HomeMy WebLinkAbout2018/06/26 - Regular Packet 26.2
BOARD OF MASON COUNTY COMMISSIONERS
DRAFT MEETING AGENDA
Commission Chambers— 6:00 p.m.
411 North Fifth Street, Shelton WA 98584
lune 26, 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 6:30 p.m.
7. Approval of Minutes — June 18, 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 execute the resolution setting a hearing date with the Hearings
Examiner for Wednesday, July 25, 2018 to consider public comment on the
proposed vacation of a portion of W. Cloquallum Road.
8.2 Approval to award $418, 875 $375,875from the Local 2163 and 2160 Document
Recording fees and enter into contracts for a one-year term with the following
agencies beginning July 1, 2018:
2060 2163 Agency Program(s)
49,500 Turning Pointe DV Shelter
50,000 63,705 Community Lifeline Adult Shelter
179,670 Crossroads Housing Family Shelter,
Transitional Housing,
Coordinated Entry, and
Rapid Rehousing
33,000 North Mason Resources Coordinated Entry-North
Mason
13,088 HOST
Heusin.g
8.3 Approval of the 2018-2019 Juvenile Detention Alternatives Initiative Grant
Application Contract Number I-501-00812 in the amount of$24,500.
Last printed 6/26/2018 8:16:00 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
June 26, 2018 — PAGE 2
8.4 Approval of Contract Number K2751 between Mason County and the Washington
State Health Care Authority for the Access to Baby &Child Dentistry (ABCD)
Program.
8.5 Approval of the Ordinance creating Mason County Lake Management District No. 2
for Mason Lake and set a public hearing on Tuesday, July 24, 2018 at 6:30 p.m. to
hear objections to the roll of rates and charges.
8.6 Approval of the resolution for the distribution of the Public Utility District Excise Tax
per RCW 54.28.090. The Mason County Current Expense Fund will receive
$734,620.43 and the City of Shelton will receive $82,020.51.
9. Other Business (Department Heads and Elected Officials)
10. 6:30 p.m. Public Hearings and Items Set for a Certain Time-
10.1 Public Hearing to consider the following Supplemental Appropriations and Budget
Transfers to the 2018 Budget:
Staff: Jennifer Beierle
Supplemental Appropriations:
• $644,255 Increase to Current Expense Non-Departmental Revenue for Road Internal
Allocation and Increase to Current Expense Ending Fund Balance
• $34,000 Increase to Belfair Sewer Fund 413 Revenue for Belfair Sewer Feasibility Study
and Increase to Fund 413 Professional Services Expense
• $38,650 Increase to Sheriff Revenue for various private contracts and Increase to MCSO
overtime expenses
• ::e - -. - . .:..- - .• - •- . . .. . . . .. .: . : : • .: -: .
cxpcnsc accounts Deleted as this grant will not be reported as revenue to
Mason County.
• $2,500 Increase to Juvenile Services Revenue for JDAI Grant increase and Increase to
Juvenile Services various expense accounts
• $24,565 Increase to Criminal Justice Treatment Account in Therapeutic Court for funding
from DSHS and Increase to Therapeutic Courts various expense accounts
• $104,737 Increase to Current Expense Non-Departmental Revenue for Community
Development Block Grant (CDBG) and Increase to Current Expense Non-
Departmental Expense
• $231,334.50 Increase to REET 2 Fund 351 for Recreation and Conservation Office Grant
and Increase to REET 2 Capital Outlays Expense
• $506,000 increase to County Road Fund 105 for Recreation and Conservation Office
Grant and increases to various other existing grants, and Increase to Capital
and Professional Services expenses.
• $290,000 increase to Skokomish Flood Zone Fund 192 for increased funding from Mason
Conservation District and Increase to various expense accounts
• $207,235 increase to Storm Drain System Development Fund 480 for Department of
Ecology Grant Funds and increase to various expense accounts and ending
fund balance
Budget Transfers:
• Landfill Reserve Fund 428 Transfer from: Ending Fund Balance - $30,000
To: Landfill Reserve— Misc. Contracted Professional Services - $30,000
• Belfair Sewer Fund 413 Transfer from: Ending Fund Balance - $66,000
To: Belfair Sewer— Professional Services/Misc - $66,000
• Auditor's O&M Fund 104 Transfer from: Ending Fund Balance - $2,050
To: Auditor's O&M — Medical/Dental/Vision/Life - $1,907.50
To: Auditor's O&M — Reserve for Technology - $142.50
• Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $31,950
To: Auditor— Medical/Dental/Vision/Life $6,500
C:\Users\mdrewry\Documents\GroupWise\2018-06-26 Reg.doc
MASON COUNTY COMMISSIONERS' MEETING AGENDA
June 26, 2018 —PAGE 3
To: Human Resources — Medical/Dental/Vision/Life - $8,000
To: Clerk— Medical/Dental/Vision/Life - $6,100
To: Treasurer- Various Salaries and Benefits - $5,050
To: Commissioners — State Retirement - $3,600
To: Assessor— Medical/Dental/Vision/Life - $2,700
• Veterans Assistance Fund 190 Transfer from: Transfers Out - $50,000
To: Mental Health Tax Fund 164 - $50,000
• Veterans Assistance Fund 190 Transfer from: Transfers Out- $50,000
To: Community Support Services Fund 117 - $50,000
• Law Library Fund 160 eliminate transfer from: Transfers Out - $4,940
To: Support Services Fund 001.090 - $4,940
• Law Library Fund 160 Transfer from: Ending Fund Balance - $4,940
To: Law Library—Various Salary and Benefits - $4,940
• Facilities &Grounds Fund 001.055 Transfer from: Transfers Out - $6,830.47
To: Historical Preservation Fund 116 - $6,830.47
• Facilities &Grounds Fund 001.055 Transfer from: Transfers Out- $10,000
To: Community Support Services Fund 117 -$10,000
• Sheriff 001.205 Transfer from: Ending Fund Balance - $55,090
To: Sheriff— Enterprise Payments 001.000000.205.267.521.22.545030.0000.00 -
$34,403
To: Sheriff— ER&R Upfit/Downfits 001.000000.205.267.521.22.548098.0000.00 -
$20,687
• Sheriff Special Funds 140 Transfer from: Ending Fund Balance - $1,380.16
To: Sheriff Special Funds— SAR Van Tires - $1,380.16
• Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $107,831
To: Auditor—Various Salary & Benefit Lines $20,828
To: Auditor—Various Expense Lines $13,700
To: Treasurer—Various Salary & Benefit Lines - $31,003
To: Clerk—Various Salary & Benefit Lines - $42,300
• Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $70,000
To: Accrued Leave—Various Salary & Benefit Lines - $70,000
• County Road Fund 105 Transfer from: Ending Fund Balance - $311,000
To: County Road — Professional Services Line - $311,000
11. Board's Reports & Calendars
12. Adjournment
J:\AGENDAS\2018\2018-06-26 Reg.doc
C I
MASON COUNTY
TO: BOARD OF MASON COUNTY COMMISSIONERS Reviewed:
FROM: Jennifer Giraldes Ext. 380
DEPARTMENT: Support Services Action Agenda
DATE: June 27, 2018 No. 4.1
ITEM: Correspondence
4.1.1 United States Department of the Interior Bureau of Indian Affairs sent notices
of applications filed by the Skokomish Island Tribe to have real property
accepted "in trust"for Parcel Number 42111-43-00000.
4.1.2 Washington State Liquor and Cannabis Board sent liquor license applications
for Faith in Action held at The Hub 111 Northeast Old Belfair Highway,
Belfair. Allyn Community Association held at Allyn Waterfront Park 18560
WA-3, Allyn and Union City Market 5101 East State Route 106, Union.
4.1.3 Olympic Region Clean Air Agency (ORCAA) sent a letter notifying Mason
County clean air contribution for 2019 is $41,925.30.
4.1.4 United States Department of Homeland Security's Federal Emergency
Management Agency (FEMA) Region 10, approved the Mason County Hazard
Mitigation Plan.
4.1.5 Raymond Lee "Randy"Olson sent in a Housing and Behavioral Health
Advisory Board application.
4.1.6 United Way of Mason County sent letter requesting support for the 2018
United Way Day of Caring.
4.1.7 Christina Williams sent in a Mason County Historic Preservation Commission
application.
Attachments: Originals on file with the Clerk of the Board.
cc:CMMRS Neatherlin,Shutty&Drexler
Clerk )ib1 ane-.,
ENT OF T
o�PP tiFym United States Department of the Interior
A �
BUREAU OF INDIAN AFFAIRS
Puget Sound Agency
CHs sA9 2707 Colby Ave. - Suite 1101 4> �P
Everett,Washington 98201-3665
(425)258-2651
June 12, 2018
CERTIFIED MAIL-RETURN RECEIPT REQUESTED 7016 3010 0001 0720 2817
Board of County Commissioners E � MEj)
Mason County
411 N. 5th street JUN 14 2018
Shelton,Washington 98584
Mason County
Dear Commissioners: Cnmmissinners
Pursuant to the Code of Federal Regulations, Title 25, INDIANS, Part 151.10, notice is given of
the application filed by the Skokomish Indian Tribe to have real property accepted "in trust" for
said applicant by the United States of America. The determination whether to acquire this
property "in trust" will be made in the exercise of discretionary authority, which is vested in the
Secretary of the Interior, or his authorized representative, U.S. Department of the Interior. To
assist us in the exercise of that discretion, we invite your comments on the proposed acquisition.
In order for the Secretary to assess the impact of the removal of the subject property from the tax
rolls, and if applicable to your organization, we also request that you provide the following
information:
(1) If known, the annual amount of property taxes currently levied on the subject
property allocated to your organization;
(2) Any special assessments, and amounts thereof, that are currently assessed against
the property in support of your organization;
(3) Any governmental services that are currently provided to the property by your
organization; and
(4) If subject to zoning, how the intended use is consistent, or inconsistent, with the
zoning.
We provide the following information regarding this application:
Applicant:
Skokomish Indian Tribe.
Legal Land Description/Site Location:
The Southwest Quarter of the Southeast Quarter of Section 11, Township 21 North, Range 4
West, Willamette Meridian. Situate in Mason County, Washington, containing 38.99 acres,
more or less.
Mason County Parcel No. 4211143 00000.
Project Description/Proposed Land Use:
The land is currently used for conservation of Treaty resources, including fisheries, and there
will be no change of use in the foreseeable future.
As indicated above, the purpose for seeking your comments regarding the proposed trust land
acquisition is to obtain sufficient data that would enable an analysis of the potential impact on
state government, which may result from the removal of the subject property from the tax rolls
and local jurisdiction.
This notice does not constitute, or replace, a notice that might be issued for the purpose of
compliance with the National Environmental Policy Act(NEPA)of 1969.
Your written comments should be addressed to the Superintendent, Bureau of Indian Affairs,
2707 Colby Avenue, Suite 1101, Everett, Washington 98201-3528. Any comments received
within thirty days of your receipt of this notice will be considered and made a part of our record.
You may be granted one thirty day extension of time to furnish comments, provided you submit
a written justification requesting such an extension within thirty days of receipt of this letter.
Additionally, copies of all comments will be provided to the applicant for a response. You will
be notified of the decision to approve or deny the application.
If any party receiving the enclosed notice is aware of additional governmental entities that may
be affected by the subject acquisition, please forward a copy to said party.
A copy of the application, excluding any documentation exempted under the Freedom of
Information Act (FOIA), is available for review at the above address. A request to make an
appointment to review the application, or questions regarding the application, may be directed to
Rich Ferguson, Acting Realty Officer, at telephone number(425) 258-4561, extension 222, or at
richard.fer us�onAbia.gov.
Sincerely,
Marcella L. Teters
Superintendent
cc:CMMRS Neatherlin,Shutty&Drexler
Clerk) EAM aj f D
WASHINGTON STATE LIQUOR AND CANNABIS BOARD - License Services J
3000 Pacific Ave SE - P O Box 43075
Olympia WA 98504-3075
EMAIL SPECIALOCCASIONS@LCB.WA.GOV FAX 360-753-2710
TO: MASON COUNTY COMMISSIONERS JUNE 13TH 2018
SPECIAL OCCASION #: 091592 ECL
FAITH IN ACTION JUN 18 2018
111 NE OLD BELFAIR HWY
BELFAIR WA 98528
Mason County
Commissioners
DATE: JUNE 24TH 2018 TIME: 12:00 PM TO 5:00 PM
PLACE: THE HUB (ENCLOSED) - 111 NE OLD BELFAIR HWY, BELFAIR
CONTACT: ELIZABETH GIZZI (DOB 03.13.1974) 360.275.0535
SPECIAL OCCASION LICENSES
* _Licenses to sell beer on a specified date for consumption at a
specific place.
* _License to sell wine on a specific date for consumption at a
specific place.
* _Beer/Wine/Spirits in unopened bottle or package in limited
quantity for off premise consumption.
* _Spirituous liquor by the individual glass for consumption at a
specific place.
If return of this notice is not received in this office within 20 days from the above
date, we will assume you have no objections to the issuance of the license. If
additional time is required please advise.
1. Do you approve of applicant? YES NO
2. Do you approve of location? YES NO
3. If you disapprove and the Board contemplates issuing a
license, do you want a hearing before final action is
taken? YES NO
OPTIONAL CHECK LIST EXPLANATION YES NO
LAW ENFORCEMENT YES NO
HEALTH & SANITATION YES NO
FIRE, BUILDING, ZONING YES NO
OTHER: YES NO
If you have indicated disapproval of the applicant, location or both,
please submit a statement of all facts upon which such objections are based.
DATE SIGNATURE OF MAYOR, CITY MANAGER, COUNTY COMMISSIONERS OR DESIGNEE
cc:CMMRS Neatherlin Shutty&Drexler
tlPrk Q;�n�t1r'\Cl'�LI {a
WASHINGTON STATE LIQUOR AND CANNABIS BOARD - LICENSE SERVICES'
3000 Pacific Ave SE - P O Box 43075
Olympia WA 98504-3075 FAX:360-753-2710
specialoccasions@lcb.wa.gov Fax: 360-753-2710
TO: MASON COUNTY COMMISSIONERS JUNE 15, 2018 RECEIVED
SPECIAL OCCASION #: 091035
ALLYN COMMUNITY ASSOCIATION JUN 18 2016
220 E CRONQUIST RD
ALLYN WA 98524 Mason County
Commissioners
DATE: JULY 20, 2018 TIME: 5 PM TO 10 PM
JULY 21-22, 2018 11 AM TO 10 PM
PLACE: ALLYN WATERFRONT PARK (ENCLOSED) - 18560 WA-3, ALLYN
CONTACT: INA CULBERSON (DOB: 3.07.44) 360-509-5733
SPECIAL OCCASION LICENSES
* _Licenses to sell beer on a specified date for consumption at a
specific place.
* _License to sell wine on a specific date for consumption at a
specific place.
* _Beer/Wine/Spirits in unopened bottle or package in limited
quantity for off premise consumption.
* _Spirituous liquor by the individual glass for consumption at a
specific place.
If return of this notice is not received in this office within 20 days from the above
date, we will assume you have no objections to the issuance of the license. If
additional time is required please advise.
1. Do you approve of applicant? YES NO
2. Do you approve of location? YES NO
3. If you disapprove and the Board contemplates issuing a
license, do you want a hearing before final action is
taken? YES NO
OPTIONAL CHECK LIST EXPLANATION YES NO
LAW ENFORCEMENT YES NO
HEALTH & SANITATION YES NO
FIRE, BUILDING, ZONING YES NO
OTHER: YES NO
If you have indicated disapproval of the applicant, location or both,
please submit a statement of all facts upon which such objections are based.
DATE SIGNATURE OF MAYOR, CITY MANAGER, COUNTY COMMISSIONERS OR DESIGNEE
cc:CMMRS Neatherlin,Shutty&Drexler
Washington State Clerk t c7 orL4
Liquor and Cannabis Board Q L i iC3
NOTICE OF LIQUOR LICENSE APPLICATION
WASHINGTON STATE LIQUOR AND CANNABIS BOARD
License Division - 3000 Pacific, P.O. Box 43075
Olympia,WA 98504-3075
Customer Service: (360) 664-1600
Fax: (360) 753-2710
Website: http://Icb.wa.gov
TO: MASON COUNTY COMMISSIONERS RETURN TO: localauthority@sp.icb.wa.gov
DATE: 6/19/18
RE:APPLICATION IN LIEU OF CURRENT PRIVILEGE
U B I: 602-145-156-001-0004 APPLICANTS:
License: 419551 -1 F County:23
Tradename: UNION CITY MARKET NORTH FORTY LODGING LLC
Loc Addr: 5101 ESTATE ROUTE 106 RAIKES,JEFFREY S
UNION WA 98592-9511 1958-05-29
RAIKES, PATRICIA M
Mail Addr: 10 E ALDERBROOK DR 1956-02-02
UNION WA 98592-9426 MCGINNIS, BRIAN PATRICK
1954-06-12
MCGINNIS, CARINA S
Phone No.: 360-898-2252 STEPHANIE MEIER (Spouse) 1957-09-09
Privileges Upon Approval: RECEIVED
ED
BEER/WINE REST-BEER/WINE
OFF PREMISES JUN 19'�1 2018
Mason County
Commissioners
As required by RCW 66.24.010(8), the Liquor and Cannabis Board is notifying you that the above has
applied for a liquor license. You have 20 days from the date of this notice to give your input on
this application. If we do not receive this notice back within 20 days,we will assume you have no
objection to the issuance of the license. If you need additional time to respond,you must submit a
written request for an extension of up to 20 days,with the reason(s)you need more time. If you
need information on SSN,contact our CHRI desk at(360) 664-1724.
YES NO
1. Do you approve of applicant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑
2. Do you approve of location? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑
3. If you disapprove and the Board contemplates issuing a license, do you wish to
request an adjudicative hearing before final action is taken? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑
(See WAC 314-09-010 for information about this process)
4. If you disapprove,per RCW 66.24.010(8)you MUST attach a letter to the Board
detailing the reason(s) for the objection and a statement of all facts on which your
objection(s)are based.
DATE SIGNATURE OF MAYOR,CITY MANAGER,COUNTY COMMISSIONERS OR DESIGNEE
cc:CMMRS Neatherlin,Shutty&Drexler
Clark
2940 Limited Lane NW
Polo'� /_ /_ Olympia, WA 98502
ohympic Region dean Air Agency Representing Clallam, Grays Harbor,Jefferson, (360) 539-7610 . 1-800-422-5623
OR C A A Mason, Pacific, and Thurston Counties
June 15, 2018 RECEIVED
JUN 18 2018
Mason County
Commissioners
Mason County Commissioners
411 N 5th
Shelton, WA 98584
Greetings:
The Washington Clean Air Act (RCW 70.94) requires that prior to the fourth Monday
of June each year; the Air Pollution Control Authority shall notify each city, town, and
county, within their jurisdiction, of their assessment.
At its June 13, 2018 meeting, the Olympic Region Clean Air Agency's Board of
Directors established the per capita assessment for 2019 at seventy-nine cents
($.79). The population figure for the unincorporated Mason County of 53,070 is
based upon the publication by the Washington State Office of Financial
Management, Forecasting Division; "2017 Population Trends for Washington State."
This letter will serve as notification that your Contribution for calendar year 2019 to
the Olympic Region Clean Air Agency is $41,925.30. You will receive a statement
for this amount in January.
Sincerely,
�,, % M va,
Francea L. McNair
Executive Director
Port Townsend Field Office: 615 Sheridan, Port Townsend, WA 98368 • (360) 338-6419
South Bend Field Office: 1216 W Robert Bush Drive, South Bend, WA 98586 o (360) 942-2137
U.S.Department of Homeland Security
FEMA Region 10
cc:CMMRS Neatherlin,Shutty&Drexler 130—2281h Street,SW
Clerk Bothell,Washington 98021
FEMA2
q ND Sl
C
June 13, 2018 c
The Honorable Randy Zeatherlin RE� Y E' ®
Chair, Board of County Commissioners SUN 1 B Zd��
Mason County
411 N. 5" St.
Shelton, Washington 98584 Mason County
Cnmmissioners
Dear Chair Zeatherlin:
On April 30, 2018,the U.S. Department of Homeland Security's Federal Emergency Management
Agency(FEMA)Region 10, approved the Mason County Hazard Mitigation Plan as a multi-
jurisdictional local plan as outlined in Code of Federal Regulations Title 44 Part 201. This approval
provides the below jurisdictions eligibility to apply for the Robert T. Stafford Disaster Relief and
Emergency Assistance Act's, Hazard Mitigation Assistance (HMA) grants projects through
April 29, 2023,through your state:
Mason County Public Utility District No. 3 Public Utility District No. 1
City of Shelton Central Mason Fire and EMS
The updated list of approved jurisdictions includes the City of Shelton that recently adopted their
respective addendum. To continue eligibility,jurisdictions must review,revise as appropriate, and
resubmit the plan within five years of the original approval date.
If you have questions regarding your plan's approval or FEMA's mitigation grant programs,please
contact Derrick Hiebert, State Mitigation Strategist with Washington Emergency Management
Division, at(253) 512-7142,who coordinates and administers these efforts for local entities.
Sincerely,
Mark Carey, Director
Mitigation Division
cc: Tim Cook, Washington Emergency Management Division
BH:vI
www.fema.gov
cc:CMMRS N atherl'n,Shutty&Drexler
Clerk %
J`�pNG'P
s RECEIV; Citizen Application:
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Housing & Behavioral Health
JUN 18 21
Advisory Board
ohm �y
P).H� 3a Mason Cou ty
MASON COUNTY Commissio ,rs Email or scan to: Todd Parker at t arker co.mason.wa.us
COMMUNITY SERVICES p
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Cell Phone: 3bo- 5��� Alternate Phone:
Email Address: QVe_- \'eW\ y-m Z (_-0 /.1O L�t CD✓V-\
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1. Please check the following boxes to certify that you:
Are a resident of Mason County
Have no direct affiliation with any organization applying for Housing, mental health or
chemical dependency grant funding through Mason County (Work for, relative employed
at or currently serve on the Board of)
e-Are willing to learn about services for people with housing and human services needs
�a-'Can commit time to a four-year term, monthly meetings and special meetings as called
2. Describe your experience with, qualifications, skills, and/or awareness in
the following areas (If relevant, job title and years experience are sufficient)
• Strategic planning A-s specS7AvCox cv•J KE.cke
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• Affordable housing in Mason County 11
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Mason County. I_
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Cc:CMMRS Neatherlin, Shutty, Drexler
Clerk
LIVE UNITED
unit•d way
of Mason County
536 W. Railroad Ave Shelton, WA 98584 ■ P:360.426.4999 E: clemmon@unitedwaymasonco.org
2017-2018 June 20, 2018 RECEIVED
Board of Directors
Blake Chard, Melissa Drewry,Clerk of the Board JUN 19 2016
President Mason County
Exceptional Foresters, 411 N 5th St Mason County
Inc.
Shelton, WA 98584 Cnmmissinners
Dana Rosenbach,
VP Marketing/Fund Re: Request for Support for the 2018 United Way of Mason County Day of Caring
Development
North Mason School Dear Melissa,
District
United Way of Mason County is requesting $2,000 from Mason County to be used in this year's
Lisa Woodard, Day of Caring effort. United Way of Mason County has hosted this event, in conjunction with
Treasurer United Way locations across the country, for over 20 years, in an effort to bring community
Columbia Bank groups together to take positive action for Mason County.
Amber Trail,Secretary
Our Community Credit In addition to several group projects which took place on the 2017 Day of Caring, United Way of
Union Mason County partnered with Mason County Garbage& Recycling to host five trash disposal
locations around our county. We started advertising only a few weeks before the Day of Caring,
Charles Gelsleichter in order to limit possible hoarding of personal trash in anticipation of the event, and we were able
Board Member to help Mason County residents get 55,000 pounds of trash delivered to the transfer station, at no
LegalShield cost to county residents.
Independent
Associate
Darrin Moody, 2018 Proposal:
Board Member This year, we have decided to host 2 trash disposal locations instead of 5, in Belfair and Shelton.
City of Shelton This smaller number of locations will allow us to be more cost-efficient and reduce the length of
Alex Apostle,Board time people must wait before appropriately dumping their trash. We do not expect much public
Member backlash, as the other 3 locations were minimally utilized in 2017.
Shelton School District
We are asking that Mason County help with our clean-up efforts and contribute$2,000 toward
Heidi McCutcheon, our efforts. Mason County Garbage & Recycling will once again be partnering with United Way
Board Member of Mason County to provide containers and staff time. No more than $500 of this contribution
Shelton-Mason from Mason County will be used for garbage bags, gloves and miscellaneous supplies needed for
County Chamber of the event. United Way of Mason County would love your support in these efforts for all Mason
Commerce County Residents.
Donna Feddern, Thank you, in advance, for considering our proposal for this year's event!
Board Member
Timberland Regional
Library Since ely,
Beau Bakken,Board
Member
North Mason Regional Carrie Lemmon
Fire Authority Executive Director
R
Cc:CMMRS N�epatthherlin, Shutty, Drexler
RECEIV .. Clerk
�QO -CQ Iwy MASON COUNTY COMMISSIONERS
♦ J U N 20 2018 411 NORTH FIFTH STREET
SHELTON WA 98584
Mason CottrttY:ax 360-427-8437; Voice 360-427-9670, Ext. 419;275-4467 or 482-5269
Commissioners
1854
1 AM SEEKING APPOINTMENT TO Mason County Historic Preservation Commission
NAME: Christina Lee Williams
ADDRESS: PHONE. 360-265-7080
CITY/ZIP: VOTING PRECINCT: WORK PHONE:
Grapeview (OR AREA IN THE COUNTY YOU LIVE) P116 E-MAIL: com
-------------------------------------------------------------------------------------------
COMMUNITY SERVICE EMPLOYMENT: (IF RETIRED. PREVIOUS EXPERIENCE)
(ACTIVITIES OR MEMBERSHIPS)
Polson Museum, Hoquiam Wa COMPANY: Brookside Vet Clinic,Gig Harbor Wa 2 YRS
Backcountry Horsemen of Washington POSITION: Veterinarian assistant
Washington Trails Association COMPANY: Winslow Animal Clinic, Bainbridge Wa 5 YRS
Coastal Raptors, Ocean Shores Wa POSITION: Receptionist/Vet assistant
--------------------------------------------------------------------------------------------
In your words, what do you perceive is the role or purpose of the Board, Committee or Council for which you are applying:
To help preserve historic properties, educate public about historic properties, enforce preservation laws
What interests, skills do you wish to offer the Board, Committee,or Council?
While my skills are general administation(typing, phones, note taking,etc), I have a strong interest in seeing historic
properties preserved.
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)
No conflict of interest
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?
Quarterly Monthly X Weekly Daily
�j Office Use Only
1B Appointment Date
Sig ature Date
Term Expire Date
BOARD OF MASON COUNTY COMMISSIONERS'BRIEFING MINUTES
Mason County Commission Chambers,411 North 5th Street,Shelton,WA
Week of June 18,2018
Monday, June 18,2018
9:00 A.M. Executive Session—RCW 42.30.110(1)(i)Litigation
Commissioners Neatherlin,Drexler and Shutty met in Executive Session with Tim
Whitehead,Frank Pinter and Dawn Twiddy from 9:00 a.m.to 9:20 a.m. for a litigation
matter.
9:15 A.M. Closed Session—RCW 42.30.140(4)Labor Discussion
Commissioners Neatherlin,Drexler and Shutty met in Closed Session with Frank Pinter
and Dawn Twiddy from 9:20 a.m.to 9:45 a.m.for a labor discussion.
9:30 A.M. Community Services—Dave Windom
Commissioners Neatherlin,Drexler and Shutty were in attendance.
• The Commissioners approved moving forward the WA State Health Care Authority
Access to Baby&Child Dentistry contract.
• Todd Parker provided recommended funding awards for the Treatment Sales Tax(TST)
and 2060 and 2163 funding. Cmmr.Neatherlin expressed frustration that the numbers
are different than what the Commissioners had discussed at the previous briefing. Cmmr.
Shutty recognizes the limited resources and is ok with the funding recommendations.
Cmmr.Drexler approved moving the awards forward and will be on the June 26 agenda.
• Review of Community Service reclassification requests: Frank provided additional
information from Human Resources(HR). The request for the Environmental Health&
Personal Health Managers is to reclass down to Range 33;HR's recommendation was to
reclass to Range 32 based on a 5%change in the current policy. Frank has reviewed the
policy and recommends that policy be eliminated. The policy should be that each request
is based on its own merits. HR agrees to the reclass to Range 33.
Planning Manager: because the PBRS is a completely new scope of work that qualifies
for reclassifying from Range 32 to Range 33.This recommendation is done with the
stipulation that the PBRS work will be done by the Planning Manager and not delegated
to a union worker. It was noted that this program has not been approved and the
recommendation is based on the PBRS being adopted. This scope of work was not
included in the original reclass request.
Permit Center manager—Frank has difficulty with seeing a change in the scope of work.
Based on the reclass policy,adding software doesn't qualify for a reclass,Frank
continues to recommend this reclass be denied.
Finance Manager—the request to reclass up to the same as the PW Finance Manager.
Frank stated the PW Finance Manager has a much broader scope than the Public Health
Manager. Public Works has a$41M budget;$9M in Health. The recommendation is to
not reclass this position.
The Commissioners are good with moving forward the reclassification requests to Range
33 for Personal Health Manager,Environmental Health and Planning Manager.The two
other reclass requests(Permit Center and Finance Manager)will be discussed at a future
date.
• Dave updated the Board on various items affecting his department including the road
construction project and how they will provide public access. Dave will bring up the
UGA expansion again and will contact the City of Shelton. The building permit lag time
is about 7 weeks. Dave is looking at outsourcing commercial permits.Dave will be
bringing in a staffing plan for the Commissioners review. The Technology fee will start
when the on-line permitting goes live. Plan review is understaffed.
• Cmmr.Drexler asked about the needle exchange program and Dave says he is still
looking at options.
Board of Mason County Commissioners' Briefing Meeting Minutes
June 18,2018
• Dave is working with the fire districts to try and remove height restrictions for multi
family structures outside of the UGA's.
10:15 A.M. Support Services—Frank Pinter
Commissioners Neatherlin,Drexler and Shutty were in attendance.
• Jennifer provided copies of draft 2019 Preliminary Budget Guidelines. Discussion of a
biennial budget which is referred to as a shadow budget in the Guidelines because it isn't
an actual adopted budget. Cmmr. Shutty recommended staff look at how Pierce County
is doing a biennial budget. Thurston County adopts a biennial budget and at the end of
the first year,they make any necessary changes for the 2°d year. Each year has its'own
budget authority(2 one-year budgets are adopted). Frank stated he will bring forward
pros and cons on a biennial budget.
Cmmr.Shutty believes it allows for a better opportunity to evaluate the programs because
two years are adopted at one time.
A proposed change for the budget process will be to start with Budget 1 (maintenance
level)that is the 2018 budget with the non-discretionary expenses included and in Budget
2(policy level requests)the Departments input their requested changes. The policy level
changes will include detail from the departments.
Include a 1%increase for the Roads Property Tax levy.
Transfer forms will be completed in the budget process so all budgets involved will be
aware of the transfer requests.
Staff is anticipating a 1.5%decrease in Current Expense revenue that recognizes the
anticipated reduction in District Court fees. Staff will be working with the Treasurer on
other anticipated revenues.
Any wage increases for non-represented employees is unknown at this time.
Traffic Policing Diversion
Expenditure authority shall be adopted as two bottom lines—salaries/benefits&
operational expenses.
Budget Narrative will include FTE count and an Organizational Chart along with
proposed fee increases and measurable indicators.
Cmmr.Neatherlin asked that this draft be circulated to all departments and to submit any
changes that can be reviewed prior to July 9,when these budget guidelines will be
circulated.
• Revisions to the Non-Represented Employee Salary Resolution. Regarding Sheriff
Command staff salary range alignments:Cmmr.Shutty supports the HR
recommendations; Cmmrs.Drexler and Neatherlin support placing the positions at the
comparable average and Y-rate current employees. This resolution also adds the
Therapeutic Court staff. Cmmr.Drexler suggested providing an opportunity for a
discussion with the Undersheriff. A briefing will be scheduled next week and the
adoption will be delayed to the following week.
• Review of the employee take-home vehicle list. Some are considered a fringe benefit and
the employee is taxed as such. Jail Chief and Jail Lieutenant vehicle status are being
reviewed to see if they qualify for a take-home vehicle. Cmmr.Neatherlin is good if the
vehicle is used in an emergency situation.
• Review of the 2018 proposed budget supplement request. Cmmr. Shutty will not be in
attendance but will call in for the budget hearing. He has concerns with the budget
supplement that adds positions because of the impact going forward. He is supportive of
one-time expenses;staffing provides long-term cost and would rather have those staffing
discussions in the 2019 budget discussion. His preference is to not support mid-year
staffing increases. He is considered of creating expectations that can't be supported.
Frank will have further discussion with Cmmr. Shutty.
11:15 A.M. Public Works—Jerry Hauth
Utilities&Waste Management
Commissioners Neatherlin,Drexler and Shutty were in attendance.
Board of Mason County Commissioners'Briefing Meeting Minutes
June 18,2018
• Mitigation for Satsop-Cloquallum Road and approval to call for bids and requested this
be added to the June 19 agenda.
• Road Vacation#396 for a portion of Cloquallum Road will be scheduled with the
Hearing Examiner.
• Mason County Garbage Company has requested a surcharge be placed on hauling paper
to be recycled due to a reduction in the price of recycled materials. In the current
contract,the County pays the rental fee for the blue boxes and a hauling fee. If the
County doesn't allow a surcharge,Mason County Garbage could quit servicing the blue
boxes and that waste could go to the transfer station. The impact could be that self
haulers would pay more when hauling to the transfer station. A surcharge of$79/haul
would increase the annual recycling costs to the County by about$17,500.The
Commissioners do not support the surcharge. The contract allows Mason County
Garbage to change what they haul.
• Jerry reported John Heustis has submitted his resignation and the Commissioners
approved posting the position and appointing Jerry Hauth as the County Road Engineer.
11:45 A.M. Juvenile Court Services-Jim Madsen
Commissioners Neatherlin,Drexler and Shutty were in attendance.
• Approval to fill the Juvenile Probation Counselor vacancy.
• Approval to move forward the Juvenile Detention Alternatives Initiative grant
application. Discussion of developing a sanction grid. Cmmr. Shutty would like to
discuss a Baby Court(reunification of family). Pierce County has such a court. Mason
County's has a high number of dependency filings.
Commissioner Discussion
• Cmmr.Drexler reported that ORCAA has agreed to tie the County's fee to a CPI index
that goes up to 3.3%which she disagreed with. HCCC didn't include economic
sustainability and talked about only environmental sustainability. She is also researching
the proposal of DNR purchasing property in Dewatto and putting it into conservation.
She has a difficult time getting numbers to know the impact to the County and noted it's
part of a bigger project.
• Discussion of the HCCC and Cmmr.Neatherlin provided history of the County's role.
Adjourned at 12:08 p.m.
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: Phil Franklin, ROW Agent Action Agenda
DEPARTMENT: Public Works EXT: 207
COMMISSION MEETING DATE: June 26, 2018 Agenda Item #
BRIEFING DATE: June 18, 2018
BRIEFING PRESENTED BY: John Huestis and Phil Franklin
[] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency:
ITEM: Road Vacation No. 396 - Set Hearing
BACKGROUND: Public Works is requesting to vacate a portion of W. Cloquallum
Road that is no longer needed due to road realignment under County Road Project
No. 1916.
An Engineer's Report has been prepared for the Hearing Examiner and Public
Works recommends vacation subject to retaining existing easements in favor of
CenturyLink Telecommunications Company and in accordance with RCW 36.87.170
retaining an easement in favor of Mason County for any other utilities present in
the vacated right-of-way.
RECOMMENDED ACTION: Recommend the Board approve and execute the
resolution setting a hearing date with the Hearings Examiner for Wednesday,
July 25, 2018 to consider public comment on the proposed vacation of a portion of
W Cloquallum Road.
ATTACHMENTS: Engineer's'Report
Resolution — Notice of Intent to Vacate
MASON COUNTY
DEPARTMENT of PUBLIC WORKS
100 W PUBLIC WORKS DRIVE
SHELTON, WASHINGTON 98584
MEMORANDUM
DATE: June 13, 2018
TO: Mason County Hearings Examiner
FROM: Phil Franklin, Right of Way Agent, for John Huestis, PE, Deputy Director/County Engineer
Cc: Loretta Swanson, Technical Services Manager
SUBJECT: ENGINEER'S REPORT—ROAD VACATION FILE NO. 396
Vacation of a portion of W. Cloquallum Road, County Road #10000
Background:
Mason County Public Works recently completed county road project, (CRP 1916), on W Cloquallum
Road between mile post 5.85 and 6.60. This project included realignment of the road to improve
driving conditions for the traveling public. As a result of the project, there is now a strip of right of way
associated with the old road alignment that is no longer necessary for maintaining W Cloquallum Road.
Public Works proposes to vacate this strip of right of way and turn it back to the underlying property
owner, Green Diamond Resources Company.
Vacating the unused portion of an original right-of-way alignment is common practice in most road
projects unless there is a purpose for retaining (such as the need to maintain a slope) or the property is
very small and of little or no value. In this case, Public Works has determined the following:
1. The road is presently in use by the public but not located within the proposed vacation area.
2. The proposed vacation area is not deemed necessary to preserve for the County road system.
3. The selected portion of Cloqullum Road, to be vacated, is a Class A Road and the right-of-way is an
easement. No compensation is required for Class A Roads with the exception of the administrative
costs of the vacation action. In this instance, Public Works is initiating the proposed vacation and will
absorb the cost of vacation.
4. CenturyLink Telecommunications has buried fiber within the proposed vacation area and an easement
is to be reserved in accordance with RCW 36.87.170 in favor of Mason County for any utilities present
in the vacated right-of-way. Both CenturyLink and Green Diamond Resources have been notified of
the proposed vacation and may wish to take additional steps outside the county process to document
utility occupation within this strip of land.
5. The public will benefit by this action as it will clear title, add the vacated area to the tax rolls and
relieve the county of any liability associated with this strip of land.
Public Notice
Public notice is to be provided as required by RCW 36.87.050, both by posting at the site and by
publishing in the county official newspaper.
Page 1 of 2
Recommendation
Public Works recommends the vacation of the portion of old and unused right of way laying north of the
now currently re-aligned W Cloquallum Road and adjacent to Assessor's Parcel #41903-00-01000 that
lays north and northeast of W. Cloquallum Road.
The recommended vacation is subject to an existing easement in favor of Centuryl-ink and in accordance
with RCW 36.87.170, retaining an easement in favor of Mason County for any utilities present in the
vacated right of way.
Hearing Examiner Options
1. Find that this vacation meets the standards established by state law and recommend the vacation be
granted as petitioned and/or as recommended by the County Engineer.
2. Find that this vacation fails to meet the standards established by state law and recommend the
vacation be denied.
3. Finding that only part of the vacation as petitioned or recommended by the County Engineer complies
with the law, develop recommendations to grant the compliant portion and deny the other.
Attachments:
• Exhibit A- Legal Description
• Exhibit 131 and B2 Plans of Road Project showing area to be vacated
• Exhibit C Aerial picture showing old right of way to be vacated
Page 2 of 2
EXIIIBIT A
All that portion of Bargain and Sale Deed granted to Simpson Resource Company recorded
June 28, 2002 under Auditors File No. 1758700,being a portion of the North half of Section 3,
To,,vriship 19 North, Range 4 West, W.M., Mason County Washington, excepting therefrom the
Southeast quarter of the Northeast quarter, lying Northerly and Easterly of the following
described line:
BEGINNING at a point shown as new Right- of-Way on the official map of Cloquallum Road,
County Road Project No. 1916, on file in the office of the Mason County Engineer,Mason
County, Washington,said point being radial to Engineers Station 26+00 and 80.00 feet left;
thence westerly to a point radial to Engineers Station 26+00 and 45.00 feet left said point being
on curve to the left; thence Northwesterly along the arc of said curve to the left having a radius
of 880.00 feet and a central angle of 6° 51' 45"a distance of 105.40 feet to a point radial to
Engineers Station 25+00 and 45.00 feet left;thence Easterly 5.00 feet to a point radial to
_ Engineers Station 25+00 and 50.00 feet left, said point being on a curve to the left; thence
Northwesterly along the arc of said curve to the left having a radius of 885.00 feet and a central
angle of 12°00' 34"a distance of 185.50 feet to a point radial to Engineers Station 23+25 and
50.00 feet left; thence Northeasterly 20.00 feet to a point radial to Engineers Station 23+25 and
70.00 feet left, said point being on a curve to the left; thence Northwesterly along the arc of said
curve to the left having a radius of 905.00 feet and a central angle of 27° 06' 32" a distance of
428.19 feet to a point radial to Engineers Station 19+30 and 70.00 feet left;thence Southwesterly
20.00 feet to a point radial to Engineers Station 19+30 and 50.00 feet left, said point being on a
curve to the left; thence Northwesterly along the arc of said curve to the left having a radius of
885.00 feet and a central angle of 12° 52' 49"a distance of 198.95 feet to a point radial to
Engineers Station 17+42.63 and 50.00 feet left and the West line of the Northwest Quarter of
Section 3; thence Northerly along the West line of the Northwest Quarter of Section 3 to the
existing Right-of Way as shown on said official map of Cloquallum Road, County Road Project
No. 1916, on file in the office of the mason County Engineer, Mason County, Washington.
BASIS OF BEARING -!00)70A,* 4, RONV���P A9 Nd/4'7t/, fr'ANGF 4 AF,5'.%^ Air%
uwcroN slMrt n.w[cauwurt snT[u swa:aK.wo u(mil[racx 4,
()a�O.caool Tlou nnaw.voslnavrt srsrtu z[wulc.Ic asTw.cs slorw ux ouc. � H J
EXHIBIT B PAGE#1 I`
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right of way to be vacated
LEGEND
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OWNERSHIP rNrn nw)ov v.r Tur.avec --____- [aq�wa rnrxo}r�u.c.r �,n rrtu rx�
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Scale 1' = 100' womMs_Mcvw n u r )su-laaw-aoa loo n[ .a >.s. s--t-i-s-r-1 srcnw [>nnuc u.[wr
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w� mer _ _ zevlsio)a ase[ z. .—••'- /�:ni 1 MASON COUNTY PUBLIC WORKS »fes"') COUNTY L>444."ROAD NO.1RIGHT OF WAY
Ff'
COUNTY ENGINEER 100 WEST PUBLIC WORKS DRIVE - 1 r
-1 CLOQUALLUM S.BS-6.60
_ I SHELTON,WASHINGTON 98587
Sa' (360)127-9670 COUNTY ROAD PROJECT Y 1916 ROAD REALIGNMENI �'
�Asls or eEAell,c S 6'.77ON .�, TOlat9l�SI)OP 19 NOW RANEE' 4 #FST O.W..
O.sr^n:r..uK cOWri«.i[S,STri 54r n•ICn[,n el(xo�l[YUN
(xo�o.wml`ao.awx rovna«w s,s..a[uaw we usrsrc[s..om.x[uo.
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100 WEST PUBLIC WORKS DRIVE s
COUNTY ENGINEER 'r1 1 `` CLOQUALLUM 5.85-6.E0
' SHELTON,WASHINGTON 985Bs i
(360)477-9670 COUNTY ROAD PROJECT 7 1916 1 ROAD REALIGNMENT
3
Mason County SVA GIS Pa-e 1 of 1
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RESOLUTION NO.
VACATION FILE NO.396
NOTICE OF INTENT TO VACATE
SETTING TIME AND PLACE FOR HEARING ON SAID VACATION
RCW 36.87
IN THE MATTER OF THE VACATION OF A PORTION OF W CLOQUALLUM ROAD
WHEREAS, NOTICE IS HEREBY GIVEN that the Mason County Public Works
Department is requesting for the vacation of the following right of way:
A portion of the old right-of-way located along W. Cloquallum Road. The right of way to be
vacated is located North and East of the newly relocated Cloquallum Road between Milepost
6.30 and 6.46 along Assessor's Parcel #41903-00-01000 which is described in the brief legal
as, N '/z Section EX. SE '/, in Township 19 Section 3 Range 4 WWM.
WHEREAS, the Board of Mason County Commissioners did set a date for public
hearing on the matter before the Hearing Examiner on the matter and directed Public Works to
prepare notice thereof for posting and publication.
NOW THEREFORE, BE IT RESOLVED that said hearing has been set for
Wednesday, July 25, 2018 at 1:00 p.m. in the Commission Chambers, Mason County
Courthouse Building I, 411 North Fifth Street, Shelton, Washington, at which time and place
any taxpayer may appear to hear the County Engineer's report, and be heard either for or
against the vacation of said portion of W. Cloquallum Road.
DATED this day of 2018.
BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
ATTEST:
Melissa Drewry, Clerk of the Board Randy Neatherlin, Chair
APPROVED AS TO FORM:
Terri Drexler, Vice Commissioner
Tim Whitehead, Ch. DPA
Assessor
Auditor Kevin Shutty, Commissioner
County Engineer
Petitioner
Post no later than 7/5/18 (20 days prior to hearing at
each terminus of the county road or portion thereof
proposed to be vacated or abandoned.)
Vacation File No. 396
JOURNAL—Publish 2t: 7/5/18—7/12/18
(Bill Public Works)
MASON COUNTY
. AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Dave Windom // Todd Parker Action Agenda _X_
Public Hearing
Other
DEPARTMENT: Community Services EXT:
COMMISSION MEETING DATE: June 26, 2018 Agenda Item # �, 2
(Commissioner staff to
complete)
BRIEFING DATE: June 5, 2018
BRIEFING PRESENTED BY: Todd Parker
[] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency:
ITEM:
Funding awards from the Local Document Recording fees to housing and
homelessness programs.
• Background:
A Request for Proposal process resulted in the following award amounts for housing &
homeless services from the local 2163 & 2060 document recording fees:
2060 2163 Agency Program(s)
49,500 Turning Pointe DV Shelter
50,000 63 705 Community Lifeline Adult Shelter
Family Shelter, Transitional
179,670 Crossroads Housing Housing, Coordinated Entry,
and Rapid Rehousing
33,000 North Mason Resources Coordinated Entry— North
Mason
43,000 HOST Youth Transitional Housing
50,000 368 875 TOTAL
RECOMMENDED ACTION:
Approval to award $418,875 from the Local Document Recording fees and
enter jnto contracts for a one-year term with a start date of July 1, 2018.
Attachment(s):
• Contract cover page. Additional documents available upon request.
I:\Community Services-Public Health\PH_06.26.18 Action Agenda CONTRACTS housing TST.doc
MASON COUNTY
PROFESSIONAL SERVICES CONTRACT
CONTRACT # CL-2018.2
THIS CONTRACT is made and entered into by and between Mason County, hereinafter referred to as
"COUNTY" and Community Lifeline, hereinafter referred to as"CONTRACTOR."
Contracted Entity Community Lifeline
Address 218 N. 3rd St. /P.O. Box 698
City, State, Zip Code Shelton, WA 98584
Phone 360-490-3430
Primary Contact Name, Title Barb Weza
Primary Contact Phone & E-mail 360-490-3430; gweza@aol.com
Contractor Fiscal Contact same
Contractor Fiscal Phone & Email same
Washington State UBI# 603-364-370
Federal EIN 46-4731341
Total Award/Contract Value $113,705
2163 Funds Awarded $63,705
2060 Funds Awarded $50,000
CHG Funds Awarded none
HEN Funds Awarded none
Contract Term Duration July 1, 2018-June 30, 2019
County Contract Contact Lydia Buchheit, Community Health Manager
County Contract Email & Phone L diab co.mason.wa.us 360-427-9670 ext 404
• County Fiscal Contact Casey Bingham, Fiscal Manager Count se b Fiscal Email & Phone Caco.mason.wa.us 360-427-9670 ext. 562
PURPOSE
The purpose of this contract/grant is to assist the COUNTY to meet its requirement to reduce
homelessness pursuant to the Revised Code of Washington and according to the Mason County
Homeless Plan.
COUNTY and CONTRACTOR, as defined above, acknowledge and accept the terms of this contract
and EXHIBITS and have executed this contract on the date below to start as of the date and year
referenced above. The rights and obligations of both parties to this contract are governed by this
contract including Special Conditions, General Terms and Conditions, Exhibits, and the following
other documents incorporated by reference: Housing RFP Application, instructions and disclosures.
CONTRACTOR BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
Agency Name
Randy Neatherlin, Chair
Aythorize Signature Date
APPROVED AS TO FORM:
Print Name &Title
• Tim Whitehead, Chief DPA
Date
Professional Services Contract(rev 05/2018) Page 1
MASON COUNTY
PROFESSIONAL SERVICES CONTRACT
CONTRACT# CH-2018.4
THIS CONTRACT is made and entered into by and between Mason County, hereinafter referred to as
"COUNTY" and Crossroads Housing, hereinafter referred to as"CONTRACTOR."
Contracted Entity Crossroads Housing
Address 71 Sar ison Loo /P.O. Box 1777
City, State, Zip Code Shelton,WA 98584
Phone 360-427-6919
Primary Contact Name, Title Lynn Lon an
Primary Contact Phone& E-mail 360-427-6919; exdirector hcc.net
Contractor Fiscal Contact Carolyn Malanowski
Contractor Fiscal Phone & Email 360-427-9670; csk@hcc.net
Washington State UBI# 601399556
Federal EIN 91-1569401
Total Award/Contract Value $364,674
2163 Funds Awarded $179,670
2060 Funds Awarded none
CHG Funds Awarded $147,504
TST Funds Awarded $37,500
Contract Term Duration July 1, 2018-June 30, 2019
County Contract Contact Lydia Buchheit, Community Health Manager
Count Contract Email & Phone L diab co.mason.wa.us 360-427-9670 ext 404
.
County Fiscal Contact Casey Bingham, Fiscal Manager
County Fiscal Email & Phone Case b co.mason.wa.us 360-427-9670 ext. 562
PURPOSE
The purpose of this contract/grant is to assist the COUNTY to meet its requirement to reduce
homelessness pursuant to the Revised Code of Washington and according to the Mason County
Homeless Plan.
COUNTY and CONTRACTOR, as defined above, acknowledge and accept the terms of this contract
and EXHIBITS and have executed this contract on the date below to start as of the date and year
referenced above. The rights and obligations of both parties to this contract are governed by this
contract including Special Conditions, General Terms and Conditions, Exhibits, and the following
other documents incorporated by reference: Housing RFP Application, instructions and disclosures.
CONTRACTOR BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
Agency Name
Randy Neatherlin, Chair
Authorize Signature Date
APPROVED AS TO FORM:
Print Name &Title
• Tim Whitehead, Chief DPA
Date
Professional Services Contract(rev 05/2018) Page 1
s.
MASON COUNTY
PROFESSIONAL SERVICES CONTRACT
CONTRACT # HOST-2018.1
THIS CONTRACT is made and entered into by and between Mason County, hereinafter referred to as
"COUNTY" and HOST, hereinafter referred to as"CONTRACTOR."
Contracted Entity Housing Options for Students in Transition HOST
Address 807 W.Pine St
City, State, Zip Code Shelton, WA 98584
Phone 360-426-7664 ext. 17012
Primary Contact Name, Title Kimberly Rinehardt
Primary Contact Phone & E-mail 360-426-7664; masoncountyhost@gmail.com
Contractor Fiscal Contact Nancy Kissner; nancy@vanderwegencpa.com
Contractor Fiscal Phone & Email 360-426-1681
Washington State UBI# 603535010 001 0001
Federal EIN 47-5160205
Total Award/Contract Value $43,000
2163 Funds Awarded $43,000
2060 Funds Awarded none
CHG Funds Awarded none
HEN Funds Awarded none
Contract Term Duration July 1, 2018-June 30, 2019
County Contract Contact Lydia Buchheit, Community Health Manager
County Contract Email & Phone L diab co.mason.wa.us 360-427-9670 ext 404
County Fiscal Contact Casey Bingham, Fiscal Manager
•
County Fiscal Email & Phone Case b co.mason.wa.us 360-427-9670 ext. 562
PURPOSE
The purpose of this contract/grant is to assist the COUNTY to meet its requirement to reduce
homelessness pursuant to the Revised Code of Washington and according to the Mason County
Homeless Plan.
COUNTY and CONTRACTOR, as defined above, acknowledge and accept the terms of this contract
and EXHIBITS and have executed this contract on the date below to start as of the date and year
referenced above. The rights and obligations of both parties to this contract are governed by this
contract including Special Conditions, General Terms and Conditions, Exhibits, and the following
other documents incorporated by reference: Housing RFP Application, instructions and disclosures.
CONTRACTOR BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
Agency Name
Randy Neatherlin, Chair
Authorize Signature Date
APPROVED AS TO FORM:
Print Name & Title
Tim Whitehead, Chief DPA
Date
Professional Services Contract (rev 05/2018) Page 1
MASON COUNTY
• PROFESSIONAL SERVICES CONTRACT
CONTRACT# NMR-2018.1
THIS CONTRACT is made and entered into by and between Mason County, hereinafter referred to as
"COUNTY" and North Mason Resources, hereinafter referred to as"CONTRACTOR."
Contracted Entity North Mason Resources
Address 140 NE State Route 300/ P.O. Box 2052
City, State, Zip Code Belfair, WA 98528
Phone 360-552-2303
Primary Contact Name, Title Steve Abels
Primary Contact Phone & E-mail 360-552-2303; director nmresources.or
Contractor Fiscal Contact Same
Contractor Fiscal Phone & Email same
Washington State UBI# 602978279
Federal EIN 27-1532961
Total Award/Contract Value $33,000
2163 Funds Awarded $33,000
2060 Funds Awarded none
CHG Funds Awarded none
HEN Funds Awarded none
Contract Term Duration July 1, 2018-June 30, 2019
County Contract Contact Lydia Buchheit, Community Health Manager
County Contract Email & Phone L diab co.mason.wa.us 360-427-9670 ext 404
County Fiscal Contact Casey Bingham, Fiscal Manager
•
County Fiscal Email & Phone Case b co.mason.wa.us 360-427-9670 ext. 562
PURPOSE
The purpose of this contract/grant is to assist the COUNTY to meet its requirement to reduce
homelessness pursuant to the Revised Code of Washington and according to the Mason County
Homeless Plan.
COUNTY and CONTRACTOR, as defined above, acknowledge and accept the terms of this contract
and EXHIBITS and have executed this contract on the date below to start as of the date and year
referenced above. The rights and obligations of both parties to this contract are governed by this
contract including Special Conditions, General Terms and Conditions, Exhibits, and the following
other documents incorporated by reference: Housing RFP Application, instructions and disclosures.
CONTRACTOR BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
Agency Name
Randy Neatherlin, Chair
Authorize Signature Date
APPROVED AS TO FORM:
Print Name &Title
Tim Whitehead, Chief DPA
Date
Professional Services Contract (rev 05/2018) Page 1
MASON COUNTY
• PROFESSIONAL SERVICES CONTRACT
CONTRACT# TPSA-2018.2
THIS CONTRACT is made and entered into by and between Mason County, hereinafter referred to as
"COUNTY" and Turning Pointe Survivor Advocacy Center, hereinafter referred to as
"CONTRACTOR."
Contracted Entity Turning Pointe Survivor Advocacy Center
Address 210 Pacific Court/ P.O. Box 2014
City, State, Zip Code Shelton, WA 98584
Phone 360-426-1216
Primary Contact Name, Title Rachel Elam
Prima Contact Phone& E-mail 360-426-1216; relam westoffice.net
Contractor Fiscal Contact Marsha Kershaw
Contractor Fiscal Phone & Email 360-426-1216; mkershaw westoffice.net
Washin ton State UBI# 602-012-811
Federal FIN 91-2024833
Total Award/Contract Value $49,500
2163 Funds Awarded $49,500
2060 Funds Awarded none
CHG Funds Awarded none
HEN Funds Awarded none
Contract Term Duration July 1, 2018-June 30, 2019
County Contract Contact Lydia Buchheit, Community Health Manager
County Contract Email & Phone L diab co.mason.wa.us 360-427-9670 ext 404
•
County Fiscal Contact Casey Bingham, Fiscal Manager
County Fiscal Email & Phone Case b co.mason.wa.us 360-427-9670 ext. 562
PURPOSE
The purpose of this contract/grant is to assist the COUNTY to meet its requirement to reduce
homelessness pursuant to the Revised Code of Washington and according to the Mason County
Homeless Plan.
COUNTY and CONTRACTOR, as defined above, acknowledge and accept the terms of this contract
and EXHIBITS and have executed this contract on the date below to start as of the date and year
referenced above. The rights and obligations of both parties to this contract are governed by this
contract including Special Conditions, General Terms and Conditions, Exhibits, and the following
other documents incorporated by reference: Housing RFP Application, instructions and disclosures.
CONTRACTOR BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
Agency Name
Randy Neatherlin, Chair
Authorize Signature Date
APPROVED AS TO FORM:
Print Name &Title
Tim Whitehead Chief DPA
Date
k Professional Services Contract(rev 05/2018) Page 1
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Jim Madsen Action Agenda _X_
Public Hearing
Other
DEPARTMENT: Juvenile Court Services EXT: 332
DATE: 6/26/18 Agenda Item # g 3
Commissioner staff to complete)
BRIEFING DATE: 6/18/18
BRIEFING PRESENTED BY: Jim Madsen
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM: Juvenile Detention Alternatives Initiative (JDAI) grant contract 2018-2019
Background: The Juvenile Detention Alternatives Initiative is a nationwide effort
created by the Annie E. Casey Foundation to reduce the use of detention and increase
the use of more effective interventions. Mason County has been a JDAI site since 2009
and receives a yearly grant to help support the efforts. These grant funds enable the
county to provide staff support and create and implement alternative programming in
lieu of detention. There are no matching funds requirements for this grant.
RECOMMENDED ACTION:
Approval to: Approve and sign the Juvenile Detention Alternatives Initiative Grant
Application for 2018-2019 in the amount of $24,500.
Attachment(s): Juvenile Detention Alternatives Initiative Grant Application Contract
Number I-501-00812
OFFICE OF JUVENILE JUSTICE(OJJ) CONTRACT NUMBER FOR OJJ USE ONLY
/11 V&`P'armeS�m�«"I Juvenile Detention Alternatives I-501-00812 DATE STAMP
healthTrans/orminglives Initiative Grant Application
Please read all instructions carefully. PROGRAM AREA
For assistance,contact the Department of Social and Health Services
(DSHS)Office of Juvenile Justice at(360)902-7526 or FAX(360)902-7527
1. APPLICANT: DO NOT USE PERSON'S NAME
AGENCY NAME TELEPHONE NUMBER FAX NUMBER
Mason County Juvenile Court Services 360-427-9670 360-427-7785
STREET ADDRESS CITY STATE ZIP CODE
426 W. Cedar Street Shelton WA 98584
MAILING ADDRESS CITY STATE ZIP CODE
PO BOX 368 Shelton WA 98584
2. IMPLEMENTING AGENCY: ENTER AGENCY,DEPARTMENT OR CONTRACTOR DIRECTLY IMPLEMENTING THE PROJECT(DO NOT USE PERSON'S NAME)
NAME TELEPHONE NUMBER
Mason County Juvenile Court Services 360-427-9670
STREET ADDRESS FEDERAL EMPLOYER IDENTIFICAITON NUMBER OR
426 W. Cedar Street SOCIAL SECUIRTY NUMBER(MANDATORY FOR
CITY STATE ZIP CODE FEDERAL TAX PURPOSES)
Shelton WA 98584 91-60013554
3. PROJECT TITLE: ENTER BRIEF,DESCRIPTIVE PROJECT TITLE(LIMITED TO THREE LINES)
JDAI Implementation Plan in Mason County,WA
4. APPLICANT'S AGREEMENT
The applicant is applying for a grant award in the amount shown in the proposed BUDGET SUMMARY(Section 8 of this application)for the purposes
identified in this application. By signing and submitting this application,the applicant agrees that this document,together with the GENERAL TERMS
AND CONDITIONS AND CERTIFICATIONS(Attachment A of this application),becomes an offer to contract with Washington State Department of
Social and Health Services(DSHS or the Department)which, if accepted,binds the applicant to the following:
The applicant agrees that this offer becomes a binding contract when a copy of this page is signed by the OJJ Director and returned to the applicant
together with an Approved Budget and Special Conditions form provided, however:
In the event any budget category amount differs from the amount shown in Section 8 of this application,as modified by the Approved budget and
Special Conditions,that amount shall be considered to be a counteroffer. The Department shall consider the counteroffer accepted by the applicant
unless rejected in writing within 30 days after the date of mailing of such counteroffer by the Office of Juvenile Justice(hereinafter referred to as OJJ)
to the applicant
b. Upon acceptance of this offer/counteroffer,the applicant shall be referred to as the"Contractor"and the Contractor agrees to accept and abide by
the special terms and conditions.
NAME AND TITLE OF AUTHORIZED OFFICER(PERSON WITH LEGAL AUTHORITY: COUNTY COMMISSIONERS'CHAIRMAN OF THE BOARD,MAYOR,CITY/TOWN
MANAGER,AGENCY DIRECTOR)
Mason County Commissioners
APPLICANT'S SIGNATURE DATE
ACCEPTANCE OF OFFER COUNTEROFFER FOR DSHS OJJ CONTRACTING OFFICER'S SIGNATURE DATE
❑Acceptance ❑ Non-acceptance
5. PROJECT DIRECTOR: PERSON INDIRECT CHARGE OF PROJECT(DAY-TO-DAY OPERATIONS AND PREPARATION OF REQUIRED PROGRESS REPORTS)
NAME TELEPHONE NUMBER
Jim Madsen 360-427-9670 ext. 332
STREET ADDRESS FAX NUMBER
426 W. Cedar Street 360-427-7785
CITY STATE ZIP CODE E-MAIL ADDRESS
Shelton WA 98584 'amesma co.mason.wa.us
6. FINANCIAL OFFICER: PERSON IN CHARGE OF FISCAL MATTERS(ACCOUNTING,FUNDS MANAGEMENT,EXPENDITURE,VERIFICATIONS,FINANCIAL
REPORTS
NAME TELEPHONE NUMBER
Paula Thale 360-427-9670 ext.338
STREETADDRESS FAX NUMBER
426 e. Cedar Street 360-427-7785
CITY STATE ZIP CODE E-MAIL ADDRESS
Shelton WA 98584 1 paulatgco.mason.wa.us
Omission of any required information or certification may be cause for denial of the application. The Department shall take a final approval/disapproval
ction on all applications within 90 days of receipt by the Department of a conforming application,together with all required certifications. The
)epartment shall not consider an application conforming unless the applicant has completed all items in accordance with instructions and has submitted
the necessary certifications. The applicant must submit two signed completed applications to: OFFICE OF JUVENILE JUSTICE, DEPARTMENT OF
SOCIAL AND HEALTH SERVICES,PO BOX 45828,OLYMPIA WA 98504-5828.
DSHS 05-180C(REV.05/2018) Page 1
JDAI GRANT APPLICATION
AGENCY NAME DATE
Mason County Juvenile Court Services 06/07/2018
PROJECT TITLE
DAI
PROJECT PERIOD
A project period is one year and may not exceed one year except by prior agreement with the Department.
Proposed project period is from July 1,2018 to June 30,2019
8. BUDGET SUMMARY
The proposed project budget is shown below. If the proposal is accepted for contracting,the budget on the Approved Budget and Special Conditions
form supersedes the proposed budget shown below.
The following items are allowable costs under this contract:
• Travel(JDAI Quarterly Meetings,State and National Conferences,Model Site Visits)
• Local Coordination to implement the eight(8)JDAI strategies
• Detention Alternatives Programs
• Data Collection and Analysis
• Indirect(up to 10%of direct charges), as noted below.
BUDGET CATEGORIES A. Personnel $18,000
Enter the category totals from Section 10. B. Supplies $500
BUDGET DETAILS. The sum of categories A-
F is entered as TOTAL DIRECT CHARGES. If C. Other services and charges $1,500
indirect costs are claimed,enter the amount in
G. These may not exceed ten(10)percent of D. Capital outlay/equipment $500
the TOTAL DIRECT CHARGES. Add TOTAL
DIRECT CHARGES and INDIRECT CHARGES, E. Travel $3,200
and enter the sum on TOTAL PROJECT
COSTS line. F. Contractual services $800
TOTAL DIRECT CHARGES
G. Indirect charges
TOTAL PROJECT COST $24,500
OURCE OF FUNDS 1. Federal %
1.May not exceed amount approved by the 2. Match %
Washington State Partnership Council on
Juvenile Justice.
2.Must be funds specifically appropriated for aha
project in applicant's budget
Project income must be applied to project
operational costs or deducted from the grant
award. It is important that all anticipated
project income be included in the budget.
TOTAL PROJECT FUNDS %
9. PROJECT SUMMARY: GIVE A BRIEF NARRATIVE SUMMARY OF THE PROJECT.
Mason County Juvenile Court Services has opened our completed Intervention Center space and begun using the space for
alternative to detention programming.During this grant cycle it is our goal to build upon this success and grow our
alternatives.We also plan to focus in on what we really are using our secure for detention facility for and if we can better serve
the youth being sentinced to detention in our Intervention Center. We plan to develop a data informed sanctions grid to
reduce disparities and implent a tiered warrant system to reduce unnecessary warrant arrests.
DSHS 05-180C(REV.05/2018) Page 2
JDAI GRANT APPLICATION
AGENCY NAME DATE
Mason County Juvenile Court 06/07/2018
DROJECT TITLE
DAI
10. BUDGET DETAILS: CATEGORY A. PERSONNEL
This category is for services rendered by all personnel employed by the project. Costs incurred include salaries,benefits, uniforms,and special clothing.
SALARIES AND WAGES: Payment for personal services rendered in accordance with rates, hours,terms and conditions as authorized by law or
stated in employment contracts.
OVERTIME,HAZARDOUS DUTY, ETC.
PERSONAL BENEFITS: FICA,retirements,insurance,etc.
UNIFORMS AND CLOTHING: Only uniforms for special clothing required by the nature of the employment and paid for by the employer may be listed.
NOTE: Project funds may not be used to pay a percentage of the compensation of any person who was employed by the implementing agency before
the project starting date without prior specific authorization from the Department separate from the grant approval. Specific authorization is not required
if a person currently employed by the applicant or the implementing agency is transferred from his/her prior position to the project if the transfer creates a
personnel vacancy to be filled by hiring a new employee.
PERCENT OF
LIST POSITION TITLES ANNUAL SALARY TIME TO ITEM TOTAL
PROJECT
Program Support Specialist 22.5% $18,000
%
%
%
CATEGORY TOTAL % $18,000
JUSTIFICATION AND EXPLANATION: Justify all positions in terms of days and/or hours required to perform the GOALS,OBJECTIVES,AND TASKS
set forth. Calculate fringe benefits for each position or class of positions.
Salary and benefits for approximately 22.5% of the Program Supports Specialist position. Position is used to collect and
analyze data as well as provide detention alternative programming in the Intervention Center.
DSHS 05-180C(REV.05/2018) Page 3
JDAI GRANT APPLICATION
AGENCY NAME DATE
Mason County Juvenile Court 06/07/2018
PROJECT TITLE
IDAI
10. BUDGET DETAILS: CATEGORY B. SUPPLIES
This category is for articles and commodities which are consumed or materially altered when used. The following are types of supplies.
OFFICE SUPPLIES: For example, office stationery,forms,small items of equipment, and maps,films,books,periodicals,and tapes.
OPERATING SUPPLIES: For example,chemicals,drugs,medicines, laboratory supplies,cleaning and sanitation supplies,fuel, household and
institutional supplies,and clothing. Food for Steering Committee meetings is permitted as outlined under 8.Budget Summary on Page 2.
REPAIR AND MAINTENANCE SUPPLIES: For example,building materials and supplies,paints and painting supplies,plumbing supplies,electrical
supplies,motor vehicle repair materials and supplies,other repair and maintenance supplies,and small tools.
ITEMIZED LISTING DESCRIPTION OF THE ITEM UNIT UNIT COST ITEM TOTAL
Office and Operating Supplies $500
CATEGORY TOTAL $500
10. BUDGET DETAILS: CATEGORY C. OTHER SERVICES AND CHARGES
ibis category is for services other than PERSONNEL which are required in the administration of the project. Such services may be provided by some
agency of the government unit or by private business organizations. The following are types of services and charges classified under this category.
COMMUNICATION: For example,telephone,telegraph, and postage.
TRANSPORTATION: For example,freight and express charges, and messenger service.
ADVERTISING
PUBLIC UTILITY SERVICE
PRINTING AND BINDING
REPAIRS AND MAINTENANCE
INSURANCE
RENTALS: For example,buildings,and equipment and machinery.
MISCELLANEOUS: For example,tuition and other training fees,dues,subscriptions and memberships,and taxes.
ITEMIZED LISTING UNIT UNIT COST ITEM TOTAL
ORD OR WORDS DESCRIBING THE COST ITEM, I.E.,POSTAGE
Copier $100
Equipment Revolving Rental(ER&R)Vehicle Lease $200
Cell Phone 12 $60 $720
Case Load Pro software rental 12 40 $480
CATEGORY TOTAL $1,500
DSHS 05-180C(REV.05/2018) Page 4
JDAI GRANT APPLICATION
AGENCY NAME DATE
Mason County Juvenile Court 06/07/2018
PROJECT TITLE
IDAI
10. BUDGET DETAILS: CATEGORY D. CAPITAL OUTLAY/EQUIPMENT
This category is for nonexpendable outlays which result in the acquisition of,rights to,or additions to fixed assets,other than structures. The following
are some of the types of charges under this category. NOTE: Exclude small tools.
MACHINERY AND EQUIPMENT: For example,communications equipment(typewriter,microcomputer),janitorial;laboratory,office furniture and
equipment, heavy duty work equipment, and other machinery and equipment.
ITEMIZED LISTING DESCRIBE THE COST ITEM UNIT UNIT COST ITEM TOTAL
Office furniture and equipment $500
CATEGORY TOTAL $500
10. BUDGET DETAILS: CATEGORY E. TRAVEL
Travel costs are for domestic travel. Contractors may follow their own established rate for staff travel as long as the rate does not exceed the allowable
state rate.
The allowable state rate for mileage will be used. Airfare should be the lowest coach fare.
ITEMIZED LISTING UNIT UNIT COST ITEM TOTAL
2 staff to National Conference $2,000
1 staff to Fall Coordinator Conference $1,000
Travel to 4 statewide quarterly JDAI meetings $200
CATEGORY TOTAL $3200
DSHS 05-180C(REV.05/2018) Page 5
FDAI GRANT APPLICATION
AGENCY NAME DATE
Mason County Juvenile Court 06/07/2018
PROJECT TITLE
FDAI
10. BUDGET DETAILS: CATEGORY F. CONTRACTUAL SERVICES
The following types of personal services may be contracted:
EVALUATION/RESEARCH
LEGAL
ACCOUNTING
MEDICAL AND HEALTH SERVICES
AUDITING
SOCIAL SERVICES
ITEMIZED LISTING UNIT UNIT COST ITEM TOTAL
Interpreter/Translation services 16 $50 $800
CATEGORY TOTAL $800
10. BUDGET DETAILS: CATEGORY G. INDIRECT CHARGES
Indirect costs may not exceed 10%of the total direct charges. Indirect costs include costs of operating the agency which are not directly attributed to
this project(e.g.,maintaining physical plan,depreciation, receptionist, agency administration salaries,etc.)
ITEMIZED LISTING DESCRIBE THE COST ITEM UNIT UNIT COST ITEM TOTAL
N/A
CATEGORY TOTAL N/A
DSHS 05-180C(REV.05/2018) Page 6
JDAI GRANT APPLICATION
AGENCY NAME DATE
Mason County Juvenile Court 06/07/2018
PROJECT TITLE
MAI
11. STATEMENT OF WORK AND IMPLEMENTATION PLAN
The contractor agrees to perform the following minimum statement of work.
1. Each jurisdiction will have a JDAI Coordinator to participate in monthly Coordinator calls with the State Coordinator.
2. Submit the AECF-JDAI Quarterly Report and annual Results Report, no later than 30 days after the end of each quarter to include:
• Detention Population Report
• Alternative Programs Report
• Detention Referrals Screened Report
• Detention Risk Assessment Instrument Override Report
3. Attend JDAI Quarterly Meetings,State and National JDAI Conferences(as held/applicable).
4. Conduct regular Stakeholder or Steering Committee meetings each year.
5. Conduct a Detention Self-Inspection as identified by the Local and State JDAI Coordinator or as directed by local management.
6. Submit quarterly progress and financial reports to the Office of Juvenile Justice on reporting forms provided by OJJ.
7. Submit a Racial and Ethnic Disparities Reduction Plan to include local data identifying the target population,objectives regarding specific changes
to policy and practice with identified outcomes,and any technical assistance needed in order to implement proposed objectives. A Racial and
Ethnic Disparities Reduction Plan template will be provided for sites to use at their discretion.
Attach the County JDAI Implementation Plan to include a minimum of three (3)goals for the contract period July 1,2018 through June 30,2019. It is
expected that implementation plans will include objectives,strategies,and tasks targeted at achieving the identified goals as well as the timeframe and
responsible party for completion of the tasks. Please also identify which of the eight(8)Core Strategies is being addressed within each goal. An
Implementation Plan Template will be provided for sites to use at their discretion.
Attached
DSHS 05-180C(REV.05/2018) Page 7
Racial and Ethnic Disparities Reduction Plan
Fiscal Year: 2018-2019
County: Mason
Total Admissions to Detention
2015 2016 2017
American Indian or Alaska Native 13 29 7
Asian 0 3 4
Black or African American 3 6 2
Hispanic 18 21 6
White 137 97 61
Unknown/Other 0 0 0
Total 171 157 80
Population Totals for Ages 10 — 17 Years
2015 2016 2017
American Indian or Alaska Native 265 302
Asian 115 125
Black or African American 92 114
Hispanic 668 852
White 3539 4086
Unknown/Other 0 0
Total 4575 5479
Rates of Admission
2015 2016 2017
American Indian or Alaska Native 49.05 96.20 23.17
Asian 0 24 32
Black or African American 32.60 52.63 17.54
Hispanic 26.94 24.64 7.04
White 38.71 22.27 14.68
Unknown/Other 0 0 0
Total
Top Demographic Group(s) to Focus Efforts Towards: Native American and Black or
African American.
Top Offense Reasons Resulting in Detention for Identified Group(s)
2015 2016 2017
Ex: Native American PV: Runaway(55) DV Assaults (43) DV Assaults(35)
DV Assaults(23) PV:Truancy(22) PV:Truancy(32)
Black or African FTA Warrant (1) New Charge (2) Probation Violation: (2)
American Civil (1) FTA Warrant(2)
Court Ordered (1) NFTA (4)
Native American FTA Warrant(5) Probation Violation (15) New Charge (2)
NFTA(5) FTA Warrant (5) Court Ordered (3)
New Charge (7) NFTA (4) Probation Violation (1)
NFTA (1)
List Policies that Govern Detention Admission for Top Offense Reasons
Lack of sanction grid and current warrant system.
Racial Impact Assessments to be conducted on all identified policies by
November 1st, 2018.
Amended Racial and Ethnic Disparities Reduction Plans due by January 1st, 2019
are to include:
• Steps to make policy and practice changes in response to completed
Racial Impact Assessments
• Deadlines identified for when changes are to be fully implemented
• Resource or Technical Assistance needs to be identified
MASON COUNTY IMPLEMENTATION PLAN
2018-2019 Grant Cycle
GOAL 1: Creation and Implementation of Sanction Grid
OBJECTIVE STRATEGY TASK TIMELINE RESP. PARTY RESP. CORE
COMMITTEE STRATEGY/ELEMENT
Create and implement a Reducing Racial
Begin by learning about what
sanctions grid that Work with administration and Disparities
other counties use as their Jim Madsen
appropriately responds to risk probation staff to develop a grid Alternatives To Detention
grid.Then building that out Spring 2019 Madison Larsen
level and safety concerns, that everyone agrees upon and Special Detention Cases
retains accountability and that best serves our population. to utilize alternatives and Mike Dunn Use of Accurate Data
reduces disparity. services we have locally. Collaboration
GOAL 2: Create and Implement a Tiered Warrant System
RESP. CORE
OBJECTIVE STRATEGY TASK TIMELINE RESP. PARTY
COMMITTEE STRATEGY/ELEMENT
Reduce the amount of
Work with local law enforcement Begin by convening a team Jim Madsen Alternatives to Detention
warrant arrests and bookings
and court administration to of key stakeholders to share Summer Madison Larsen Special Detention Cases
into detention. develop tiered warrant system data and the benefits of a 2018 Mike Dunn Use of Accurate Data
and procedures. tiered warrant system. Collaboration
GOAL 3: Full Implementation of Intervention Center
RESP. CORE
OBJECTIVE STRATEGY TASK TIMELINE RESP. PARTY
COMMITTEE STRATEGY/ELEMENT
Full use of the intervention Present current alternative Summer Jim Madsen Alternatives to Detention
center and alternative Implement alternatives into our options to stakeholders and 2018— Madison Larsen Special Detention Cases
programming. sanction grid development. brainstorm future needs. Spring 2019 Mike Dunn Use of Accurate Data
Collaboration
1 Modified 513112018
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Casey Bingham Acticn Agenda X
Public Hearing
Other
DEPARTMENT: Public !health EXT: 583
COMMISSION MEETING DATE: 6/2612016 .Agenda Item #
Commissioner staff to cdm lets
BRXEFIN(-j DATE: 6/18/18
BRIEFING PRESENTED BY. Casey Bingham
ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
P3 as8 provide explariation sof urgency
ITEM: Approval of state &r'V'jas6 ington Health Care ,Authority (HCA Access
to Baby and Child Dentistry (ABCD) contract K2751.
Background: This contract provides funding to perform functions in the Access to
Baby & Child Dentistry (ABCD)program. Some of these functions are: Providing
Family Orientation to the Program, Connecting enrolled families with qualified and -
ABCD certified dentist, addressing family barriers to accessing oral health care. This µ
contract is to for 7/1/2018 to 6/60/2018 and is for$38,200.
BUDGET IMPACT: This has been budgeted for the 2018 budget
RECOMMENDED ACTION: Approve Contract K2751 between Mason County and
Health Care Authority
Attachment(s): Contract K2751
t'-
PROFESSIONAL SERVICES HCA Contract Number: K2751
CON
Washington State k- u
Y $oACT
Health Care thOrit ASCD DENTAL SERVICES Contractor/Vendor Contract Number:
Mason County
THIS CONTRACT is made by and between Washington State Health Care Authority, (HCA) and the
(Contractor).
CONTRACTOR NAME CONTRACTOR DOING BUSINESS AS (DBAI
Mason County Public Health
CONTRACTOR ADDRESS I Street City State Zip Code
P O BOX 1666, SHELTON,WA 98564
CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS
Lydia Buchheit 360-427-9670x545 lydiab@co.mason.wa.us
Is Contractor a Subrecioient under this Contract? CFDA NUMBER(S): FFATA Form Reauired
[]YES ®NO 93.778 ®YES ❑NO
HCA PROGRAM HCA DIVISION/SECTION
ABCD Dental Program Clinical Quality and Care Transformation (CQCT)
HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESS
Health Care Authority
Janice Tadeo, Dental Program Manager 626 8th Avenue SE
Health Services and Management PO Box 42702
Clinical Quality and Care Transformation (CQCT) Olympia, WA 98504
Health Care Services
HCA CONTACT TELEPHONE HCA CONTACT E-MAIL ADDRESS
(360) 725-1583 Janice.Tadeo(a hca.wa.gov
CONTRACT START DATE CONTRACT END DATE TOTAL MAXIMUM CONTRACT AMOUNT
July 1, 2018 June 30, 2020 $38,200.00
PURPOSE OF CONTRACT:
Provide 'Access to Baby and Child Dentistry' (ABCD) services to detect and prevent early childhood dental decay by
engaging dentists in seeing birth to six (6) year old Medicaid eligible children and engaging local public health
departments in outreach and case management.
The parties signing below warrant that they have read and understand this Contract, and have authority to
execute this Contract. This Contract will be binding on HCA only upon signature by HCA.
CONTRACTOR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
Lydia Buchheit
HCA SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
James W. Gayton
Contracts Administrator
Washington State
Health Care Authority Page 1 of 53 Contract#2751
i
TABLE OF CONTENTS
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........................... 6
Recitals................... .................................
1. STATEMENT OF WORK
SOW) ............. ......................
2. DEFINITIONS..................... . ... .. . .
;. SPECIAL TERMS AND CONDITIONS7
....: ...................7
........................
......
3.1 PERFORMANCE EXPECTATIONS...••••�•••�--•••"•..............................................
8
3.2 TERM....................
.........................
3.3 COMPENSATION...
........................
3.4 INVOICE AND PAYMENT.......................................................
...................
CONTRACTOR and HCA CONTRACT MANAGER .......................
11
3.5 11
3.6 KEY STAFF ... ......... ..
3,7 LEGAL NOTICES...••.. . ORDER OF PRECEDENCE
3.8 INCORPORATION
. ................
. ..............
.......................... .
OF DOCUMENTS AND �•••••---••��'••�•• .......
••••��•----
3.9 INSURANCE
TERMS AND CONDITIONS.......................... ..........................................
4. GENERAL ......13
.........................
.
............................................
...................................
4.1 ACCESS TO DATA.... ............. ,.-14
4.2 ADVANC ................ ...................
.................
14
4.3 AMENDMENTE PAYMENT PROHIBITED����••�•---�•"'••••••
.....
..........
..............................
..................
4,4 ASSIGNMENT
. ................................
..................................
.•��•��••-
.....14
. ..........................
..................................
...........................
..14
4.5 ATTORNEYS FEE .............. . ....................... 15
4.6 CHANGE IN STATUS ..................... . .... .
.............
........................... .
4.7
CONFIDENTIAL INFORMATION PROTECTION
ROUR T ON.................... • ... ................
................15
4 8 CONFIDENTIAL INFORMATION BREACH — REQUIRED NOTIFICATION
4.9 CONFIDENTIAL INFOR 16
CONTRACTOR'S PROPRIETARY INFORMATION
4.10 .......................
17
...........
............................................ ................................
.......................17
4.11 COVENANT AGAINST CONTINGENT FEE ••--•••�---•
...........
4.12 DEBARMENT
............................
.............
. ...............................
4.13 DISPUTES...• • .. . IE
4.14 ENTIRE AGREEMENT . 1 f
ACCOUNTABILITY &TRANSPARENCY ACT (FF
4.15 FEDERAL FUNDI •-•,,,....................... ..
4.16 FORCE MAJEUR ....................
..........
REDUCED OR LIMITED......................... .............................1
............................... .
4.17 FUNDING WITHDRAW ........�
4.18 GOVERNING LAW ...................................• .................
4.19 HCA NETWORK SECURITY ....----- ................ .
........................ .
..
......
............
4.20 INDEMNIFICATION ......... . ..... NCTOR.....................I...
4,21 INDEPENDENT CAPACITY OFVE�GE
........................................................
4.22 INDUSTRIAL INSURANCE CO
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4.23 LEGAL AND REGULATORY COMPLIANCE ......................................................................20
4.24 LIMITATION OF AUTHORITY.........................................................
4.25 NO THIRD-PARTY BENEFICIARIES..................................................................................20
4.26 NONDISCRIMINATION........................................................................................
4.27 OVERPAYMENTS TO CONTRACTOR .....................................................................�
4.28 PAY Equity..........................................................................................................................21
4.29 PUBLICITY ...........................................................................................................
4.30 RECORDS AND DOCUMENTS REVIEW...........................................................................22
4.31 REMEDIES NON-EXCLUSIVE .................................................................................
4.32 RIGHT OF INSPECTION ..............................................................................
4.33 RIGHTS IN DATA/OWNERSHIP.............. ..
4.34 RIGHTS OF STATE AND FEDERAL GOVERNMENTS......................................................24
4.35 SEVERABILITY.......................................................................
4.36 SITE SECURITY.....................
...........................................................................................24
4.37 SUBCONTRACTING.......................................................................................
4.38 SUBRECIPIENT..................................................................................................................25
4.39 SURVIVAL .........................................
...............................................
4.40 TAXES................................................................................................................................27
4.41 TERMINATION ..........................................................
...............................................
4.42 TERMINATION PROCEDURES ...................
4.43 WAIVER...........................................
............................................................................
4.44 WARRANTIES ......................................................................................
Attachments
Attachment 1: Federal Compliance, Certifications and Assurances
Attachment 2: Federal Funding Accountability and Transparency Act (FFATA) Data
Collection Form
Schedules
Schedule A: Statement of Work (SOW) ABCD Dental Services
Exhibits
Exhibit A: ABCD Quarterly Outreach and Case Management Report
Exhibit B: ABCD Quarterly Outreach and Coordination of Care Report
Exhibit C: ABCD Yearly Budget Tool
Washington State Page 3 of 53 Contract#2751
Health Care Authority
Contract K2751 for ABCD Dental Services
Recitals
The state of Washington, acting by and through the Health Care Authority (HCA), is entering
into a contract that is exempt front procurement.
HCA has determined that entering into a contract with Masan County Public Health in
accordance with its authority under chapters 39.26 and 41.05 RCW.
HCA has determined that entering into a Contract with Mason County Public Health will meet
HCA's needs and will be in the State's best interest.
NOW THEREFORE, HCA awards to Mason County Public Health this Contract, the terms
and conditions of which will govern Contractor's providing to HCA the services to detect and
prevent early childhood dental decay by engaging dentists in seeing birth to six (6) year old
Medicaid eligible children and engaging local public health departments or organizations in
outreach and case management.
IN CONSIDERATION of the mutual promises as set forth in this Contract, the parties agree as
follows:
1. STATEMENT OF WORK (SOW)
The Contractor will provide the services and staff as described in Schedule A: Statement of
Work.
2. DEFINITIONS
"Authorized Representative" means a person to whom signature authority has been
delegated in writing acting within the limits of his/her authority.
"Breach" means the unauthorized acquisition, access, use, or disclosure of Confidential
Information that compromises the security, confidentiality, or integrity of the Confidential
Information.
"Business Associate" means a Business Associate as defined in 45 CFR 160.103, who
performs or assists in the performance of an activity for or on behalf of HCA, a Covered Entity,
that involves the use or disclosure of protected health information (PHI). Any reference to
Business Associate in this DSA includes Business Associate's employees, agents, officers,
Subcontractors, third party contractors, volunteers, or directors.
"Business Days and Hours" means Monday through Friday, 8:00 a.m. to 5:00 p.m., Pacific
Time, except for holidays observed by the state of Washington.
"Centers for Medicare and Medicaid Services" or"CMS" means the federal office under
the Secretary of the United States Department of Health and Human Services, responsible for
the Medicare and Medicaid programs.
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Health Care Authority
"CFR" means the Code of Federal Regulations. All references in this Contract to CFR
chapters or sections include any successor, amended,
are reor placement
t regulation. The CFR
may be accessed at http//www ecfr aov/cql-bin/ pg -
"Confidential Information" means information that may be exempt from disclosure to the
public or other unauthorized persons under chapter 42.56 RCW or chapter 70.02 RCW or
other state or federal statutes or regulations. Confidential Information includes,'but is not
limited to, any information identifiable to an individ educationthat labusi ess, unatural
se opeeceipt o health,
(see also Protected Health Information); finances,
governmental services, names, addresses, telephone numbers, social security numbers,
driver license numbers, financial profiles, credit card numbers, financial identifiers and any
other identifying numbers, law enforcement records, HCA source code or object code, or HCA
or State security information.
"Contract" means this Contract document and all schedules, exhibits, attachments,
incorporated documents and amendments.
"Contractor" means its employees and agents. Contractor includes any firm, provider,
organization, individual or other entity performing services under this Contract. It also includes
any Subcontractor retained by Contractor as permitted under the terms of this Contract.
"Covered entity" means a health plan, a health care clearinghouse or a health care provider
who transmits any health information in electronic form to carry
out financial or administrative
activities related to health care, as defined In 4
"Data" means information produced, furnished, acquired, or used by Contractor in meeting
requirements under this Contract.
"Effective Date" means the first date this Contract is in full force and effect. It may be a
specific date agreed to by the parties, or, if not so specified, the date of the last signature of a
party to this Contract.
"HCA Contract Manager" means the individual i dentifieities d on the ed uoderver page of thishis Contract
who will provide oversight of the Contractor's act
t.
"Health Care Authority" or "HCA" means the Washington State Health Care Authority, any
division, section, office, unit or other entity of HCA, or any of the officers or other officials
lawfully representing HCA.
"Overpayment" means any payment or benefit to the Contractor in excess of that to which
the Contractor is entitled by law, rule, or this Contract, including amounts in dispute.
"Proprietary Information" means information owned by Contractor to which Contractor
claims a protectable interest under law. ProprietaryInformationI fortrade
rm tiosecret laws
includes, but is not limited to,
information protected by copyright, patent, trademark,
Washington State P,acie 5 of 53 Contract#2751
Health Care Authority
"Protected Health Information" or "PHI" means individually identifiable information that
relates to the provision of health care to an individual; the past, present, or future physical or
mental health or condition of an individual; or past, present, or future payment for provision of
health care to an individual, as defined in 45 CFR 160.103. Individually identifiable information
is information that identifies the individual or about which there is a reasonable basis to
believe it can be used to identify the individual, and includes demographic information. PHI is
information transmitted, maintained, or stored in any form or medium. 45 CFR 164.501. PHI
does not include education records covered by the Family Educational Rights and Privacy Act,
as amended, 20 USC 1232g(a)(4)(b)(iv).
"RCW" means the Revised Code of Washington. All references in this Contract to RCW
chapters or sections include any successor, amended, or replacement statute. Pertinent
RCW chapters can be accessed at: http://@Pps.leq.wa.gov/rcw/.
"Statement of Work" or "SOW" means a detailed description of the work activities the
Contractor is required to perform under the terms and conditions of this Contract, including the
deliverables and timeline, and is Schedule A hereto.
"Subcontractor" means a person or entity that is not in the employment of the Contractor,
who is performing all or part of the business activities under this Contract under a separate
contract with Contractor. The term "Subcontractor" means subcontractor(s) of any tier.
"Subrecipient" means a contractor operating a federal or state assistance program receiving
federal funds and having the authority to determine both the services rendered and disposition
of program. See OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501, "Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards for
additional detail.
"USC" means the United States Code. All references in this Contract to USC chapters or
sections shall include any successor, amended, or replacement statute. The USC may be
accessed at http.//uscode.house.gov/
"WAC" means the Washington Administrative Code. All references to WAC chapters or
sections will include any successor, amended, or replacement regulation. Pertinent WACs
may be accessed at: http•//app leg wa.gov/wac/.
3. SPECIAL TERMS AND CONDITIONS
a) "ABCD" means Access to Baby and Child Dentistry, a program designed to
detect and prevent early childhood dental decay by engaging dentists in seeing
birth to six (6) year old Medicaid eligible children and engaging local public
health departments in outreach and case management.
b) "ABCD Coordinators Group" means the Contractors.
c) "ABCD Dental Champion, means a participating dentist(s) who has/have been
identified by the University of Washington in each local program to deliver the
University of Washington designed training to newly recruited dentists and assist
Washington State Page 6 of 53 Contract#2751
Health care Authority
the local ABCD coordinator and the local dental society in recruiting dentists to
participate.
d) "Case Management" means identifying barriers to early oral health care for
Medicaid eligible children and assisting families in addressing those barriers;
preparing families for their child's first visit to the dentists by providing a family
orientation and assisting them in making that first appointment; and following-up
to insure that appointments were made and kept, and that the families
understand the need for future visits and home care.
e) "Client" means Medicaid eligible Clients ages birth through six (6) years of age.
f) "CMS" means the Centers for Medicare and Medicaid Services of the United
States Department of Health and Human Services.
g) "Confidential Information" means information that is exempt from disclosure
to the public or other unauthorized persons under Chapter 42.56 RCW or other
federal or state laws. Confidential information includes, but is not limited to,
Personal Information.
h) "Family Orientation" means educating the family of Medicaid children on the
need for early, preventive dental care, and dental office etiquette, including the
need to make and keep dental appointments.
i) "Health Care Authority or "HCA" means the agency designated by the
Washington Legislature as the Single State Agency that oversees Washington
State's medical assistance programs, including Medicaid, and its employees and
authorized agents.
j) "Health Coalition" means a group of health care providers and community
organizations that meet to collaborate for a common cause.
k) "Local Programs" means the constellation of local partners who deliver this
program in a county or group of counties.
1) "Outreach" means identifying families with Medicaid eligible children and
linking them with dental care through a variety of methods, including but not
limited to partnerships with other organizations who work with low-income
families, earned media, and referral services.
m) "Personal Information" means information identifiable to any person,
including, but not limited to, information that relates to a person's name, health,
finances, education, business, use or receipt of governmental services or other
activities, addresses, telephone numbers, Social Security Numbers, driver
license numbers, other identifying numbers, and any financial identifiers.
n) "Steering Committee" means a smaller subset of the bigger Health Coalition
tasked with working on specific causes that identified by the Health Coalition.
3.1 PERFORMANCE EXPECTATIONS
Expected performance under this Contract includes, but is not limited to, the following:
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3.1.1 Knowledge of applicable state and federal laws and regulations pertaining to subject
of contract;
3.1.2 Use of professional judgment;
3.1.3 "Collaboration with HCA staff in Contractor's conduct of the services;
3.1.4 Conformance with HCA directions regarding the delivery of the services;
3.1.5 Timely, accurate and informed communications;
3.1.6 Regular completion and updating of project plans, reports, documentation and
communications;
3.1.7 Regular, punctual attendance at all meetings; and
3.1.8 Provision of high quality services.
Prior to payment of invoices, HCA will review and evaluate the performance of Contractor
in accordance with Contract and these performance' erformanexpectations ce is unmay satisfactory.
sfactoryld
payment if expectations are not met or Cont p
3.2 TERM
3.2.1 The initial term of the Contract will commence on July 1,through June 3018, or date of last
signature, whichever is later, and co
ntinue terminated sooner as provided herein.
ime increments
3.2.2 This Contract may be extended through June a0, 2028 in whatver nd conditions wel betpermitted during
HCA deems appropriate. No change In toms
these extensions unless specifically agreed to in writing.
3.2.3 Work performed without a contract or amendment signed by the authorized
representatives of both parties will be at the
an sole As fuwillllyot
pay any costs incurred before a contract o y subsequent amendment(s)
executed.
3.3 COMPENSATION
3.3.1 The Maximum Compensation payable to Contractor for ihe performance of s set forth in Schedule things
necessary for or incidental to the performance of work a
Statement of Work is $38,200.00, and includes any allowable expenses.
Source(s) of Funds. The above maxims payable
f funding from theract,
for the service to be provided is based o the amounts(s) o
following sources:
Washington State Pae 8 of 53 Contract#2751
Health Care Authority
a) 50% is allotted under this Contract from federal funds received by HCA under
the United States Department of Health & Human Services Medical
Assistance Program, Title XIX of the Social Security Act, Catalog of Federal
Domestic Assistance #93.778; and
b) 50% is allotted under this Contract from GFS (General Fund-State) funds.
If indicated on page one (1) of this Agreement the Contractor is a sub-recipient for
purposes of this Contract, and as such, shall comply with the terms and conditions
listed in Section 4.37, Sub-recipients.
Funding Stipulations.
a) The Contractor shall cooperate in supplying any information to HCA that may
be needed to verify accuracy of reimbursable billings.
b) The Contractor shall not use funds payable under this Contract for lobbying
activities of any nature. The Contractor certifies that no state or federal funds
payable under this Contract shall be paid to any person or organization to
influence, or attempt to influence, either directly or indirectly, an officer or
employee of an state or federal agency, or an officer or member of any state
or federal legislative body or committee, regarding the award, amendment,
modification, extension, or renewal of a state or federal contract or grant.
c) The Contractor shall not pay Consultants and/or Billing Agents, or
Subcontractors on either a contingent, or percentage basis, for work
performed as a result of this Contract.
3.3.2 Contractor's compensation for services rendered will be based on the rates in
accordance with the Exhibits.
3.3.3 Federal funds disbursed through this Contract were received by HCA through OMB
Catalogue of Federal Domestic Assistance (CFDA) Number: 93.788, Contractor
agrees to comply with applicable rules and regulations associated with these federal
funds and has signed Attachment 1: Federal Compliance, Certification and
Assurances, attached.
3.4 INVOICE AND PAYMENT
3.4.1 Contractor must submit accurate invoices to the following address for all amounts to
be paid by HCA via e-mail to: AcctspayC�hca.wa.gov. Include the HCA Contract
number in the subject line of the email.
3.4.2 Invoices must describe ands he
°of ntrooect and feesaAll invo�iction a dCescwpl description
oeviewed
f the
work performed, the progre project,
and must be approved by the Contract Manager or his/her designee prior to
payment.
Washington State Page 9 of 53 Contract#2751
Health Care Authority
3.4.3 Contractor must submit properly itemized invoices to include the following
information, as applicable:
3.4.3.1 HCA Contract number K2751;
3.4.3.2 Contractor name, address, phone number;
3.4.3.3 Description of Services;
3.4.3.4 Date(s) of delivery;
3.4.3.5 Net invoice price for each item;
3.4.3.6 Applicable taxes;
3.4.3.7 Total invoice price; and
3.4.3.8 Payment terms and any available prompt payment discount.
3.4.4 HCA will return incorrect or incomplete invoices to the Contractor for correction and
reissue. The Contract Number must appear on all invoices, bills of lading, packages,
and correspondence relating to this Contract.
3.4.5 In order to receive payment for services or products provided to a state agency,
Contractor must register with the Statewide Payee Desk at
htt //des wa gov/services/ContractingP urchasing/BusinessNendorPay/Pages/defa
ult.as x. Payment will be considered timely if made by HCA within thirty (30)
calendar days of receipt of properly completed invoices. Payment will be directly
deposited in the bank account or sent to the address Contractor designated in its
registration.
3.4.6 Upon expiration of the Contract, any claims for payment for costs due and payable
under this Contract that are incurred prior to the expiration date must be submitted
by the Contractor to HCA within sixty (60) calendar days after the Contract
expiration date. HCA is under no obligation to pay any claims that are submitted
sixty-one (61) or more calendar days after the Contract expiration date ("Belated
Claims"). HCA will pay Belated Claims at its sole discretion, and any such potential
payment is contingent upon the availability of funds.
3.5 CONTRACTOR AND HCA CONTRACT MANAGERS
3.5.1 Contractor's Contract Manager will have prime responsibility and final authority for
the services provided under this Contract and be the principal point of contact for
the HCA Contract Manager for all business matters, performance matters, and
administrative activities.
3.5.2 HCA's Contract Manager is responsible for monitoring the Contractor's performance
and will be the contact person for all communications regarding contract
performance and deliverables. The HCA Contract Manager has the authority to
accept or reject the services provided and must approve Contractor's invoices prior
to payment.
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3.5.3 The contact information provided below may be changed by written notice of the
change (email acceptable) to the other party.
CONTRACTOR Health Care Authority
Contract Manager Information Contract Manager Information
Name: Lydia Buchheit Name: Janice Tadeo
Title: Title: Dental Program Manager
P O Box 1666, Shelton, Address: P.O. Box 45506
Address: WA 98564 Olympia, WA 98504-5506
Phone: 360-427-9670x545 Phone: 360/725-1583
Email: lydiab@co.mason.wa.us Email: janice.tadeo@hca.wa.gov
3.6 KEY STAFF
3.6.1 Except in the case of a legally required leave of absence, sickness, death,
termination of employment or unpaid leave of absence, Key Staff must not be
changed during the term of the Statement of Work (SOW) from the people who
were described in the Response for the first SOW or those Key Staff initially
assigned to subsequent SOWS, without the prior written approval of HCA until
completion of their assigned tasks.
3.6.2 During the term of the Statement of Work (SOW), HCA reserves the right to approve
or disapprove Contractor's Key Staff assigned to this Contract, to approve or
disapprove any proposed changes in Contractor's Key Staff, or to require the
removal or reassignment of any Contractor staff found unacceptable by HCA,
subject to HCA's compliance with applicable laws and regulations. Contractor must
provide a resume to HCA of any replacement Key Staff and all staff proposed by
Contractor as replacements for other staff must have comparable or greater skills
for performing the activities as performed by the staff being replaced.
3.7 LEGAL NOTICES
Any notice or demand or other communication required or permitted to be given under
this Contract or applicable law is effective only if it is in writing and signed by the
applicable party, properly addressed, and either delivered in person, or by a recognized
courier service, or deposited with the United States Postal Service as first-class mail,
postage prepaid certified mail, return receipt requested, to the parties at the addresses
provided in this section.
3.7.1 In the case of notice to the Contractor:
Mason County Public Health
P O Box 1666, Shelton, WA 98564
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Health Care Authority Page 11 of 53
3.7.2 In the case of notice to HCA:
Attention: Contracts Administrator
Health Care Authority
Division of Legal Services
` Post Office Box 42702 '
Olympia, WA 98504-2702
3.7.3 Notices are effective upon receipt or four (4) Business days after mailing, whichever
is earlier.
3.7.4 The notice address and information provided above may be changed by written
notice of the change given as provided above.
3.8 INCORPORATION OF DOCUMENTS AND ORDER OF PRECEDENCE
Each of the documents listed below is by this reference incorporated into this Contract. In
the event of an inconsistency, the inconsistency will be resolved in the following order of
precedence:
3.8.1 Applicable Federal and State of Washington statutes and regulations;
3.8.2 Recitals
3.8.3 Special Terms and Conditions;
3.8.4 General Terms and Conditions;
3.8.5 Attachment 1: Federal Compliance, Certifications and Assurances;
3.8.6 Attachment 2: Federal Funding Accountability and Transparency Act (FFA TA) Data
Collection Form
3.8.7 Schedule A: Statement of Work;
3.8.8 Exhibits A: ABCD Quarterly Outreach and Case Management Report, Exhibit B:
ABCD Quarterly Outreach and Coordination of Care Report and Exhibit C: ABCD
Yearly Budget Tool; and
3.8.9 Any other provision, term or material incorporated herein by reference or otherwise
incorporated.
3.9 INSURANCE
Contractor must provide insurance coverage as set out in this section. The intent of the
required insurance is to protect the State should there be any claims, suits, actions, costs,
damages or expenses arising from any negligent or intentional act or omission of
Contractor or Subcontractor, or agents of either, while performing under the terms of this
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Contract. Contractor must provide insurance coverage that is maintained in full force and
effect during the term of this Contract, as follows:
3.9.1 Commercial General Liability Insurance Policy - Provide a Commercial General
Liability Insurance Policy, including contractual liability, in adequate quantity to
protect against legal liability arising out of contract activity but no less than $1 million
per occurrence/$2 million general aggregate. Additionally, Contractor is responsible
for ensuring that any Subcontractors provide adequate insurance coverage for the
activities arising out of subcontracts.
3.9.2 Business Automobile Liability. In the event that services delivered pursuant to this
Contract, involve the use of vehicles, owned, either hired, or non-owned by the
Contractor, automobile liability insurance is required covering the risks of bodily
injury (including death) and property damage, including coverage for contractual
liability. The minimum limit for automobile liability is $1,000,000 per occurrence,
using a Combined Single Limit for bodily injury and property damage.
3.9.3 Professional Liability Errors and Omissions — Provide a policy with coverage of not
less than $1 million per claim/$2 million general aggregate.
3.9.4 The insurance required must be issued by an insurance coimpanyhes authorized to
do business within the state of Washington, and must name HCA and the state of
Washington, its agents and employees as additional insured's under any
Commercial General and/or Business Automobile Liability policy/ies. All policies
must be primary to any other valid and collectable insurance. In the event of
cancellation, non-renewal, revocation or other termination of any insurance
coverage required by this Contract, Contractor must provide written notice of such
to HCA within one (1) Business day of Contractor's receipt of such notice. Failure to
buy and maintain the required insurance may, at RCA's sole option, result in this
Contract's termination.
Upon request, Contractor must submit to HCA a certificate of insurance that outlines the
coverage and limits defined in the Insurance section. If a certificate of insurance is
requested, Contractor must submit renewal certificates as appropriate during the term of
the contract.
4. GENERAL TERMS AND CONDITIONS
4.1 ACCESS TO DATA
In compliance with RCW 39.26.180 (2) and federal rules, the Contractor must provide
access to any data generated under this Contract to HCA, the Joint Legislative Audit and
Review Committee, the State Auditor, and any other state or federal officials so
authorized by law, rule, regulation, or agreement at no additional cost. This includes
access to all information that supports the findings, conclusions, and recommendations of
the Contractor's reports, including computer models and methodology for those models.
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4.2 ADVANCE PAYMENT PROHIBITED
No advance payment will be made for services furnished by the Contractor pursuant to
this Contract.
4.3 AMENDMENTS
This Contract may be amended by mutual agreement of the parties. Such amendments
will not be binding unless they are in writing and signed by personnel authorized to bind
each of the parties.
4.4 ASSIGNMENT
4.4.1 Contractor may not assign or transfer all or any portion of this Contract or any of its
rights hereunder, or delegate any of its duties hereunder, except delegations as set
forth in Section 4.37, Subcontracting, without the prior written consent of HCA. Any
permitted assignment will not operate to relieve Contractor of any of its duties and
obligations hereunder, nor will such assignment affect any remedies available to
HCA that may arise from any breach of the provisions of this Contract or warranties
made herein, including but not limited to, rights of setoff. Any attempted assignment,
transfer or delegation in contravention of this Subsection 4.4.1 of the Contract will
be null and void.
4.4.2 HCA may assign this Contract to any public agency, commission, board, or the like,
within the political boundaries of the State of Washington, with written notice of thirty
(30) calendar days to Contractor.
4.4.3 This Contract will inure to the benefit of and be binding on the parties hereto and
their permitted successors and assigns.
4.5 ATTORNEYS' FEES
In the event of litigation or other action brought to enforce the terms of this Contract, each
party agrees to bear its own attorneys' fees and costs.
4.6 CHANGE IN STATUS
In the event of any substantive change in its legal status, organizational structure, or
fiscal reporting responsibility, Contractor will notify HCA of the change. Contractor must
provide notice as soon as practicable, but no later than thirty (30) calendar days after
such a change takes effect.
4.7 CONFIDENTIAL INFORMATION PROTECTION
4.7.1 Contractor acknowledges that some of the material and information that may come
into its possession or knowledge in connection with this Contract or its performance
may consist of Confidential Information. Contractor agrees to hold Confidential
Information in strictest confidence and not to make use of Confidential Information
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for any purpose other than the performance of this Contract, to release it only to
authorized employees or Subcontractors requiring such information for the purposes
of carrying out this Contract, and not to release, divulge, publish, transfer, sell,
disclose, or otherwise make the information known to any other party without HCA's
express written consent or as provided by law.
Contractor agrees to implement physical, electronic, and managerial safeguards to
prevent unauthorized access to Confidential Information.
4.7.2 Contractors that come into contact with Protected Health Information may be
required to enter into a Business Associate Agreement with HCA in compliance with
the requirements of the Health Insurance Portability and Accountability Act of 1996,
Pub. L. 104-191, as modified by the American Recovery and Reinvestment Act of
2009 ("ARRA"), Sec. 13400 — 13424, H.R. 1 (2009) (HITECH Act) (HIPAA).
4.7.3 HCA reserves the right to monitor, audit, or investigate the use of Confidential
Information collected, used, or acquired by Contractor through this Contract.
Violation of this section by Contractor or its Subcontractors may result in termination
of this Contract and demand for return of all Confidential Information, monetary
damages, or penalties.
4.7.4 The obligations set forth in this Section will survive completion, cancellation,
expiration, or termination of this Contract.
4.8 CONFIDENTIAL. INFORMATION SECURITY
The federal government, including the Centers for Medicare and Medicaid Services
(CMS), and the State of Washington all maintain security requirements regarding privacy,
data access, and other areas. Contractor is required to comply with the Confidential
Information Security Requirements set out in this Contract and appropriate portions of the
Washington OCIO Security Standard, 141.10 (https://ocio Na.gov/loolicies/141-securing-
informationtechnology assets/14110-securing-information-technology-assets).
4.9 CONFIDENTIAL INFORMATION BREACH — REQUIRED NOTIFICATION
4.9.1 Contractor must notify the HCA Privacy Officer (HCAPrivacyOfficer(d)hca.wa.gov)
within five Business days of discovery of any Breach or suspected Breach of
Confidential Information.
4.9.2 Contractor will take steps necessary to mitigate any known harmful effects of such
unauthorized access including, but not limited to, sanctioning employees and taking
steps necessary to stop further unauthorized access. Contractor agrees to
indemnify and hold HCA harmless for any damages related to unauthorized use or
disclosure of Confidential Information by Contractor, its officers, directors, and
employees, Subcontractors or agents.
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4.9.3 If notification of the Breach or possible Breach must (in the judgment of HCA) be
made under the HIPAA Breach Notification Rule, or RCW 42.56.590 or RCW
19.254.010, or other law or rule, then:
4.9.3.1 HCA may choose to make any required notifications to the
individuals, to the U.S. Department of Health and Human
Services Secretary (DHHS) Secretary, and to the media, or
direct Contractor to make them or any of them.
4.9.3.2 In any case, Contractor will pay the reasonable costs of
notification to individuals, media, and governmental agencies
and of other actions HCA
4.9.3.3 Reasonably considers appropriate to protect HCA Clients (such
as paying for regular credit watches in some cases).
4.9.3.4 Contractor will compensate HCA Clients for harms caused to
them by any Breach or possible Breach.
4.9.4 Any breach of this clause may result in termination of the Contract and the demand
for return or disposition of all Confidential Information.
4.9.5 Contractor's obligations regarding Breach notification survive the termination of this
Contract and continue for as long as Contractor maintains the Confidential
Information and for any breach or possible breach at any time.
4.10 CONTRACTOR'S PROPRIETARY INFORMATION
Contractor acknowledges that HCA is subject to Chapter 42.56 RCW, the Public Records
Act, and that this Contract will be a public record as defined in chapter 42.56 RCW. Any
specific information that is claimed by Contractor to be Proprietary Information must be
clearly identified as such by Contractor. To the extent consistent with Chapter 42.56
RCW, HCA will maintain the confidentiality of Contractor's information in its possession
that is marked Proprietary. If a public disclosure request is made to view Contractor's
Proprietary Information, HCA will notify Contractor of the request and of the date that
such records will be released to the requester unless Contractor obtains a court order
from a court of competent jurisdiction enjoining that disclosure. If Contractor fails to obtain
the court order enjoining disclosure, HCA will release the requested information on the
date specified.
4.11 COVENANT AGAINST CONTINGENT FEES
Contractor warrants that no person or selling agent has been employed or retained to
solicit or secure this Contract upon an agreement or understanding for a commission,
percentage, brokerage or contingent fee, excepting bona fide employees or bona fide
established agents maintained by the Contractor for the purpose of securing business.
HCA will have the right, in the event of breach of this clause by the Contractor, to annul
this Contract without liability or, in its discretion, to deduct from the contract price or
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consideration or recover by other means the full amount of such commission, percentage,
brokerage or contingent fee.
4.12 DEBARMENT
By signing This Contract, Contractor certifies that it is not presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded in any Washington
State or Federal department or agency from participating in transactions (debarred).
Contractor agrees to include the above requirement in any and all subcontracts into which
it enters, and also agrees that it will not employ debarred individuals. Contractor must
immediately notify HCA if, during the term of this Contract, Contractor becomes debarred.
HCA may immediately terminate this Contract by providing Contractor written notice, if
Contractor becomes debarred during the term hereof.
4.13 DISPUTES
The parties will use their best, good faith efforts to cooperatively resolve disputes and
problems that arise in connection with this Contract. Both parties will continue without
delay to carry out their respective responsibilities under this Contract while attempting to
resolve any dispute. When a genuine dispute arises between HCA and the Contractor,
regarding the terms of this Contract or the responsibilities imposed herein and it cannot
be resolved between the parties' Contract Managers, either party may initiate the
following dispute resolution process.
4.13.1 The initiating party will reduce its description of the dispute to writing and deliver it to
the responding party (email acceptable). The responding party will respond in
writing within five (5) Business days (email acceptable). If the initiating party is not
satisfied with the response of the responding party, then the initiating party may
request that the HCA Director review the dispute. Any such request from the
initiating party must be submitted in writing to the HCA Director within five (5)
Business days after receiving the response of the responding party. The HCA
Director will have sole discretion in determining the procedural manner in which he
or she will review the dispute. The HCA Director will inform the parties in writing
within five (5) Business days of the procedural manner in which he or she will review
the dispute, including a timeframe in which he or she will issue a written decision.
4.13.2 A party's request for a dispute resolution must:
4.13.2.1 Be in writing;
4.13.2.2 Include a written description of the dispute;
4.13.2.3 State the relative positions of the parties and the remedy sought;
4.13.2.4 State the Contract Number and the names and contact
information for the parties;
4.13.3 This dispute resolution process constitutes the sole administrative remedy available
under this Contract. The parties agree that this resolution process will precede any
action in a judicial or quasi-judicial tribunal.
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4.14 ENTIRE AGREEMENT
HCA and Contractor agree that the Contract is the complete and exclusive statement of
the agreement between the parties relating to the subject matter of the Contract and
supersedes all letters of intent or prior contracts, oral or written, between the parties
relating to the subject matter of the Contract, except as provided in Section 4.44
Warranties.
4.15 FEDERAL FUNDING ACCOUNTABILITY &TRANSPARENCY ACT (FFATA)
4.15.1 This Contract 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 federal funds are spent.
4.15.2 To comply with the act and be eligible to enter into this Contract, Contractor must
have a Data Universal Numbering System (DUNS®) number. A DUNS® number
provides a method to verify data about your organization. If Contractor does not
already have one, a DUNS® number is available free of charge by contacting Dun
and Bradstreet at www.dnb.com.
4.15.3 Information about Contractor and this Contract will be made available on
www.uscontractorregistration.com by HCA as required by P.L. 109-282. RCA's
Attachment 1: Federal Funding Accountability and Transparency Act Data
Collection Form, is considered part of this Contract and must be completed and
returned along with the Contract.
4.16 FORCE MAJEURE
A party will not be liable for any failure of or delay in the performance of this Contract for
the period that such failure or delay is due to causes beyond its reasonable control,
including but not limited to acts of God, war, strikes or labor disputes, embargoes,
government orders or any other force majeure event.
4.17 FUNDING WITHDRAWN, REDUCED OR LIMITED
If HCA determines in its sole discretion that the funds it relied upon to establish this
Contract have been withdrawn, reduced or limited, or if additional or modified conditions
are placed on such funding after the effective date of this contract but prior to the normal
completion of this Contract, then HCA, at its sole discretion, may:
4.17.1 Terminate this Contract pursuant to Section 4.41.3, Termination for Non-Allocation
of Funds;
4.17.2 Renegotiate the Contract under the revised funding conditions; or
4.17.3 Suspend Contractor's performance under the Contract upon five (5) Business days'
advance written notice to Contractor. HCA will use this option only when HCA
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determines that there is reasonable likelihood that the funding insufficiency resumebe
resolved in a timeframe that would allow Contractor's performance
to beprior to the normal completion date of this Contract.
4.17.3.1 During the period of suspension of performance, each party will
► inform the other of any conditions that may reasonably affect the
potential for resumption of performance.
4.17.3.2 When HCA determines in its sole discretion that the funding
insufficiency is resolved, it will give Contractor written notice to
resume performance. Upon the receipt of this notice, Contractor
will provide written notice to HCA informing HCA whether it can
resume performance and, if so, the date of resumption. For
purposes of this subsection, "written notice" may include email.
4.17.3.3 If the Contractor's proposed resumption
be ndate is not acceptable egotiated, HCA may to
HCA and an acceptable date cannot
terminate the contract by giving written notice to Contractor. The
parties agree that the Contract will be terminated retroactive to
the date of the notice of suspension. HCA will be liable only for
payment in accordance with the terms of this Contract for
services rendered prior to the retroactive date of termination.
4.18
GOVERNING LAW
n all respects by the laws of the
action hereunder is
state dwihout
This Contract is governed in fo
reference to conflict of law principles. The jurisdictioany
exclusively in the Superior Court for the state of Washington, ad the Nothing venue ofn this action
hereunder is in the Superior Court for Thurston County,
States immunity under the 11th
Contract will be construed as a waiver by HCA of the
Amendment to the United States Constitution.
4.19 HCA NETWORK SECURITY
Contractor agrees not to attach any Contractor-supplied computers, peripherals or
software to the HCA Network without prior written authorization
Works al nd from
ems s a violation of
ief
Information Officer. Unauthorized access to HCA n pursuant a RCW
HCA Policy and constitutes of theseelaws oapoliciesss in efirst cou d reg ult iree n termination of the
9A.52.110. Violation of any
contract and other penalties.
Contractor will have access to the HCA visitor Wi-Fi Internet connection while on site.
4.20 INDEMNIFICATION
nst
Contractor must defend, indemnify, and save HCA such claims, foess from r or fall injuriestoos
including reasonable attorneys fees resulting from su
persons or damage to property, or Breach of its confidentiality dand Sectiond4 8 notIConfidentbialgity ions
under Section 4.7 Confidential Information Protection
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Health Care Authorit
Breach-Required Notification, arising from intentional or negligent acts or omissions of
Contractor, its officers, employees, or agents, or Subcontractors, their officers,
employees, or agents, in the performance of this Contract.
4.21 INDEPENDENT CAPACITY OF THE CONTRACTOR
The parties intend that an independent contractor relationship will be created by this
Contract.
Contractor and its employees or agents performing under this Contract are not
employees or agents of HCA. Contractor will not hold itself out as or claim to be an officer
dr employee of HCA or of the State of Washington by reason hereof, nor will Contractor
make any claim of right, privilege or benefit that would accrue to such employee under
law. Conduct and control of the work will be solely with Contractor.
4.22 INDUSTRIAL INSURANCE COVERAGE
Prior to performing work under this Contract, Contractor must provide or purchase
industrial insurance coverage for the Contractor's employees, as may be required of an
"employer" as defined in Title 51 RCW, and must maintain full compliance with Title 51
RCW during the course of this Contract.
4.23 LEGAL AND REGULATORY COMPLIANCE
4.23.1 During the term of this Contract, Contractor must comply with all local, state, and
federal licensing, accreditation and registration requirements/standards, necessary
for the performance of this Contract and all other applicable federal, state and local
laws, rules, and regulations.
4.23.2 While on the HCA premises, Contractor must comply with HCA operations and
process standards and policies (e.g., ethics, Internet/ email usage, data, network
and building security, harassment, as applicable). HCA will make an electronic copy
of all such policies available to Contractor.
4.23.3 Failure to comply with any provisions of this section may result in Contract
termination.
4.24 LIMITATION OF AUTHORITY
Only the HCA Authorized Representative has the express, implied, or apparent authority
to alter, amend, modify, or waive any clause or condition of this Contract. Furthermore,
any alteration, amendment, modification, or waiver or any clause or condition of this
Contract is not effective or binding unless made in writing and signed by the HCA
Authorized Representative.
4.25 NO THIRD-PARTY BENEFICIARIES
HCA and Contractor are the only parties to this contract. Nothing in this Contract gives or
is intended to give any benefit of this Contract to any third parties.
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4.26 NONDISCRIMINATION
During the performance of this Contract, the Contractor must comply with all federal and
state nondiscrimination laws, regulations and policies, including but not limited to: Title VII
of the Civil Rights Act, 42 U.S.C. §12101 et seq.; the Americans with Disabilities Act of
` 1990 (ADA), 42 U.S.C. §12101 et seq., 28 CFR Part 35; and Title 49.60 RCW,
Washington Law Against Discrimination.
In the event of Contractor's noncompliance or refusal to comply with any
nondiscrimination law, regulation or policy, this Contract may be rescinded, canceled, or
terminated in whole or in part under the Termination for Default sections, and Contractor
may be declared ineligible for further contracts with HCA.
4.27 OVERPAYMENTS TO CONTRACTOR
In the event that overpayments or erroneous payments have been made to the
Contractor under this Contract, HCA will provide written notice to Contractor and
Contractor shall refund the full amount to HCA within thirty (30) calendar days of the
notice. If Contractor fails to make timely refund, HCA may charge Contractor one percent
(1%) per month on the amount due, until paid in full. If the Contractor disagrees with
HCA's actions under this section, then it may invoke the dispute resolution provisions of
Section 4.13 Disputes.
4.23 PAY EQUITY
4.28.1 Contractor represents and warrants that, as required by Washington state law
(Laws of 2017, Chap. 1, § 147), during the term of this Contract, it agrees to
equality among its workers by ensuring similarly employed individuals are
compensated as equals. For purposes of this provision, employees are similarly
employed if (i) the individuals work for Contractor, (ii) the performance of the job
requires comparable skill, effort, and responsibility, and (iii) the jobs are performed
under similar working conditions. Job titles alone are not determinative of whether
employees are similarly employed.
4.28.2 Contractor may allow differentials in compensation for its workers based in good
faith on any of the following: (i) a seniority system; (ii) a merit system; (iii) a system
that measures earnings by quantity or quality of production; (iv) bona fide job-
related factor(s); or (v) a bona fide regional difference in compensation levels.
4.28.3 Bona fide job-related factor(s)" may include, but not be limited to,
education, training, or experience, that is: (i) consistent with business necessity;
(ii) not based on or derived from a gender-based differential; and (iii) accounts for
the entire differential.
4.28.4 A "bona fide regional difference in compensation level" must be (i) consistent with
business necessity; (ii) not based on or derived from a gender-based differential;
and (iii) account for the entire differential.
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4.28.5 Notwithstanding any provision to the contrary, upon breach of warranty and
Contractor's failure to provide satisfactory evidence of compliance within thirty (30)
days of HCA's request for such evidence, HCA may suspend or terminate this
Contract.
4.29 PUBLICITY
4.29.1 The award of this Contract to Contractor is not in any way an endorsement of
Contractor or Contractor's Services by HCA and must not be so construed by
Contractor in any advertising or other publicity materials.
4.29.2 Contractor agrees to submit to HCA, all advertising, sales promotion, and other
publicity materials relating to this Contract or any Service furnished by Contractor in
which HCA's name is mentioned, language is used, or Internet links are provided
from which the connection of HCA's name with Contractor's Services may, in RCA's
judgment, be inferred or implied. Contractor further agrees not to publish or use
such advertising, marketing, sales promotion materials, publicity or the like through
print, voice, the Web, and other communication media in existence or hereinafter
developed without the express written consent of HCA prior to such use.
4.30 RECORDS .AND DOCUMENTS REVIEW
4.30.1 The Contractor must maintain books, records, documents, magnetic media,
receipts, invoices or other evidence relating to this Contract and the performance of
the services rendered, along with accounting procedures and practices, all of which
sufficiently and properly reflect all direct and indirect costs of any nature expended
in the performance of this Contract. At no additional cost, these records, including
materials generated under this Contract, are subject at all reasonable times to
inspection, review, or audit by HCA, the Office of the State Auditor, and state and
federal officials so authorized by law, rule, regulation, or agreement [See 42 USC
1396a(a)(27)(B); 42 USC 1396a(a)(37)(B); 42 USC 1396a(a)(42(A); 42 CFR 431,
Subpart Q; and 42 CFR 447.2021.
4.30.2 The Contractor must retain such records for a period of six (6) years after the date
of final payment under this Contract.
4.30.3 If any litigation, claim or audit is started before the expiration of the six (6) year
period, the records must be retained until all litigation, claims, or audit findings
involving the records have been resolved.
4.31 REMEDIES NON-EXCLUSIVE
The remedies provided in this Contract are not exclusive, but are in addition to all other
remedies available under law.
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4.32 RIGHT OF INSPECTION
The Contractor must provide right of access to its facilities to HCA, or any of its officers,
or to any other authorized agent or official of the state of Washington or the federal
government, at all reasonable times, in order to monitor and evaluate performance,
compliance, and/or quality assurance under this Contract.
4.33 RIGHTS IN DATAIOWNERSHIP
4.33.1 HCA and Contractor agree that all data and work products (collectively "Work
Product") produced pursuant to this Contract will be considered a work for hire
under the U.S. Copyright Act, 17 U.S.C. §101 et seq, and will be owned by HCA.
Contractor is hereby commissioned to create the Work Product. Work Product
includes, but is not limited to, discoveries, formulae, ideas, improvements,
inventions, methods, models, processes, techniques, findings, conclusions,
recommendations, reports, designs, plans, diagrams, drawings, Software,
databases, documents, pamphlets, advertisements, books, magazines, surveys,
studies, computer programs, films, tapes, and/or sound reproductions, to the extent
provided by law. Ownership includes the right to copyright, patent, register and the
ability to transfer these rights and all information used to formulate such Work
Product.
4.33.2 If for any reason the Work Product would not be considered a work for hire under
applicable law, Contractor assigns and transfers to HCA, the entire right, title and
interest in and to all rights in the Work Product and any registrations and copyright
applications relating thereto and any renewals and extensions thereof.
4.33.3 Contractor will execute all documents and perform such other proper acts as HCA
may deem necessary to secure for HCA the rights pursuant to this section.
4.33.4 Contractor will not use or in any manner disseminate any Work Product to any third
party, or represent in any way Contractor ownership of any Work Product, without
the prior written permission of HCA. Contractor shall take all reasonable steps
necessary to ensure that its agents, employees, or Subcontractors will not copy or
disclose, transmit or perform any Work Product or any portion thereof, in any form,
to any third party.
4.33.5 Material that is delivered under this Contract, but that does not originate therefrom
("Preexisting Material"), must be transferred to HCA with a nonexclusive, royalty-
free, irrevocable license to publish, translate, reproduce, deliver, perform, display,
and dispose of such Preexisting Material, and to authorize others to do so.
Contractor agrees to obtain, at its own expense, express written consent of the
copyright holder for the inclusion of Preexisting Material. HCA will have the right to
modify or remove any restrictive markings placed upon the Preexisting Material by
Contractor.
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4.33.6 Contractor must identify all Preexisting Material when it is delivered under this
Contract and must advise HCA of any and all known or potential infringements of
publicity, privacy or of intellectual property affecting any Preexisting Material at the
time of delivery of such Preexisting Material. Contractor must provide HCA with
prompt written notice of each notice or claim of copyright infringement or
infringement of other irlitellectual property right worldwide received by Contractor
with respect to any Preexisting Material delivered under this Contract.
4.34 RIGHTS OF STATE AND FEDERAL GOVERNMENTS
In accordance with 45 C.F.R. 95.617, all appropriate state and federal agencies, including
but not limited to the Centers for Medicare and Medicaid Services (CMS), will have a
royalty-free, nonexclusive, and irrevocable license to reproduce, publish, translate, or
otherwise use, and to authorize others to use for Federal Government purposes: (i)
software, modifications, and documentation designed, developed or installed with Federal
Financial Participation (FFP) under 45 CFR Part 95, subpart F; (ii) the Custom Software
and modifications of the Custom Software, and associated Documentation designed,
developed, or installed with FFP under this Contract; (iii) the copyright in any work
developed under this Contract; and (iv) any rights of copyright to which Contractor
purchases ownership under this Contract.
4.35 SEVERABILITY
If any provision of this Contract or the application thereof to any person(s) or
circumstances is held invalid, such invalidity will not affect the other provisions or
applications of this Contract that can be given effect without the invalid provision, and to
this end the provisions or application of this Contract are declared severable.
4.36 SITE SECURITY
While on HCA premises, Contractor, its agents, employees, or Subcontractors must
conform in all respects with physical, fire or other security policies or regulations. Failure
to comply with these regulations may be grounds for revoking or suspending security
access to these facilities. HCA reserves the right and authority to immediately revoke
security access to Contractor staff for any real or threatened breach of this provision.
Upon reassignment or termination of any Contractor staff, Contractor agrees to promptly
notify HCA.
4.37 SUBCONTRACTING
4.37.1 Neither Contractor, nor any Subcontractors, may enter into subcontracts for any of
the work contemplated under this Contract without prior written approval of HCA.
HCA has sole discretion to determine whether or not to approve any such
subcontract. In no event will the existence of the subcontract operate to release or
reduce the liability of Contractor to HCA for any breach in the performance of
Contractor's duties.
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4.37.2 Contractor is responsible for ensuring that all terms, conditions, assurances and
certifications set forth in this Contract are included in any subcontracts.
4.37.3 If at any time during the progress of the work HCA determines in its sole judgment
that any Subcontractor is incompetent or undesirable, HCA will notify Contractor,
and Contractor must take immediate steps to terminate the Subcontract9r's
involvement in the work.
4.37.4 The rejection or approval by the HCA of any Subcontractor or the termination of a
Subcontractor will not relieve Contractor of any of its responsibilities under the
Contract, nor be the basis for additional charges to HCA.
4.37.5 HCA has no contractual obligations to any Subcontractor or vendor under contract
to the Contractor. Contractor is fully responsible for all contractual obligations,
financial or otherwise, to its Subcontractors.
4.38 SUBRBCIRIENT
4.38.1 General
If the Contractor is a subrecipient (as defined in 45 CFR 75.2 and 2 CFR 200.93)
of federal awards, then the Contractor, in accordance with 2 CFR 200.501 and 45
CFR 75.501, shall:
4.38.1.1 Maintain records that identify, in its accounts, all federal awards
received and expended and the federal programs under which
they were received, by Catalog of Federal Domestic Assistance
(CFDA) title and number, award number and year, name of the
federal agency, and name of the pass-through entity;
4.38.1.2 Maintain internal controls that provide reasonable assurance that
the Contractor is managing federal awards in compliance with
laws, regulations, and provisions of contracts or grant
agreements that could have a material effect on each of its
federal programs;
4.38.1.3 Prepare appropriate financial statements, including a schedule of
expenditures of federal awards;
4.38.1.4 Incorporate OMB Super Circular 2 CFR 200.501 and 45 CFR
75.501 audit requirements into all agreements between the
Contractor and its Subcontractors who are subrecipients;
4.38.1.5 Comply with any future amendments to OMB Super Circular 2
CFR 200.501 and 45 CFR 75.501 and any successor or
replacement Circular or regulation;
4.38.1.6 Comply with the applicable requirements of OMB Super Circular
2 CFR 200.501 and 45 CFR 75.501 and any future amendments
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to OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501, and
any successor or replacement Circular or regulation; and
4.38.1.7 Comply with the Omnibus Crime Control and Safe streets Act of
1968, Title VI of the Civil Rights Act of 1964, Section 504 of the
R Rehabilitation Act of 1973, Title 11 of the Americans with
Disabilities Act of 1990, Title IX of the Education Amendments of
1972, The Age Discrimination Act of 1975, and The Department
of Justice Rion-Discrimination Regulations, 28 C.F.R. Part 42,
Subparts C.D.E. and G, and 28 C.F.R. Part 35 and 39. (Go to
http://oip.gov/about/offices/ocr.htm for additional information and
access to the aforementioned Federal laws and regulations.)
4.38.2 Single Audit Act Compliance
If the Contractor is a subrecipient and expends $750,000 or more in federal
awards from any and/or all sources in any fiscal year, the Contractor shall procure
and pay for a single audit or a program-specific audit for that fiscal year. Upon
completion of each audit, the Contractor shall:
4.38.2.1 Submit to the Authority contact person the data collection form
and reporting package specified in OMB Super Circular 2 CFR
200.501 and 45 CFR 75.501, reports required by the program-
specific audit guide (if applicable), and a copy of any
management letters issued by the auditor;
4.38.2.2 Follow-up and develop corrective action for all audit findings; in
accordance with OMB Super Circular 2 CFR 200.501 and 45
CFR 75.501, prepare a "Summary Schedule of Prior Audit
Findings."
4.38.3 Overpayments
4.38.3.1 If it is determined by HCA, or during the course of a required
audit, that Contractor has been paid unallowable costs under this
or any Program Agreement, Contractor shall refund the full
amount to HCA as provided in Section 4.27 Overpayments to
Contractors.
4.39 SURVIVAL
The terms and conditions contained in this Contract that, by their sense and context, are
intended to survive the completion, cancellation, termination, or expiration of the Contract
will survive. In addition, the terms of the sections titled Confidential Information
Protection, Confidential Information Breach — Required Notification, Contractor's
Proprietary Information, Disputes, Overpayments to Contractor, Publicity, Records and
Documents Review, Rights in Data/Ownership, and Rights of State and Federal
Governments will survive the termination of this Contract. The right of HCA to recover
any overpayments will also survive the termination of this Contract.
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4.40 TAXES
HCA will pay sales or use taxes, if any, imposed on the services acquired hereunder.
Contractor must pay all other taxes including, but not limited to, Washington Business
and Occupation Tax, other taxes based on Contractor's income or gross receipts, or
personal property taxes levied or assessed on Contractor's personal property. HCA, as
an agency of Washington State government, is exempt from property tax.
Contractor must complete registration with the Washington State Department of Revenue
and be responsible for payment of all taxes due on payments made under this Contract.
4.41 TERMINATION
4.41.1 TERMINATION FOR DEFAULT
In the event HCA determines that Contractor has failed to comply with the terms
and conditions of this Contract, HCA has the right to suspend or terminate this
Contract. HCA will notify Contractor in writing of the need to take corrective action.
If corrective action is not taken within five (5) Business days, or other time period
agreed to in writing by both parties, the Contract may be terminated. HCA
reserves the right to suspend all or part of the Contract, withhold further
payments, or prohibit Contractor from incurring additional obligations of funds
during investigation of the alleged compliance breach and pending corrective
action by Contractor or a decision by HCA to terminate the Contract.
In the event of termination for default, Contractor will be liable for damages as
authorized by law including, but not limited to, any cost difference between the
original Contract and the replacement or cover Contract and all administrative
costs directly related to the replacement Contract, e.g., cost of the competitive
bidding, mailing, advertising, and staff time.
If it is determined that Contractor: (i) was not in default, or (ii) its failure to perform
was outside of its control, fault or negligence, the termination will be deemed a
"Termination for Convenience."
4.41.2 TERMINATION FOR CONVENIENCE
When, at RCA's sole discretion, it is in the best interest of the State, HCA may
terminate this Contract in whole or in part by providing ten (10) calendar days'
written notice. If this Contract is so terminated, HCA will be liable only for payment
in accordance with the terms of this Contract for services rendered prior to the
effective date of termination. No penalty will accrue to HCA in the event the
termination option in this section is exercised.
4.41.3 TERMINATION FOR NONALLOCATION OF FUNDS
If funds are not allocated to continue this Contract in any future period, HCA may
immediately terminate this Contract by providing written notice to the Contractor.
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The termination will be effective on the date specified in the termination notice.
HCA will be liable only for payment in accordance with the terms of this Contract
for services rendered prior to the effective date of termination. HCA agrees to
notify Contractor of such non-allocation at the earliest possible time. No penalty
will accrue to HCA in the event the termination option in this section is exercised.
4.41.4 TERMINATION FOR WITHDRAWAL OF AUTHORITY
In the event that the authority of HCA to perform any of its duties is withdrawn,
reduced, or limited in any way after the commencement of this Contract and prior
to normal completion, HCA may immediately terminate this Contract by providing
written notice to the Contractor. The termination will be effective on the date
specified in the termination notice. HCA will be liable only for payment in
accordance with the terms of this Contract for services rendered prior to the
effective date of termination. HCA agrees to notify Contractor of such withdrawal
of authority at the earliest possible time. No penalty will accrue to HCA in the
event the termination option in this section is exercised.
4.41.5 TERMINATION FOR CONFLICT OF INTEREST
HCA may terminate this Contract by written notice to the Contractor if HCA
determines, after due notice and examination, that there is a violation of the Ethics
in Public Service Act, Chapter 42.52 RCW, or any other laws regarding ethics in
public acquisitions and procurement and performance of contracts. In the event
this Contract is so terminated, HCA will be entitled to pursue the same remedies
against the Contractor as it could pursue in the event Contractor breaches the
contract.
4.42 TERMINATION PROCEDURES
4.42.1 Upon termination of this Contract, HCA, in addition to any other rights provided in
this Contract, may require Contractor to deliver to HCA any property specifically
produced or acquired for the performance of such part of this Contract as has been
terminated.
4.42.2 HCA will pay Contractor the agreed-upon price, if separately stated, for completed
work and services accepted by HCA and the amount agreed upon by the Contractor
and HCA for (i) completed work and services for which no separate price is stated;
(ii) partially completed work and services; (iii) other property or services that are
accepted by HCA; and (iv) the protection and preservation of property, unless the
termination is for default, in which case HCA will determine the extent of the liability.
Failure to agree with such determination will be a dispute within the meaning of
Section 4.13 Disputes. HCA may withhold from any amounts due the Contractor
such sum as HCA determines to be necessary to protect HCA against potential loss
or liability.
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4.42.3 After receipt of notice of termination, and except as otherwise directed by HCA,
Contractor must:
4.41.3.1 Stop work under the Contract on the date of, and to the extent specified
in, the notice;
4.42.3.2 Place no further orders or subcontracts for materials, services, or
facilities except as may be necessary for completion of such portion of
the work under the Contract that is not terminated;
4.42.3.3 Assign to HCA, in the manner, at the times, and to the extent directed
by HCA, all the rights, title, and interest of the Contractor under the
orders and subcontracts so terminated; in which case HCA has the
right, at its discretion, to settle or pay any or all claims arising out of the
termination of such orders and subcontracts;
4.42.3.4 Settle all outstanding liabilities and all claims arising out of such
termination of orders and subcontracts, with the approval or ratification
of HCA to the extent HCA may require, which approval or ratification will
be final for all the purposes of this clause;
4.42.3.5 Transfer title to and deliver as directed by HCA any property required to
be furnished to HCA;
4.42.3.6 Complete performance of any part of the work that was not terminated
by HCA; and
4.42.3.7 Take such action as may be necessary, or as HCA may direct, for the
protection and preservation of the records related to this Contract that
are in the possession of the Contractor and in which HCA has or may
acquire an interest.
4.43 WAIVER
Waiver of any breach of any term or condition of this Contract will not be deemed a
waiver of any prior or subsequent breach or default. No term or condition of this Contract
will be held to be waived, modified, or deleted except by a written instrument signed by
the parties. Only the HCA Authorized Representative has the authority to waive any term
or condition of this Contract on behalf of HCA.
4.44 WARRANTIES
4.44.1 Contractor represents and warrants that it will perform all services pursuant to this
Contract in a professional manner and with high quality and will immediately re-
perform any services that are not in compliance with this representation and
warranty at no cost to HCA.
4.44.2 Contractor represents and warrants that it shall comply with all applicable local,
State, and federal licensing, accreditation and registration requirements and
standards necessary in the performance of the Services.
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4.44.3 Any written commitment by Contractor within the scope of this Contract will be
binding upon Contractor. Failure of Contractor to fulfill such a commitment may
constitute breach and will render Contractor liable for damages under the terms of
this Contract.
For purposes of this section, a commitment by Contractor includes: (i) Prices,
discounts, and options committed to remain in force over a specified period of
time; and (ii) any warranty or representation made by Contractor to HCA or
contained in any Contractor publications, or descriptions of services in written or
other communication medium, used to influence HCA to enter into this Contract.
Approved as to Form:
This contract format was approved by
the Office of the Attorney General.
Approval on file.
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ATTACHMENT 1 FEDERAL COMPLIANCE, CERTIFICATIONS, AND ASSURANCES
In the event federal funds are included in this agreement,the following sections apply: I. Federal Compliance
and II.Standard Federal Assurances and Certifications. In the instance of inclusion of federal funds,the
Contractor may be designated as a sub-recipient and the effective date of the amendment shall also be the
date at which these requirements go into effect.
FEDERAL COMPLIANCE-The use of federal funds requires additional compliance and control
mechanisms to be in place. The following represents the majority of compliance elements that may
apply to any federal funds provided under this contract. For clarification regarding any of these elements
or details specific to the federal funds in this contract, contact the Health Care Authority.
a. Source of Funds: This agreement is being funded partially or in full through Cooperative Agreement
number, the full and complete terms and provisions of which are hereby incorporated into this
agreement can be found by reference. Federal funds to support this agreement are identified by the
Catalog of Federal Domestic Assistance (CFDA) number 93.778. The sub-awardee is responsible
for tracking and reporting the cumulative amount expended under HCA Contract No.K2751
b. Period of Availability of Funds: Pursuant to 45 CFR 92.23, Sub-awardee may charge to the award
only costs resulting from obligations of the funding period specified, unless carryover of unobligated
balances is permitted, in which case the carryover balances may be charged for costs resulting from
obligations of the subsequent funding period. All obligations incurred under the award must be
liquidated no later than 90 days after the end of the funding period.
c. Single Audit Act: A sub-awardee (including private, for-profit hospitals and non-profit institutions)
shall adhere to the federal Office of Management and Budget(OMB) Super Circular 2 CFR 200.501
and 45 CFR 75.501. A sub-awardee who expends$750,000 or more in federal awards during a
given fiscal year shall have a single or program-specific audit for that year in accordance with the
provisions of OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501.
d. Modifications:This agreement may not be modified or amended, nor may any term or provision be
waived or discharged, including this particular Paragraph, except in writing, signed upon by both
parties.
1. Examples of items requiring Health Care Authority prior written approval include, but are not
limited to, the following:
i. Deviations from the budget and Project plan.
ii. Change in scope or objective of the agreement.
iii. Change in a key person specified in the agreement.
iv. The absence for more than three months or a 25% reduction in time by the Project
Manager/Director.
v. Need for additional funding.
vi. Inclusion of costs that require prior approvals as outlined in the appropriate cost principles.
vii. Any changes in budget line item(s) of greater than twenty percent(20%) of the total
budget in this agreement.
2. No changes are to be implemented by the Sub-awardee until a written notice of approval is
received from the Health Care Authority.
e. Sub-Contracting: The sub-awardee shall not enter into a sub-contract for any of the work performed
under this agreement without obtaining the prior written approval of the Health Care Authority. If
sub-contractors are approved by the Health Care Authority, the subcontract, shall contain, at a
minimum, sections of the agreement pertaining to Debarred and Suspended Vendors, Lobbying
certification, Audit requirements, and/or any other project Federal, state, and local requirements.
f. Condition for Receipt of Health Care Authority Funds: Funds provided by Health Care Authority to
the sub-awardee under this agreement may not be used by the sub-awardee as a match or cost-
sharing provision to secure other federal monies without prior written approval by the Health Care
Authority.
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g. Unallowable Costs:The sub-awardees' expenditures shall be subject to reduction for amounts
included in any invoice or prior payment made which determined by HCA not to constitute allowable
costs on the basis of audits, reviews, or monitoring of this agreement.
h. Citizenship/Alien Verification/Determination:The Personal Responsibility and Work Opportunity
Reconciliation Act(PRWORA) of 1996 (PL 104-193) states4that federal public benefits should be
made available only to U.S. citizens and qualified aliens. Entities that offer a service defined as a
"federal public benefit" must make a citizenship/qualified alien determination/verification of
applicants at the time of application as part of the eligibility criteria. Non-US citizens and unqualified
aliens are not eligible to receive the services. PL 104-193 also includes specific reporting
requirements.
i. Federal Compliance:The sub-awardee shall comply with all applicable State and Federal statutes,
laws, rules, and regulations in the performance of this agreement, whether included specifically in
this agreement or not.
j. Civil Rights and Non-Discrimination Obligations During the performance of this agreement, the
Contractor shall comply with all current and future federal statutes relating to nondiscrimination.
These include but are not limited to: Title VI of the Civil Rights Act of 1964 (PL 88-352), Title IX of
the Education Amendments of 1972 (20 U.S.C. §§ 1681-1683 and 1685-1686), section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. § 794), the Age Discrimination Act of 1975 (42 U.S.C. §§6101-
6107), the Drug Abuse Office and Treatment Act of 1972 (PL 92-255), the Comprehensive Alcohol
Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), §§523 and
527 of the Public Health Service Act of 1912 (42 U.S.C. §§290dd-3 and 290ee-3), Title VIII of the
Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), and the Americans with Disability Act(42
U.S.C., Section 12101 et seq.) http://www.hhs.gov/ocr/civilrights
HCA Federal Compliance Contact Information
Federal Grants and Budget Specialist
Health Care Policy
Washington State Health Care Authority
Post Office Box 42710
Olympia, Washington 98504-2710
CIRCULARS `COMPLIANCE MATRIX' -The following compliance matrix identifies the OMB Circulars
that contain the requirements which govern expenditure of federal funds. These requirements apply to
the Washington State Health Care Authority (HCA), as the primary recipient of federal funds and then
follow the funds to the sub-awardee, x. The federal Circulars which provide the applicable administrative
requirements, cost principles and audit requirements are identified by sub-awardee organization type.
II.
OMB CIRCULAR
ENTITY TYPE ADMINISTRATIVE COST AUDIT REQUIREMENTS
REQUIREMENTS PRINCIPLES
State. Local and Indian Tribal OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501
Governments and
Governmental Hospitals
Non-Profit Organizations and
Non-Profit Hospitals
Colleges or Universities and
Affiliated Hospitals
For-Profit Organizations
Definitions:
"Sub-recipient";means the legal entity to which a sub-award is made and which is accountable to the State for the
use of the funds provided in carrying out a portion of the State's programmatic effort under a sponsored project.The
term may include institutions of higher education, for-profit corporations or non-U.S. Based entities.
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"Sub-award and Sub-grant"are used interchangeably and mean a lower tier award of financial support from a prime awardee
(e.g.,Washington State Health Care Authority)to a Sub-recipient for the performance of a substantive portion of the
program.These requirements do not apply to the procurement of goods and services for the benefit of the Washington
State Health Care Authority.
IV. STANDARD FEDERAL CERTIFICATIONS AND ASSURANCES - Following are the Assurances,
Certifications, and Special Conditions that apply to all federally funded (in whole or in part) agreements
administered by the Washington State Health Care Authority.
CERTIFICATIONS
1. CERTIFICATION REGARDING Covered Transactions" in all lower tier covered
DEBARMENT AND SUSPENSION transactions (i.e., transactions with sub-grantees
and/or contractors) and in all solicitations for lower
The undersigned (authorized official signing for the tier covered transactions in accordance with 45
contracting organization) certifies to the best of his CFR Part 76.
or her knowledge and belief, that the contractor,
defined as the primary participant in accordance
with 45 CFR Part 76, and its principals: 2. CERTIFICATION REGARDING DRUG-FREE
WORKPLACE REQUIREMENTS
a) are not presently debarred, suspended,
proposed for debarment, declared ineligible, or The undersigned (authorized official signing for the
voluntarily excluded from covered transactions contracting organization) certifies that the
by any Federal Department or agency; contractor will, or will continue to, provide a drug-
free workplace in accordance with 45 CFR Part 76
b) have not within a 3-year period preceding this by:
contract been convicted of or had a civil
judgment rendered against them for a) Publishing a statement notifying employees
commission of fraud or a criminal offense in that the unlawful manufacture, distribution,
connection with obtaining, attempting to obtain, dispensing, possession or use of a controlled
or performing a public (Federal, State, or local) substance is prohibited in the grantee's
transaction or contract under a public workplace and specifying the actions that will
transaction; violation of Federal or State be taken against employees for violation of
antitrust statutes or commission of such prohibition;
embezzlement, theft, forgery, bribery,
falsification or destruction of records, making b) Establishing an ongoing drug-free awareness
false statements, or receiving stolen property; program to inform employees about
(1) The dangers of drug abuse in the
c) are not presently indicted or otherwise workplace;
criminally or civilly charged by a governmental (2) The contractor's policy of maintaining a
entity (Federal, State, or local)with commission drug-free workplace;
of any of the offenses enumerated in paragraph (3)Any available drug counseling,
(b) of this certification; and rehabilitation, and employee assistance
programs; and
d) have not within a 3-year period preceding this (4) The penalties that may be imposed upon
contract had one or more public transactions employees for drug abuse violations
(Federal, State, or local) terminated for cause occurring in the workplace;
or default.
c) Making it a requirement that each employee to
Should the contractor not be able to provide this be engaged in the performance of the contract
certification, an explanation as to why should be be given a copy of the statement required by
placed after the assurances page in the contract. paragraph (a) above;
The contractor agrees by signing this contract that d) Notifying the employee in the statement
it will include, without modification, the clause titled required by paragraph (a), above, that, as a
"Certification Regarding Debarment, Suspension, condition of employment under the contract,
In eligibility, and Voluntary Exclusion--Lower Tier the employee will—
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(1) Abide by the terms of the statement; and Title 31, United States Code, Section 1352, entitled
(2) Notify the employer in writing of his or her "Limitation on use of appropriated funds to
conviction for a violation of a criminal drug influence certain Federal contracting and financial
statute occurring in the workplace no later than transactions," generally prohibits recipients of
five calendar days after such conviction; Federal grants and cooperative agreements from
using Federal (appropriated) funds for lobbying the
e) Notifying the agency in writing within ten Executive or Legislative Branches of the Federal
calendar days after receiving notice under Government in connection with a SPECIFIC grant
paragraph (d)(2) from an employee or or cooperative agreement. Section 1352 also
otherwise receiving actual notice of such requires that each person who requests or receives
conviction. Employers of convicted employees a Federal grant or cooperative agreement must
must provide notice, including position title, to disclose lobbying undertaken with non-Federal
every contract officer or other designee on (nonappropriated) funds. These requirements
whose contract activity the convicted employee apply to grants and cooperative agreements
was working, unless the Federal agency has EXCEEDING $100,000 in total costs (45 CFR Part
designated a central point for the receipt of 93).
such notices. Notice shall include the
identification number(s) of each affected grant; The undersigned (authorized official signing for the
contracting organization) certifies, to the best of his
f) Taking one of the following actions, within 30 or her knowledge and belief, that:
calendar days of receiving notice under
paragraph (d)(2),with respect to any employee (1) No Federal appropriated funds have been paid
who is so convicted— or will be paid, by or on behalf of the
(1) Taking appropriate personnel action undersigned, to any person for influencing or
against such an employee, up to and attempting to influence an officer or employee
including termination, consistent with of any agency, a Member of Congress, an
the requirements of the Rehabilitation officer or employee of Congress, or an
Act of 1973, as amended; or employee of a Member of Congress in
(2) Requiring such employee to participate connection with the awarding of any Federal
satisfactorily in a drug abuse contract, the making of any Federal grant, the
assistance or rehabilitation program making of any Federal loan, the entering into
approved for such purposes by a of any cooperative agreement, and the
Federal, State, or local health, law extension, continuation, renewal, amendment,
enforcement, or other appropriate or modification of any Federal contract, grant,
agency; loan, or cooperative agreement.
g) Making a good faith effort to continue to (2) If any funds other than Federally appropriated
maintain a drug-free workplace through funds have been paid or will be paid to any
implementation of paragraphs (a), (b), (c), (d), person for influencing or attempting to
(e), and (f). influence an officer or employee of any
agency, a Member of Congress, an officer or
For purposes of paragraph (e) regarding agency employee of Congress, or an employee of a
notification of criminal drug convictions, Authority Member of Congress in connection with this
has designated the following central point for Federal contract, grant, loan, or cooperative
receipt of such notices: agreement, the undersigned shall complete
and submit Standard Form-LLL, "Disclosure of
Legal Services Manager Lobbying Activities," in accordance with its
WA State Health Care Authority instructions. (If needed, Standard Form-LLL,
PO Box 42700 "Disclosure of Lobbying Activities," its
Olympia, WA 98504-2700 instructions, and continuation sheet are
included at the end of this application form.)
3. CERTIFICATION REGARDING LOBBYING (3) The undersigned shall require that the
language of this certification be included in the
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award documents for all subcontracts at all tiers Failure to comply with the provisions of the law
(including subcontracts, subcontracts, and may result in the imposition of a civil monetary
contracts under grants, loans and cooperative penalty of up to $1,000 for each violation and/or
agreements) and that all sub-recipients shall the imposition of an administrative compliance
certify and disclose accordingly. order on the responsible entity.
This certification is a material representation of fact By signing the certification, the undersigned
upon which reliance was placed when this certifies that the contracting organization will
transaction was made or entered into. Submission of comply with the requirements of the Act and will not
this certification is a prerequisite for making or allow smoking within any portion of any indoor
entering into this transaction imposed by Section facility used for the provision of services for children
1352, U.S. Code. Any person who fails to file the as defined by the Act.
required certification shall be subject to a civil penalty
of not less than$10,000 and not more than$100,000 The contracting organization agrees that it will
for each such failure. require that the language of this certification be
included in any subcontracts which contain
4. CERTIFICATION REGARDING PROGRAM provisions for children's services and that all sub-
FRAUD CIVIL REMEDIES ACT (PFCRA) recipients shall certify accordingly.
The undersigned (authorized official signing for the The Public Health Services strongly
contracting organization) certifies that the encourages all recipients to provide a smoke-
statements herein are true, complete, and accurate free workplace and promote the non-use of
to the best of his or her knowledge, and that he or tobacco products.This is consistent with the
she is aware that any false, fictitious, or fraudulent PHS mission to protect and advance the
statements or claims may subject him or her to physical and mental health of the American
criminal, civil, or administrative penalties. The people.
undersigned agrees that the contracting
organization will comply with the Public Health 6. CERTIFICATION REGARDING
Service terms and conditions of award if a contract DEBARMENT, SUSPENSION, AND OTHER
is awarded. RESPONSIBILITY MATTERS
INSTRUCTIONS FOR CERTIFICATION
5. CERTIFICATION REGARDING 1) By signing and submitting this proposal, the
ENVIRONMENTAL TOBACCO SMOKE prospective contractor is providing the
Public Law 103-227, also known as the Pro- certification set out below.
Children Act of 1994 (Act), requires that smoking 2) The inability of a person to provide the
not be permitted in any portion of any indoor facility certification required below will not necessarily
owned or leased or contracted for by an entity and result in denial of participation in this covered
used routinely or regularly for the provision of transaction. The prospective contractor shall
health, day care, early childhood development submit an explanation of why it cannot provide
services, education or library services to children the certification set out below. The certification
under the age of 18, if the services are funded by or explanation will be considered in connection
Federal programs either directly or through State or with the department or agency's determination
local governments, by Federal grant, contract, loan, whether to enter into this transaction. However,
or loan guarantee. The law also applies to failure of the prospective contractor to furnish a
children's services that are provided in indoor certification or an explanation shall disqualify
facilities that are constructed, operated, or such person from participation in this
maintained with such Federal funds. The law does transaction.
not apply to children's services provided in private 3) The certification in this clause is a material
residence, portions of facilities used for inpatient representation of fact upon which reliance was
drug or alcohol treatment, service providers whose placed when the department or agency
sole source of applicable Federal funds is Medicare determined to enter into this transaction. If it is
or Medicaid, or facilities where WIC coupons are later determined that the prospective contractor
redeemed. knowingly rendered an erroneous certification,
in addition to other remedies available to the
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Federal Government, the department or knowledge and information of a participant is
agency may terminate this transaction for not required to exceed that which is normally
cause of default. possessed by a prudent person in the ordinary
4) The prospective contractor shall provide course of business dealings.
immediate written notice to the department or 10) Except for transactions authorized under
agency to whom this contract is submitted if at paragraph 6 of these instructions, if a
any time the prospective contractor learns that participant in a covered transaction knowingly
its certification was erroneous when submitted enters into a lower tier covered transaction with
or has become erroneous by reason of a person who is suspended, debarred,
changed circumstances. ineligible, or voluntarily excluded from
5) The terms covered transaction, debarred, participation in this transaction, in addition to
suspended, ineligible, lower tier covered other remedies available to the Federal
transaction, participant, person, primary Government, Authority may terminate this
covered transaction, principal, proposal, and transaction for cause or default.
voluntarily excluded, as used in this clause,
have the meanings set out in the Definitions 7. CERTIFICATION REGARDING
and Coverage sections of the rules DEBARMENT, SUSPENSION, AND OTHER
implementing Executive Order 12549. You may RESPONSIBILITY MATTERS --PRIMARY
contact the person to whom this contract is COVERED TRANSACTIONS
submitted for assistance in obtaining a copy of
those regulations. 1) The prospective contractor certifies to the best
6) The prospective contractor agrees by of its knowledge and belief, that it and its
submitting this contract that, should the principals:
proposed covered transaction be entered into, a) Are not presently debarred, suspended,
it shall not knowingly enter into any lower tier proposed for debarment, declared
covered transaction with a person who is ineligible, or voluntarily excluded from
debarred, suspended, declared ineligible, or covered transactions by any Federal
voluntarily excluded from participation in this department or agency;
covered transaction, unless authorized by b) Have not within a three-year period preceding
Authority. this contract been convicted of or had a civil
7) The prospective contractor further agrees by judgment rendered against them for
submitting this contract that it will include the commission of fraud or a criminal offense in
clause titled Certification Regarding connection with obtaining, attempting to obtain,
Debarment, Suspension, Ineligibility and or performing a public (Federal, State or local)
Voluntary Exclusion -- Lower Tier Covered transaction or contract under a public
Transaction," provided by HHS, without transaction; violation of Federal or State
modification, in all lower tier covered antitrust statutes or commission of
transactions and in all solicitations for lower tier embezzlement, theft, forgery, bribery,
covered transactions. falsification or destruction of records, making
8) A participant in a covered transaction may rely false statements, or receiving stolen property;
upon a certification of a prospective participant c) Are not presently indicted for or otherwise
in a lower tier covered transaction that it is not criminally or civilly charged by a
debarred, suspended, ineligible, or voluntarily governmental entity (Federal, State or
excluded from the covered transaction, unless local) with commission of any of the
it knows that the certification is erroneous. A offenses enumerated in paragraph (1)(b)of
participant may decide the method and this certification; and
frequency by which it determines the eligibility d) Have not within a three-year period
of its principals. Each participant may, but is not preceding this contract had one or more
required to, check the Non-procurement List(of public transactions (Federal, State or local)
excluded parties). terminated for cause or default.
9) Nothing contained in the foregoing shall be 2) Where the prospective contractor is unable to
construed to require establishment of a system certify to any of the statements in this certification,
of records in order to render in good faith the such prospective contractor shall attach an
certification required by this clause. The explanation to this proposal.
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CONTRACTOR SIGNATURE REQUIRED
SIGNATURE OF AUTHORIZED TITLE
CERTIFYING OFFICIAL
Please also print or type name:
ORGANIZATION NAME: (if applicable) DATE
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Attachment 2 Federal Funding Accountability and Transparency Act(FFATA) Data Collection Form
This Contract 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 federal funds are spent. -
To comply with the act and be eligible to enter into this contract, your organization must have a Data Universal
Numbering System (DUNS®) number. A DUNS® number provides a method to verify data about your
organization. If you do not already have one, you may receive a DUNS® number free of charge by contacting
Dun and Bradstreet at www.dnb.com.
Required Information about your organization and this contract will be made available on USASpending.gov by
the Washington State Health Care Authority (HCA)as required by P.L. 109-282. As a tool to provide the
information, HCA encourages registration with the Central Contractor Registry (CCR) because less data entry
and re-entry is required by both HCA and your organization. You may register with CCR on-line at
https://www.uscontractorreqistration.com/.
Contractor must complete this form and return it to the Health Care Authority (HCA).
CONTRACTOR
1. Legal Name 2. DUNS Number
3. Principle Place of Performance
3a. City 3b. State
3c. Zip=4 3d. Country
4. Are you registered in CCR (https://www.uscontractorreqistration.com/)? DYES (skip to page 2. Sign, date and
return) ONO
5. In the preceding fiscal year did your organization:
a. Receive 80% or more of annual gross revenue from federal contracts, subcontracts, grants, loans, subgrants,
and/or cooperative agreements; and
b. $25,000,000 or more in annual gross revenues from federal contracts, subcontracts, grants, loans,
subgrants, and/or cooperative agreements; and
c. The public does not have access to information about the compensation of the executives through periodic
reports filled with the IRS or the Security and Exchange Commission per 2 CFR Part 170.330
❑ NO (skip the remainder of this section - Sign, date and return)
❑ YES (You must report the names and total compensation of the top 5 highly compensated officials of your
organization).
Name Of Official Total Compensation
1.
2.
3.
•
4.
5.
Note: "Total compensation" means the cash and noncash dollar value earned by the executive during the
sub-recipient's past fiscal year of the following (for more information see 17 CFR 229.402 (c)(2)).
Washington State
Health Care Authority Page 38 of 53 Contract#2751
Schedule A:
Statement of Work (SOW)
The Contractor shall provide the services and staff, and otherwise do all things necessary for or
incidental to the performance of work, as set forth below:
A. In accordance with deadlines in Exhibit A, ABCD Quarterly Outreach and Case
Management Report, develop and implement an ABCD action plan in accordance with
the ABCD program principles and submit corresponding budget, using Exhibit C, ABCD
Yearly Budget Tool. The ABCD program principles are outlined below.
1. Provide outreach and recruitment of Apple Health/Medicaid-eligible Clients, ages birth
to six (6), in collaboration with other organizations, including, but not limited to:
a) Contact no less than ten (10%) of Client list provided by HCA to the Contractor;
i. HCA shall provide the Contractor's contact name identified on page 1, a list
that shall include the following data elements: Client ID, Name, Address,
and Telephone Number of Clients who have not gone to the dentist, as well
the Client's caregiver name and preferred spoken language. HCA shall
securely transmit Client information and the Contractor shall be responsible
for notifying the Dental Program Manager within five (5) business days prior
to the beginning of the quarter if they have not received this information.
b) Provide outreach by attending, visiting or working with the below, but not limited to
the following:
i. County Health Fairs;
ii. SmileMobile locations (a mobile clinic serving dental needs to children
by the Washington Dental Service Foundation);
iii. Women, Infants, and Children WIC offices (a federal assistance
program of the Food and Nutrition Services of the United States
Department of Agriculture;
iv. Head Start facilities (a federal program that promotes the school
readiness of children under five from low-income families);
v. Early Learning Regional Coalitions (that are a not-for-profit alliance of
employers and community subsidized before and after school child
care); and
vi. Day Care facilities throughout the state of Washington.
c) Provide care coordination, including:
i. Provide family orientation; including but not limited to, sharing information
about the value of a child going to the dentist, what activities will occur in the
dentist's office;
Washington State
Health Care Authority Page 39 of 53 Contract#2751
ii. Connect families with an ABCD certified dentist who accepts Apple
Health/Medicaid, and providing information including, but not limited to,
names and referrals to dentists, sharing information about interpreters and
transportation benefits, and following up after an appointment, if appropriate;
iii. Assisting in scheduling dental appointments for eligible children and council
on the importance of keeping the appointment; and
iv. Identify and address family barriers to accessing oral health care.
2. Convene Health Coalition/ABCD Steering Committee or participate in a Coalition or
Steering Committee focused on health care, access or early learning with ABCD semi-
annually.
a) Invite the ABCD program manager with ARCORA Foundation and the Health
Care Authority Dental program administrator.
3. Coordinate with the local ABCD Dental Champions to:
a) Identify and recruit dental providers who will take Apple Health/Medicaid Clients
through the ABCD Program;
b) Maintain a list of active ABCD providers who accept Apple Health/Medicaid
Clients birth to six (6) years and monitor provider availability to accept new
Clients birth to six (6) years into their practice;
c) Support current ABCD providers by communicating program changes and policy
updates through in-person meetings and written communication;
d) Provide or assist in providing new ABCD provider trainings to providers as
needed;
e) Assure certification process is completed;
f) Provide Apple Health/Medicaid billing training assistance to ABCD offices/or
providers or arrange for billing assistance;
g) Update dental society (or local dentists/study clubs in counties without a society)
on the ABCD Program and encourage their continued recruitment of new Apple
Health/Medicaid providers; and
h) Support the Dental Champion(s) participation in meetings and activities
necessary to effectively conduct Apple Health/Medicaid provider outreach,
recruitment and training, including financial support of attendance in development
day.
4. Identify and recruit primary care medical providers to participate in Apple
Health/Medicaid, secure their training in preventive oral health techniques and build
their role in referring Apple Health/Medicaid-eligible children to the ABCD Program.
This may include oral health education, fluoride treatments, etc.
Washington State
Health Care Authority Page 40 of 53 Contract#2751
5. Participate in all three (3) statewide ABCD Coordinators group meetings to remain
current with ABCD policies, practices and opportunities.
6. Participate in statewide ABCD Champion Development Day meeting to remain current
with any new clinical practices and opportunities. As well as meeting and networking
with other champions to discuss roadblocks and program success stories.
7. Identify an ABCD Coordinator within the contracting organization who will develop and
maintain a desk manual that outlines the expected ABCD contractual deliverables and
how the contractor meets each deliverable. The Coordinator will utilize this manual to
fulfill the contractual requirements.
If the Contractor's Coordinator leaves, the contractor is responsible to notify the Health
Care Authority within two weeks, of the coordinators departure or as soon as possible
and share the Contractor's developed work plan that outlines how the expected
contract deliverables will be met. The Contractor will share with HCA the contact
information of the newly hired or appointed Coordinator and coordinate with HCA to
assure a smooth transition of the expected contracted work deliverables.
8. Each quarter complete and submit the following via email:
1) Community Outreach and Coordination Care summary which shall include;
a) Exhibit A, ABCD Quarterly Outreach and Case Management Report for the
specific quarter; and
b) Exhibit B, ABCD Quarterly Outreach and Coordination of Care Report.
2) Each year complete and submit via email the Exhibit C, ABCD Yearly Budget Tool, as
applicable to the requirements, contained in Exhibit A.
3) A fully completed invoice that correlates with dollar values for completed deliverables
outlined in Exhibit A:
a) Exhibit templates are available on the ABCD website http://abcd-dental.orq/for-
coordinators/; and
b) Reports and billing must be submitted no later than one month after each quarter
end date, unless otherwise mutually agreed by both parties.
Washington State
Health Care Authority Page 41 of 53 Contract#2751
Exhibit A ABCD Quarterly Outreach & Case Management Report
Year One 2018 - 2019 • 1st Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.TadeoHCA.WA.GOV
Organization: Mason County Public Health
ABCD Contact Person: Lydia Buchheit
Phone: 360-427-9670x545 lydiab@co.mason.wa.us
1st
Quarter
Report Due: 10/31/18 7/1/18—
9/30/18
Brief description (for events, provide date
Maximum held/attended/for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Category Yes/No deliverable additional detail)
Allocate staff and review contract to plan and Include attached budget (Exhibit C) and copy of your
create the year 1 action plan. $1,470 plan.
Community and Provider Outreach $2,140 Complete Exhibit B
Coordinate Care $665 Complete Exhibit B
Provide outcome information such as minutes, copies of
Convene Health Coalition/ABCD Steering information provided or list of items provided, examples of
committee or participate in a Coalition or type of Organizations attended, what were outcomes or
Steering Committee Focused on Health Care, next steps for ABCD.
Access or Early Learning with ABCD as a *Send invitation and report back any concerns/issues to
Quarterly Agenda Item. HCA Dental Program Administrator & ABCD
$500 Administrator
Washington State
Health Care Authority Page 42 of 53 Contract#2751
Exhibit A ABCD Quarterly Outreach & Case Management Report
Year One 2018 - 2019 • 2nd Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.TadeoHCA.WA.GOV
Organization: Mason County Public Health
ABCD Contact Person: Lydia Buchheit
Phone: 360-427-9670x545 lydiab@co.mason.wa.us
2nd
Quarter
Report Due: 01/30/19 10/1/18 —
12/31/18
Brief description (for events, provide date
Maximum held/attended/ for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Category Yes/No deliverable additional detail)
Attend and participate in ABCD
Coordinator/Program Meeting $1,470
Community and Provider Outreach $500 Complete Exhibit B
Coordinate Care $2,140 Complete Exhibit B
Provide outcome information such as minutes, copies of
Convene Health Coalition/ABCD Steering information provided or list of items provided, examples of
committee or participate in a Coalition or type of Organizations attended, what were outcomes or
Steering Committee Focused on Health Care, next steps for ABCD.
Access or Early Learning with ABCD as a *Send invitation and report back any concerns/issues to
Quarterly Agenda Item. FICA Dental Program Administrator & ABCD
$665 Administrator
Washington State
Health Care Authority Page 43 of 53 Contract#2751
Exhibit A ABCD Quarterly Outreach & Case Management Report
Year One 2018 - 2019 • 3rd Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.TadeoAHCA.WA.GOV
Organization: Mason County Public Health
ABCD Contact Person: Lydia Buchheit
Phone: 360-427-9670x545 lydiab@co.mason.wa.us
3rd
Quarter
Report Due: 04/30/19 1/1/19 —
3/31/19
Brief description (for events, provide date
Maximum held/attended/for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Category Yes/No deliverable additional detail)
Attend and participate in ABCD
Coordinator/Program Meeting $500
Community and Provider Outreach $2,625 Complete Exhibit B
Coordinate Care $1,150 Complete Exhibit B
Provide outcome information such as minutes, copies of
Convene Health Coalition/ABCD Steering information provided or list of items provided, examples of
committee or participate in a Coalition or type of Organizations attended, what were outcomes or
Steering Committee Focused on Health Care, next steps for ABCD.
Access or Early Learning with ABCD as a *Send invitation and report back any concerns/issues to
Quarterly Agenda Item. HCA Dental Program Administrator & ABCD
$500 Administrator
Washington State
Health Care Authority Page 44 of 53 Contract#2751
Exhibit A ABCD Quarterly Outreach & Case Management Report
Year One 2018 - 2019 • 4th Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.TadeoCa?HCA.WA.GOV
Or.anization: Mason Count Public Health
ABCD Contact Person:
L dia Buchheit
360-427-9670x545 I diab • co.mason.wa.us
Phone: 4th
Quarter
Report Due: 07/31/2019 411119—
6/30/19rovide date
Brief description (for events, p
Maximum held/attended/ for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Cate•o Yes/No deliverable additional detail)
Contact at least 10% of client list
$1,470 Complete Exhibit B
Attend and participate in ABCD $500
Coordinator/Pro.ram Meetin. $2 140 Complete Exhibit B
Communit and Provider Outreach $665 Corn slate Exhibit B
Coordinate Care
Washington State
Page 45 of 53 Contract#2751
Health Care Authority
Exhibit A ABCD Quarterly Outreach & Case Management Report -
Year Two 2019 - 2020 • 1st Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.TadeoaHCA.WA.GOV
Organization: Mason County Public Health
ABCD Contact Person: Lydia Buchheit
Phone: 360-427-9670x545 lydiab@co.mason.wa.us
1st
Quarter
Report Due: 10/31/19 711/19 —
9/30/19
Brief description (for events, provide date
Maximum held/attended/for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Category Yes/No deliverable additional detail)
Allocate staff and review contract to plan and Include attached budget (Exhibit C) and copy of your
create the year 2 action plan. $1,470 plan.
Community and Provider Outreach $2,140 Complete Exhibit B
Coordinate Care $665 Complete Exhibit B
Provide outcome information such as minutes, copies of
Convene Health Coalition/ABCD Steering information provided or list of items provided, examples of
committee or participate in a Coalition or type of Organizations attended, what were outcomes or
Steering Committee Focused on Health Care, next steps for ABCD.
Access or Early Learning with ABCD as a *Send invitation and report back any concerns/issues to
Quarterly Agenda Item. HCA Dental Program Administrator & ABCD
$500 Administrator
Washington State
Health Care Authority Page 46 of 53 Contract#2751
Exhibit A ABCD Quarterly Outreach & Case Management Report
Year Two 2019 - 2020 • 2nd Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.TadeoAHCA.WA.GOV
Organization: Mason County Public Health
ABCD Contact Person: Lydia Buchheit
Phone: 360-427-9670x545 lydiab@co.mason.wa.us
2nd
Quarter
Report Due: 01/31/2020 10/1/19 —
12/31/19
Brief description (for events, provide date
Maximum held/attended/ for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Category Yes/No deliverable additional detail)
Contact at least 10% of client list $1,470 Complete Exhibit B
Attend and participate in ABCD $500
Coordinator/Program Meeting $2 140 Complete Exhibit B
Community and Provider Outreach $665 Complete Exhibit B
Coordinate Care
Washington State Page 47 of 53 Contract#2751
Health Care Authority
Exhibit A ABCD Quarterly Outreach & Case Management Report
Year Two 2019 - 2020 • 3rd Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.Tadeo(a�HCA.WA.GOV
Organization: Mason County Public Health
ABCD Contact Person: Lydia Buchheit
Phone: 360-427-9670x545 lydiab@co.mason.wa.us
3rd
Quarter
Report Due: 04/30/20 1/1/20 —
3/31/20
Brief description (for events, provide date
Maximum held/attended/ for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Category Yes/No deliverable additional detail)
Attend and participate in ABCD
Coordinator/Program Meeting $500
Community and Provider Outreach $2,625 Complete Exhibit B
Coordinate Care $1,150 Complete Exhibit B
Provide outcome information such as minutes, copies of
Convene Health Coalition/ABCD Steering information provided or list of items provided, examples of
committee or participate in a Coalition or type of Organizations attended, what were outcomes or
Steering Committee Focused on Health Care, next steps for ABCD.
Access or Early Learning with ABCD as a *Send invitation and report back any concerns/issues to
Quarterly Agenda Item. HCA Dental Program Administrator & ABCD
$500 Administrator
Washington State
Health Care Authority Page 48 of 53 Contract#2751
Exhibit A ABCD Quarterly Outreach & Case Management Report
Year Two 2019 - 2020 • 4th Quarter Report
Please complete and submit report electronically to:
Janice Tadeo, Dental Program Administrator
Division of Health Care Services, Washington State Health Care Authority
PO Box 45506, Olympia, WA 98504-5506
Phone: (360) 725-1583 Email: Janice.TadeoHCA.WA.GOV
Organization: Mason County Public Health
ABCD Contact Person: Lydia Buchheit
Phone: 360-427-9670x545 lydiab@co.mason.wa.us
4th
Quarter
Report Due: 07/31/2020 4/1/20 —
6/30/20
Brief description (for events, provide date
Maximum held/attended/ for staff assignments, provide name
$$ available and title) - no more than 100 words (complete Exhibit
for this A and attach supporting document if providing
Performance Category Yes/No deliverable additional detail)
Contact at least 10% of client list $1,470 Complete Exhibit B
Attend and participate in ABCD
Coordinator/Program Meeting $500
Community and Provider Outreach $2,140 Complete Exhibit B
Coordinate Care $665 Complete Exhibit B
Washington State
Health Care Authority Page 49 of 53 Contract#2751
Exhibit B ABCD Quarterly Outreach and Coordination of Care Report
COORDINATE CARE
Family Orientation
How Many How Location & Date
How provided: in-person/phone/email/mail/etc.
Clients Contacted from List (10%)
How Many
How provided: in-person/phone/email/mail/etc.
Assisted Client w/Initial Dental Appts.
& Provided Follow-Up How Many
If applicable
Referrals To Dental Home How Many
Barriers to Care Identified
How Many
interpreter services/transportation/etc.
Washington State
Health Care Authority Page 50 of 53 Contract#2751
COMMUNITY OUTREACH
Type of Outreach/Place Date How many reached
Examples: County health fairs/coordination w/Smile Mobile/WIC offices/Headstart/Early Learning Centers/Day Cares.
WORK WITH CHAMPION/RECRUIT PROVIDERS
Activity How Many Notes
New Providers Certified
Provider Trainings Held How Many Place and Date
•
Provider Recruitment How Many Place and Date
Washington State
Health Care Authority Page 51 of 53 Contract#2751
Exhibit C A'=CD Yearly Budget Tool
2018-2020 Yearly Expenses (estimated)
Year One Year Two
EXPEN ESXv { July 1, 2018 July 1, 2019
rte,r , to To
• June 30, 2019 June 30, 2020
Staffing/Salary & Benefits—add a column to identify % and hours per week for each year
Program Coordinator (x hrs/week = .X FTE)
Outreach Staff(x hrs/week = .X FTE)
Program Manager (x hrs/week = .X FTE)
Support Staff (clerical, IT, finance, communications/per staff, other x hrs/week = .X FTE)
Administration (x hrs/week (.X FTE)
Salary & Benefits Subtotal
Operating Expenses
Advertising/Marketing (print, broadcast ads; cable TV time, movie ads, weekly newspaper,
billboards, social media)
Office Equipment (Copier, Fax)
Meeting Expenses (steering committee room, food, etc.)
Postage
Printing (Outside Vendors)
Professional Services
Office Supplies
Operating Supplies
Telephone
ABCD Certification Training/dentists and staff (room, audiovisuals, food, thank you to
participating families, promotion, etc.)
Travel (Per Diem, Transportation, Mileage/airfare, accommodations as required) for 3x
annual ABCD Coordinators meeting — 2 Seattle, 1 Central WA; and for lx annual Dental
Washington State
Health Care Authority Page 52 of 53 Contract#2751
Cont.
Champion(s) travel/expenses to Development Day, Seattle (Coordinator participation in this
meeting optional but recommended)
Computer Support/Tech Services
Rent/Insurance/Janitorial/Maintenance
Utilities
Operating Expenses Subtotal
Indirect Costs
TOTAL EXPENSES
FUNDING SOURCES Year One Year Two
Other Funding (United Way, Grants, Community Development Block Grant, etc.)
Agency Funds and/or In-Kind
Current Health Care Authority Contract
TOTAL FUNDING
Washington State
Health Care Authority Page 53 of 53 Contract#2751
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: June 26, 2018 Agenda Item # g,5
(Commissioner staff to complete)
BRIEFING DATE: June 11, 2018
BRIEFING PRESENTED BY: Support Services
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM: Approval of the Ordinance creating Mason County Lake Management District
No. 2 for Mason Lake and set a public hearing on Tuesday, July 24, 2018 at 6:30 p.m.
to hear objections to the roll of rates and charges.
Background: The lake management district (LMD) for Mason Lake was first formed
in 2002, again in 2008 and now in 2018 for the 2019 — 2028 period. It is a lengthy
process and in a nutshell - Determine petition is sufficient, hold 2 hearings, adopt 3
resolutions, adopt 1 ordinance, mail and process 1 ballot to each land owner, 3
mailings (982 pieces in each mailing) to all property owners that can include multiple
documents, 3 publications of legal notices.
Ballots were mailed to all landowners in the LMD boundary and due by May 16, 2018.
There were 1083 parcel ballots mailed and 477 were returned by the due date and the
majority are in the affirmative to form a 10 year LMD for Mason Lake for 2019-2028.
The next step is to adopt an ordinance officially creating the LMD and set a public
hearing to hear objections. Notice of the hearing will be sent to all landowners with
instructions on how to file an objection. Objections must be in writing and are due by
July 13, 2018.
Budget Impacts: The hard costs for the process will be paid from the Mason Lake
LMD Fund. Staff time is not reimbursed
RECOMMENDED ACTION: Approve the Ordinance creating Mason County Lake
Management District No. 2 for Mason Lake and set a public hearing on Tuesday, July
24, 2018 at 6:30 p.m. to hear objections to the roll of rates and charges.
Attachment(s): Ordinance
ORDINANCE NO.
AN ORDINANCE creating a Lake Management District for Mason Lake pursuant to Chapters 36.61 RCW,to be designated
Mason County Lake Management District No.2 for Mason Lake.
WHEREAS,Chapter 36.61 RCW authorized the Board of Mason County Commissioners to initiate the creation of lake
management districts;
WHEREAS,the Board of Mason County Commissioners found creation of a lake management district for Mason Lake
to be in the public interest through adoption of Resolution 29-18;and
WHEREAS,the proposal to create the lake management district received a majority of the votes cast by property owners
within the proposed district pursuant to RCW 36.61.080.100.
NOW,THEREFORE BE IT ORDAINED by the Board of County Commissioners of Mason County as follows.
Creation of District
Mason County Lake Management District No.2 for Mason Lake,as proposed in Resolution No. 15-18 adopted on March 13,
2018,is hereby created.
Conditions for District Operation
The conditions for the operation of Lake Management District No.2 are set forth in Resolution 29-18,Exhibit A hereto,which
resolution is incorporated by reference as though set forth in full. The conditions for operation set forth in Exhibit A include the
findings and determinations,with district purposes,district boundaries,duration(10 years);annual rates and charges and
provision for a steering committee.
Rates and Charges-Collection
1. Rates and charges for Lake Management District No.2 shall be included in Mason County's annual property tax
statements. Properties,which do not receive a property tax statement,will receive a separate billing statement for these
rates and charges.
2 The total amount of the Lake Management District No.2 rate and charge shall be due and payable on or before the 30th
day of April and shall be delinquent after that date;however,if one-half of such rate and charge is paid on or before the
said 30th of April the remainder shall be due and payable on or before the 31°day of October and shall be delinquent
after that date.
3. If a payment is received in conjunction with a combined property tax and Lake Management District No.2 rate and
charge,and the payment is less than the amount due,the payment shall be applied first to the annual property tax of the
parcel and any remaining due amount to the Lake Management District No.2 rate and charge.
Severability
If any clause,sentence,paragraph,section,or provision of this Ordinance or the application thereof to any person or
circumstances shall be found to be invalid,the validity of the remaining provisions shall not be affected,and the Ordinance shall
be construed or enforced as if it did not contain the particular provision held to be invalid.
ADOPTED this 26th day of June 2018.
A HEST: BOARD OF COUNTY COMMISSIONERS
MASON COUNTY,WASHINGTON
Melissa J.Drewry,Clerk of the Board
Randy Neatherlin,Chair
APPROVED AS TO FORM:
Teri Drexler,Commissioner
Timothy White cad,Chief Deputy
Prosecuting Attorney
Kevin Shutty,Commissioner
C: Auditor/Accounting
Assessor
Treasurer
J:\Lake Management District\Mason Lake LMD 2017-2018 Process\LMD-Ordinance to Create.doc
Exhibit A
RESOLUTION NO: oC -
A RESOLUTION adopting findings and determinations consistent with RCW 36.61.070 regarding
the establishment of Lake Management District No. 2 for Mason Lake, and submitting the
establishment of Lake Management District No. 2 to a vote of property owners within the
proposed district.
WHEREAS, the Board of Mason County Commissioners adopted Resolution No. 15-18 on
March 13, 2018 setting out its intention to consider formation of Lake Management District No. 2
for Mason Lake (LMD No. 2); and
WHEREAS, a public hearing was held on April 17, 2018 to consider formation of LMD No.
2 and the County Commissioners heard support from persons affected by the formation of LMD
No. 2 and other comments regarding the proposed work program; and
WHEREAS, a representatives from the Department of Ecology, the Department of Fish
and Wildlife and Department of Natural Resources had the opportunity to make presentations
and comments on the proposal.
NOW, THEREFORE,THE BOARD OF MASON COUNTY COMMISSIONERS DOES
RESOLVE AS FOLLOWS:
Section 1. The Board of County Commissioners adopts the following findings and
determinations:
1. The formation of LMD No. 2 is in the public interest as evidenced by the following proposed
plan (Exhibit A)of lake improvement and maintenance activities, which is approved as part of
these findings. The proposed LMD will:
a. Manage noxious aquatic plants in Mason Lake to meet recreational and aesthetic
needs, fishery and wildlife habitat requirement, and ecosystem and groundwater
concerns.
b. Employ proven techniques based on environmental safety.
c. Conduct water quality monitoring as needed.
d. Investigate and promote the best management practices and shoreline
enhancement.
e. Monitor for recurrence of Eurasian Water Milfoil, Slender Arrowhead and Yellow Flag
Iris or emergence of other lake plants that could adversely impact the freshwater
system and recommend prompt action to control these.
f. Maintain an advisory committee of neighborhood representatives to direct the efforts
and funds of the LMD.
2. The financing of the lake improvement and maintenance activities is feasible since the
revenues to be raised match the activities set out in the proposed plan for LMD No. 2.
3. The plan for proposed lake improvement and maintenance activities avoids adverse impacts
on fish and wildlife and provides for measures to protect and enhance fish and wildlife.
4. LMD No. 2 will exist for a period of 10 years, commencing in 2019.
5. The amount to be raised through rates and charges is approximately $36,000.00 the first
year with a maximum escalation for inflation of 5% per year for the following nine years.
Exhibit A
LMD—Mason Lake—Resolution No.t29-«'
6. The boundaries of the District are all properties fronting Mason Lake or having community
access to Mason Lake, in Mason County, Washington.
7. Annual Charge per Parcel: The proposed formula for annual rates and charges to property
in 2019 is 11 cents per thousand valuation. Revenue bonds will not be issued.
Section 2. The question of whether to form Lake Management District No. 2 for Mason Lake
shall be submitted to the property owners within the proposed district. The Support
Services Department shall prepare the ballots for submittal to the property owners.
Ballots will be received by the Office of the County Commissioners, 411 N. Fifth
Street, Shelton, WA 98584 no later than 5:00 pm, May 16, 2018.
Section 3. Ballots will be available for public inspection after they have been counted.
Dated this 17u day of April, 2018.
BOARD OF COUNTY COMMISSIONERS
MASON COUNTY,WASHINGTON
Absextt
Randy Neatherlin, Chair
A I1`ST: �..
Terri Drexler, Con? sioner
4/ pie ,11 /
Melis J. = , Clerk the Board
Kevin Shu' , fommissioner
Approved as to form:
Chief Deputy Prosecuting Attorney
Timothy Whitehead
J:\Lake Management District\Mason Lake LMD 2017-2018 Process\LMD-Resolution to Form&send
ballot#2.doc
Exhibit A
4
LAKE MANAGEMENT PLAN EshibA A-
MASON LAKE, WA
JANUARY 1, 2018
The following is the cost estimate and plan for the continued control of invasive
species of plant life in Mason Lake. This plan is for calendar year 2018.
CURRENT FUNDS ON HAND AS OF JANUARY 1, 2018:
Milfoil Fund Checking Account* $9,171.88
LMD442 Tax Receipts $112,418.10
Total $121,589.98
ESTIMATED 2018 INCOME FROM TAX RECEIPTS**:
$49,000.00
ESTIMATED 2018 EXPENDITURES***:
$55,674.00
ESTIMATED BALANCE DECEMBER 31, 2018:
$114,915.98
*funds from donations prior to LMD creation. Used for one-off bills, e.g. tax
preparation, insurance and legal.
**based on same 2017 rate of approx. $.16 per $1,000 assessed.
***includes expenses for re-election of the LMD in 2018
Exhibit A
E>4 A
The Mason Lake Management District (LMD#2) and volunteer committee has
been tasked with the identification, mapping and treatment of invasive species of
plant (as identified by the Washington State Department of Ecology) in Mason
Lake. Current invasive species include Eurasian Water Milfoil (EWM), Slender
Arrowhead (SAG) and Yellow Flag Iris. Licensing, identification, mapping,
treatment and reporting is completed by our contractor, AquaTechnex, LLC. On
an annual basis, the biologists from AquaTechnex procure licensing from
Washington State DOE for the treatment of invasive species in Mason Lake.
Herbicides used for the treatment are approved by the DOE, and only by licensed
and qualified professionals. In the spring, an initial survey is completed by a diver
from AquaTechnex, to determine location and type of invasive species. Based on
this initial survey, a map of the locations and plant types is created, along with a
plan of treatment, to be approved by the LMD#2 committee. Treatment timing
and frequency are scheduled around fish windows and high occupancy weekends.
Generally, treatment is done during a Tuesday to Thursday window to avoid
weekend lake traffic. Prior to treatment, notices of treatment (dates, products
used and restrictions) are sent out by mail to all residents. In addition, postings
are placed on the shoreline in the specific areas of treatment.
In the fall, another survey of the shoreline is done to determine effectiveness of
the treatments.
The current LMD expires at the end of 2018. Petitions have been submitted to
create a new LMD starting in 2019. The current rate of tax collected in 2018 is
approx. $.16 per $1,000 assessed. The new LMD is requesting a voter approved
rate of $.11 per assessed starting in 2019. The LMD committee believes that with
the current funds on hand, the rate of collection at $.11 will be sufficient to
sustain the program. A 5% rate increase annually is available if it is determined
that additional funds are required. The increase would require LMD committee
approval.
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: June 26, 2018 Agenda Item # X,(e
(Commissioner staff to complete)
BRIEFING DATE: June 11, 2018
BRIEFING PRESENTED BY: Diane Zoren
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
ITEM: Approval of the resolution for the distribution of the Public Utility District Excise
Tax, per RCW 54.28.090. The Mason County Current Expense Fund will receive
$734,620.43 and the City of Shelton will receive $82,020.51.
Background: Chapter 54.28.090 RCW pertains to Privilege Taxes that are due to the
county and the city. The County Treasurer receives the total privilege tax paid by the
Public Utility Districts and the county must distribute an amount equal to three-fourths
of one percent of the gross revenues obtained by a district from the sale of electric
energy within any incorporated city (gross revenues in 2017 were $10,936,067) and
must be remitted to such city.
The privilege tax paid by PUD #1 is $70,829.92 and PUD #3 is $745,811.02.
BUDGET IMPACTS: Mason County 2018 budget anticipated receiving $700,000 for
this tax.
RECOMMENDED ACTION:
Approval of the resolution for the distribution of the Public Utility District Excise Tax,
per RCW 54.28.090. The Mason County Current Expense Fund will receive
$734,620.43 and the City of Shelton will receive $82,020.51
Attachment(s): Resolution
6/15/2018
RESOLUTION NO.
DISTRIBUTION OF PUD EXCISE TAX
WHEREAS, the P.U.D. Excise Tax Monies which have accrued to the credit of Mason
County have now been received in the total amount of $816,640.94.
WHEREAS, under Chapter 278, Session Laws of 1957, provision has been made for the
distribution of said funds (RCW 54.28.090);
NOW, THEREFORE BE IT HEREBY RESOLVED by the Board of Mason County
Commissioners that the following distribution of P.U.D. Excise Tax be made as follows:
RECEIPTS
P.U.D. NUMBER 1 $ 70,829.92
P.U.D. NUMBER 3 $745,811.02
DISTRIBUTION
City of Shelton $ 82,020.51
Computed as 3/4 of 1% of Gross
Revenue from sales of electricity
in the City of Shelton
Current Expense Fund $734,620.43
BE IT FURTHER RESOLVED that the Treasurer of Mason County is hereby directed to
make the distribution as herein set forth.
DATED this 26th day of June, 2018.
BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
ATTEST:
Melissa Drewry, Clerk of the Board Randy Neatherlin, Chair
APPROVED AS TO FORM:
� Terri Drexler, Commissioner
Tim Whitehead -------
Chief Deputy Prosecuting Attorney
C: Clerk of the Board Kevin Shutty, Commissioner
City Clerk
Treasurer
J:\resolute\2018\pudtax
MASON COUNTY
AGENDA ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
From: Jennifer Beierle Action Agenda
Public Hearing _X
Other
DEPARTMENT: Support Services EXT: 532
DATE: June 12, 2018 Agenda Item #
(Commissioner staff to complete)
BRIEFING DATE: May 21, 2018, June 4, 2018, &June 11, 2018
BRIEFING PRESENTED BY: Jennifer Beierle
[ ] ITEM WAS NOT PREVIOUSLY BRIEFED WITH THE BOARD
Please provide explanation of urgency
Item:
Hold a public hearing to consider approval of supplemental appropriation and budget transfer requests
to the 2018 budget.
Background:
The following are requests for supplemental appropriations and budget transfers:
Supplemental Appropriations:
$644,255 Increase to Current Expense Non-Departmental Revenue for Road Internal Allocation
and Increase to Current Expense Ending Fund Balance
$34,000 Increase to Belfair Sewer Fund 413 Revenue for Belfair Sewer Feasibility Study and
Increase to Fund 413 Professional Services Expense
$38,650 Increase to Sheriff Revenue for various private contracts and Increase to MCSO overtime
expenses -;: . - . :. - - --- - . :. — Deleted
since this grant will not be reported as revenue to Mason County.
$2,500 Increase to Juvenile Services Revenue for JDAI Grant increase and Increase to Juvenile
Services various expense accounts
$24,565 Increase to Criminal Justice Treatment Account in Therapeutic Court for funding from
DSHS and Increase to Therapeutic Courts various expense accounts
$104,737 Increase to Current Expense Non-Departmental Revenue for Community Development
Block Grant(CDBG) and Increase to Current Expense Non-Departmental Expense
$231,334.50 Increase to REET 2 Fund 351 for Recreation and Conservation Office Grant and
Increase to REET 2 Capital Outlays Expense
$506,000 increase to County Road Fund 105 for Recreation and Conservation Office Grant and
increases to various other existing grants, and Increase to Capital and Professional Services
expenses.
$290,000 increase to Skokomish Flood Zone Fund 192 for increased funding from Mason
Conservation District and Increase to various expense accounts
$207,235 increase to Storm Drain System Development Fund 480 for Department of Ecology
Grant Funds and increase to various expense accounts and ending fund balance
Budget Transfers:
J:Uennifer B\Briefmg,Agenda,&Public Hearing Items\Budget Hearings\6.26.18 Budget Hearing
Info\Cover Sheet for 6.26.18 Public Hearing w-revision.doc :---.•' - - ._ • . • ' :-.:•, = '
Landfill Reserve Fund 428 Transfer from: Ending Fund Balance - $30,000
To: Landfill Reserve- Misc. Contracted Professional Services - $30,000
Belfair Sewer Fund 413 Transfer from: Ending Fund Balance - $66,000
To: Belfair Sewer- Professional Services/Misc - $66,000
Auditor's O&M Fund 104 Transfer from: Ending Fund Balance - $2,050
To: Auditor's O&M - Medical/Dental/Vision/Life - $1,907.50
To: Auditor's O&M - Reserve for Technology - $142.50
Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $31,950
To: Auditor- Medical/Dental/Vision/Life $6,500
To: Human Resources- Medical/Dental/Vision/Life - $8,000
To: Clerk- Medical/Dental/Vision/Life - $6,100
To: Treasurer- Various Salaries and Benefits - $5,050
To: Commissioners-State Retirement- $3,600
To: Assessor- Medical/Dental/Vision/Life - $2,700
Veterans Assistance Fund 190 Transfer from: Transfers Out- $50,000
To: Mental Health Tax Fund 164 - $50,000
Veterans Assistance Fund 190 Transfer from: Transfers Out- $50,000
To: Community Support Services Fund 117 - $50,000
Law Library Fund 160 eliminate transfer from: Transfers Out - $4,940
To: Support Services Fund 001.090 - $4,940
Law Library Fund 160 Transfer from: Ending Fund Balance - $4,940
To: Law Library-Various Salary and Benefits - $4,940
Facilities &Grounds Fund 001.055 Transfer from: Transfers Out - $6,830.47
To: Historical Preservation Fund 116 - $6,830.47
Facilities &Grounds Fund 001.055 Transfer from: Transfers Out- $10,000
To: Community Support Services Fund 117 -$10,000
Sheriff 001.205 Transfer from: Ending Fund Balance - $55,090
To: Sheriff- Enterprise Payments 001.000000.205.267.521.22.545030.0000.00 -
$34,403
To: Sheriff- ER&R Upfit/Downfits 001.000000.205.267.521.22.548098.0000.00 -
$20,687
Sheriff Special Funds 140 Transfer from: Ending Fund Balance - $1,380.16
To: Sheriff Special Funds-SAR Van Tires - $1,380.16
Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $107,831
To: Auditor-Various Salary &Benefit Lines $20,828
To: Auditor-Various Expense Lines $13,700
To: Treasurer-Various Salary & Benefit Lines - $31,003
To: Clerk-Various Salary &Benefit Lines - $42,300
Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $70,000
To: Accrued Leave-Various Salary&Benefit Lines - $70,000
County Road Fund 105 Transfer from: Ending Fund Balance - $311,000
To: County Road - Professional Services Line - $311,000
Budget Impacts:
Increase in ending fund balance - Current Expense
(001.000000.320.000.508.80.500000.0000.00)
$357,613.53
Decrease in ending fund balance-Auditor's O&M (104.000000.000.000.508.10.500000.0000.00)
$2,050
Decrease in ending fund balance- County Road (105.000000.000.000.508.30.500000.0000.00)
$311,000
Increase in ending fund balance- Historical Preservation
(116.000000.000.000.508.30.500000.0000.00)
$6,830.47
Increase in ending fund balance-Community Support Services
(117.000000.000.000.508.30.500000.0000.00)
$60,000
J:Vennifer B\Briefmg.Agenda.&Public Hearing Items\Budget Hearings\6.26.18 Budget Hearing
Info\Cover Sheet for 6.26.18 Public Hearing w-revision.doc :--:. : - - •_ •- -2, ` .• •:•, =
i 7........,.T.e.«.,1
Decrease in ending fund balance— Sheriff Special Funds
(140.000000.000.000.508.80.500000.0000.00)
$1,380.16
Increase in ending fund balance— Mental Health Tax
(164.000000.000.000.508.30.500000.0000.00)
$50,000
Decrease in ending fund balance—Veterans Assistance
(190.000000.000.000.508.30.500000.0000.00)
$100,000
Decrease in ending fund balance— Belfair Sewer (413.000000.000.000.508.10.500000.0000.00)
$66,000
Decrease in ending fund balance— Landfill Reserve
(428.000000.000.000.508.10.500000.0000.00)
$30,000
Increase in ending fund balance—Storm Drain System Development
(480.000000.000.000.508.10.500000)
$169,284
Recommended Action: Motion to approve the following Supplemental Appropriations and
Budget Transfers to the 2018 Budget:
Supplemental Appropriations:
$644,255 Increase to Current Expense Non-Departmental Revenue for Road Internal Allocation
and Increase to Current Expense Ending Fund Balance
$34,000 Increase to Belfair Sewer Fund 413 Revenue for Belfair Sewer Feasibility Study and
Increase to Fund 413 Professional Services Expense
$38,650 Increase to Sheriff Revenue for various private contracts and Increase to MCSO overtime
expenses
since this grant will not be reported as revenue to Mason County.
$2,500 Increase to Juvenile Services Revenue for JDAI Grant increase and Increase to Juvenile
Services various expense accounts
$24,565 Increase to Criminal Justice Treatment Account in Therapeutic Court for funding from
DSHS and Increase to Therapeutic Courts various expense accounts
$104,737 Increase to Current Expense Non-Departmental Revenue for Community Development
Block Grant(CDBG) and Increase to Current Expense Non-Departmental Expense
$231,334.50 Increase to REET 2 Fund 351 for Recreation and Conservation Office Grant and
Increase to REET 2 Capital Outlays Expense
$506,000 increase to County Road Fund 105 for Recreation and Conservation Office Grant and
increases to various other existing grants, and Increase to Capital and Professional Services
expenses.
$290,000 increase to Skokomish Flood Zone Fund 192 for increased funding from Mason
Conservation District and Increase to various expense accounts
$207,235 increase to Storm Drain System Development Fund 480 for Department of Ecology
Grant Funds and increase to various expense accounts and ending fund balance
Budget Transfers:
Landfill Reserve Fund 428 Transfer from: Ending Fund Balance - $30,000
To: Landfill Reserve— Misc. Contracted Professional Services - $30,000
Belfair Sewer Fund 413 Transfer from: Ending Fund Balance - $66,000
To: Belfair Sewer— Professional Services/Misc - $66,000
Auditor's O&M Fund 104 Transfer from: Ending Fund Balance - $2,050
To: Auditor's O&M — Medical/Dental/Vision/Life - $1,907.50
To: Auditor's O&M — Reserve for Technology - $142.50
Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $31,950
To: Auditor— Medical/Dental/Vision/Life $6,500
J:\Jennifer B\Briefmg.Agenda,&Public Hearing Items\Budget Hearings\6.26.18 Budget Hearing
Info\Cover Sheet for 6.26.18 Public Hearing w-revision.doc :--•••• - _ - -:, • •.•,
To: Human Resources— Medical/Dental/Vision/Life - $8,000
To: Clerk— Medical/Dental/Vision/Life - $6,100
To: Treasurer-Various Salaries and Benefits - $5,050
To: Commissioners—State Retirement - $3,600
To: Assessor— Medical/Dental/Vision/Life - $2,700
Veterans Assistance Fund 190 Transfer from: Transfers Out- $50,000
To: Mental Health Tax Fund 164 - $50,000
Veterans Assistance Fund 190 Transfer from: Transfers Out- $50,000
To: Community Support Services Fund 117 - $50,000
Law Library Fund 160 eliminate transfer from: Transfers Out- $4,940
To: Support Services Fund 001.090 - $4,940
Law Library Fund 160 Transfer from: Ending Fund Balance - $4,940
To: Law Library—Various Salary and Benefits - $4,940
Facilities &Grounds Fund 001.055 Transfer from: Transfers Out - $6,830.47
To: Historical Preservation Fund 116 - $6,830.47
Facilities &Grounds Fund 001.055 Transfer from: Transfers Out- $10,000
To: Community Support Services Fund 117 -$10,000
Sheriff 001.205 Transfer from: Ending Fund Balance - $55,090
To: Sheriff— Enterprise Payments 001.000000.205.267.521.22.545030.0000.00 -
$34,403
To: Sheriff— ER&R Upfit/Downfits 001.000000.205.267.521.22.548098.0000.00 -
$20,687
Sheriff Special Funds 140 Transfer from: Ending Fund Balance - $1,380.16
To: Sheriff Special Funds— SAR Van Tires - $1,380.16
Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $107,831
To: Auditor—Various Salary &Benefit Lines $20,828
To: Auditor—Various Expense Lines $13,700
To: Treasurer—Various Salary& Benefit Lines - $31,003
To: Clerk—Various Salary & Benefit Lines - $42,300
Current Expense Fund 001.320 Transfer from: Ending Fund Balance - $70,000
To: Accrued Leave—Various Salary &Benefit Lines - $70,000
County Road Fund 105 Transfer from: Ending Fund Balance - $311,000
To: County Road — Professional Services Line - $311,000
J:\Jennifer B\Briefing,Agenda,&Public Hearing Items\Budget Hearings\6.26.18 Budget Hearing
Info\Cover Sheet for 6.26.18 Public Hearing,w-revision.doc :, -•.•• - = .: •- •2, . •:•, : '••: •
\ ')6 1 Q Rauda't 8—wina Tnfn\enver Sheet for 6.26.18 Public Hcarine.doc
ORDER
2018 Budget
IN THE MATTER OF:
BUDGET SUPPLEMENTAUTRANSFERS - NOTICE OF HEARING
RESOLUTION NO. 38-18
DATED AND PASSED: June 12, 2018
FOR BUDGET SUPPLEMENTAUTRANSFERS OF:
WHEREAS, a notice was published and a public hearing was held in accordance with
RCW 36.40.100 and RCW 36.40.195 and with Resolution No. 38-18 (see Attachment A
which is incorporated as part of this order).
THE BOARD OF COUNTY COMMISSIONERS OF MASON COUNTY, hereby approves
the budget supplementals/transfers to the 2018 budget as follows:
Supplemental Requests:
$644,255 to Current Expense Non-Departmental (Fund 001.300) Revenue for Road Fund Internal
Allocation Fees
$34,000 to Belfair Sewer (Fund 413) Revenue for Belfair Sewer Feasibility Study from City of
Bremerton
$38,650 to Current Expense Sheriff's Office(Fund 001.205)Revenue from various private contracts
imaging-grant Deleted since this grant will not be revenue to Mason County.
$2,500 to Current Expense Juvenile Services(Fund 001.171)Revenue from JDAI grant increase
$24,565 to Current Expense Therapeutic Court(Fund 001.256)for funding from DSHS
$104,737 to Current Expense Non-Departmental (Fund 001.300) for funding from Department of
Commerce Grant
$231,334.50 to REET 2(Fund 351)for funding from Recreation and Conservation Office Grant
$506,000 to County Roads (Fund 105) for funding from Recreation and Conservation Office Grant
and increased grant funding
$290,000 to Skokomish Flood Zone (Fund 192) for increased funding from Mason Conservation
District
$207,235 to Storm Drain System Development (Fund 480) for revenue to be received from
Department of Ecology Grant
TOTAL SUPPLEMENTAL REQUESTS:$27090474,60$2,083,276.50
Budget Transfers:
$30,000 from Landfill Reserve(Fund 428)Ending Fund Balance to
$30,000 Landfill Reserve(Fund 428)Misc.Contracted Professional Services
$66,000 from Belfair Sewer(Fund 413)Ending Fund Balance to
$66,000 Belfair Sewer(Fund 413)Professional Services/Misc.
$2,050 from Auditor's O&M (Fund 104)Ending Fund Balance to
$1,907.50 Auditor's O&M(Fund 104)Medical/Dental/Vision/Life,
$142.50 Auditor's O&M(Fund 104)Reserve for Technology
$31,950 from Current Expense Ending Fund Balance(Fund 001.320)to
$6,500 Auditor(Fund 001.030)Medical/Dental/Vision/Life
$8,000 Human Resources/Risk Management (Fund 001.057)
Medical/Dental/Vision/Life
$6,100 Clerk(Fund 001.070)Medical/Dental/Vision/Life
$5,050 Treasurer(Fund 001.260)Various Salaries and Benefits
$3,600 Commissioners(Fund 001.080)State Retirement
$2,700 Assessor(Fund 001.020)Medical/Dental/Vision/Life
$50,000 from Veterans Assistance(Fund 190)Transfers Out to
$50,000 Mental Health Tax(Fund 164)Transfers In
$50,000 from Veterans Assistance(Fund 190)Transfers Out to
$50,000 Community Support Services(Fund 117)Transfers In
$4,940 eliminate transfer from Law Library(Fund 160)Transfers Out to
$4,940 Support Services(Fund 001.090)Transfers In
$4,940 from Law Library(Fund 160) Ending Fund Balance to
$4,940 Law Library(Fund 160)Various Salary and Benefits
$6,830.47 from Facilities&Grounds(Fund 001.055)Transfers Out to
$6,830.47 Historical Preservation(Fund 116)Transfers In
$10,000 from Facilities&Grounds(Fund 001.055)Transfers Out to
$10,000 Community Support Services(Fund 117)Transfers In
$55,090 from Current Expense Ending Fund Balance(Fund 001.320)to
$34,403 Sheriff(Fund 001.205)Enterprise Payments
$20,687 Sheriff(Fund 001.205)ER&R Upfit/Downfits
$1,380.16 from Sheriff Special Funds(Fund 140)Ending Fund Balance to
$1,380.16 Sheriff Special Funds—SAR Van Tires
$107,831 from Current Expense Ending Fund Balance(Fund 001.320)to
$34,528 Auditor(Fund 001.030)Various Salary&Benefit Lines
$31,003 Treasurer(Fund 001.260)Various Salary&Benefit Lines
$42,300 Clerk(Fund 001.070)Various Salary&Benefit Lines
$70,000 from Current Expense Ending Fund Balance(Fund 001.320)to
$70,000 Non Departmental(Fund 001.300)Accrued Leave Lines
$311,000 from County Roads(Fund 105)Ending Fund Balance to
$311,000 County Roads Professional Services
TOTAL TRANSFERS TO:$802,011.63
TOTAL TRANSFERS FROM:$802,011.63
BE IT FURTHER RESOLVED that these Supplemental Appropriations and Budget Transfers will be
expended and recorded in the 2018 budget as listed in Attachment B which is also incorporated
as part of this order.
PASSED in open session this 26th day of June,2018.
DATED this 26th of June,2018
ATTEST: BOARD OF COUNTY COMMISSIONERS
MASON COUNTY,WASHINGTON
Melissa Drewry,Clerk of the
Board Randy Neatherlin,Chair
APPROVED AS TO FORM:
Terri Drexler,Commissioner
Tim Whitehead,Chief DPA
CC: Auditor—Financial Services Kevin Shutty,Commissioner
Treasurer
Budget Order 6.26.2018
Attachment B
Amount S/U I/D Account Description
$ 644,255.00 Revenue Inc 001.000000.300.310.341.43.300105 Non-Departmental for Road Internal Allocation
$ 644,255.00 Expense Inc 001.000000.320.000.508.80.500000 Ending Fund Balance Unreserved
$ 34,000.00 Revenue Inc 413.000000.000.000.369.91.300000 From City of Bremerton per contract
$ 34,000.00 Expense Inc 413.000000.000.000.535.84.541040 Professional Services/Misc.
$ 38,650.00 Revenue Inc 001.000000.205.267.342.10.300500 Various private contracts
$ 38,650.00 Expense Inc 001.000000.205.267.521.22.512000 Patrol Overtime
x$7,,000..00 Revenue #+e T8B
6-77000:00 Expense IImaging
$ 2,500.00 Revenue Inc 001.000000.171.100.334.04.360025 DSHS Office of Juvenile Justice Grant
$ 1,700.00 Expense Inc 001.000000.171.100.527.40.510010 Program Support Specialist
$ 200.00 Expense Inc 001.000000.171.100.527.40.520010 Industrial Insurance
$ 200.00 Expense Inc 001.000000.171.100.527.40.520020 Social Security/Medicare
$ 200.00 Expense Inc 001.000000.171.100.527.40.520030 State Retirement
$ 200.00 Expense Inc 001.000000.171.100.527.40.520040 Medical/Dental/Vision/Life
$ 24,565.00 Revenue Inc 001.000000.256.200.336.01.511000 OTA Funding
$ 24,565.00 Expense Inc 001.000000.256.200.566.51.541010 Therapeutic Court-Various Expense Lines
$ 104,737.00 Revenue Inc 001.000000.300.000.333.14.322810 Department of Commerce Grant
$ 104,737.00 Expense Inc 001.000000.300.000.557.20.541010 Professional Services
$ 231,334.50 Revenue Inc 351.000000.100.000.334.02.371581 Recreation and Conservation Office Grant
$ 231,334.50 Expense Inc 351.000000.100.000.594.76.563000 Other Capital Improvements
$ 26,000.00 Revenue Inc 105.000000.000.000.333.20.320000 Federal Aid Secondary
$ 340,375.00 Revenue Inc 105.000000.000.000.333.97.336000 FEMA
$ 48,625.00 Revenue Inc 105.000000.000.000.334.01.380000 WA State Military Department
$ 27,000.00 Revenue Inc 105.000000.000.000.334.03.370000 Rural Arterial Program
$ 64,000.00 Revenue Inc 105.000000.000.000.334.02.370000 RCO Grant
$ 74,000.00 Expense Inc 105.000000.000.000.544.20.541000 Professional Services
$ 432,000.00 Expense Inc 105.000000.000.000.595.10.565000 Construction of Capital Assets
$ 290,000.00 Revenue Inc 192.000000.000.000.337.00.300000 Mason Conservation District
$ 265,000.00 Expense Inc 192.000000.000.000.554.90.541000 Professional Services
$ 15,000.00 Expense Inc 192.000000.000.000.554.90.548000 Repairs and Maintenance
$ 10,000.00 Expense Inc 192.000000.000.000.554.90.541091 Interfund Services
$ 207,235.00 Revenue Inc 480.000000.000.000.334.03.310542 WA St DOE Belfair Stormwater
$ 7,951.00 Expense Inc 480.000000.000.000.531.30.510025 Technical Services Manager
$ 30,000.00 Expense Inc 480.000000.000.000.531.30.541000 Professional Services
$ 169,284.00 Expense Inc 480.000000.000.000.508.80.500000 Ending Fund Balance
$ 30,000.00 Expense Inc 428.000000.000.000.537.00.541070 Misc.Contracted Professional Services
$ 30,000.00 Expense Dec 428.000000.000.000.508.10.500000 Ending Fund Balance Reserved
$ 66,000.00 Expense Inc 413.000000.000.000.535.84.541040 Professional Services/Misc.
$ 66,000.00 Expense Dec 413.000000.000.000.508.10.500000 Ending Fund Balance Reserved
$ 2,050.00 Expense Dec 104.000000.000.000.508.10.500000 Ending Fund Balance Reserved
$ 1,907.50 Expense Inc 104.000000.000.000.514.89.520040 Medical/Dental/Vision/Life
$ 142.50 Expense Inc 104.000000.000.000.514.89.541501 Reserve For Technology
$ 31,950.00 Expense Dec 001.000000.320.000.508.80.500000 CE Ending Fund Balance
$ 2,455.00 Expense Inc 001.000000.030.030.513.10.520040 Medical/Dental/Vision/Life
$ 1,500.00 Expense Inc 001.000000.030.031.514.23.520040 Medical/Dental/Vision/Life
$ 35.00 Expense Inc 001.000000.030.032.514.30.520040 Medical/Dental/Vision/Life
$ 80.00 Expense Inc 001.000000.030.033.514.81.520040 Medical/Dental/Vision/Life
$ 2,430.00 Expense Inc 001.000000.030.034.514.40.520040 Medical/Dental/Vision/Life
$ 8,000.00 Expense Inc 001.000000.057.100.518.90.520040 Medical/Dental/Vision/Life
$ 6,100.00 Expense Inc 001.000000.070.000.512.30.520040 Medical/Dental/Vision/Life
$ 1,400.00 Expense Inc 001.000000.260.000.514.22.510050 Finance Accounting Deputy
$ 108.00 Expense Inc 001.000000.260.000 .514.22.520020 Social Security/Medicare
$ 178.00 Expense Inc 001.000000.260.000.514.22.520030 State Retirement
$ 1,256.00 Expense Inc 001.000000.260.000.513.10.520040 Medical/Dental/Vision/Life
$ 1,908.00 Expense Inc 001.000000.260.000.514.22.520040 Medical/Dental/Vision/Life
$ 200.00 Expense Inc 001.000000.260.000.514.22.546096 Unemployment
$ 3,600.00 Expense Inc 001.000000.080.000.511.60.520030 State Retirement
$ 2,700.00 Expense Inc 001.000000.020.000.514.24.520040 Medical/Dental/Vision/Life
$ 50,000.00 Expense Inc 190.000000.000.000.597.00.500164 Transfer Out
$ 50,000.00 Revenue Inc 164.000000.000.000.397.00.300190 Transfer In
$ 50,000.00 Expense Inc 190.000000.000.000.597.00.500117 Transfer Out
$ 50,000.00 Revenue Inc 117.000000.000.000.397.00.300190 Transfer In
$ 4,940.00 Expense Dec 160.000000.000.000.597.00.500090 Transfer Out
$ 4,940.00 Revenue Dec 001.000000.090.000.397.00.300160 Transfer In
$ 4,940.00 Expense Dec 160.000000.000.000.508.10.500000 Ending Fund Balance Reserved
$ 3,322.00 Expense Inc 160.000000.000.000.572.20.510010 Law Librarian Clerk
$ 15.00 Expense Inc 160.000000.000.000.572.20.520010 Industrial Insurance
$ 253.00 Expense Inc 160.000000.000.000.572.20.520020 Social Security/Medicare
$ 312.00 Expense Inc 160.000000.000.000.572.20.520030 State Retirement
$ 1,038.00 Expense Inc 160.000000.000.000.572.20.520040 Medical/Dental/Vision/Life
$ 6,830.47 Expense Inc 001.000000.055.000.597.00.500116 Transfer Out
$ 6,830.47 Revenue Inc 116.000000.000.000.397.00.300055 Transfer In
$ 10,000.00 Expense Inc 001.000000.055.000.597.00.500117 Transfer Out
$ 10,000.00 Revenue Inc 117.000000.000.000.397.00.300055 Transfer In
$ 55,090.00 Expense Dec 001.000000.320.000.508.80.500000 CE Ending Fund Balance
$ 34,403.00 Expense Inc 001.000000.205.267.521.22.545030 Enterprise Payments
$ 20,687.00 Expense Inc 001.000000.205.267.521.22.548098 ER&R Upfit/Downfits
$ 1,380.16 Expense Dec 140.000000.800.000.508.10.500000 Ending Fund Balance Reserved
$ 1,380.16 Expense Inc 140.000000.800.000.523.90.531010 SAR Van Tires
$ 107,831.00 Expense Dec 001.000000.320.000.508.80.500000 CE Ending Fund Balance
$ 11,220.00 Expense Inc 001.000000.030.031.514.23.510049 Accounting Tech I
$ 70.00 Expense Inc 001.000000.030.031.514.23.520010 Industrial Insurance
$ 860.00 Expense Inc 001.000000.030.031.514.23.520020 Social Security/Medicare
$ 1,480.00 Expense Inc 001.000000.030.031.514.23.520030 State Retirement
$ 7,248.00 Expense Inc 001.000000.030.031.514.23.520040 Medical/Dental/Vision/Life
$ 9,500.00 Expense Inc 001.000000.030.034.514.40.549010 Eletion Envelopes
$ 3,000.00 Expense Inc 001.000000.030.034.514.40.510600 Extra Help
$ 1,200.00 Expense Inc 001.000000.030.034.514.40.549030 Training
$ 19,336.00 Expense Inc 001.000000.260.000.514.22.510050 Finance Accounting Deputy
$ 200.00 Expense Inc 001.000000.260.000.514.22.520010 Industrial Insurance
$ 1,553.00 Expense Inc 001.000000.260.000.514.22.520020 Social Security/Medicare
$ 2,578.00 Expense Inc 001.000000.260.000.514.22.520030 State Retirement
$ 7,336.00 Expense Inc 001.000000.260.000.514.22.520040 Medical/Dental/Vision/Life
$ 27,000.00 Expense Inc 001.000000.070.000.512.30.510120 Judicial Support Specialist
$ 300.00 Expense Inc 001.000000.070.000.512.30.520010 Industrial Insurance
$ 2,150.00 Expense Inc 001.000000.070.000.512.30.520020 Social Security/Medicare
$ 3,550.00 Expense Inc 001.000000.070.000.512.30.520030 State Retirement
$ 9,300.00 Expense Inc 001.000000.070.000.512.30.520040 Medical/Dental/Vision/Life
$ 311,000.00 Expense Dec 105.000000.000.000.508.30.500000 Ending Fund Balance Restricted
$ 311,000.00 Expense Inc 105.000000.000.000.544.20.541000 Professional Services