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HomeMy WebLinkAboutContract between Benton Franklin and KCPHDei^r'�r Y s (/ Kittitas County �' 1 Review Form K17 I' Il'iti � n 17 I Z' Grants & Contract Agreement Today's Date 01/19/2018 Fund/Department 116 -Public Health Contract/Grant Information Agenda Date Contract /Grant Agency: Contract between Benton Franklin Health District and KCPHD Period Begin Date: 01/01/2018 Period End Date: 06/30/2018 Total Grant/Contract Amount: $4200.00 Grant/Contract Number: Contract/Grant Summary: The contract for services between Benton Franklin Health District and KCPHD is created to help support the efforts to reduce initiation and use of tobacco and vapor products in the Greater Columbia Accountable Community of Health region through a comprehensive tobacco control program focusing on policy, systems, and environmental changes. 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: Signature of Prosecutor's Office Date Signature of Auditor's Office Date Signature of Board of Health member Date Financial Information Total Amount $4,200.00 Percentage County Funds State Funds $4,200.00 Federal Funds $ Matching Funds $ CFDA# Grant/Contract Review Page 1 Is Equipment being purchased? In -Kind $ Explain Who owns equipment? New Personnel being hired? Contact HR hiring — reporti Future impacts or liability to Kittitas County: Budget Information _Budget Amendment Needed? Yes New Division Created? _ Revenue Code 116.612.044.334.04.93 _1 Pass i nrougn inrormation Agency to Pass Through Amount to Pass Through $ Sub -Contract Approved Date: attach budget form requirements No ❑ Why not Prosecutor Review Has the Prosecutor reviewed this agreement? Yes❑ No ❑ County Departments Impacted Auditor Facilities Maintenance Information Services Human Resource Prosecutor Treasurer Submitted Signature: Department: Assignment of Tracking Information Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer I Date Grant/Contract Review Page 2 F, U Y I'-- L �, 11-M P. - k. HIMTH Prevent s Promote • Protect -7--. -+ CONTRACT FOR SERVICES Between Benton -Franklin Health District And Kittitas County Public Health This agreement is made and entered into between the Benton -Franklin Health District hereinafter referred to as the "District" and the Kittitas County Public Health hereinafter referred to as "Contractor", Effective Dates: 1/1/18-6/30/18 Organizational Contact Information Benton -Franklin Health District Phone: (509) 460-4200 7102 W. Okanogan Place Fax: (509) 460-4590 Kennewick, WA 99336 Responsibility Contact Name Phone Fax Email Administrator/Signature Authority Jason Zaccaria 509-460-4567 509-460-4590 Jasonz bfhd.wa. ov Contracts Manager Bonnie Hall 509-460-4553 509-460-4590 Bonn ieh bfhd.wa. ov Program Supervisor Carla Prock 509-460-4225 509-460-4515 Carla bfhd.wa. ov Program Support _Specialist Vanessa McCollum 509-460-4258 509-460-4590 Vanessam bfhd.wa. ov Accounts Payable Jared Strait 509-460-4556 509-460-4590 Jareds bfhd.wa. cv Kittitas County Public Health 507 N. Nanum, Suite 102 Phone: 509-962-7575 Ellensburg, WA 98926 Fax: 509-962-7518 Responsibility Contact Name Phone Email Administrator/Signature Authority Robin Read 509-962-7515 Robin.readC7co.kittitas.wa.us �- -- Billing/Finance Robin Read 509-962-7515 Robin. read co.kittitas.wa.us Program contact Kasey Knutson 509-962-7515 Kasey.knutson a0co.kittitas.wa.us Kittitas County Public Health agreement 2018 Page 1 PURPOSE The purpose of this agreement is to support efforts to reduce initiation and use of tobacco and vapor products in the Greater Columbia Accountable Community of Health (GCACH) region through a comprehensive tobacco control program focusing on policy, systems and environmental changes. PERIOD OF PERFORMANCE The period of performance of this Agreement shall commence January 1, 2018 and be completed by June 30, 2018 unless terminated or suspended sooner as provided for herein. STATEMENT OF WORE Contractor agrees to perform the following activities throughout the duration of this agreement. • Coordinate and implement a policy ask related to SmokeNape Free Policy in your county in one or more of the following areas as indicated on the Budget (Exhibit A): ❑ Clean Air Fair ❑ Public Parks ❑ Public Housing ❑College Campus ❑ Other (describe): • Coordinate with local youth to conduct Standardized Tobacco Assessment for Retailer Settings (STARS) in local retail shops. BFHD will assist in compiling data from the assessments, and using the data to identify policy gaps. This may also be used as a youth leadership project, where youth are trained to present their findings to policy makers. BFHD can provide training for participants, or work with local adult advisors to train youth. • Submit monthly reports using the Monthly Report Form (Exhibit B) to the District's Program Contact (page 1) by the 10'h of each month. • Submit STARS and vSTARS data, through use of provided Survey Monkey link or scanned copies of completed STARS and vSTARS Assessment Forms to the Districts Program Contact (page 1) by June 30, 2018. • Be subject to periodic audits by BFHD administrative staff. District agrees to provide the following support and activities throughout the duration of this agreement: ■ Provide all reporting templates and links • Provide technical assistance as needed • Provide STARS training for youth assessors and/or materials to train youth • Complied STARS assessment data to Contractor and the GCACH region. REIMBURSEMENT The District will reimburse Contractor for allowable expenses based on monthly invoices submitted by Contractor to the District. Invoices must itemize specific hours and charges based on the budget previously submitted, not to exceed $4,200 for goods and services provided during the period of performance. Any charges based on an allocation method need to have an explanation for the basis of the cost approved by the District in advance. Submit invoices be the 20th of the following month by email, fax or mail to the Districts contact listed on page 1 of this agreement. In-kind services are not reimbursable expenses under this agreement. Kittitas County Public Health agreement 2018 r Page 2 FUNDING SOURCE The funding for this contract comes from WA State Department of Health Youth Tobacco Vapor Products. Bars Revenue Code 334.04.93. BILLING INSTRUCTIONS The Benton -Franklin Health District receives it's funding for this contract through a Department of Health (DOH) grant. Because the District must adhere to specific requirements in order to access these funds, the following billing and invoice requirements must be met by the Contractor in order to be reimbursed for services performed under this contract: • Payment must be based on reimbursement for allowable costs only. Itemized invoices must be received within 20 days of the close of the month in which services were provided. Expenditures will be guided by the estimated budget provided separately. With prior email approval from the District's Program Supervisor, the Contractor may make changes to this budget (within the maximum consideration) to accomplish contract tasks efficiently. • Invoices must include expenditure object/category information for each program (i.e. salaries, benefits, travel, equipment, goods and services, etc.). A summary sheet of expenditures by category must be included along with a copy of a system -generated report (e.g. trial balance, expenditure report, general ledger report) from your accounting system supporting the summary. Expenditure categories to be included are: o Salaries o Benefits o Equipment o Supplies o Travel o Administrative/Indirect/Overhead o Other Supporting documentation to be made available to the District upon request. Invoices can be sent electronically as a PDF attachment to an email (preferred method) to the Accounts Payable contact listed on page 1, or the original invoice with appropriate supporting documentation can be mailed. If you choose to provide electronic copies of invoices, please retain the original signed invoice in your files. CONTRACTOR NOT AN EMPLOYEE OF THE DISTRICT Contractor and its employees or agents performing under this contract are not employees or agents of the District. INDEMNIFICATION/ HOLD HARMLESS Contractor shall indemnify and hold the District, its officers, officials, employees, and volunteers harmless from any and all claims, injuries, damages, losses, or suits including attorney fees, arising from the acts, errors or omissions of the Contractor in the performance of this Agreement, except for injuries and damages caused by the sole negligence of the District. Kittitas County Public Health agreement 2018 Page 3 INSURANCE Contractor shall procure and maintain for the duration of this contract insurance against claims for injuries to persons or damage to property that may arise from or in connection with the performance of the work hereunder by the Contractor, its agents, representatives, or employees. Workers' Compensation Coverage — Contractor shall procure and maintain coverage as required by the Industrial Insurance laws of the State of Washington. RIGHTS IN DATA Data, which is delivered under this contract, are the District's property and shall be transferred fully to the District with all rights to the license to publish, translate, reproduce, modify, deliver, dispose of, and to authorize others to do so. STATUTORY AND REGULATORY COMPLIANCE Contractor shall comply with all applicable federal, state, and local laws, ordinances, rules, regulations, guidelines and standards applicable to any service provided pursuant to this Agreement. Contractor agrees to comply with the provisions of the Americans with Disabilities Act (ADA). NONDISCRIMINATION Contractor shall not discriminate against anyone in providing services under this Agreement on the grounds of race, color, sex, religion, national origin, creed, marital status, age, Vietnam era or disabled veterans' status, or the present of any sensory, mental or physical disability. CULTURALLY AND LINGUISTICALLY APPROPRIATE All project materials must be culturally and linguistically appropriate. For questions or assistance related to culturally and linguistically appropriate material, contact the District's Program Supervisor listed on the first page of this agreement. CHANGES OR MODIFICATIONS The District may, at any time, by written notification to Contractor, make changes within the general scope of the services to be performed under this Agreement. Both parties shall execute a contract amendment reflecting such change and an equitable adjustment of cost, period of performance or both will be made if required by the changes. CONTRACT SUSPENSION For Investigation: In the event Contractor or any of its partners, employees, officers is investigated by a local, county, state or federal agency for a matter which the District feels may adversely affect the delivery of services under this contract, the District may, without advance notice, suspend the delivery of services or disallow the person(s) involved in the allegation from providing services pending final resolution of the investigation. For Suspension of Funding and work: Because the District receives both state and federal funds occasionally the District's funding source may enact a contract suspension due to sequestration, loss of budget appropriation, or other causes. When this occurs, the District may exercise its right to suspend this contract until the District's funding has resumed and approval to continue work has been received. At that time, the District will notify the Contractor that they may resume work. All notice to suspend or reinstate work will be in writing. Any expenses incurred during the suspension of this Kittims County Public Health agreement 2018 Page 4 contract may not be reimbursed later unless it is specifically approved at the time the contract is reinstated. TERMINATION OF AGREEMENT • For Convenience: This contract may be terminated by either party for convenience with two weeks written notice. If this contract is so terminated, the parties are only liable for performance rendered or costs incurred in accordance with this contract prior to the effective date of termination. • By Mutual Agreement: This contract may be terminated at any time by mutual agreement of both parties. • For Non -Allocation of Funds: The District's ability to make payments is contingent on the availability of its various funding sources. In the event funding from state, federal, or other funding sources is withdrawn, reduced, limited or suspended during the course of this contract, the District at its sole discretion may elect to terminate this agreement in whole or in part or to renegotiate this contract subject to new funding limitations or conditions. RECOVERY OF FUNDS The right of the contractor to retain funds received from the District is contingent upon satisfactory performance of this contract and completion of work, and subject to an on-site audit of books and records if requested. If the District is required to repay funds to the Department of Health for disallowed or unsupported expenses performed by the contractor, the contractor will promptly repay the District the full amount. ALL WRITING CONTAINED HEREIN This contract contains all the terms and conditions agreed upon by the parties. No other understandings, oral or otherwise, regarding the subject matter of this contract shall be deemed to exist or to bind either of the parties. BENTON-FRANKLIN HEALTH DISTRICT KITTITAS COUNTY PUBLIC HEALTH Jason Zaccaria - Administrator 7102 W. Okanogan Place Kennewick, WA 99336 Date. Robin Read - Administrator 507 N. Nanum, Suite 102 Ellensburg, WA 98926 Tax ID # Statewide Payee # Date: Kltdtas County Public Health agreement 2018 Page 5 Exhibit A Budget Tobacco & Vapor Product Prevention and Control Grantee Name: Kittitas County Public Health Department Contract Period: January 1, 2018 — June 30, 2018. Please indicate below which area you will be working in: ® Clean Air Fair O Public Parks O Public Housing OCollege Campus ® Other (describe): STARS assessments, cessation outreach Complete the table below (not to exceed $4200.00) Proposed Budget Line itemlDescii tion Arrtount. Personnel costs $2,678.00 Travel Supplies/Other $750.00 Indirect costs federally approved rate of 40.75 % $772.00 Total $4,200.00 Funded by: Washington State Department of Health Youth Tobacco Vapor Products program Submitted by: Tax ID #: Cq I . 0 0 1 "1 • ON SCTC 0�19 Stats and Community Wal -co Control Research Start time: End time: 1. Date of visit: 2. Store ID: 3. Coder ID: 4. Store Name: Does the actual store name match the assigned store name? ❑1 Yes 0a No — Enter correct name: 5. Store Location: Does the actual store address match the assigned address? ❑, Yes Oo No — Enter correct address: 6. Can you survey this store? (If not, then select an option below and STOP.] ❑1 Yes, I can ❑, No, store does not exist ❑3 No, store is closed ❑, No, membership or fee required to enter 05 No, environment unsafe for me ❑, No, asked to leave before completing the survey ❑, Other (specify): 7. Does this store sell vaping products? ❑1 Yes (Continue to question #8) ❑o No (Discontinue this survey) STORE DEMOGRAPHICS 8. Is this store best categorized as a... ❑, Vapeshop OZ Vape kiosk ❑3 Head shop with vaping products O, Convenience store, pharmacy; beer/wine/liquor store; grocery store/supermarket; mass merchandiser/discount store —> use STARS ❑5 Other: 9. Exterior sign stating policy regarding minors entering the store? ❑, Minimum age must be 18 or older to enter ❑Z Minimum age must be 19 or older to enter ❑3 Minimum age must be 21 or older to enter ❑o No minimum age posted to enter 10. Does the store sell... a. Alcoholic beverages? ❑, Yes ❑Q No b. Cannabis / Marijuana? ❑, Yes Oa No c. Whipped cream chargers or dispensers (used for whippets)? ❑, Yes ❑, No d. Other psychoactive substances (e.g., kratom, K2"spice, synthetic cannabinoids such as "herbal incense" or "Scooby Snax", salvia)? ❑, Yes ❑a No TYPES OF PRODUCTS SOLD 11. Tobacco devices or products sold: a. Cigarettes? ❑, Yes ❑o No b. Cigarillos/Ilttle cigars? 01 Yes 0o No c. Large Cigars? ❑, Yes ❑o No d. Pipe or roll your own tobacco? ❑, Yes ❑o No e. Smokeless tobacco products? 01 Yes ❑p No f. Hookah pipes /Water pipes? ❑, Yes ❑o No g. Shisha? 0, Yes ❑o No 12. Electronic devices sold: a. Closed systems (cig-a-likes, e -cigarettes, or e -hookah that either use cartridges or do not have a refillable tank)? ❑, Yes ❑, No b. Vape pens/eGos/vape sticks, all with a tank to fill with e -juice? ❑, Yes ❑, No c. Mods/RBAs/RDAs? ❑, Yes ❑, No d. Herbal/dry-chamber vaporizers, designed for loose -leaves? ❑, Yes ❑, No 13. E-liquids/juices a. Are e-llqulds4uices sold? b. Candy/fruit flavored? c. Flavor of alcoholic drinks? d. Menthol/mint flavored? e. Nicotine -free? f. ContalnsTHC? g. Contains CBD? h. Contains caffeine? I. Displayed in self-service display? ❑, Yes ❑o No (check N/A for #13B —#14) ❑, Yes O, No ❑, N/A ❑, Yes ❑, No ❑, N/A ❑, Yes ❑, No 09 N/A ❑, Yes Q. No ❑, N/A ❑, Yes O, No ❑, N/A 01 Yes 0, No E3, N/A ❑, Yes U. No ❑, N/A O, Yes ❑, No 0, N/A 14. If e-liquids/juices are sold, does the store have a menu for them? O, Yes - booklet, pamphlet, or menu board on wall/counter Oa No ❑, N/A - not sold 15. Cartridges a. Are cartridges sold? b. Candy/fruit flavored? c. Flavor of alcoholic drinks? d. Menthol/mint flavored? e. Nicotine -free? f. ContainsTHC7 g. Contains CBD7 h. Contains caffeine? 1. In self-service displayl O, Yes Q. No (check N/A for #15b-1) ❑, Yes Q. No ❑, N/A ❑, Yes ❑, No ❑, N/A O, Yes Q. No ❑, N/A O, Yes U, No ❑, N/A ❑, Yes Q. No ❑, N/A ❑, Yes ❑, No O9 N/A ❑, Yes U. No ❑, N/A ❑, Yes O, No ❑, N/A 16. Price promotions, including clearance, on e -liquids or devices? ❑, Yes ❑, No 17. Can customers sample products while inside the store/kiosk... a. If they bring their own device ❑, Yes ❑, No b. Using a device provided by the store ❑, Yes ❑, No MESSAGING 18. One or more sign(s) posted inside the store/kiosk that... a. Suggest vaping Is saferthan cigarettes ❑, Yes Do No (including customer testimonials)? b. Promote vaping as a way to quit smoking U Yes Q. No cigarettes (including customer testimonlals)? c. Promote vaping as a cheaper alternative ❑Yes ❑ No to conventional cigarettes? u d. Promote vaping in places where smoking LI, ❑ No Is not allowed? u e. Promote a customer loyalty program? O, Yes Oa No f. Are directed towards veterans or ❑ Yes ❑ No the military population? g. Are directed towards college students? ❑, Yes Q. No h. Display graphic health warnings? ❑, Yes U, No 19. Signs stating that vaping is allowed in the store/kiosk? ❑, Yes, vaping is allowed ❑o No, vaping is not allowed ❑, N/A, there are no signs 20. Anyone vaping while you completed this audit (including store staff)? ❑, Yes ❑, No 21. Branded marketing materials for vaping products placed In the interior of the store? ❑, Yes ❑, No 22. Branded marketing materials for vaping products placed on the exterior of the store, or on store property? ❑, Yes ❑, No 23. Ask clerk at the end of the survey: a. "Can store staff make e -liquids (mix propylene glycol, and/or vegetable glycerin, flavors, and/or nicotine) on-site?" ❑, Yes ❑o No ❑, Refused to answer b. "Does the store allow customers/staff to mix e -liquids on-site?" ❑, Yes ❑, No ❑, Refused to answer FIELD NOTES 1. Date of visit: 2. Coder Name/ID: Start Time: End Time: 3, Store Name/ID: El, Store name matches assigned name 4. Store Address: F1, Actual address matches assigned address 5 FIELD NOTES ❑ This retail environment provides a great photo opportunity. Can you survey this store? [If not, then select an option below and STOP.] ❑, Yes, i can ❑Z No, store does not exist 1:13 No, store is closed ❑4 No, under 18 not allowed to enter ❑5 No, membership or fee required to enter ❑6 No, environment unsafe for me ❑7 No, asked to leave before completing the survey ❑8 Other (specify): EXTERIOR Which products are advertised outside the store (on windows/doors, building, sidewalk or elsewhere)? Cigarettes - non -menthol ❑ , Yes El -a No b_ Cigarettes - menthol ❑ , Yes ❑ r, No c. Cigarillos/little cigars ❑ , Yes ❑ 0 No d. Large cigars ❑ , Yes ❑ No e. Chew, moist or dry snuff, dip or snus ❑ , Yes ❑ No f. E -cigarettes ❑ , Yes ❑ , No INTERIOR 7. Store Type: (Choose one) El Convenience store with or without gas (e.g., 7 -Eleven, Exxon, Wawa) ❑ z Drug store/pharmacy (e.g., Walgreens, Rite Aid, Duane Reade) 113 Beer, wine, or liquor store (e.g., ABC) ❑4 Grocery store (e.g., small market/deli/produce market) or supermarket (e.g., Stop & Shop, Harris Teeter, Albertson's) El Mass merchandiser (e.g., WalMart, Costco, BYs, Sam's Club) or discount store (e.g., Dollar General, Family Dollar) 1:16 Tobacco shop (e.g., Cigarettes Cheaper, cigar shops, hookah bars, e -cigarette shops, or other tobacco shops) ❑ 7 Other (specify): (e.g., donut shop, bait & tackle) 8. Any tobacco products sold here (i.e., cigarettes, cigars, cigarillos/little cigars, chew, moist or dry snuff, dip, snus, or e -cigarettes)? (Choose one) ❑, Yes and visible to customers ❑ a Yes but not visible to customers ❑Q No [STOP if focusing on tobacco retailers] Does the store have a pharmacy counter? ❑ l Yes ❑o No 10. Alcoholic beverages sold here? ❑ 1 Yes El. No 11 Does store display a graphic health warning sign? ❑ 1 Yes ❑o No SCT+C 0009 .Noir 1-101 nmm'f, H.lwuo l unln l Nunmh Vemon i 0 14! CIGARETTES 1 Answer these questions about cigarettes. a. Any cigarettes sold here? ❑ , Yes ❑ o No b. Menthol cigarettes sold here? ❑ 1 Yes ❑ o No c. Any cigarettes (menthol or non -menthol) within 12 inches of toys, candy, gum, ❑ , Yes ❑ o No slushy/soda machines, or ice cream? ❑ , Cashier provided price ❑ 1 Cashier provided price ❑ Z Advertised price ❑ 2 Advertised price d. Cigarette ad (menthol or non -menthol) within 3 feet of the floor? ❑ 1 Yes ❑ 0 No e. Any cigarette price promotions? ❑ 1 Yes ❑ o No f. Any menthol cigarette price promotions? ❑ 1 Yes 130 No OTHER PRODUCTS a. Sold here? b. Flavored products? c. Singles sold here? d. Advertised for less than $1 ? c_ Product within 12 inches of toys, candy, gum, slushy/soda machines, or ice cream? 13. Cigarillos/little cigars 11 Yes ❑oNo ❑, Yes ❑oNo ❑ 1 Yes ❑ o No ❑, Yes ❑o No 14. Large cigars Chew, moist/dry 16. E -cigarettes snuff, dip, or snus ❑, Yes ❑oNo ❑, Yes ❑oNo 01 Yes ❑oNo ❑, Yes 13, No ❑, Yes ❑oNo 01 Yes ❑oNo ❑ t Yes ❑oNo ❑, Yes ❑,, No ❑, Yes ❑o No ❑, Yes ❑oNo I Product ad within 3 feet of floor? ❑ , Yes ❑ u No ❑ 1 Yes ❑ o No ❑, Yes ❑o No ❑, Yes ❑oNo g. Self-service display? ❑ 1 Yes ❑ o No ❑ 1 Yes ❑ o No ❑, Yes ❑ o No h. Any price promotions? I Cross -product promotion with cigarettes? 11 Yes ❑oNo 17 WIC and/or SNAP (i.e., food stamps, EBT) accepted here? a. :, _ ❑, Yes ❑ a No b. i ❑, Yes ❑ a No "Aryl PRICES 01 Yes 0. No ❑, Yes ❑oNo ❑, Yes 110 No ❑t Yes ❑oNo 18. Cheapest cigarette 19, Newport menthol pack i (regular hard pack) 20. Blu disposable e -cigarette (menthol) a. Sold here? ❑ 1 Yes ❑ o No ❑ Yes ❑ 0 No ❑ 1 Yes ❑ o No [if cigarettes not sold here, skip to Q101 b. Enter single pack/item price: $ _ `. _ $ . _ _ $ Sales tax included? ❑ 1 Yes ❑ o No ❑ , Yes ❑ o No ❑ , Yes ❑ o No How was the price obtained? E71 Cashier provided price ❑ , Cashier provided price ❑ 1 Cashier provided price ❑ Z Advertised price ❑ 2 Advertised price ❑ 2 Advertised price ❑ U Unable to determine ❑ U Sold here but price ❑ o Sold here but price (e.g. only cartons sold) unavailable unavailable N m i� L- 0 O LL ttoc L O CL a) u CL a s u c 0 2tQ u '3 I N M . I N rq . I N M ci r -I a -I N N N M M rn �) u f O m t/1 C +� Q C o 4+ N a) CA4- o� '^ U U O N v v NLn Ln 0