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Home My WebLink AboutCHOICE Regional Health Network Amendment # 4 0ocuSign nvelope ID:11491965-24D4-4018-8837-11116E61A1E7 CHOICE Regional Health Network CONTRACT AMENDMENT 1 A.NAME OF SUBCONTRACTOR 2A.CONTRACT NUMBER • Mason County Public Health Dept. N21896-17 I B.ADDRESS OF CONTRACTOR 2B. AMENDMENT 415 N 66'St #4 I C.CITY, STATE,ZIP CODE Shelton,WA,98584 MC Contract it19-100 3. ® THIS ITEM APPLIES ONLY TO BILATERAL AMENDMENTS 'the Contract identified herein, including any previous amendments thereto, is hereby amended as set forth in item 5 below by mutual consent of all parties hereto. 4. ❑ THiS ITEM APPLIES ONLY TO UNILATERAL AMENDMENTS The Contract identified herein,including any previous amendments thereto, is hereby unilaterally amended as set forth in item S below pursuant to the changes and modifications clause as contained therein. 5. DESCRIPTION OF AMENDMENT: Mason County Public Health Service and CHOICE Regional Health Network have entered into the Youth Marijuana Prevention and Education Program Agreement executed in 2016.All terms and conditions set forth in that Agreement remain in full force and effect,except to the extent that such terms and conditions are modified or in conflict with the provisions of this Amendment, in which case this Amendment shall prevail. The purpose of this amendment is to revise the following: i. Extend the period of performance from July 1,2019 to June 30,2020. ii. The Monthly Activity Reports are to be submitted to the CHOICE by the 5th day of each month and the Expenditure Report and Request for Reimbursement must be provided to CHOICE by the end of each month in order to receive reimbursement for the previous month. If CI IOICE does not receive the Monthly Expenditure Report and Request for Reimbursement form by the end of the month,CHOICE may withhold approval and payment,at its discretion,until the 30th of the month following submittal. a. Subcontractor will submit all reimbursement forms to financelcrlingorg not to YMPEP Program Manager. b. Subcontractor will produce a required final 6-month expenditure plan by January 315f,2020 to CHOICE YMPEP Program Manager. Explaining in detail how the remaining YMPEP funds will be spent by June 30",2020.If CHOICE YMPEP Program Manager does not receive a final 6-month expenditure plan by January 3131,2020 and/or are not 50%spent through, CHOICE reserves the right to reduce funding for this contract year. iii. CHOICE will provide$25,000 Not-to-Exceed compensation for year 5 deliverables. iv. Subcontractor will provide verification that background checks have been completed for any staff and volunteers who will work with youth(ages 0-17)Verification must be sent to the CHOICE Program Manager prior to the individual's start date. Please send a signed CHOICE Regional Health Network Amendment#4 Contract N2I896-17 Page I DocuSign Envelope ID:11491965-24D4-4018-8837-11116E61A1E7 attestation with the individual's name,title and start date stating a criminal background check was completed on(date background check was performed)with no record found. CHOICE reserves the right to audit statements of attestations without prior notice. Please do not forward a copy of the background check unless in compliance with the WA Criminal Records Privacy Act,Chapter 10.97 RCW.as secondary dissemination of criminal history records is prohibited. v. Revises the Subcontractor's Exhibit A—Statement of work July 2018-June 2019: a. Community collaborations: Serve as a community-level content expert to the YMPEP Program Manager.Participate in scheduled monthly YMPEP Work Group meeting preparation and/or meeting attendance.This will include in- person meetings,teleconference meetings,and e-mail correspondence as needed. b. Maintain and expand relationships: Will work with CHOICE Program Manager to maintain,engage with,and fill gaps in participation of current regional marijuana prevention programs,drug free community coalitions, and community prevention and wellness coalitions within the region. c. Will work with CHOICE Program Manager and Regional Partners to implement the specified activities in the work plan as outlined in the YMPEP 5-Year Strategic Plan in the following categories: i. Use the various media campaigns to include Under the influence of You and Start Talking Now.Identify and implement media campaign(s)that will best serve identified priority target populations for each County. Host one YMPEP partner meeting where various media campaigns/tool kits are introduced. Identify individual campaign strengths and limitations for individual communities.Each County select the campaign(s)they will use and work with regional partners that selected the same campaign to share success and problem solve challenges. il. Identify readiness of rural communities in each county for needed support such as funding and program implementation through HYS, local community survey,youth focus group survey,key stakeholders and the Tri-ethnic Center tool. iii. Work with CHOICE Program Manager for Program implementation iv. Host parent education forums at schools,town meetings,coalitions. Inviting Jason Kilmer to help educate parents. v. Review HYS Survey Data from 2014-2018,local community survey, youth focus group survey,key stakeholder meetings. vi. Engage local officials to change current smoke free policy to include vape free public areas. vii. Attend a refresher training on the role of advertising in substance use/media literacy will occur for involved staff and stakeholders. viii. Based on WACK and the regional network start discussion on state law and policy change. ix. The Youth2Youth Program will continue to pilot in two counties (Cowlitz and Mason).Conduct planning meetings period to determine the proposed project areas within their communities. Activities are to be laid out with desired outcomes and measurable outcomes(if applicable). x. Recruit youth to participate. CHOICE Regional Health Network Amendment 1t4 Contract N2I 896-t 7 Page 2 DoeuSign Envelope ID:11491965-24D4-401 8-8 837-1 1 1 1 6E61 Al E7 xi. Planning meeting for Y2Y to identify project areas by youth and advisors. xii. Submit Proposal to CHOICE Program Manager for approval. xiii. Planning meetings for Y2Y to occur monthly to work on proposed project areas xiv. Reach out to decision-makers to promote prevention work,present the new data and strategic plan to your Board of Health in person. vi. This Amendments Effective Date shall July 1,2019. 6. ❑ This is a unilateral amendment. Signature of contractor is not required below. ® Contractor hereby acknowledges and accepts the terms and conditions of this amendment. Signature is required below. IN WITNESS WHEREOF,CHOICE and the Subcontractor have signed this agreement. SUBCONTRACTOR SIGNATURE GATE ZRt ltr,46Aft llEALTH.,„,..2f:SIGNATURE DATE 01044 chief Executive Officer 11/21/2019 '-3AC82ADC 1 FC3407... CHOICE Regional Health Network Amendment 114 Contract N2t396-17 Page 3