HomeMy WebLinkAbout2018/09/18 - Regular Packet BOARD OF MASON COUNTY COMMISSIONERS
DRAFT MEETING AGENDA
Commission Chambers — 9:00 a.m.
411 North Fifth Street, Shelton WA 98584
September 18, 2018
1. Call to Order
2. Pledge of Allegiance
3. Roll Call
4. Correspondence and Organizational Business
4.1 Correspondence
5. Open Forum for Citizen Input (5 minutes per person, 15 minutes time limit)
If you wish to address the Commission, raise your hand to be recognized by the Chair. When you
have been recognized, please step up to the microphone and give your name and address before
your comments.The Mason County Commission is committed to maintaining a meeting atmosphere
of mutual respect and speakers are encouraged to honor this principle.
6. Adoption of Agenda
Items appearing on the agenda after"Item 10. Public Hearings", may be acted upon before 9:30
a.m.
7. Approval of Minutes—August 27, and September 10, 2018 Briefing Minutes
8. Approval of Action Agenda: All items listed under the"Action Agenda"may be enacted
by one motion unless a Commissioner or citizen requests an item be removed from the
Action Agenda and considered as a separate item.
8.1 Approval to authorize the Deputy Director/Utilities and Waste Management to
sign a contract amendment extending the existing drop box hauling contract
with Mason County Garbage Co., Inc. through July 31, 2020.
8.2 Approval to appoint Chad White to the Solid Waste Advisory Committee
effective October 4, 2018 through October 4, 2021.
8.3 Approval of amendment #4 of Consolidated Contract CLH18253 between
Mason County Public Health and the State of Washington Department of
Health.
8.4 Approval of Warrants &Treasure Electronic Remittances
Claims Clearing Fund Warrant #s 8058830-8059045 $ 422,747.21
Direct Deposit Fund Warrant #s 52733-53115 $ 655,410.38
Salary Clearing Fund Warrant #s 7003877-7003914 $ 944,381.05
8.5 Approval to transfer $60,000 from Sheriff Department Salaries to Sheriff
Department Operations in order to purchase two vehicles for Sheriff Traffic.
8.6 Approval to appoint Marilyn Vogler (Commissioner District 3) and Randy Olson
(Commissioner District 2) to the Mason County Housing and Behavioral Health
Advisory Board for a four-year term ending September 30, 2022.
Agendas are subject to change,please contact the Commissioners'office for most recent version. This agenda was last
printed on 09/13/18 10:58 AM.
If special accommodations are needed,contact the Commissioners'office at ext.419,Shelton#360-427-9670;Belfair
#275-4467,Elma#482-5269.
MASON COUNTY COMMISSIONERS' MEETING AGENDA
September 18, 2018— PAGE 2
8.7 Approval for the Chair to sign the Personal Property Certificate and Authorized
Agenda Representative form for the Local Agency Financing Contract that
purchased Mason County's communication system in 2016. This form is to be
completed annually.
9. Other Business (Department Heads and Elected Officials)
10. 9:30 a.m. Public Hearings and Items Set for a Certain Time- No hearings
11. Board's Reports and Calendar
12. Adjournment
J:\AGENDAS\2018\2018-09-18 REG.doc
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MASON COUNTY
TO: BOARD OF MASON COUNTY COMMISSIONERS Reviewed:
FROM: Jennifer Giraides Ext. 380
DEPARTMENT: Support Services Action Agenda
DATE: September 18, 2018 No. 4.1
ITEM: Correspondence
4.1.1 Patrick Langan and Maryann Bannon sent in a letter regarding tax
assessments.
4.1.2 Glen Brydges sent in an application for the Lodging Tax Advisory Committee.
Attachments: Originals on file with the Clerk of the Board.
cc:CMMRS Neatherlin,Shutty&Drexler
Clerk
Dear Commissioner Neatherlin; 7 Sep 2018
My Wife Maryann and I are Constituents and Neighbors living in Belfair.
We are writing you because I'm really concerned about the rapid increase in Tax Assessments over the
last three years.We neither understand the justification nor the actual calculations done in our area. We
believe these increases to be"Arbitrary"since we have not been provided any analysis.
We are filing a formal dispute with the County using the requisite forms provided from the State.We
sincerely hope the Assessor's office and the Board of Equalization will reconsider our case using the
"evidence" we are providing to support our claim.We are providing a detailed appraisal with thorough
comparables'from the area.This is certainly more evidence than has been provided us.
I don't want to live in a County that doesn't do its Due Diligence and isn't accountable to its Citizens. I
hope you agree.
If We are not satisfied the Mason County Assessor's office has treated us fairly in this matter,we will be
following up with you for your assistance.
If you need any additional information or if you have questions please don't hesitate to contact us.
Very Respectfully
(RECEIVED
na SEP 10 2018
Patrick Langan a Maryann Bannon
80 NE Rainbow Place South Mason CountyCommissioners
Belfair,WA 98528
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Received Time Sep- 11. 2018 3: 05PM No. 0936
BOARD OF MASON COUNTY COMMISSIONERS'BRIEFING MINUTES
Mason County Commission Chambers,411 North 5th Street,Shelton,WA
Week of August 27,2018
9:00 A.M. Support Services—Frank Pinter
Commissioners Neatherlin,Shutty and Drexler were in attendance
• Shelton Chamber of Commerce State of the Community-Cmmr.Drexler said she is not
available on September 20s'adding that the Chair usually attends as the representative.
Cmmr.Neatherlin said he would attend.
• Boating regulations-No evidence of a scrivener's error was found.Cmmr.Neatherlin
asked if a hearing should be held noting that these regulations are difficult to enforce in
some areas.Cmmr.Drexler said she would be willing to hold a hearing since the code is
being interpreted differently by the sheriffs office.
• Jennifer Beierle read through requests for Supplemental Appropriations and Budget
Transfers.She noted she would be striking the$5,314 from Historical Preservation fund
116.A discussion was had about the litter crew and the amount budgeted for the
program.Cmmr.Neatherlin noted he is in favor of the program,but would like financial
conversations for this discussed during budget instead of during the year.
o Cmmr.Drexler noted she would like to see each department come together for a
round table discussion about allocated funds.Cmmr.Neatherlin questioned if this
would be a special briefing to which she answered yes.Judge Monty Cobb spoke
about the State Auditor's Office and reporting requirements.
o Cmmr.Neatherlin is in support of some of the transfers including those for the
Auditor's office.
o Cmmr.Drexler would like to brief with the Sheriff regarding the litter program.
o A public hearing will be scheduled.
• Dawn presented a resignation and Release and Hold Harmless Agreement in the amount
of$11,742.60 from Weston Sharer. This will be placed on the agenda.
• Ross presented an agreement for water services for Sandhill Park from North Mason
School District. There is no charge for the water and the School can use the fields at
charge.
9:45 A.M. Community Services—Dave Windom
Commissioners Neatherlin,Shutty and Drexler were in attendance
• Lydia presented a request to reclassify Abe Gardner from a Community Health Program
Assistant to Program Coordinator. It has been determined that according to the CBA it's
a promotional opportunity and should be posted within the labor union. Lydia stated
there are two additional revenues and the Program Coordinator position will be
temporary,for two years(term of funding). This will be placed on the Action Agenda.
• The Prescription Drug Overdose grant has been increased by$25,000 and the request is
to increase the part-time staff to full-time and will be for one year(term of funding). This
will need a budget supplement.
• The Housing and Behavioral Health Board had its first meeting. There are two
applications from Commissioner District 3 and the Commissioners would like to
interview Randy Olson.
• Met with Mason Matters;ABC will be getting paid.
• Dave provided an update on a solid waste violation at Cherry Park.
10:15 A.M. The Commissioners took a break until 10:30 a.m.
10:30 A.M. Public Works—Bart Stepp
Utilities&Waste Management
Commissioners Neatherlin,Shutty and Drexler were in attendance
Board of Mason County Commissioners'Briefing Meeting Minutes
August 27,2018
• Request to close the Eells Hill Transfer Station on September 8 and V2 day closure on
Monday,September 10 to accommodate improvements made at the Station was approved
and a news release will be issued.
• Title VI Non-Discrimination Agreement will be placed on the agenda.
• Approved to surplus a 2007 Volvo Loader and 1994 Cat Grader that have been replaced.
• Cmmr.Shutty asked staff to follow up on a speed study and working with the Port of
Hoodsport for DOT funding.
• Cmmr.Drexler asked staff for information on what type of litter is being collected for the
litter grant. Is it volume or weight.
Commissioner Discussion—
• Cmmr.Drexler gave the NACO membership bill to Frank Pinter for the 2019 budget.
• Cmmr.Neatherlin asked Cmmr.Drexler is there other changes she wants to consider at
the public hearing for placement of buoys in the motorboat regulations. Cmmr.
Neatherlin suggested changing the language to include community associations placing
the buoys. Cmmr.Drexler stated what could be considered are distance,speed,and
water skiing. She would prefer to strike the language under special restrictions so
individual lakes could make their own unique regulations. Chiefs Dracobly and Spurling
joined the conversation. Other ideas would be to classify lakes by size or allow only
certain size boats.
11:00 A.M. United Angels Volunteer Group-Jo Ridlon
Commissioners Neatherlin,Shutty and Drexler were in attendance. Chiefs Dracobly and
Spurling were also in attendance.
• Jo Ridlon,United Angels Volunteer Group,wants to know what type of contract they
would need to provide volunteer services which include providing funds for animals in
need such as veterinary care and food. This would not be for animal control. She has met
with Sheriff Salisbury and Chief Dracobly to discuss their services and was referred to
the Commissioners for a contract. United Angels is a 501 C3. Cmmr.Neatherlin
suggested she provide a list of services they can provide to the Sheriff but he doesn't
know if a contract is necessary. There was a discussion of how this could work. Cmmr.
Neatherlin suggested some type of release document be created and he will ask for legal
review. She was referred to Pasado for a sample document. Cmmr. Shutty questioned
the Commissioners' involvement in this process. Sheila Christiansen,Sunrise Equine
Rescue,joined the briefing at 11:30 am.
Briefing adjourned at 11:35 a.m.
Respectfully submitted,
Diane Zoren,Administrative Services Manager
BOARD OF MASON COUNTY COMMISSIONERS
Randy Neatherlin Terri Drexler Kevin Shutty
Chair Commissioner Commissioner
BOARD OF MASON COUNTY COMMISSIONERS' BRIEFING MINUTES
Mason County Commission Chambers,411 North 5th Street,Shelton,WA
Week of September 10,2018
Monday,September 10,2018
9:00 A.M. Closed Session—RCW 42.30.140(4)Labor Discussion
Commissioners Neatherlin,Shutty and Drexler met in Closed Session for a labor
discussion from 9:00 a.m.to 9:30 a.m.with Frank Pinter.
9:15 A.M. Executive Session—RCW 42.30.110(1)(b)Real Estate purchase
Commissioners Neatherlin,Shutty and Drexler met in an Executive Session with Frank
Pinter from 9:30 a.m.to 9:45 a.m.to discuss a real estate purchase.
9:30 A.M. Support Services—Frank Pinter
Commissioners Neatherlin,Shutty and Drexler were in attendance.
• 2019 Budget Workshop Schedule—will utilize Monday afternoons,Tuesdays following
Commission meeting,Tuesday afternoons and Wednesdays. The Commissioners asked
for a presentation of Budget 3 on September 25. They stressed that the 2019 budget will
be a status quo budget and are willing to consider policy level requests(PLR)if there is
revenue to support the request. Budget workshops will be scheduled in October with
departments to hear the details of the PLR's.
• Real Estate Services contract expires in October 2018 and there are no more extensions
available under current contract.A request for proposals will be issued.
• Review of the internal allocations will be on the October 1 Elected Official/Director
agenda.
• Review of Special Pay&Out-of-Class pays will be rescheduled.
The Commissioners took a 3 minute break from 10:27 a.m.to 10:30 a.m.
10:30 A.M. Community Services—Dave Windom
Commissioners Neatherlin,Shutty and Drexler were in attendance.
• The Commissioners conducted a phone interview with Morgan Ireland at 10:30 a.m. The
appointment is on the September 11 agenda.
• Review of the 2018 Building Valuation Data that could result in an increase to revenue.
• The 2018 permit numbers were handed out through August.Kristopher Nelson noted
these numbers are available on the website.Dave and Kristopher noted the need for
additional staff.
• Cmmr.Drexler asked when the Public Benefit Rating System(PBRS)would be
addressed because she had some questions about what the Planning Advisory
Commission(PAC)has been working on.Kell noted the upcoming meeting on
September 17`h and said once the PAC has their finished recommendations they can hold
a workshop before a hearing is held.
• Casey Bingham presented a contract between the Department of Health and Mason
County Public Health.The Board approved moving it to the action agenda for September
18'h.
• Dave reported The Cove Apartment complex is still under a boil order and he is in talks
with the City of Shelton on how to clean the water and run tests.
• RV's in the Urban Growth Area and expansion of the Urban Growth Areas are on the
agenda for the PAC once the PBRS is done.
10:45 A.M. Public Works—Jerry Hauth
Utilities&Waste Management
Commissioners Neatherlin,Shutty and Drexler were in attendance.
Board of Mason County Commissioners' Briefing Meeting Minutes
Week of September 10,2018
• An agreement with Green Diamond to use Forest Road 800 as an evacuation route for
Skokomish Valley was addressed by Tim Whitehead.He said Green Diamond had sent a
contract which placed most liability on the County so the County responded with an
updated draft agreement from the 90's.No response has been received yet. A discussion
was had regarding how much liability the County should be responsible for.Cmmr.
Shutty said he would like an agreement reached before the flood season.
• Jerry presented the contract extension for Mason County Garbage.Cmmr.Neatherlin said
if there is a change in the contract it needs to be discussed,but if the contract remains the
same he is fine with an extension.
• An updated Public Works Organizational Chart was presented.Jerry requested approval
to move the chart to the Action Agenda on September 186'.Changes include a hydraulics
engineer.He added that there will be a request in the budget for an additional GIS
position.Cmmr.Neatherlin requested additional positions be formally requested for
transparency.
• Jerry requested to replace Rik Fredrickson's membership on the Solid Waste Advisory
Committee as he is retiring.Chad White is going to replace Rik as an industry
representative effective October 4,2018.
• Sarah Grice talked about the Title VI Non-Discrimination Agreement which is on the
September 11,2018 agenda.
• Cyndi Ticknor requested authorization to fill a vacant position that will be open as of
November 16,2018.The Board authorized posting of the position.
11:15 A.M. WSU Extension Office—Dan Teuteberg
Commissioners Neatherlin,Shutty and Drexler were in attendance.
• Dan began by inviting the Board to a 4-H celebration the first week of October.Over the
summer there was a fair,camp,day camps,and currently 4-H is involved in the
Washington State Fair in Puyallup.
• Kathy Landers talked about how the Master Gardner Program works,how one obtains the
title of Master Gardner,and how they assist citizens with questions.
• Dan quickly briefed his quarterly report and announced the new partnership with the
Mason County Moral Reconation Therapy program.
11.30 "."n M it Gemm}ttee Lee Kim canceled
Commissioner Discussion—as needed
• Cmmr.Drexler asked that when the interviews are held for boards,Cmmr.Neatherlin
make sure to notify applicants they are not required to leave the room during interviews
of other candidates.
BREAK—NOON
1:30 P.M. Community Services—Kristopher Nelsen
SmartGov Demonstration&Review of On-Line Permitting
Commissioners Neatherlin,Shutty and Drexler were in attendance.
• Kristopher Nelsen,Building Department Manager introduced Michelle Keeton and Mari
Lomax who presented the SMARTGov platform which will be used by Mason County
Community Services to handle permits and will allow citizens to follow the complete
route of the permit from application to the final inspection.The program also allows
public notices,which Kristopher pointed out is great for the Planning Department when
large projects are happening or a SEPA review is in progress.
• In reviewing submission of code enforcement a discussion of the RCW allowing
complainants to remain anonymous was reviewed.Dave Windom said he checked with
MRSC to verify the RCW is correct to protect the identity of said complainants.
Board of Mason County Commissioners' Briefing Meeting Minutes
Week of September 10,2018
• Currently,they are proofing all of the platform work and will then be ready to handle the
training so they are able to go live in October.Notice will be sent to various contractors,
master builders,and announced to the public.
2:30 P.M. Sheriffs Office
Commissioners Neatherlin,Shutty and Drexler were in attendance.
• Chief Dracobly said the Sheriff's office would like to move$60,000 from Salary and
Benefits to operations in order to replace two vehicles.The funds are coming from five
open positions and from the ProPhoenix records management system.
Frank explained that two vehicles will cost around$120,000.
Cmmr.Drexler and Neatherlin questioned the request coming in after a recent
supplemental request was submitted. She voiced concern over expenditures through the
end of the year.
Cmmr. Shutty talked about the supplemental request that came at the end of 2017 which
lacked clarity.He said despite that,he would be willing to move forward with this
request.Cmmr.Drexler also said she would be willing to move forward.
Commissioner Discussion
• More talk was had about allowing other applicants in the room during interviews.
Tuesday,September 11,2018
10:00 A.M. Housing&Behavioral Health Advisory Board Interviews
Commissioners Neatherlin,Shutty and Drexler interviewed Marilyn Vogler and Randy
Olson for the Housing&Behavioral Health Advisory Board.
Respectfully submitted,
Diane Zoren,Administrative Services Manager
BOARD OF MASON COUNTY COMMISSIONERS
Randy Neatherlin Terri Drexler Kevin Shutty
Chair Commissioner Commissioner
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Bart Stepp, Deputy Director/U&W Management Action Agenda
DEPARTMENT: Public Works EXT: 207
COMMISSION MEETING DATE: September 18, 2018 Agenda Item #
BRIEFING DATE: September 10, 2018
BRIEFING PRESENTED BY: Jerry Hauth
[] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency:
ITEM: Solid Waste Drop Box Hauling Contract Extension
BACKGROUND: Mason County has a contract with Mason County Garbage Co., Inc. to
provide hauling services for our drop box containers at our solid waste facilities. The
contract was signed on September 20, 2016 and expires on October 23, 2018 if it is not
extended. This contract is for Mason County Garbage Co., Inc. to haul containers from our
Belfair, Hoodsport, and Union drop box stations to our Shelton Transfer Station where they
are emptied into long haul containers.
Public Works is proposing the commissioners extend this contract under the existing
contract pricing conditions to July 31, 2020; which is the same day that our blue box
recycle container hauling contract expires. This would allow the County to go out for a RFP
that combines both contracts in 2020.
BUDGET IMPACTS: The cost of this contract is covered by the tipping fee revenue in
Solid Waste Fund #402. The existing contract allows the contractor to increase their fees
by 90% of the June —June CPI annually. The contract amendment would have the same
language for determining price increases. No general funds will be needed to pay for this
contract extension.
RECOMMENDED ACTION: Recommend the Board of Commissioners authorize the
Deputy Director/Utilities and Waste Management to sign a contract amendment extending
the existing drop box hauling contract with Mason County Garbage Co., Inc. through July
31, 2020.
ATTACHMENT(S): Agreement Amendment #1
SOLID WASTE DROP BOX HAULING CONTRACT AMENDMENT #1
WITH MASON COUNTY GARBAGE CO., INC.
The CONTRACT between COUNTY and CONTRACTOR is amended as follows:
1. The contract expiration date is changed from October 23, 2018 to July 31, 2020.
2. The Mason County Garbage Co., Inc. contract administration contact is changed to the
following:
• MASON COUNTY GARBAGE CO. INC.
Chad White
PO Box 787
81 E Wilbur's Way
Shelton, WA 98584
3. The hours of facility operations for the County have changed from the original contract. The
current hours of operation are as follows:
• Shelton Monday — Saturday 8 AM — 5 PM
• Belfair Tuesday — Saturday 9 AM — 4 PM
• Hoodsport Friday — Sunday 9 AM — 4 PM
• Union Sunday and Monday 9 AM — 4 PM
4. The County finds that a performance bond is unnecessary for this contract. Accordingly, Mason
County Garbage Co., Inc. is no longer required to maintain a $10,000 performance bond for this
contract.
5. The June 2018 CPI-U for Olympia is 3.6% and 90% of that is 3.28%. Accordingly effective
11/1/2018 the contract prices will be increased 3.28% and are as follows:
• Shelton $47.52 per haul
• Belfair $255.62, includes the rental of three lidded 40 CY containers
• Hoodsport $183.81 per haul
• Union $183.81 per haul
• Weekend On Call $160.17 per hour
6. Contract prices will increase on 11/1/2019 based on 90% of the June 2019 Consumer Price
Index-U (CPI-U) for all Urban Consumers as calculated by the US Department of Labor for the
Olympia, WA area.
7. All other language of the original contract not altered by this amendment remains in effect.
Amendment dated this day of , 2018.
MASON COUNTY GARBAGE CO., INC. DEPUTY DIRECTOR/UTILITIES &WASTE MASON
COUNTY, WASHINGTON
Chad White Bart Stepp
AP ED AS TO FORM:
Tim White ead, Chief DPA
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Bart Stepp, Deputy Director/U&W Management Action Agenda
DEPARTMENT: Public Works EXT: 207
COMMISSION MEETING DATE: September 18, 2018 Agenda Item #
BRIEFING DATE: September 10, 2018
BRIEFING PRESENTED BY: Jerry Hauth
[] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency:
ITEM: SWAC Membership —Chad White
BACKGROUND: The Solid Waste Advisory Committee (SWAC) is made up of
citizen and industry members. Rik Fredrickson's membership, a solid waste
industry representative for Mason County Garbage, expires on October 31, 2018.
Rik is retiring and Chad White is the new site manager for Mason County Garbage.
He has applied to take Rik's place as the industry representative for Mason County
Garbage.
Mason County Garbage is the only certificated hauler in the County and has
recycling and drop box hauling contracts with the City. It is appropriate that Mason
County Garbage continue to have an industry representative on the SWAC. Chad
White would take over membership starting October 4, 2018.
BUDGET IMPACTS: N/A
RECOMMENDED ACTION: Recommend the Board appoint Chad White to the
Solid Waste Advisory Committee effective October 4, 2018 through
October 4, 2021.
Attachment: Chad White SWAC Application
;: D6otr COpes MASON COUNTY COMMISSIONERS
411 NORTH FIFTH STREET
_ SHELTON WA 98584
(`
Fax 360-427-8437;Voice 360-427-9670, Ext. 419;275-4467 or 482-5269
1
I AM SEEKING APPOINTMENT TO SWAC Committee
i
NAME: Chad W `1
AD E Malaney Creek Rd PHONE: 13604905184 I
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CITY/ZIP: VOTING PRECINCT: WORK PHONE: 13604268729
Shelton/9858 3 E-MAIL:
O(OR AREA IN THE COUNTY YOU LIVE) chadw@wasteconnections.com
-------------------------------------------------------------------------------------------
COMMUNITY SERVICE EMPLOYMENT:(IF RETIRED,PREVIOUS EXPERIENCE)
(ACTIVITIES OR MEMBERSHIPS) COMPANY: Mason County Garbage/15 YRS
POSITION: Site Manager
COMPANY: YRS
POSITION:
--------------------------------------------------------------------------------------------
In your words, what do you perceive is the role or purpose of the Board,Committee or Council for which you are applying:
Incl_ ust[y rP,pregpntatiyP
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What interests,skills do you wish to offer the Board,Committee,or Council?
I was-rldver for abol it 8 years and then moveri into operations at Mason ('niipty r,nrhngi;-for the last 7 and naul am
the site manager
Please list any financial, professional, or voluntary affiliations which may influence or affect your position on this Board:
(i.e.create a potential conflict of interest)
Nene
Your participation is dependent upon attending certain trainings made available by the County during regular business hours
(such as Open Public Meetings Act and Public Records).The trainings would be at no cost to you.Would you be
able to attend such trainings? Yes
Realistically,how much time can you give to this position?
rly X thIV Weekly Daily
Q Office Use Only l
Appointment Date
Signature Date
Term Expire Date
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MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Casey Bingham Action Agenda _X
Public Hearing
Other
DEPARTMENT: Community Services EXT: 562
DATE: 9/19/18 Agenda Item #
Commissioner staff to complete)
BRIEFING DATE: 9/10/18
BRIEFING PRESENTED BY: Casey Bingham
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM: Consolidated Contract CLH18253 Amendment 4
Adds Statement of work for:
1. Office of Emergency Preparedness & Response: Provide $48,453 to be used
for continuing operations in Public Health Emergency Response and Preparedness
Program.
Amends Statement of Work for:
1. Childhood Lead Poisoning Prevention Program: Provides $1,500 for onsite
visits of children who have been referred to us for elevated lead levels.
2. Maternal &Child Health Block Grant: Includes $67,694 for Public Health to
continue working in Children with Special Health Care Needs and Maternal Child
Health.
3. Office of Immunization and Child Profile: Changes funding cycle.
4. Promotion of Immunization to Improve Vaccination Rates: Changes
funding cycle.
S. Prescription Drug Overdose Prevention Program: Provides $75,000 for
Ongoing Prescription Drug Overdose Prevention and increase outreach to persons
with Substance Abuse Disorder.
9/12/2018
BUDGET IMPACTS: This increasing Amendment provides an increase of $192,647 of
funding for both 2018 and 2019. A budget amendment has already been included to
adjust 2018 and 2019 was budgeted with these funds included.
RECOMMENDED OR REQUESTED ACTION: Approve amendment 4 of the
CLH18253 Consolidated Contract to the Action Agenda.
9/12/2018
MASON COUNTY PUBLIC HEALTH
2018-2020 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH18253 AMENDMENT NUMBER: 4
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as"DOH",and
MASON COUNTY PUBLIC HEALTH hereinafter referred to as"LHJ",pursuant to the Modifications/Waivers clause,and to make
necessary changes within the scope of this contract and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work,attached and incorporated by this reference,are amended as follows:
® Adds Statements of Work for the following programs:
• Office of Emergency Preparedness&Response-Effective July 1,2018
® Amends Statements of Work for the following programs:
• Childhood Lead Poisoning Prevention Program-Effective January 1,2018
• Maternal&Child Health Block Grant-Effective January 1,2018
• Office of Immunization&Child Profile-Perinatal Hepatitis B-Effective July 1,2018
• OICP-Promotion of Immunizations to Improve Vaccination Rates-Effective July 1,2018
• Prescription Drug Overdose Prevention for States Supplement-Effective January 1,2018
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-4 Allocations,attached and incorporated by this reference,amends and replaces Exhibit B-3 Allocations as follows:
® Increase of$192,647 for a revised maximum consideration of$672,683.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C-4 Schedule of Federal Awards,attached and incorporated by this reference,amends and replaces Exhibit C-3.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
MASON COUNTY PUBLIC HEALTH STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Date Date
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 23
AMEN ?NT#4
2018-2020 CONSOLIDATED CONTRACT
EXIIIBIT A
STATEMENTS OF WORK
TABLE OF CONTENTS
DOH Program Name or Title: Childhood Lead Poisoning Prevention Program-Effective January 1,2018.....................................................................................3
DOH Program Name or Title: Maternal&Child Health Block Grant-Effective January 1,2018.....................................................................................................7
DOH Program Name or Title: Office of Emergency Preparedness&Response-Effective July 1,2018........................................................................................12
DOH Program Name or Title: Office of Immunization&Child Profile-Perinatal Hepatitis B -Effective July 1,2018..................................................................17
DOH Program Name or Title: OICP-Promotion of Immunizations to Improve Vaccination Rates-Effective July 1,2018...........................................................19
DOH Program Name or Title: Prescription Drug Overdose Prevention for States Supplement-Effective January 1,2018...........................................................21
Exhibit A,Statements of Work Page 2 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN___NT#4
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Childhood Lead Poisoning Prevention Program- Local Health Jurisdiction Name: Mason County Public Health
Effective January 1,2018
Contract Number: CLH18253
SOW Type: Revision Revision#(for this SOW) 2 Funding Source Federal Compliance Type of Payment
❑Federal<Select One> (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through June 30,2019 ® State ❑FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to support local interventions with the case management of elevated blood lead levels in children 14 years
of age and younger.The focus of this program in 2018 is to build local capacity statewide to provide standard case management services to all children with elevated blood lead
levels.
Revision Purpose: The purpose of this revision is to extend the period of performance from June 30,2018 to June 30,2019,add SFY2 funding and update the statement of work.
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Consideration
Code Code Increase(+)
Start Date End Date
SFYI Lead Environments of Children(proviso funds N/A 334.04.93 25715110 01/01/18 06/30/18 3,000 0 3 000
SFY2 Lead Environments of Children roviso funds N/A 334.04.93 25715120 07/01/18 06/30/19 0 1,500 1,500
TOTALS 3,000 1,500 4,500
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
1 Contact the provider to gather complete information on Submit the eempleted updated Child Reimbursement of up
the assigned elevated blood lead case to conduct an Bleed Lead Inves0eatien Form Child 30`,*tke to$500 maximum per
environmental assessment Blood Lead Investigation Form via home visit,per child.
a) Verify the blood lead level(BLL)is confirmed. Washington Disease Reporting Submit as needed Up to two(2)home
Reference Centers for Disease Control and System (WDRS)available through within 60 days visits per child not to
Prevention's(CDC's)confirmed case definition: WA DOH indicating: after completion. exceed total finding
haps://wwwn.cdc.gov/nndss/conditions/lead- consideration.
elevated-blood-levels/case-defmition/2016/ a) Confirmed BLL
b) Call family and schedule a home visit.If b) Date LHJ contacted the family Note: this excludes
interpretation services are needed, contact DOH c) Date the environmental indirect costs
at lead ,doh.wa.gov. Note:Interpretation assessment was completed
services will not be reimbursed through the d) Date the interview was
ConCon process. I completed
Exhibit A, Statements of Work Page 3 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN__._-NT#4
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
c) Visit the child's residence(or other sites where e) Specify if the home is Section 8
the child spends significant amounts of time)at or HUD Housing and if the
least once child is Medicaid enrolled
d) Interview the caregivers using the Child Blood f) (If applicable)If DOH
Lead Investigation Form and conduct an assistance is requested,list the
environmental assessment to identify factors that DOH contact and date contacted
may impact the child's blood lead level. /f g) (If applicable)If the LHJ opts to
laboratory services are needed, contact DOH at close the case after verifying
Ieadfa doh.wa.gov. that the second lead level has
Note: Laboratory services will not be reimbursed dropped to<5 µg/dL,it must
through the ConCon process. submit a copy of the letter
e) Determine if the family lives in Section 8 or HUD mailed to the family
Housing.If the child is Medicaid enrolled collect
the Provider One number Submit a written report summarizing
f) Provide educational material to the child's the environmental assessment lab test
caregivers in the family's primary language results and a Plan of Care that lists
g) (Optional)If warranted,contact DOH to request recommendations on how to remove
technical or environmental investigation and remediate lead exposure via
assistance with an X-ray fluorescent(XRF) WDRS.Include the educational
analyzer material provided to the family that
addresses the child's needs.(DOH
Have the child retested following the Pediatric will provide a generic template.)The
Environmental Health Specialty Units(PEHSU) LHJ will previ upload a copy of
medical management guidelines.If the lead level the report to DOH via WDRS, and
remains>_5 pg/dL the LHJ will conduct a second home provide a copy to the child's
visit to connect the family to other service providers as caregivers and provider.
needed.
PEHSU medical management guidelines:
hgps://www.pehsu.net/ Library/facts/medical-m,pmnt-
childhood-lead-exposure-June-2013.pdf
If the second lead level drops to<5 gg/dL,the LHJ has
the option to: 1)Mail the child's caregivers a letter
recommending a developmental and nutritional
screening,the letter will include providers in the
child's residential area.The LHJ may then close the
case.(DOH will provide a template letter.);or
2)proceed to Task 2 and conduct a second home visit.
Exhibit A,Statements of Work Page 4 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMD ENT#4
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
2 The purpose of the second home visit is to connect the Submit an updated Plan of Care to Reimbursement of up
family to other service providers as needed: DOH via WDRS and provide a copy 3911"-ffhe to$500 maximum per
a) LHJ staff will facilitate and guide the child's to the child's caregivers and provider fellewing mendr. home visit,per child.
caregiver in completing the WithinReach that includes: Submit as needed Up to two(2)home
Developmental Screening Questionnaire online a) Completion date and results of within 60 days visits per child not to
http://www.parenthelp 123.orp/.The LHJ must the online WithinReach after completion. exceed total funding
provide a hard copy of the developmental Developmental Screening consideration.
screening in case it cannot be submitted online.In Questionnaire
unusual,and DOH approved cases,in which the b) If blood lead testing of at-risk Note: this excludes
WithinReach assessment cannot be performed, family members was indirect costs.
the LHJ may refer the family to the child's recommended,list the
physician or to another entity that is trained to individuals
administer developmental screening tests c) The referral date and provider of
b) Encourage blood lead testing of other children the nutritional assessment,
less than 72 months of age and pregnant or include all other referrals
nursing caregivers in the home d) The members of the case
c) If appropriate,refer the child's caregivers to the management team,their
Women,Infants,and Children(WIC)program or involvement,and the case
a Registered Dietitian Nutritionist(RDN)for a information provided to them
nutritional assessment and to other service
providers as appropriate
d) Coordinate services and communicate regularly
with members of the case management team
3 DOH will reimburse LHJ staff for DOH-approved case Attend approved training and submit As needed Reimbursement for
management related training opportunities and travel training invoices and receipts to aPWO1 PO4DOH-
including training.fees if applicable and mileage, DOH approved training
lodging and meals at the current federal GSA rates atfees, mileage and per
the time of travel. diem not to exceed
total funding
consideration.
(See Special Billing
Requirements below.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hitp://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.O.pdf
Program Specific Requirements/Narrative
Exhibit A,Statements of Work Page 5 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN :NT 44
Program Manual,Handbook,Policy References
Guide for Public Health Case Management of Children with Elevated Blood Lead Levels
haps•//www.doh.wa.gov/Portais/1/Docuna ents/4000/334-414.pdf
A Targeted Approach to Blood Lead Screening in Children,Washington State
2015 Expert Panel Recommendations
https://www.doh.wa.gov/Portals/1/Documents/Pubs/334-383.pdf
Special References(RCWs,WACs,etc)
Laboratories are required to report to the Department of Health all Blood Lead test results(WAC 246-101-201).Elevated results(>_5 mcg/dL)must be reported within 2 days;non-
elevated results<5 mcg/dL need to be reported within one month.
Monitoring Visits(frequency,type)
Telephone calls with contract manager at least once every quarter.
Definitions
BLL-Blood Lead Level
EBLL-Elevated Blood Lead Level
PEHSU-Pediatric Environmental Health Specialty Units
Special Billing Requirements
Reimbursement for pre-approved travel expenses including mileage, lodging and meals will be calculated at the current federal General Services Administration(GSA)rates at
the time of travel. Current per diem rates by state can be found at: haps://www.gsa.gov/travel/plan-book) -diem-rates/per-diem-rates-lookup
Special Instructions
Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable written report to include a plan of care.Payment to completely expend the"Total
Consideration"for a specific funding period will not be processed until all deliverables are accepted and approved by DOH.Invoices mus t may be submitted menthly by the 30th qf
as needed within 60 days after home visit completion and must be based on actual allewable direct
program costs.Billing for services on a monthly fraction of the"Total Consideration'will not be accepted or approved. If needed, additional funding may be added upon request
and DOH approval while funds are available. Contact lead a,doh.wa.gov for additional information.
Note: blood lead case management reimbursement excludes indirect costs.
DOH Program Contact
Araceli Mendez,Health Services Consultant
Office of Environmental Public Health Sciences
Washington State Department of Health
Street Address:310 Israel Rd SE,Tumwater,WA 98501
Telephone:360-236-3392/Fax:360-236-3059
Email:araceli.mendez@doh.wa.gov
DOH Fiscal Contact
Victoria Reyes,Management Analyst I
Assistant Secretary's Office
Telephone: 360-236-3071
Exhibit A,Statements of Work Page 6 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMP.__._ENT#4
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Maternal&Child Health Block Grant- Local Health Jurisdiction Name: Mason County Public Health
Effective Janumy 1,2018
Contract Number: CLH18253
SOW Type: Revision Revision#(for this SOW) 2 Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through September 30,2019 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to support local interventions that impact the target population of the Maternal and Child Health Block
Grant.
Revision Purpose: The purpose of this revision is to provide additional funding,add activities and deliverable due dates,and extend the period of performance and funding period
from September 30,2018 to September 30,2019 for continuation of MCHBG related activities.
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
FFY18 MCHBG LHJ CONTRACTS 93.994 333.93.99 78120281 01/01/18 09/30/18 56,115 0 56,115
FFY19 MCHBG LHJ CONTRACTS 93.994 333.93.99 78120291 10/01/18 09/30/19 0 67,694 67,694
TOTALS 1 56,115 67,694 123,809
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
Maternal and Child Health Block Grant(MCHBG)Administration
la Participate in calls,at a minimum of every Designated LHJ staff will participate September 30,2018 Reimbursement for
quarter,with DOH contract manager.Dates in contract management calls. September 30, 2019 actual costs,not to
and time for calls are mutually agreed upon exceed total funding
between DOH and LHJ consideration.Action
lb Report actual expenditures for October 1, r Submit actual expenditures using the May 26,2018 Plan and Progress
2017 through March 31,2018 MCHBG Budget Workbook to DOH Reports must only
contract manager reflect activities paid
1 c Develop 2018-2019 MCHBG Budget Submit MCHBG Budget Workbook September 5,2018 for with funds provided
Workbook for October 1,2018 through to DOH contract manager in this statement of
September 30,2019 using DOH provided work for the specified
template. funding period.
Exhibit A, Statements of Work Page 7 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN ?NT#4
Task Task/Activity/Description "May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures -and/or Amount
Id Report actual expenditures for October 1, Submit actual expenditures using the May 24, 2019 See Program Specific
2018 through March 31, 2019 MCHBG Budget Workbook to DOH Requirements and
contract manager. Special Billing
Requirements.
le Develop 2019-2020 MCHBG Budget Submit MCHBG Budget Workbook to September S, 2019
Workbook for October 1, 2019 through DOH contract manager
September 30, 2020 using DOH provided
template.
1/' Report actual expenditures for October 1, Submit actual expenditures using the November 30, 2018
2017 through September 30, 2018 MCHBG Budget Workbook to DOH
contract manager.
MCHBG Assessment and Evaluation
2a Participate in project evaluation activities Documentation using report template September 30,2018 Reimbursement for
developed and coordinated by DOH,as provided by DOH September 30, 2019 actual costs,not to
requested. exceed total funding
2b Report program level strategy measure data Documentation using report template January 15,2018 consideration.
(CSHCN,UDS,ACEs). provided by DOH April 15,2018
July 15,2018 See Program Specific
October 15, 2018 Requirements and
January 15, 2019 Special Billing
April 15, 2019 Requirements.
July 15, 2019
Conduct a Maternal and Child Health Submit Needs Assessment May 24, 2019
(MCH)Needs Assessment. documentation to DOH contract
r manager using templates provided by
DOH
MCHBG Implementation
3a Develop 2018-2019 MCHBG Action Plan Submit MCHBG Action Plan to Draft August 17,2018 Reimbursement for
for October 1,2018 through September 30, DOH contract manager Final September 5,2018 actual costs,not to
2019 using DOH-provided template. exceed total funding
3b Report activities and outcomes of 2017-2018 Submit Action Plan monthly reports Monthly,on or before consideration.Action
MCHBG Action Plan using DOH-provided to DOH contract manager the 151 of the following Plan and Progress
template. month Re orts must only
Exhibit A,Statements of Work Page 8 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEIN._-.-ENT#4
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
3c Develop 2019-2020 MCHBG Action Plan Submit MCHBG Action Plan to DOH Draft August 17, 2019 reflect activities paid
for October 1, 2019 through September 30, contract manager Final-September S, for with funds provided
2020 using DOH-provided template. 2019 in this statement of
3d Report activities and outcomes of 2018-2019 Submit Action Plan monthly reports Monthly, on or before work for the specified
MCHBG Action Plan using DOH-provided to DOH contract manager the 15"of the following funding period.
template. month
See Program Specific
Requirements and
Special Billing
Requirements.
Children with Special Health Care Needs(CSHCN)
4a Complete Child Health Intake Form(CHIF) Submit CHIF data into Secure File January 15,2018 Reimbursement for
using the CHIF Automated System on all Transport(SFT)website: April 15,2018 actual costs,not to
infants and children served by the CSHCN hiips:Hsft.wa.gov July 15,2018 exceed total funding
Program as referenced in CSHCN Program October 15, 2018 consideration.Action
Manual. January 15, 2019 Plan and Progress
April 15, 2019 Reports must only
Ensure client data is collected on all children July 15, 2019 reflect activities paid
served by CSHCN contractors,including for with funds provided
neurodevelopmental centers,regional in this statement of
maxillofacial coordinators,and the DOH work for the specified
Newborn Screening Program. funding period.
4b Administer requested DOH Diagnostic and Submit completed Health Services 30 days after forms are
Treatment funds for infants and children per Authorization forms and Central completed. See Program Specific
CSHCN Program Manual when funds are Treatment Fund requests directly to Requirements and
used. the CSHCN Program as needed. Special Billing
4c Participate in the CSHCN Regional System Submit Action Plan monthly reports Monthly,on or before Requirements.
and quarterly meetings as described in the including number of regional the 15*of the following
CSHCN Pregrom A4Wn Focus of Work. meetings attended to the DOH month
contract manager.
4d Develop and update CYSHCN County Submit completed resource list September 30, 2019
Resource List and share with partners as electronically to the DOH contract
described in the CSHCN Focus of Work. manager.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may,be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
http://www.phaboard.or //M-content/uploads/PHAB-Standards-and-Measures-Version-1.O.pdf
Program Specific Reguirements/Narrative
Exhibit A,Statements of Work Page 9 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN -'-NT#4
Special Requirements
Federal Fundin¢Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpendina.¢ov by DOH as required by P.L. 109-282.
Program Manual,Handbook,Policy References
Children with Special Health Care Needs Manual-http://www.doh.wa.pov/Portals/I/Documents/Pubs/970-209-CSHCN-Manual.pdf
Health Services Authorization(HSA)Form
littp://www.doh.wa.gov/Portals/1/Documents/Pubs/910-002-ApprovedHSA.docx
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc.)
1. At least 30%of federal Title V funds must be used for preventive and primary care services for children and at least 30%must be used services for children with
special health care needs. [Social Security Law,Sec. 505(a)(3)].
2. Funds may not be used for:
a. Inpatient services,other than inpatient services for children with special health care needs or high risk pregnant women and infants,and other patient services approved by
Health Resources and Services Administration(HRSA).
b. Cash payments to intended recipients of health services.
c. The purchase or improvement of land,the purchase,construction,or permanent improvement of any building or other facility,or the purchase of major medical
equipment.
d. Meeting other federal matching funds requirements.
e. Providing funds for research or training to any entity other than a public or nonprofit private entity.
f. payment for any services furnished by a provider or entity who has been excluded under Title XVIII(Medicare),Title XIX(Medicaid),or Title XX(social services block
grant).[Social Security Law,Sec 504(b)].
3. If any charges are imposed for the provision of health services using Title V(MCH Block Grant)funds,such charges will be pursuant to a public schedule of charges;will not
be imposed with respect to services provided to low income mothers or children;and will be adjusted to reflect the income,resources,and family size of the individual
provided the services. [Social Security Law,Sec.505(1)(13)].
Monitoring Visits(frequency,type)
Telephone calls with contract manager at least one every quarter,and annual site visit.
Special Billing Requirements
Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable A19-IA invoice voucher. Payment to completely expend the"Total Consideration"
for a specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices must be submitted monthly by the 30th of each month
following the month in which the expenditures were incurred and must be based on actual allowable program costs. Billing for services on a monthly fraction of the"Total
Consideration"will not be accepted or approved.
Exhibit A,Statements of Work Page 10 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN: NT #4
DOH Program Contact
Mary Dussol,Community Consultant
Office of Family and Community Health Improvement
Washington State Department of Health
Street Address:310 Israel Rd SE,Tumwater,WA 98501
Mailing Address:PO Box 47848,Olympia,WA 98504
Telephone:360-236-3781 /Fax:360-236-3646
Email: Mary.Dusso]Odoh.wagov
Exhibit A,Statements of Work Page l 1 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AME1S.__._ENT#4
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Office ofEmereency Preparedness&Response- Local Health Jurisdiction Name: Mason County Public Health
Effective July 1,2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: July 1,2018 through June 30,2019 ❑ State N FFATA(Transparency Act) ❑Fixed Price
❑Other 0 Research&Development
Statement of Work Purpose: The purpose of this statement of work is to establish the funding and tasks for the Public Health Emergency Preparedness and Response program
for the 2018 grant period.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code, Code Start Date End Date
FFY18 EPR PHEP BPI SUPP LHJ FUNDING 93.069 333.93.06 18101580 07/01/18 06/30/19 0 48,453 48,453
TOTALS 1 0 1 48,453 1 48,453
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
1 Attend emergency preparedness events,(e.g. Submit summary on the mid-year December 31,2018 Reimbursement for
trainings,meetings,conference calls,and and end of year progress report. and June 28,2019 actual costs not to
conferences)as necessary to advance LHJ exceed total funding
preparedness or complete the deliverables in this consideration amount.
statement of work.
2 Complete reporting templates as requested by Submit completed templates to Upon request by DOH
DOH to comply with program and federal grant DOH
requirements(e.g.performance measures,gap
analysis,mid-year and end-of-year reporting
templates,etc.
3 Training&Evaluation: Submit mid-year and end-of-year December 31,2018
progress reports and June 28,2019
3.1)Provide training for appropriate staff who
serve in the Emergency Operations Center(EOC) Provide agenda and sign in sheets June 28,2019
and the Emergency Support Function#8(ESF#8) of trainings conducted,with
role on the Incident Command System,ESF#8 attendee signatures and contact
response plans and policies. information or registrations if
Exhibit A,Statements of Work Page 12 of 23 Contract Number CLH 18253-4
Revised as of July 16,2018
AMET.__ _?NT#4
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
training is not conducted by the
3.2)Train appropriate public health emergency LHJ
response staff on Web EOC or applicable
information management system utilized by local
emergency management in the county.
3.3)Participate in an evaluation of response Document participation in June 28,2019
capabilities based on a standard evaluation tool evaluation on midyear and end of
created b DOH. year progress report.
4 Develop decision making protocol to support the Submit mid-year and end-of-year December 31,2018
Local Health Officer and the Public Health progress reports and June 28,2019
Administrator in making policy level decisions
during an emergency. Submit decision making protocol June 28,2019
to DOH
5 Maintain Washington Secure Electronic Submit mid-year and end-of-year December 31,2018
Communication,Urgent Response and Exchange progress reports and June 28,2019
System(WASECURES)program as the primary
emergency notification system within the LHJ and Submit list of registered users to June 28,2019
include all critical LHJ positions as registered include their title and role in the
users. emergency response plan.
5.1) Conduct a notification drill using Submit results of notification drill. June 28,2019
WASECURES.
Notes: Registered users must log in quarterly at a
minimum. DOH will provide on-site technical
assistance to LHJs,as needed,on utilizing
WASECURES.LHJs may choose to utilize other
notification systems in addition to WASECURES
to alert staff during incidents.
6 Use established procedures and plans to inform Submit mid-year and end-of-year December 31,2018
the public of threats to health and safety by progress reports and June 28,2019
various means. Include a list of the various .R,
mechanisms used by your LHJ for releasing 5 Submit After Action Reports June 28,2019
information to the public during drills,exercises b (AARs)and messaging used to
or incident response. inform the public during drills,
exercise or incident response.
Include a summary of how
communication tools were used.
7 Participate in training on situational awareness Submit mid-year and end-of-year December 31,2018
during an incident. progress reports and June 28,2019
Exhibit A,Statements of Work Page 13 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN ENT#4
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
8 Update plan to request,receive and dispense Submit mid-year and end-of-year December 31,2018
medical countermeasures.Plans should include progress reports and June 28,2019
the addresses of all local distribution sites(Hub)
identified by the LHJ. Submit updated plan to request, June 28,2019
receive and dispense medical
Note:Not all LHJs require a distribution site; countermeasures including to
LHJs may partner with others to create a DOH.
centralized distribution location.
9 Provide notification to the DOH Duty Officer at Submit mid-year and end-of-year December 31,2018
360-888-0838 or hanalert@doh.wa.gov for all progress reports and June 28,2019
response incidents involving utilization of
emergency response plans and structures. Documentation that notification to June 28,2019
DOH was provided;or statement
that no incident response occurred.
10 Provide LHJ situation reports to DOH during all Submit mid-year and end-of-year December 31,2018
incidents involving an emergency response by the progress reports and June 28,2019
LHJ.
Submit Situation Reports. During all responses
11 Submit essential elements of information(EEIs) Submit mid-year and end-of-year December 31,2018
during incident response upon request by DOH. progress reports and June 28,2019
Provide information upon request. Upon request by DOH
12 Participate in the regional healthcare coalition Submit mid-year and end-of-year December 31,2018
(HCC)and attend coalition meetings as necessary progress reports and June 28,2019
Provide a summary of participation June 28,2019
in coalition activities.
13 For all LHJs that have identified a Hub for receipt Submit mid-year and end-of-year December 31,2018
of medical countermeasures from DOH during progress reports and June 28,2019
disasters:
• Participate in the 2019 T-Rex medication Documentation of participation in June 28,2019
distribution exercise by receiving a shipment the exercise
of exercise medications from DOH at the
designated local Hub.
z
• LHJs are not required to test dispensing,
transportation,or redistribution during the T-
Rex exercise.
Exhibit A,Statements of Work Page 14 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN ;NT#4
Payment
Task TasidActivity/Description *May Support PHAB Deliverables/Outcomes Due Date/ Information and/or
Number Standards/Measures Framee Amount
14 Participate in one or more exercises or real world Submit mid-year and end-of-year December 31,2018
incidents testing each of the following: progress reports and June 28,2019
• The process for requesting and receiving
mutual aid resources AAR and Corrective Action Plan June 28,2019
• The process for gaining and maintaining for each drill/exercise/incident
situational awareness of,at a minimum: participated in.
o The functionality of critical public
health operations
o The functionality of critical healthcare
facilities and the services they provide
o The functionality of critical
infrastructure serving public health and
healthcare facilities(roads,water,sewer,
power,communications)
o Number of disease cases
o Number of fatalities attributed to an
incident
• Development of an ESF#8 situation report,
or compilation of situational awareness
information to be included in a County
situation report
• EOC or Incident Command System(ICS)
activation
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
htip•//www phaboard org/mT-content/uploads/PHAB-Standards-and-Measures-Version-1 0 pdf
Program Specific Reg u irements/Na rrative
Any subcontract/s must be approved by DOH prior to executing the contract/s.
Deliverables are to be submitted to the ConCon deliverables mailbox at concondeliverables a,doh.wa.gou
Special Requirements
Federal Funding Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Exhibit A,Statements of Work Page 15 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN_._-NT#4
Information about the LHJ and this statement of work will be made available on USASpending,gov by DOH as required by P.L. 109-282.
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc)
Please reference the Code of Federal Regulations:
https•//www ecfrgov/cgi-bin/retrieveECFR?gp=l&SID=58ffddb5363a27f26e9dl2ccec462549&tv=HTML&h=L&mc=true&r=PART&n=pt2.1.200#se2.1.200 1439
DOH Program Contact
Jennifer Albertson,Contract and Finance Specialist
Department of Health
P O Box 47960,Olympia,WA 98504-7960
360-2364596/iennifer.albertson n,doh.wa. og_v
Exhibit A,Statements of Work Page 16 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN__ ?NT#4
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Office of Immunization&Child Profile-Perinatal Local Health Jurisdiction Name: Mason County Public Health
Hepatitis B-Effective July 1,2018
Contract Number: CLH18253
SOW Type: Revision Revision#(for this SOW) 1 Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: July 1,2018 through June 30,2019 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to define required Perinatal Hepatitis B activities,deliverables,and funding.
Revision Purpose: The purpose of this revision is to correct the Chart of Accounts Program Name/Title and the Master Index Code.
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration None Consideration
Code Code Start Date End Date
FFY18 PPHF Ops 93.268 333.93.26 74310284 07/01/18 06/30/19 500 -500 0
FFY17 PPHF Ops 93.268 333.93.26 74310274 07/01/18 06/30/19 0 500 500
TOTALS 500 0 500
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
1 1. In coordination with hospitals,health care Enter information for each case By the last day of Reimbursement for
providers,and health plans(if applicable), identified into the Perinatal each month actual costs incurred,
conduct activities to prevent perinatal hepatitis Hepatitis B module of the not to exceed total
B infection in accordance with the Perinatal Washington Immunization funding consideration
Hepatitis B Prevention Program Guidelines, Information System amount.
including the following:
• Identification of hepatitis B surface
antigen(HBsAG)-positive pregnant
women and pregnant women with
unknown HBsAg status.
• Reporting of HBsAg-positive women and
their infants.
• Case management for infants born to
HBsAg-positive women to ensure
administration of hepatitis B immune
globulin(HBIG)and hepatitis B vaccine
within 12 hours of birth,the completion of
the 3-dose hepatitis B vaccine series,and
post vaccination serologic testing.
Exhibit A,Statements of Work Page 17 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN ANT#4
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
2. Provide technical assistance to birthing
hospitals to encourage administration of the
hepatitis B birth dose to all newborns within 12
hours of birth,in accordance with Advisory
Committee on Immunization Practices(ACIP)
recommendations.
3. Report all perinatal hepatitis B investigations,
including HBsAg-positive infants,in the
Perinatal Hepatitis B Module of the
Washington State Immunization Information
System.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
http://www.phaboard.orp-/M-content/uploads/PHAB-Standards-and-Measures-Version-1.O.pdf
Proeram Specific Req uirements/Narrative
• Tasks in this statement of work may not be subcontracted without prior written approval from DOH OICP.
Special Requirements
Federal Fundine Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS(&)number.
Information about the LHJ and this statement of work will be made available on USASpending eov by DOH as required by P.L. 109-282.
Staffing Requirements
Provide notification via email to oiencontracts(a,doh.wa.eov within fifteen(15)days of any changes to staffmg for those who conduct work outlined in this statement of work.
DOH Contract Manager DOH Program Contact DOH Fiscal Contact
Tawney Harper,MPA Steffen Burney Vanessa Mojica
Budget and Operations Manager Perinatal Hepatitis B Coordinator Special Projects Coordinator
Office of Immunization and Child Profile Office of Immunization and Child Profile Office of Immunization and Child Profile
Department of Health Department of Health PO Box 47843,Olympia WA 98504-7843
PO Box 47843,Olympia WA 98504-7843 PO Box 47843,Olympia,WA 98504-7843 vanessa.mojica ,doh.wa.gov,360-236-3802
tawney harper(c�r�,doh.wa.gov,360-236-3525 steffen.burney@doh.wa. og_v,360-236-3569
Exhibit A,Statements of Work Page 18 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN] NT #4
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: OICP-Promotion of Immunizations to Improve Local Health Jurisdiction Name: Mason County Public Health
Vaccination Rates-Effective July 1,2018
Contract Number: CLH18253
SOW Type: Revision Revision#(for this SOW) 1 Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: July 1,2018 through June 30,2019 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑Other Research&Development
Statement of Work Purpose: The purpose of this statement of work is to contract with local health to conduct activities to improve immunization coverage rates.
Revision Purpose: The purpose of this revision is to correct the Chart of Accounts Program Name/Title and the Master Index Code.
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration None Consideration
Code Code Start Date End Date
FFY18 Increasing Immzs Rates ConCon 93.268 333.93.26 74310285 07/01/18 06/30/19 5,600 -5,600 0
FFY17 Increasing Immunization Rates 93.268 333.93.26 74310276 07/01/18 06/30/19 0 5,600 5,600
TOTALS 5,600 0 5,600
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
1 Develop a proposal to improve immunization Written proposal and a report that August 1,2018 Reimbursement for
coverage rates for a target population by increasing shows starting immunization rates actual costs incurred,
promotion activities and collaborating with for the target population not to exceed total
community partners. The proposal must meet funding consideration
guidelines outlined in the Local Health Jurisdiction amount.
Funding Opportunity,Promotion of Immunizations
to Increase Vaccination Rates announcement. See Restrictions on
Funds below.
2 Upon approval of proposal,implement the plan to Written report describing the November 30,2018 Reimbursement for
increase immunization coverage rates with the progress made on reaching actual costs incurred,
target population identified. milestones for activities identified March 31,2019 not to exceed total
in the plan(template will be funding consideration
provided) amount.
See Restrictions on
Funds below
Exhibit A,Statements of Work Page 19 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN ;NT#4
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
3 Conduct an evaluation of the interventions Final written report,including a June 15,2019 Reimbursement for
implemented. report showing ending actual costs incurred,
immunization rates for the target not to exceed total
population(template will be funding consideration
provided) amount.
See Restrictions on
Funds below
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
http://www phaboard org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf
Prouram Saecific Reauirements/Narrative
Tasks in this statement of work may not be subcontracted without prior written approval from DOH OICP.
Special Requirements
Federal Fundine Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending,gov by DOH as required by P.L. 109-282.
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc.)
Allowable Uses of Federal Operations Funds document(dated 12/20/2017)is posted on the DOH Consolidated Contract website at this link. These federal funds may not be used
for expenses related to travel or attendance at any non-DOH sponsored conference,training,or event without prior written approval from the DOH Office of Immunization and
Child Profile.
Other
Deliverables may be sent electronically via email to oicpcontracts@doh.wa.gov,by fax to 360-236-3590,or by mail to PO Box 47843, Olympia WA 98504-7843
DOH Program Contact DOH Fiscal Contact
Tawney Harper,MPA Vanessa Mojica
Budget and Operations Manager Special Projects Coordinator
Office of Immunization and Child Profile Office of Immunization and Child Profile
Department of Health Department of Health
PO Box 47843,Olympia WA 98504-7843 PO Box 47843,Olympia WA 98504-7843
tawney.harper doh.wa.gov/360-236-3525 vanessa.moiicaaa,doh.wa.gov/360-236-3802
Exhibit A,Statements of Work Page 20 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN__._-NT#4
Exhibit A
Statement of Work
Contract Term: 2018-20207
DOH Program Name or Title: Prescription Drug Overdose Prevention for States Local Health Jurisdiction Name: Mason County Public Health
Supplement-Effective January 1,2018
Contract Number: CLH18253
SOW Type: Revision Revision#(for this SOW) 2 Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through September 30,2019 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑Other 0 Research&Development
Statement of Work Purpose: Under the Centers for Disease Control and Prevention(CDC)Prescription Drug Overdose Prevention for States grant(5 NU17CE002734)an
Opioid Overdose Prevention position will be funded.This position will be staffed by a public health nurse and other public health professional to conduct the work described
below.Positions will provide community and prescriber technical assistance and education to help prevent overdoses,and to improve clinical care for patients taking opioids for
chronic pain and those with opioid use disorder.
Mason County Public Health(MCPH)will 1)follow up with nonfatal overdose patients,provide training for overdose reversal,and refer nonfatal overdose patients to treatment
and other services;2)if the overdose involved a prescription opioid,follow up with the prescriber regarding the nonfatal overdose;3)when available,obtain a list of patients'
prescriptions from the Prescription Drug Monitoring Program(PDMP),and follow up with provider(s)to discuss opioid prescribing and provide education;4)on a monthly basis
provide DOH with opioid overdose reports which include the number of nonfatal overdose patients in Mason County and the number of patients served by the public health
consultant;5)perform public outreach,education and trainings to improve community awareness around opioid use and opioid overdose;and 6)attend monthly meetings with
DOH and provide updates on activities.
Revision Purpose: The purpose of this revision is to extend the period of performance from September 30,2018 to September 30,2019,and add additional tasks and funding of
$75,000 for funding year September 1,2018 through August 31,2019.
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
FFY17 PRESCRIPTION DRUG OD-SUPP 93.136 333.93.13 77520271 01/01/18 08/31/18 63 027 0 63,027
FFY18 PRESCRIPTION DRUG OD-SUPP 93.136 333.93.13 77520281 09/01/18 08/31/19 0 75,000 7-510-0-0
TOTALS 63,027 75,000 138,027
Task *May Support PHAB Payment Information
Number Task/Activity/DescriptionStandards/Measures Deliverables/Outcomes Due Date/Time Frame and/or Amount
1. Follow up with overdose patients in Provide monthly reports to DOH MCPH will submit monthly Monthly invoices for
Mason County to connect them to which includes number of fatal and written progress reports of actual cost reimbursement
evidence based substance abuse nonfatal overdoses and number of ongoing activities on D014 will be submitted to
treatment and other needed services. persons contacted. previded tengplatc January 1, DOH.
Increase outreach to persons with 2018—August 31,2018.
substance use disorder SUD to
Exhibit A,Statements of Work Page 21 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN ?NT#4
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
navigate services such as evidence Report technical assistance Final report to be submitted Total of all invoices will
based treatment and recovery support. provided(dates,location, by September 30,2018. not exceed$63,027
participants-TA consultation)If through August 31,2018.
In the case of a suspected opioid materials are prepared,please (See Special Instructions
overdose: share. below.) Final invoice must be
Notify the person's prescribers listed in received by
the PMP and person's primary care At least one(1)community forum September 15,2018.
provider,if known,of the overdose will be held where opioid addiction
event. and treatment is discussed. (See Special Billing
Requirements below.)
Provide technical assistance,training, Provide updates on ongoing
consultation and resources regarding activities related to opioid
opioid prescribing guidelines and opioid overdose prevention and linkages
use disorder. to treatment at monthly meetings
with DOH.
Provide public outreach,education,and
training to community around opioids Will report on these efforts and
and opioid use disorder. discussions at meetings with DOH.
efforts.
Increase prevention activities such as
naloxone education to include law
enforcement, discuss overdose response =
and prevention efforts by the sherds
office, tribal police, etc.
Continuation of activities above for new Continuation of deliverables/ MCPH will submit monthly Monthly invoices for
funding year. Increase staff assigned to outcomes listed above. written progress reports of actual cost reimbursement
24 hours a week. ongoing activities through will be submitted to DOH.
August 31, 2019.
Total of all invoices for
Final report to be submitted this funding period will
by September 30, 2019. not exceed $75,000
(See Special Instructions Final invoice must be
below.) received by
September 15,2019
Exhibit A, Statements of Work Page 22 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
AMEN-_ _ENT#4
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
(See Special Billing
Requirements below.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hn://www.phaboard.org/mT-content/uploads/PHAB-Standards-and-Measures-Version-1.O.pdf
Proeram Specific Requirements/Narrative
Special Requirements
Federal Fundin¢Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Staffing Requirements:
Added time for specialist to perform community outreach
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc):
This grant cannot be used for purchase of food/drinks, lobbying,for purchase of naloxone or for distribution of sterile needles or syringes.
Special Billing Requirements:
DOH will provide an A19-1A invoice voucher form that must be used for monthly billing.
Special Instructions
Monthly written progress reports via email and conference calls with DOH program contacts.
DOH Program Contacts:
Jennifer Alvisurez Rachel Meade
Program Manager Opioid Overdose Prevention Specialist
Injury and Violence Prevention Injury and Violence Prevention
Office of Community Health Systems Phone: 360-236-2846
Washington State Department of Health rachel.meadeAdoh.wa.gov
P.O.Box 47853 47855,Olympia,WA 98504-7855
Phone:360-236-2845 Fax:360-236-2830
iennifer.alvisurezna doh.wa. og_v
Exhibit A, Statements of Work Page 23 of 23 Contract Number CLH18253-4
Revised as of July 16,2018
C � �
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Jennifer Giraldes Action Agenda _X_
Public Hearing
Other
DEPARTMENT: Support Services EXT: 380
DATE: September 18, 2018 Agenda Item #
(Commissioner staff to complete)
BRIEFING DATE:
BRIEFING PRESENTED BY:
[X] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM:
Approval of Warrants &Treasure Electronic Remittances
Claims Clearing Fund Warrant #s 8058830-8059045 $ 422,747.21
Direct Deposit Fund Warrant #s 52733-53115 $ 655,410.38
Salary Clearing Fund Warrant #s 7003877-7003914 $ 944,381.05
Background: The Board approved Resolution No. 80-00 Payment of Claims Against County:
Procedure Authorizing Warrant Issue and Release Prior to Board Claim Approval. Mason
County Code 3.32.060(a) requires that the board enter into the minutes of the County
Commissioners the approval of claims listing warrant numbers.
Claims Clearing YTD Total $ 18,604,796.50
Direct Deposit YTD Total $ 11,994,269.75
Salary Clearing YTD Total $ 12,904,341.73
Approval of Treasure Electronic Remittances YTD Total $ 6,618,553.60
RECOMMENDED ACTION:
Approval to: Move to approve the following warrants:
Claims Clearing Fund Warrant #s 8058830-8059045 $ 422,747.21
Direct Deposit Fund Warrant #s 52733-53115 $ 655,410.38
Salary Clearing Fund Warrant #s 7003877-7003914 $ 944,381.05
Attachment(s): Originals on file with Auditor/Financial Services (Copies on file with Clerk of
the Board)
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Jennifer Beierle Action Agenda _X_
Public Hearing
Other
DEPARTMENT: Support Services EXT: 532
DATE: September 18, 2018 Agenda Item #
Commissioner staff to complete)
BRIEFING DATE: September 10, 2018
BRIEFING PRESENTED BY: Jason Dracobly, Chief Criminal Deputy
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM: Move $60,000 from Sheriff Department Salaries to Sheriff Department
Capital Purchases in order to purchase 2 vehicles for Sheriff Traffic
EXECUTIVE SUMMARY: The Mason County Sheriff Department is in need of two
replacement Traffic Vehicles at a total cost of approximately $120,000. The vehicles are
able to be purchased at a discount, but the department does not have proper budget
authority to purchase the vehicles within the 2018 operating budget. The Sheriff
Department has identified $110,000 in unfilled positions within the 2018 budget and
$10,000 in unspent operating costs that would support the budget for this purchase.
Resolution No. 26-17 allows for an annual transfer of the Sheriff Department budget of
up to $50,000 from salaries and benefits to operating. The department is requesting a
budget reallocation of an additional $60,000 of identified unfilled positions to be moved
from salaries to operating in order to obtain appropriate budget authority for the vehicle
purchases.
BUDGET IMPACTS: N/A
RECOMMENDED ACTION: Motion for the Board of Mason County Commissioners to
approve the transfer of$60,000 from Sheriff Department Salaries to Sheriff Department
Operating in order to purchase 2 vehicles for Sheriff Traffic.
J:\Budget Office\Jennifer\Briefing, Agenda,&Public Hearing Items\Budget Action Agenda- Sheriff
Salaries to Captial.doc
2018 BUDGET CHANGE REQUEST
Date: Change Request#
PLEASE SUBMIT BUDGET CHANGE REQUESTS TO BUDGET MANAGER - SUPPORT SERVICES
Supplemental Appropriation Non-Debatable Emergency Debatable Emergency Budget Amendement
For increased expenditures due to unanticipated For the relief of a stricken community For a Public emergency other than a For increased expenditures to be funded from
federal,state,or local funds requiring immediate address;to meet non-debatable emergency which Current Expense funds
mandatory expenditures required by law could not reasonably have been
foreseen at the time of making the
budget,requiring the expenditure of
money not provided for in the budget.
REVENUE/SOURCE
EXPENDITURES
o, From 001.000000.205.265 521.10.510100.0000.00 < 15,000.00 > Chief Admin Deputy
c
From 001.000000.205.267 521.22.510010.0000.00 < 10,000.00 > Deputy
From 001.000000.205.267 521.22.510359.0000.00 < 20,000.00 > Deputy
rn
5 From 001.000000.205.267 521.70.510371.0000.00 < 15,000.00 > Traffic Deputy
N
v
To + 001.000000.205.267 594.21.564010.0000.00 60,000.00 Vehicles
m
`c To +
v
E To +
0
va. To +
a
To +
.c
To +
0
To +
t
Reason forChange:Reallocate unfilled position to cap I purchases in order to purchase two Sheriff Traffic vehicles.
N
L
Please indicate w h i ny of the requested Cliange To BARS lines are new and need to be added.
Authorizing signature for
department requesting transfer: rst I EK T:
Title of authorizing signature: Date:
rn o Action taken by Budget Manager: Change Approved Change Denied
a c
� o
O° g Budget Manager signature: Date:
CHANGE COMPLETED IN FINANCIAL SERVICES BY:
C u
c DATE: COPIES TO:
� N
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Diane Zoren Action Agenda x
Public Hearing
Other
DEPARTMENT: Support Services EXT: 747
DATE: September 18, 2018 Agenda Item # `
Commissioner staff to complete)
BRIEFING DATE: September 11, 2018
BRIEFING PRESENTED BY: Commissioners interviewed applicants
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM: Approval to appoint Marilyn Vogler (Commissioner District 3) and Randy Olson
(Commissioner District 2) to the Mason County Housing and Behavioral Health
Advisory Board for a four-year term ending September 30, 2022.
Background: The Mason County Housing and Behavioral health Advisory Board was
established by adoption of Resolution 33-18 to strategically align the housing,
homelessness, mental health and chemical dependency grant awards to improve the
health of Mason County residents.
Membership is as follows:
• One County Commissioner, designated as Chair, voting in case of a tie;
• One City Council Member;
• One Board of Health member that is not a county commissioner;
• One representative from a social services funding organization; and
• Up to 3 Mason County residents, not employed by Mason County, and not to
exceed one resident per commissioner district. All interested citizens must
complete a Citizens Application found on the Mason County Website. All
applicants will be selected and appointed through the County Commissioners;
and
• All members shall serve a four-year term
RECOMMENDED ACTION: Approval to appoint Marilyn Vogler (Commissioner
District 3) and Randy Olson (Commissioner District 2) to the Mason County Housing
and Behavioral Health Advisory Board for a four-year term ending September 30,
2022.
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Diane Zoren Action Agenda x
Public Hearing
Other
DEPARTMENT: Support Services EXT: 747
DATE: September 18, 2018 Agenda Item # g,7
Commissioner staff to complete)
BRIEFING DATE: None — Diane contacted Commissioners
BRIEFING PRESENTED BY:
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM: Approval for the Chair to sign the Personal Property Certificate and Authorized
Agenda Representative form for the Local Agency Financing Contract that purchased
Mason County's communication system in 2016. This form is to be completed
annually.
Background:
In 2016, Mason County obtained a loan to purchase our new phone system and the
Personal Property Certificate verifying possession of the system is required annually.
The loan will be paid off in 2019.
RECOMMENDED ACTION:
Approval for the Chair to sign the Personal Property Certificate and Authorized Agenda
Representative form for the Local Agency Financing Contract that purchased Mason
County's communication system in 2016. This form is to be completed annually.
Certificate Designating Authorized Agency Representatives
I, Randy Neatherlin, Chair of Mason County Board of Commissioners(the "Local Agency"),
hereby certify that, as of the date hereof, pursuant to Resolution No. 38-16, the following
individuals are each an "Authorized Agency Representative," as indicated by the title appended
to each signature, that the following individuals are duly authorized to execute and deliver the
Local Agency Financing Agreement to which this Certificate is attached as Exhibit C, and all
documentation in connection therewith, including but not limited to the Personal Property
Certificate(s) attached thereto as Exhibit B, that the signatures set forth below are the true and
genuine signatures of said Authorized Agency Representatives and that pursuant to such
resolution/ordinance, two of the three following signature(s) {is/are} required on each of the
aforementioned documents in order to consider such document executed on behalf of the Local
Agency:
Randy Neatherlin, Chair
Frank Pinter, Director
Dated this day of September, 2018
Randy Neatherlin, Chair
Mason County Board of Commissioners
SUBSCRIBED AND SWORN TO before me this day of September, 2018
By:
NOTARY PUBLIC in and for the State of Washington
Residing at:
Printed Name:
My Commission expires:
Personal Property Certificate
Name of Local Agency: Mason County
Address: 411 N.51"Street
Shelton,WA 98584
All capitalized terms not defined herein shall have the meanings assigned to such terms in the Local Agency Financing Contract that this Exhibit
B is attached to.The undersigned,Randy Neatherlin and Frank Pinter do hereby certify,that they are the Authorized Agency Representative of_Mason
County_(the"Local Agency")pursuant to the terms of the Local Agency Financing Contract.
The undersigned,confirms that the Property described below will be placed in use at the location listed below.The undersigned confirms that the
Property described below has been delivered to and received by the Local Agency.All installation or other work necessary prior to the use thereof has been
completed. The Property has been examined and/or tested and is in good operating order and condition and is in all respects satisfactory to the Local
Agency and complies with all terms of the Master Financing Contract and the Local Agency Financing Contract.
Notwithstanding the foregoing,the undersigned does not waive or limit,by execution of this certificate, any claim against the vendor or any
other seller, installer, contractor or other provider of property or services related to the purchase,shipment,delivery, installation or maintenance of the
Property.
The Local Agency further confirms that the Property will be used to fulfill an essential governmental function which the Local Agency has the
authority to provide in the State.
PROPERTY INFORMATION
Description: Office Communication System Name of Vendor: Cerium Networks
Address: 1636 West 19.Avenue
Spokane,WA 99201
CDW Government LLC
Serial No.: Numerous Serial Numbers 73 Remittance Drive,Suite 1515
Tag No.: Numerous Tag Numbers
Location of Property Acquired: Mason County=all county buildings
INSTRUCTIONS TO STATE TREASURER FOR PAYMENT:
Disburse to: ❑Vendor ❑City ®County Treasurer []Other
Entity Name: Mason County
Disbursement Amount: $$235,000
Method of Payment: ❑ACH ❑Wire ®Check
ACH/Wire Instructions:
Attached hereto are:
1. A vendor's invoice for the Property approved by the Local Agency.
2. A Certificate of Insurance,demonstrating liability insurance coverage and stating that insurance will be renewed annually automatically,unless
said office notifies the State Treasurer of any discontinuation of coverage.
In connection with the Local Agency's acquisition of the Property as agent of the Washington Finance Officers Association,you are hereby requested to
make a disbursement as indicated above.
Authorized Agency Representative Authorized Agency Representative
Date: Date:
Countersigned and
Approved for Payment:
Designated State Treasurer Representative
Date:
1
Resolution.No.
Authorization for the acquisition of personal property and execution of
a.financing contract and related documentation relating to the
acquisition of Equipment
WHEREAS,Mason County(the"Local Agency")has executed a Notice of Latent to the Office of State
Treasurer,in the form attached hereto as Annex 1 (the"NOI"),in relation to the acquisition of and the financing of
the acquisition of the Property,as defined below,under the provisions of RCW ch 39.94;and
WHEREAS,it is deemed necessary and advisable by the Commission of the Local Agency that the Local
Agency acquire the equipment and/or personal property identified on Annex I attached hereto("Property"); and
WHEREAS,it is deemed necessary and advisable by the Commission of the Local Agency that the Local
Agency entex into a Local Agency Financing Contract with the Office of the State Treasurer,in the form attached I
hereto as Annex 2(the"Local.Agency Financing Contract"),in an amount not to exceed$350,000.00 plus related 1
financing costs in order to acquire the Property and finance the acquisition of the Property;
WHEREAS,the Local Agency will undertake to acquire and/or improve the Property on behalf of and as
agent of the Washington Finance Officers Association(the"Corporation")pursuant to the terms of the Local
Agency Financing Contract,and in accordance with all applicable purchasing statutes and regulations applicable to
the Local Agency;and
WHEREAS,the Local Agency desires to appoint the individuals set forth in Annex 3 as the representatives
of the Local Agency in connection with the acquisition of the Property and execution of the Local Agency Financing
Contract(each an"Authorized Agency Representative'');
NOW,THEREFORE,BE IT RESOLVED,by the Commissioners of Mason County as follows:
Section 1.The individuals holding the offices or positions set forth in Annex 3 are each hereby appointed
as a representative of the Local Agency in connection with the acquisition of the Property and execution of the Local
Agency Financing Contract and all other related documents. A minimum of two Authorized Agency
Representatives shall be required to execute any one document in order for it to be considered duly executed on
behalf of the Local Agency.
Section 2.The form of the Local Agency Financing Lease attached hereto as Annex 2 is hereby approved
and the Authorized Agency Representatives are hereby authorized and directed to execute and deliver the Local
Agency Financing Contract,in an amount not to exceed$350,000 plus related financing costs, and in substantially
the form attached hereto with such changes as may be approved by the Authorized Representatives,for the
acquisition of the Property and financing of the acquisition of the Property.
Section 3.The Local Agency hereby authorizes the acquisition of the property as agent of the Corporation
in accordance with the terms and provisions of the Local Agency Financing Contract.
Section 4.The Authorized Representatives are hereby authorized to execute and deliver to the Office of
State Treasurer all other documents,agreements and certificates,and to take all other action,which they deem
necessary or appropriate in connection with the financing of the property,including,but not limited to, any
amendment to the NOI,any tax certificate and any agreements relating to initial and ongoing disclosure in 1
connection with the offering of securities related to the financing.
Section 5.This resolution shall become effective immediately upon its adoption.
1
Resolution No. �`
ADOPTED by the Mason County Commissioners at a regular meeting thereof held this 12th day of July,2016.
BOARD OF COUNTY COMMISSIONERS
MASON COUNTY,WASHINGTON
ATTEST:
L
Terri Jefl&#Chq&
Juh Almanzor,Clerk of the Boar
C,
APPROVED AS TO FORM: T SnnT heldon,Commissioner
I
Tim Whiteh hief DPA Randy Neatherlin,Commissioner
I
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