June 9, 200
Contact Person:
Please complete all sections above the Official Review line.
Lori Hill
Contractor/Supplier/Consultant Name:
Department:
Phone #:
Mental Health Dept.
322-7535
!Oregon Department of Human Services
Goods and/or Services: Consideration and signature of document #2008-322, an
intergovernmental agreement, #119929-36, 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 #119929-36 revises
the awarded funds for a specific individual for a specific period of time.
Amendment #119929-36 includes revisions for the following service elements:
1. Service element #20 - Non -Residential Adult Mental Health Services - increase of
$4,207 for rent subsidy at Hosmer House.
2. Service element #34 - Adult Foster Care Mental Health Services - increase of
$172,374 for foster care services. The majority of these monies are sent directly to
our foster care service providers from the Oregon Department of Human Services.
3. Service element #201 - Non-residential Designated Services, Mental Health Services
decrease of $24,431 - removed from Golden Eagle AFH and awarded to Hosmer
House. These monies pass through DCMH to the foster care service providers.
Agreement Starting Date:
1/1/2008
Annual Value or Total Payment:
2007-2009 biennium.
Ending Date:
6/30/2009
Increases contract revenue by $152,150 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
6/19/2008
Funding Source: (Included in current budget? ® Yes ❑ No
If No, has budget amendment been submitted? 111 Yes ❑ No
Departmental Contact:
Title:
Lori Hill
Adult Treatment Program Manager
Phone #:
Department Director Approval:
Signature
322-7535
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)
El Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. )
Legal Review Date
Document Number
6/19/2008
)rDHs
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 Agreement #119929, between the State of Oregon,
acting by and through the Department of Human Services and Deschutes County,
from April D. Barrett on May 10, 2007.
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
Oregon
Theodore R. Kulongoski, Governor
DATE: May 22, 2008
TO: Scott Johnson, Director
Deschutes County
RE:
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
Amendment #36 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 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
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.
THIRTY-SIXTH AMENDMENT TO
DEPARTMENT OF HUMAN SERVICES
2007-2009 INTERGOVERNMENTAL AGREEMENT FOR THE
FINANCING OF MENTAL HEALTH, DEVELOPMENTAL DISABILITY
AND ADDICTION SERVICES AGREEMENT #119929
>(DHS
This Thirty -Sixth 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: Stella Transue
Title: Administrator, DHS Office of Contracts & Procurement
Deschutes County
By: Date:
Name: Title:
Document date: 05/22/2008 Amendment #36 Page 2
Reference 1/032
Exhibit 1 to the 36th 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: 05/22/2008
Reference #032
Amendment #36 Page 3
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
2007-2009
CONTRACTOR: DESCHUTES COUNTY Contract#: 119929
DATE: 05/20/2008 Reference#: 032
MENTAL HEALTH SERVICES
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# 20 NON-RESIDENTIAL ADULT MH SERV
A 4/2008- 6/2008 N/A $4,207 $0 15. SLT N/A
SUBTOTAL SE# 20 $4,207 $0
SE# 34 ADULT FOSTER CARE MHS
B 4/2008- 6/2008 ASORAN-810809 $16,602 $0 3. SLT N/A
B 4/2008- 6/2008 N/A $81,985 $0 15. SLT N/A
B 7/2008- 6/2009 ASORAN-810809 $73,787 $0 1. SLT N/A
SUBTOTAL SE# 34
$172,374 $0
SE# 201 NON -RES DESIGNATED SVCS MHS
A 1/2008- 2/2008 ASORAN-810809 $926 $0 0. NA N/A
A 1/2008- 6/2008 ASORAN-810809 $84 $0 0. NA N/A
A 2/2008- 2/2008 ASORAN-810809 $141 $0 0. NA N/A
A 4/2008- 6/2008 ASORAN-810809 -$4,697 $0 0. NA N/A
A 7/2008- 6/2009 ASORAN-810809 -$20,885 $0 0. NA N/A
SUBTOTAL SE# 201
TOTAL SECTION 1
-$24,431 $0
$152,150 $0
TOTAL AUTHORIZED FOR MENTAL HEALTH SERVICES $152,150
TOTAL AUTHORIZED FOR THIS FAAA: $152,150
DEPARTMENT OF HUMAN SERVICES
Financial Assistance Award Amendment (FAAA)
CONTRACTOR: DESCHUTES COUNTY Contract#: 119929
DATE: 05/20/2008
REASON FOR FAAA (for information only):
REF#: 032
Non -Residential Adult Mental Health (General) (MHS 20) funds are awarded
for rent subsidy at Hosmer House, LOI #183.
Adult Foster Care (MHS 34) limitation is increased for service payment at
Hosmer House, LOI #183.
Non -Residential Adult Mental Health (Designated) (MHS 201) funds are
awarded for medications and medical costs, LOI #190.
Adult Foster Care Services (MHS 34) funds are awarded for service payment
at Hosmer House, LOT #222.
Non -Residential Adult Mental Health (Designated) (MHS 201) funds are
removed from Golden Eagle AFH and awarded to Hosmer House, LOI #222.
0
U
m
m
PI 0
N
a
0 O
U
n
124
o
A
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SE# DESCRIPTION
M w r
01 01 0
0) N N
O W
kO r M-
.4, O
if} •
H
t/}
0 0 N
th- a
•N
0 0 0
tR VT t?
$1,539,494
0
$1,535,287
a a a
xPI • N NN
H H H
H H H
W W W
H• HHH O
U1 CO U7 N
a a
zz°z
O o 0
N N N
TOTAL SE#
0)
yr
0
+?
SERVICES
111
0a
H
0
N
N
N
N
TOTAL SE#
$1,711,395
$1,711,395
H
REGIONAL ACUTE
$1,711,395
N-
$1,711,395
01 01 N N o N N
N N H o N W d'
r r M M l0 N La
N r CO kir W W W
M M th 00 01 H rl
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N r H o (1 d' d'
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TOTAL SE#
4'
41
it
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x
i<
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w
it
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41
it
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41
41
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m o H O
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SE# DESCRIPTION
00 W O O co co
m m 0 0 10 10
ON 0\ 0 0 to VI
m m O 0 m CO
N N 111 10 O O
co co to- iQ H r-1
U} V} i/1' th
0
0
0
t/t
$4,977,419
0
th
0) W O O Ot O1
m m O O 0t 0\
01 01 0 0 01 01
M m 0 0 N 0 -
CI
N N 111 111 N N
N N M. (0- rI H
m 4* 411-
SUPPORTED EMPLOYMENT SERVCS
a) a)
m
co
m
TOTAL SE#
CSS -HOMELESS
01
Cd
0
m
TOTAL SE#
NON -RES DESIG
H
O
N
TOTAL SE# 201
O
id -
$4,997,643
0
H
U
C7
z
QHQ
7-�
W
a
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w
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DESCRIPTION
M CO M M
(0 l0 M M
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0
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0) 01 ida ri
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in. in- r/} i/}
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W
H • O
N N
a
0
z
N
TOTAL SE#
CHILD & ADOLES MH SERVICES
N
N
$1,049,516
$1,049,516
N
U
$1,049,516
v}
M M ri di N N to
W d( W N rl 10 (0
01 01 0 M di CO 00
di di M N CO CO CO
id id N N di rl H
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N CO F ri F Fdi rCdi i-7 10
O N O M 0 M M O M
F F H F
TAL SE# 36
$2,380,035
N
M
N
N
ar
$2,207,661
rl
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01 N W
N M In F
o o H O
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H W
H a
SE# DESCRIPTION
0 0 0
o o 0
W d' W
1/40 10
ri ri ri
H H ri
0
tR
ai-
+0a
tik
+0)
0 0 0
O O O
W al rM
to 10
H ri H
H ri H
0) 0) 0)
PROJECTS
if
if44
•
in
4
w 44
4
[ 4
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H O)
01 N W
N to V) H
m o H O
01 J H
H W
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a 7zin id
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pa;° DoH
N
O N N
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4 a 0 o
0 id C in N
U
SE# DESCRIPTION
(1 N N
O Lf) O
01 LI) (1
o fn
WI 0 ur
W N
in- •
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VI- in- in-
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(0 N o
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01 If)
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ur
a
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$1,668,757
ur
$1,664,550
zzz
AAA
HHH o
0 0) in N
aaa
i L i
O O O
zzz
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N N N
TOTAL SE#
N N l0
CO CO H
0 0 H
H CO Cr;
N 01 H
H w 10
in- in- in
0 0
in- in-
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In m H
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N 01 H
H y4 (0
in- in- in
-
(n (n
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0 Ca
H H
U
N N
N N
N
N
TOTAL SE#
$1,711,395
414
$1,711,395
REGIONAL ACUTE PSYCH INPATIENT
$1,711,395
0
4/1-
(1).
r
ur
$1,711,395
d'
N
TOTAL SE#
In -
H
U
a
COMM CRISIS -
In
N
$1,049,516
ar
$1,049,516
TMENT SERVICES
$1,049,516
0
ur
$1,049,516
H
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N W N
TOTAL SE#
H
(n
CO
N
TOTAL SE#
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SE# DESCRIPTION
o M m H W 1n N N N to o o 00
N d' W d' h H d' d' in 10 0 0 M
10 01 01 O M d' to '0 co 0) d' d' O1
W d' d' M N In CO 0) 01 01 10 l0 M
01 H H N N ' H H ri H H H N
V} r) M If) H N V} V} V} V} H H N
V} V} V} V} V} 0- N V}
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d' d• d' co M O) co 01 01 HO 1.0 M
01 ri H 0) 0.ri H H 40 H H N
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V} V} v} t? V} in AA -
TOTAL SE#
cn01 0 CO
0
wto W Q
U q
W w W a{qq
H H rl
q H 0 0 w H
W M Co Co M q
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W Q P141 <11 111
T
T
PROJECTS
V H
H
10 V) U N
M M W M
C114
CO
W £
m
a co
TOTAL SE#
10 H N
M O M
T
TOTAL SE#
SUPPORTED EMPLOYMENT SERVCS
The amounts in the "REVISED
01 N Wch
m O H H
H W
H a
H W
ita
*
*
it
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* 0 w
itV
* °a 0
w * 04
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w *
*
*
*
*
*
*
*
*
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7a
SE# DESCRIPTION
on o 0 0) of
M 0 O to to
O1 O O N u)
M O O m m
N 10 W 0 0
N VT U? rl ri
yr +n (0-
th-
ca
0)
0)
$7,473,854
H H 0
Cr) 01 to
4 d' H
d' W N
N N LO
in -in- H
1
1 in-
h
in-
m-
co
co 0 o al ON
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