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HomeMy WebLinkAboutInteragency Agreement GC and KCPHDKittitas County Review Form Grants & Contract Agreement Today's Date 03/05/2015 Fund/Department 116 -Public Health Contract/Grant Information Agenda Date Contract /Grant Agency: Interagency Agreement between Grant County Health District and Kittitas County Public Health Department Period Begin Date: January 1, 2015 Total Grant/Contract Amount: $18,500.00 Grant/Contract Number: Contract/Grant Summary: Period End Date: September 29, 2018 The agreement is made and entered into by and between the Grant County Health District and Kittitas County Public Health to provide a mechanism for the collaborative work, completion of deliverables, and transfer of funds necessary to carry out the priority health improvement initiatives associated with the North Central Washington Healthy Communities Obesity, Diabetes, Heart Disease and Stroke Prevention Program. Recommendation for Board of Health and Board of Health Review on Department Head Signature: Administrator Date: Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: APPROVED AS TO FORM: Signa%re of�rose&td�s Office Signat��e 6Auditor's Office Signature of Board of Health member lr� Date Date Financial Information Total Amount $18,500.00 State Funds $ Federal Funds $18,500.00 Grant/Contract Review Page 1 Percentage County Funds Matching Funds $ CFDA#93.757 In -Kind $ Explain _ Is Equipment being purchased? Who owns equipment? New Personnel being hired? I Contact HR hiring - reporting requirements Future impacts or liability to Kittitas County: Budget Information Budget Amendment Needed? Yes ❑x attach budget form No F -]Why not New Division Created? Will enter in budget center Revenue Code 116-612.49.03.333.93.757 - Healthy Communities Component #1 116-612.49.04.333.93.757 - Healthy Communities Component #2 Pass Through Information Agency to Pass Through Auditor Information Services Amount to Pass Through $ Sub -Contract Approved Date: Prosecutor Review Has the Prosecutor reviewed this agreement? Yes❑ No ❑ County Departments Impacted Submitted Signature: _ Date: Department: I Assignment of Tracking Information Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer Date Grant/Contract Review Page 2 Auditor Information Services Facilities Maintenance Human Resource Prosecutor Treasurer Submitted Signature: _ Date: Department: I Assignment of Tracking Information Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer Date Grant/Contract Review Page 2 BOARD OF COUNTY COMMISSIONERS COUNTY OF KITTITAS STATE OF WASHINGTON RESOLUTION TO AUTHORIZE EXECUTION OF INTERAGENCY AGREEMENT BETWEEN THE GRANT COUNTY HEALTH DISTRICT AND THE KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT RESOLUTION No. 2015 - WHEREAS, RCW 39.34, the Interlocal Cooperation Act, provides the capability for public agencies to cooperate for mutual advantage; and WHEREAS, Kittitas County, through the Kittitas County Public Health Department, is charged with the preservation, promotion, and improvement of health in the County; and WHEREAS, the Kittitas County Public Health Department and the Grant County Health District wish to collaborate to carry out the priority health improvement initiatives associated with the North Central Washington Healthy Communities Obesity, Diabetes, Heart Disease and Stroke Prevention Program; and WHEREAS, All parties have agreed to enter into such an agreement under the terms and conditions of the Interagency Agreement shown on and attached hereto; and WHEREAS, the Board of County Commissioners authorized the execution of this Interagency Agreement by action taken at a regular meeting; and NOW THEREFORE, BE IT HEREBY RESOLVED that the Board of County Commissioners of Kittitas County, Washington authorizes the Director of the Kittitas County Public Health Department to execute the Interagency Agreement with the Grant County Health District that is attached hereto, and incorporated herein by this reference. ADOPTED this day of ATTEST: CLERK OF THE BOARD Julie A. Kjorsvik 2015. BOARD OF COUNTY COMMISSIONERS KITTITAS COUNTY, WASHINGTON Gary Berndt, Chairman Obie O'Brien, Vice -Chairman Paul Jewell, Commissioner INTERAGENCY AGREEMENT Between GRANT COUNTY HEALTH DISTRICT And Kittitas County Public Health Department January 1, 2015 - September 29, 2018 THIS INTERAGENCY AGREEMENT is made and entered into pursuant to Chapter 39.34 RCW, the Interlocal Cooperation Act, by and between the Grant County Health District, hereinafter referred to as "GRANT" acting as the Community Lead Organization (CLO) to coordinate the Healthy Communities Obesity, Diabetes, Heart Disease and Stroke Prevention Program and the Kittitas County Public Health Department hereinafter referred to as "PARTICIPANT", as funded by the Washington State Department of Health). IT IS THE PURPOSE OF THIS AGREEMENT to provide a mechanism for the collaborative work, completion of deliverables, and transfer of funds necessary to carry out the priority health improvement initiatives associated with the North Central Washington Healthy Communities Obesity, Diabetes, Heart Disease and Stroke Prevention Program. The PARTICIPANT will develop and implement the North Central Washington Healthy Community work plans that include policy, environmental and system (PSE) strategies that work toward reducing death and disability due to diabetes, heart disease, and stroke; and reduce the prevalence of obesity among adult Washington residents with an emphasis on populations that bear a disproportionately high burden and/or risk for high blood pressure, type 2 diabetes, and obesity. IT IS, THEREFORE, MUTUALLY AGREED THAT: Statement of Work PARTICIPANT shall furnish the necessary personnel and services and otherwise do all things necessary for or incidental to the performance of the work set forth in Exhibit "A" attached hereto and incorporated herein. Unless otherwise specified, PARTICIPANT shall be responsible for performing all fiscal and program responsibilities as set forth in Exhibit "A." Terms and Conditions All rights and obligation of the parties to this contract shall be subject to and governed by the special terms and conditions contained in the text of this agreement. Period of Performance Subject to its other provisions, the period of performance of this agreement shall commence on January 1, 2015 and conclude on September 29, 2018 unless continued by written agreement or terminated sooner as provided herein. In consideration whereof: Upon receipt of a properly executed A-19 Invoice Voucher and complete billing documentation, GRANT Interagency Agreement — Kittitas 03/02/15 to Page 1 shall pay to PARTICIPANT the reimbursed sum as agreed upon in Exhibit "A". Parties may mutually agree to additional sums and deliverables as additional funding is available. Services and Reporting Requirements PARTICIPANT will report to GRANT on any services and/or reporting requirements that may be required under this agreement. Approved Expenses Allowable expenses are for reasonable program purposes, including personnel, travel, supplies and services such as contractual (refer to circular A-87). The primary recipient must perform a substantial role in carrying out project objectives and not merely serve as a conduit for an award to another party or provider who may be ineligible. No expenses will be reimbursed for any lobbying efforts of any kind or for any clinical care. Any type of equipment purchase must be pre -approved by GRANT. Indirect Costs and Line Item Budget Requirements Indirect costs are limited to 22 percent of salaries and benefits. PARTICIPANT need not amend the budget if they anticipate going over in any line item within component 1 or component 2 by less than 10 percent of total direct charges. However, if they anticipate going over by more than 10 percent of total direct charges for any line item they will be required to amend their budget before being refunded for costs that exceed 10 percent in respective line items. Component 1 and component 2 budgets must be tracked separately and funding cannot be moved from one component to the other component. Monitoring of fund allocation spending There will be two check-in points (1) mid -year and (2) two months before contract end date: (1) At mid -year (April, 2015), GRANT will evaluate how much of the PARTICIPANT funds have been spent. If less than 30% of the funds have been billed, GRANT reserves the right to amend the contract and reduce the funding allocation. (2) Two months before the end of the contract (July 31, 2015), GRANT will evaluate how much PARTICIPANT funds have been spent. If less than 80% of the funds have been billed and if the PARTICIPANT doesn't have a reasonable explanation for how they will use the remainder of the funds, GRANT reserves the right to amend the contract and reduce the funding allocation. Non -Discrimination In the performance of this agreement, PARTICIPANT shall not discriminate on the grounds of race, color, national origin, sex, religion, marital status, age, creed, Vietnam era and disabled veterans status, or the presence of any sensory, mental, or physical handicap in: Any terms or conditions of employment to include taking affirmative action necessary to accomplish the objectives of this part; and Denying an individual the opportunity to participate in any program provided by this agreement through the provision of services, or otherwise afforded others. Interagency Agreement - Kittitas 03/02/15 to Page 2 Records Maintenance PARTICIPANT and GRANT shall each maintain sufficient records to demonstrate that funds allocated under this contract have been expended in accordance with the terms and conditions of the Federal Healthy Communities Obesity, Diabetes, Heart Disease and Stroke Prevention 1422 Program Statement of Work guidelines and any federal terms and conditions that may apply. Audit Requirements: An organization that expends $500,000 or more in a year in Federal awards shall have a single or program -specific audit conducted for that year in accordance with the provisions of OMB Circular A-133, Audit of States, Local Governments, and Non -Profit Organizations. The audit must be completed along with a data collection form, and the reporting package shall be submitted within the earlier of 30 days after receipt of the auditor's report(s), or nine months after the end of the audit period. The audit report must be sent to Federal Audit Clearing House; Bureau of the Census; 1201 East 10th St; Jeffersonville, IN 47132. All duly authorized auditors or their representatives of the State of Washington and of the CLO, GRANT, shall have full access and the rights to examine any of these materials during this period, subject to confidentiality laws and regulations. These records shall be retained for five (5) years. PARTICIPANT shall adhere to all other Federal Grant requirements. Restrictions on f=unds (what funds can be used for which activities, not direct payme nts, etc): 1. Recipients may not use funds for research. 2. Recipients may not use funds for clinical care. 3. Recipients may only expend funds for reasonable program purposes, including personnel, travel, supplies, and services, such as contractual. 4. Recipients may not generally use HHS/CDC/ATSDR funding for the purchase of furniture or equipment. However, if equipment purchase is integral to a selected strategy, it will be considered. Any such proposed spending must be identified in the budget. 5. Recipients may not use funding for construction. 6. The direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project objectives and not merely serve as a conduit for an award to another party or provider who is ineligible. 7. Reimbursement of pre -award costs is not allowed. 8. Recipients may not use funds for abortions in accordance with Executive Order 13535. If requesting indirect costs in the budget a copy of the indirect cost rate agreement is required. If the indirect cost rate is a provisional rate, the agreement should be less than 12 months of age. Agreement Alterations and Amendments GRANT and PARTICIPANT may mutually amend this agreement. Such amendments shall not by binding unless they are in writing and signed by personnel authorized to bind PARTICIPANT and GRANT. Interagency Agreement - Kittitas 03/02/15 to Page 3 Indemnification Each party shall defend, protect and hold harmless the other party from and against all claims, suits and/or actions arising from any negligent or intentional act or omission of that party's employees, agency and/or authorized subcontractor (s) while performing this contract. Termination Except as otherwise provided in this agreement, either party may terminate this agreement upon 90 days written notification. If this agreement is so terminated, the termination party shall be liable only for performance in accordance with the terms of this agreement for performance rendered prior to the effective date of termination. Ori m i n ictrntnr Pursuant to RCW 39.34.030(4)(x), the administrator for this agreement shall be Jefferson Ketchel of the Grant County Health District. Nothing in this agreement shall be deemed to establish a separate legal entity to conduct the cooperative undertaking described herein. Property Unless otherwise specifically agreed by the parties in writing, all property, personal and real, utilized by the parties hereto in the execution of this Agreement shall remain the property of that party initially owning it. Notice All notices, reports, and correspondence to the respective parties of this Agreement shall be sent to the following: To GRANT: Grant County Health District 1038 W. Ivy St. Moses Lake, WA 98837 Primary Contact: Jefferson Ketchel, Administrator To PARTICIPANT: Kittitas County Public Health Department 507 N Nanum St. # 102 Ellensburg, WA 98926 Primary Contact: Robin Read, Administrator Savings In the event that funding from state or federal funds is withdrawn, reduced, or limited in any way after the effective date of this contract and prior to normal completion, GRANT may terminate the contract under the "termination" clause, or reduce to the new funding limitations and conditions. Interagency Agreement - Kittitas 03102115 to Page 4 Disputes In the event that a dispute arises under this agreement, it shall be determined in the following manner: GRANT shall appoint a member to the Dispute board. PARTICIPANT shall appoint a member to the Dispute board. GRANT and PARTICIPANT shall jointly appoint a member to the Dispute Board. The Dispute Board shall evaluate the dispute and make a determination of the dispute. The determination of the Dispute Board shall be final and binding on the parties hereto. Filing Pursuant to RCW 39.34.040, this Agreement shall be shall be filed with the county auditor of the parties hereto or, alternatively, listed by subject on a public agency's web site or other electronically retrievable public source of the parties hereto. All Writings contained herein This agreement contains all the terms and conditions agreed upon by the parties. No other understandings, oral or otherwise, regarding the subject matter of this agreement shall be deemed to exist or to bind any of the parties hereto. IN WITNESS WHEREOF, the parties have executed this agreement. Kittitas County Public Health Department Signature Robin Read, Administrator (Print) Grant County Health District Signature Jefferson_Ketchel. Administrator (Print) Date Date Interagency Agreement - Kittitas 03/02/15 to Page 5 EXHIBIT "A" Kittitas County Public Health Department Reimbursement up to $11,000 shall be paid for the following Component #1 healthy communities strategies. Reference the detailed work plan approved by Washington State Department of Health for specific activities and deadlines. Deliverables: 1. PARTICIPANT will work with a retail or community venue to strengthen healthier food access by increasing availability, improved pricing, placement, and promotion. (PS2) 2. PARTICIPANT will work with up to two worksites to promote physical activity through signage, worksite policies and shared use/joint use agreements. 3. PARTICIPANT will provide a monthly progress report by the 8th of the following month. First report will summarize January -March activities and will be due on April 8, 2015. Reimbursement up to $7,500 shall be paid for the following Component #2 healthy communities strategies. Reference the detailed work plan approved by Washington State Department of Health for specific activities and deadlines. Deliverables: 1. PARTICIPANT will assist Community Choice, Grant County Health District, and Washington State Department of Health to provide linkages for Component #2 strategies 9-15 by engaging multi -sector community stakeholders, health systems, existing coalitions and community based resources to prevent obesity, diabetes, heart disease, and stroke. 2. PARTICIPANT will provide a monthly progress report by the 8th of the following month. First report will summarize January -March activities and will be due on April 8, 2015. Billing Information: All A-19 Invoice billings with original signatures and detailed documentation attached are to be sent to Grant County Health District 1038 W Ivy Ave Suite 1, Moses Lake WA 98837 attn: Ryan Brimacombe. Please indicate the costs for each separate component on your A-19. Billings should be submitted monthly within 30 days after the close of a month. Exception: For the month after a funding source's expiration date please have the billing submitted within 25 days after the close of the month. Interagency Agreement — Kittitas 03/02/15 to Page 6 Budget Description Component #1 Component Total #2 DIRECT: Salaries 5158 4044 Benefits 1927 1496 Travel 741 Goods & Services 2356 Total Direct Costs: 9441 6281 INDIRECT: Overhead (22.0% of Salaries & Benefits) 1559 1219 Total Funding $11,000 $7,500 $18,500 Funding Source (expiration date) 93.757(S eptember 29, 2015) Interagency Agreement - Kittitas 03/02/15 to Page 7 Interagency Agreement - Kittitas 03/02/15 to Page 8 Agency Use Only Form State of Washington A19 -1A INVOICE VOUCHER (Rev. 5/91) Agency Location Code P.R. or NO. Auth. No. AGENCY NAME INSTRUCTIONS TO VENDOR OR CLAIMANT: Submit this form to claim payment for materials, merchandise or services. Show complete detail for each item. Vendor's Certificate: I hereby certify under penalty of perjury that the items and totals listed herein are proper charges for materials, merchandise or services furnished to the State of Washington, and that all goods furnished and/or services rendered have been provided without discrimination because of age, sex, marital status, race, creed, color, national origin, handicap, religion, or Vietnam era or disabled veterans status. (Signature) By (Title) (Date) Grant County Health District 1038 W Ivy Ave Moses Lake, WA 98837 VENDOR OR CLAIMANT (Warrant is to be payable to) Federal ID No or Social Security No (For Reporting Personal Services Contract Payments toIRS) Received By Date Received Date Description Component #1 Component #2 Total Month: Salaries Benefits Travel Goods & Services Indirect Rate: 22% of salary/benefits only TOTAL Prepared by Telephone Number Date Agency Approval Date Interagency Agreement - Kittitas 03/02/15 to Page 8