HomeMy WebLinkAboutPSA Amend between Youth Services of KC and Kittitas CountyKittitas County
Review Form
Grants & Contract Agreement
[To—day's Date
/30/2018
Fund/Department
116 -Public Health
Contract/Grant Information
Contract /Grant A
Agenda Date
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PSA Amendment between Youth Services of Kittitas County and Kittitas Cou
Period Begin Date: April 1, 2018 Period End Date: June 30, 2018
Total Grant/Contract Amount: $28,151.88
Grant/Contract Number:
Contract/Grant Summary:
The original agreement between Youth Services of Kittitas County and Kittitas County was established to
allow Youth Services of Kittitas County to implement the Community Prevention Wellness Initiative
(CPWI) community based mentoring program in Kittitas County. The amended agreement amends
Exhibit "B" Budget Expenditures
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 $
State Funds $
Federal Funds $
Percentage County Funds
Matching Funds $
CFDA#
Grant/Contract Review Page 1
...........
In -Kind $
Explain
Is Equipment being purchased? Who owns equipment?
New Personnel being hired? Contact HR hiring — reporting requirements
Future impacts or liability to Kittitas County:
Budget Information
Budget Amendment Needed? Yes ❑ attach budget form No ❑ why not
New Division Created?
Revenue Code
Pass Through Information
Agency to Pass Through
Amount to Pass Through $
Sub -Contract Approved Date:
Prosecutor Review
Has the Prosecutor reviewed this agreement? Yes ❑ No ❑
County Departments Impacted
Submitted
Signature:
Department:
Assignment of Trackine Information
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer I Date
Grant/Contract Review Page 2
Auditor
Facilities Maintenance
Information Services
Human Resource
Prosecutor
Treasurer
Submitted
Signature:
Department:
Assignment of Trackine Information
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer I Date
Grant/Contract Review Page 2
PROFESSIONAL SERVICES AGREEMENT
CONTRACT AMENDMENT
This Agreement is made by and between Kittitas County (hereinafter "the County")
and Youth Services of Kittitas County (hereinafter "Contractor"). The County and
Contractor agree as follows:
General Conditions; Exhibit A (Scope of Work); Exhibit B (Compensation);
Exhibit C (Proof of Insurance).
copies of which are attached hereto and incorporated herein by this reference as fully as if
set forth herein.
The term of this Agreement shall commence on the 1st of April, 2018 and continue
until the 30th of June, 2019. Any party may terminate this Agreement by giving thirty (30)
days notice in writing either personally delivered or mailed postage -prepaid by certified
mail, return receipt requested, to the party's last known address for the purposes of giving
notice under this paragraph.
Contractor acknowledges and by signing this Agreement agrees that the
Indemnification provisions set forth in Paragraphs 7 (Independent Contractor), 9 (Taxes),
15 (Defense and Indemnity Agreement), 21 (Patent/Copyright Infringement) and 24
(Confidentiality), are totally and fully part of this Agreement and have been mutually
negotiated by the parties.
Professional Services Agreement
Page 1
Professional Services Agreement
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IN WITNESS WHEREOF, the parties have executed this Agreement this
of , 2018.
APPROVED:
Youth Services of Kittitas County BOARD OF COUNTY COMMISSIONERS
KITTITAS COUNTY, WASHINGTON
Signature of Signatory
(Date )
Print Name of Signatory
Contractor Address:
Youth Services of Kittitas County
PO Box 523
213 W. 3rd Ave
Ellensburg, WA 98926
Project Contact:
Crystal Church
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Laura Osiadacz, Chairman
Obie O'Brien, Vice -Chairman
Cory Wright, Commissioner
Attest:
Clerk of the Board
Approved as to Form:
By:
Deputy Prosecuting Attorney
County's Address:
Kittitas County
205 West 5th Avenue, Suite 108
Ellensburg, WA 98926
Project Contact:
Kasey Knutson
day
GENERAL CONDITIONS
1. Scope of Contractor's Services:
Contractor agrees to provide to the County services and any materials set forth in the
project narrative identified in Exhibit "A" during the Agreement period. No material, labor,
or facilities will be furnished by the County, unless otherwise provided for in the
Agreement.
2. Performance of Work:
Contractor shall perform work in accordance with, and shall comply with, all of the
provisions of this Agreement. All work shall comply with applicable codes and ordinances.
3. Schedule of Performance:
Unless directed otherwise by the County, Contractor shall perform the work in accordance
with any schedules made a part of this Agreement.
4. Definitions:
4.1 "Additional Insured's" means the County, its successors and assigns, and
the respective directors, officers, employees, agents and representatives of
the County and its successors and assigns.
4.2 "Support" means the following: Contractor's directors, officers, employees,
agents and representatives; and sub -Contractors of any tier; the respective
directors, officers, employees, agents and representatives of these sub -
Contractors of any tier; and any other person or entity acting under the
direction or control of, or on behalf of, Contractor or any Contractor's sub -
Contractors of any tier in connection with or incident to the performance of
the Work or this Agreement.
4.3 The "Work" means all of the duties listed in Exhibit A and the performance of
all other obligations, under this Agreement by Contractor or its Support.
5. Accountina and Payment for Contractor Services:
Payment to the Contractor for services rendered under this Agreement shall be as set
forth in Exhibit "B". Where Exhibit "B" requires payments by the County, payment shall be
based upon billings, supported unless otherwise provided in Exhibit "B", by documentation
of units of work actually performed and amounts earned, including where appropriate, the
actual number of days worked each month, total number of hours for the month, and the
total dollar payment requested. Unless specifically stated in Exhibit "B" or approved in
writing in advance by the Kittitas County Board of Commissioners, the County will not
reimburse the Contractor for any costs or expenses incurred by the Contractor in
performance of this Agreement.
Where required, the County shall, upon receipt of appropriate documentation, compensate
the Contractor, no more often than monthly, through the County voucher system, for the
Contractor's service pursuant to the fee schedule set forth in Exhibit "B".
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6. Assignment and Subcontracting:
No portion of this Agreement may be assigned or subcontracted to any other individual,
firm or entity without the express and prior written approval of the County.
7. Independent Contractor:
The Contractor's services shall be furnished by the Contractor as an independent
Contractor and nothing herein contained shall be construed to create a relationship of
employer-employee or master -servant, but all payments made hereunder and all services
performed shall be made and performed pursuant to this Agreement by the Contractor as
an independent Contractor.
The Contractor acknowledges that the entire compensation for this Agreement is specified
in Exhibit "B" and the Contractor is not entitled to any County benefits including, but not
limited to: vacation pay, holiday pay, sick leave pay, medical, dental, or other insurance
benefits, or any other rights or privileges afforded to Kittitas County employees.
Contractor will defend, indemnify and hold harmless the County, its Additional Insured's,
officers, agents or employees from any loss or expense, including but not limited to
settlements, judgments, setoffs, attorneys' fees or costs incurred by reason of claims or
demands because of breach of the provisions of this paragraph.
8. No Guarantee of Employment:
The performance of all or part of this Agreement by the Contractor shall not operate to
vest any employment rights whatsoever and shall not be deemed to guarantee any
employment of the Contractor or any employee of the Contractor or any sub -Contractor or
any employee of any sub -Contractor by the County at the present time or in the future.
9. Taxes:
The Contractor understands and acknowledges that the County will not withhold Federal
or State income taxes. Where required by State or Federal law, the Contractor authorizes
the County to make withholding for any taxes other than income taxes (i.e. Medicare). All
compensation received by the Contractor will be reported to the Internal Revenue Service
at the end of the calendar year in accordance with the applicable IRS regulations. It is the
responsibility of the Contractor to make the necessary estimated tax payments throughout
the year, if any, and the Contractor is solely liable for any tax obligation arising from the
Contractor's performance of this Agreement. The Contractor hereby agrees to indemnify
the County against any demand to pay taxes arising from the Contractor's failure to pay
taxes on compensation earned pursuant to this Agreement.
The County will pay sales and use taxes imposed on goods or services acquired
hereunder as required by law. The Contractor must pay all other taxes including, but not
limited to: Business and Occupation Tax, taxes based on the Contractor's gross or net
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income, or personal property to which the County does not hold title. The County is
exempt from Federal Excise Tax.
10. Regulations and Requirement:
This Agreement shall be subject to all laws, rules and regulations of the United States of
America, and State of Washington, and political subdivisions of the State of Washington,
and to any other provisions set forth herein or in the attached exhibits.
11. Right to Review:
This contract is subject to review by any Federal or State auditor. The County or its
designee shall have the right to review and monitor the financial and service components
of this program by whatever means are deemed expedient by the County. Such review
may occur with or without notice, and may include, but is not limited to, on-site inspection
by County agents or employees, inspection of all records or other materials which the
County deems pertinent to the Agreement and its performance, and any and all
communications with or evaluation by service recipients under this Agreement. The
Contractor shall preserve and maintain all financial records and records relating to the
performance of work under this Agreement for 6 years after contract termination, and shall
make them available for such review, within Kittitas County, State of Washington, upon
request.
12. Modifications:
12.1 Either party may request changes in the Agreement. Any and all agreed
modifications shall be in writing, signed by each of the parties.
12.2 The County may, at any time, by written notice thereof to Contractor
("Change Notice") makes changes in the Work within the general scope of
this Agreement, including, but not limited to: (a) changes in, revisions to,
substitutions for, additions to or deletions of any Work; (b) changes in
schedule; and (c) acceleration, deceleration or suspension of performance
of any Work.
12.3 If any change in the Work causes an increase or decrease on Contractor's
cost of, or the time required for, performance of the Work, an equitable
adjustment in the compensation to Contractor and in the schedule for the
performance of the Work shall be made to reflect such an increase or
decrease.
12.4 Notwithstanding any dispute or delay in arriving at a mutually acceptable
equitable adjustment, Contractor shall proceed in accordance with all
Change Notices. Contractor must, within thirty (30) days after receipt of any
Change Notice that does not set forth any acceptable adjustment, submit to
the County a written statement setting forth any adjustment claimed.
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12.5 If any change results in a decrease in the Work performed, Contractor shall
be entitled to compensation associated with changing the Work, such as
revising design already completed, revising calculations already performed,
and revising documents.
13. Termination for Default:
If the Contractor defaults by failing to perform any of the obligations of the Agreement or
becomes insolvent or is declared bankrupt or commits any act of bankruptcy or insolvency
or makes an assignment for the benefit of creditors, the County may, by depositing written
notice to the Contractor in the U.S. mail, postage prepaid, terminate the Agreement, and at
the County's option, obtain performance of the work elsewhere. If the Agreement is
terminated for default, the Contractor shall not be entitled to receive any further payments
under the Agreement until all work called for has been fully performed. Any extra cost or
damage to the County resulting from such default(s) shall be deducted from any money
due or coming due to the Contractor. The Contractor shall bear any extra expenses
incurred by the County in completing the work, and all damage sustained, or which may be
sustained by the County by reason of such default.
If a notice of termination for default has been issued and it is later determined for any
reason that the Contractor was not in default, the rights and obligations of the parties shall
be the same as if the notice of termination had been issued pursuant to the Termination for
Public Convenience paragraph hereof.
14. Termination for Public Convenience:
The County may terminate the Agreement in whole or in part whenever the County
determines, in its sole discretion that such termination is in the best interests of the
County. Whenever the Agreement is terminated in accordance with this paragraph, the
Contractor shall be entitled to payment for actual work performed at unit contract prices for
completed items of work. In the event of such termination, an equitable adjustment shall
be made in the compensation payable to Contractor.
An equitable adjustment in the contract price for partially completed items of work will be
made, but such adjustment shall not include provision for loss of anticipated profit on
deleted or uncompleted work. Termination of this Agreement by the County at any time
during the term, whether for default or convenience, shall not constitute a breach of
contract by the County.
15. _Defense & Indemnity Agreement:
The Contractor agrees to and shall defend, indemnify and hold harmless the County, its
Additional Insured's, appointed and elective officers, agents and employees, from and
against all loss or expense, including but not limited to judgments, settlements, attorney's
fees and costs by reason of any and all claims and demands upon the County, its
Additional Insured's, its elected or appointed officials, agents, or employees for damages
because of personal or bodily injury, including death at any time resulting therefrom,
Professional Services Agreement
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sustained by any person or persons and on account of damage to property including loss
of use thereof, whether such injury to persons or damage to property is due to the
negligence of the Contractor, its sub -Contractors, its elected officers, employees or their
agents, except only such injury or damage as shall have been occasioned by the sole
negligence of the County, its Additional Insured's, appointed or elected officials, agents, or
employees. It is further provided that no liability shall attach to the County by reason of
entering into this contract, except as expressly provided herein.
16. Industrial Insurance Waiver:
With respect to the performance of this Agreement and as to claims against the County, its
Additional Insured's, officers, agents and employees, the Contractor expressly waives its
immunity under Title 51 of the Revised Code of Washington, the Industrial Insurance Act,
for injuries to its employees and agrees that the obligations to indemnify, defend and hold
harmless provided in this agreement extend to any claim brought by or on behalf of any
employee of the Contractor. This waiver is mutually negotiated by the parties to this
Agreement.
17. Venue and Choice of Law:
In the event that any litigation should arise concerning the construction or interpretation of
any of the terms of this Agreement, the venue of such action of litigation shall be in the
Superior Court of the State of Washington in and for the County of Kittitas. This
Agreement shall be governed by the law of the State of Washington.
18. Withholdin Payment:
In the event the Contractor has failed to perform any obligation to be performed by the
Contractor under this Agreement within the time set forth in this Agreement, then the
County may, upon written notice, withhold all monies due and payable to Contractor,
without penalty, until such failure to perform is cured or otherwise adjudicated.
19. Future Non -Allocation of Funds:
If sufficient funds are not appropriated or allocated for payment under this Agreement for
any future fiscal period, the County will not be obligated to make payments for services or
amounts incurred after the end of the current fiscal period. No penalty or expense shall
accrue to the County in the event this provision applies.
20. Contractor Commitments, Warranties and Representations:
The Contractor represents and warrants to the County as follows:
20.1 The Contractor is duly incorporated, validly existing and in good standing
under the laws of the State of Washington, and has all requisite corporate
power and authority to enter into and to perform its obligations under this
Agreement.
20.2 The Contractor has the authority to execute this Agreement, to make the
representations and warranties set forth in it and to perform the
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obligations of the Contractor under this Agreement in accordance with its
terms.
20.3 This Agreement has been validly executed by an authorized
representative of the Contractor and constitutes a valid and legally
binding and enforceable obligation of Contractor.
20.4 The Contractor has or will obtain prior to the commencement date such
licenses, permits and other authorizations from federal, state and other
governmental authorities, as are necessary for the performance of its
obligations under this Agreement.
20.5 The Contractor is not in violation of any applicable law, ordinance or
regulation the consequence of which will or may materially affect
Contractor's ability to perform its obligations under this Agreement. The
Contractor is not subject to any order or judgment of any court, tribunal or
governmental agency which materially and adversely affects its
operations or assets in the State of Washington, or its ability to perform
its obligations under this Agreement.
20.6 None of the representations or warranties in this Agreement, and none of
the documents, statements, certificates or schedules furnished or to be
furnished by Contractor pursuant hereto or in connection with the
performance of the obligations contemplated under this Agreement,
contains or will contain any untrue statement of a material fact or omits or
will omit to state a material fact necessary to make the statements of fact
contained therein not misleading.
21. Patent/Copyright Infringement:
Contractor will defend and indemnify the County from any claimed action, cause or
demand brought against the County; to the extent such action is based on the claim that
information supplied by the Contractor infringes any patent or copyright. The Contractor
will pay those costs and damages attributable to any such claims that are finally awarded
against the County in any action. Such defense and payments are conditioned upon the
following:
21.1 Contractor shall be notified promptly in writing by County of any notice of
such claim.
21.2 Contractor shall have the right, hereunder, at its option and expense, to
obtain for the County the right to continue using the information, in the event
such claim of infringement is made, provided no reduction in performance or
loss results to the County.
22. Disputes:
22.1 General
Differences between the Contractor and the County, arising under and by
virtue of the Agreement Documents shall be brought to the attention of the
County at the earliest possible time in order that such matters may be settled
or other appropriate action promptly taken. Except for such objections as are
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made of record in the manner hereinafter specified and within the time limits
stated, the records, orders, instructions, and decisions of the Kittitas County
Commissioners shall be final and conclusive.
22.2 Notice of Potential Claims
The Contractor shall not be entitled to additional compensation which
otherwise may be payable, or to extension of time for (1) any act or failure to
act by the County, or (2) the happening of any event or occurrence, unless
the Contractor has given the County a written Notice of Potential Claim
within ten (10) days of the commencement of the act, failure, or event giving
rise to the claim, and before final payment by the County. The written Notice
of Potential Claim shall set forth the reasons for which the Contractor
believes additional compensation or extension of time is due, the nature of
the cost involved, and insofar as possible, the amount of the potential claim.
Contractor shall keep full and complete daily records of the work performed,
labor and material used, and all costs and additional time claimed to be
additional.
22.3. Detailed Claim
The Contractor shall not be entitled to claim any such additional
compensation, or extension of time, unless within thirty (30) days of the
completion of the portion of the work from which the claim arose, and before
final payment by the County, the Contractor has given the County a detailed
written statement of each element of cost or other compensation requested
and of all elements of additional time required, and copies of any supporting
documents evidencing the amount or extension of time claimed to be due.
23. Ownership of Items Produced:
All writings, programs, data, public records or other materials prepared by the Contractor
and/or its consultants or sub -Contractors, in connection with performance of this
Agreement shall be the sole and absolute property of the County.
24. Confidentiality:
The Contractor, its employees, sub -Contractors, and their employees shall maintain the
confidentiality of all information provided by the County or acquired by the Contractor in
performance of this Agreement, except upon the prior written consent of the Kittitas
County Prosecuting Attorney or an order entered by a court after having acquired
jurisdiction over the County. Contractor shall immediately give to the County notice of any
judicial proceedings seeking disclosure of such information. Contractor shall indemnify
and hold harmless the County, its Additional Insured's, officials, agents or employees from
all loss or expense, including, but not limited to settlements, judgments, setoffs, attorneys'
fees and costs resulting from Contractor's breach of this provision.
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To the extent that any information obtained by the Contractor is required to be shared with
or provided to others by the terms of the Statement of the Work, this provision is not
breached by such acts.
25. Notice:
Except as set forth elsewhere in the Agreement, for all purposes under this Agreement,
except service of process, notice shall be given by the Contractor to the department head
of the department for whom services are rendered, and to the Kittitas County
Commissioners, 205 W 5t" Ave, Suite 108, Ellensburg, WA 98926. Notice to the
Contractor for all purposes under this Agreement shall be given to the address reflected on
the signature page. Notice may be given by delivery or by depositing in the U.S. Mail, first
class, postage prepaid.
26. Severability:
If any term or condition of this Agreement or the application thereof to any person(s) or
circumstances is held invalid, such invalidity shall not affect other terms, conditions or
applications which can be given effect without the invalid term, condition or application. To
this end, the terms and conditions of this Agreement are declared severable.
27. Miscellaneous.-
27.1
iscellaneous:27.1 The County's failure or delay to insist upon strict performance of any of the
provisions of this Agreement or to exercise any rights or remedies under this
Agreement shall not be construed as a waiver or relinquishment to any
extent of its right to assert or rely upon any such provisions, rights or
remedies in that or any other instance; rather the same shall be and remain
in full force and effect.
27.2 This Agreement embodies the entire Agreement between the County and
Contractor, and supersedes any and all prior agreements, regarding the
Work. No change, amendment or modification of any provisions of this
Agreement shall be valid unless set forth in a written instrument signed by
the party to be bound thereby.
27.3 The rights and remedies of the County set forth in any provision of this
Agreement are in addition to and do not in any way limit any other rights of
remedies afforded to the County by any other provisions of this Agreement,
by any of Contractor's Support or by law.
27.4 The headings of sections and paragraphs of this Agreement are for
convenience of reference only and are not intended to restrict, affect or be
of any weight in the interpretation or construction of the provisions of such
sections or paragraphs.
28. Waiver:
Waiver of any breach or condition of this Agreement shall not be deemed a waiver of any
prior or subsequent breach. No terms or conditions of this Agreement shall be held to be
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waived, modified or deleted except by an instrument, in writing, signed by the parties
hereto.
29. Survival:
The provisions of paragraphs 7, 9, 11, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 28,
30, and 31, 32 shall survive, notwithstanding the termination or invalidity of this Agreement
for any reason.
30. Nondiscrimination:
30.1 The County is an equal opportunity employer.
30.2 Nondiscrimination in Employment
In the performance of this Agreement, the Contractor will not
discriminate against any employee or applicant for employment on the
grounds of race, creed, color, national origin, sex, sexual orientation,
marital status, age or the presence of any sensory, mental or
physical handicap; provided that the prohibition against discrimination
in employment because of handicap shall not apply if the particular
disability prevents the proper performance of the particular worker
involved. The Contractor shall ensure that applicants are employed,
and that employees are treated during employment without
discrimination because of their race, creed, color, national origin, sex,
sexual orientation, marital status, age or the presence of any sensory,
mental or physical handicap. Such action shall include, but not be
limited to: employment, upgrading, demotion or transfers, recruitment or
recruitment advertising, layoff or termination, rates of pay or other
forms of compensation, and programs for training including
apprenticeships. The Contractor shall take such action with respect to
this Agreement as may be required to ensure full compliance with
local, state and federal laws prohibiting discrimination in employment.
30.3 Nondiscrimination in Services
The Contractor will not discriminate against any recipient of any services
or benefits provided for in this Agreement on the grounds of race,
creed, color, national origin, sex, sexual orientation, marital status, age or
the presence of any sensory, mental or physical handicap.
30.4 If any assignment and/or subcontracting has been authorized by the
County, said assignment or subcontract shall include appropriate
safeguards against discrimination. The Contractor shall take such
action as may be required to ensure full compliance with the
provisions in the immediately preceding paragraphs herein.
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31. Prevailing_ Wage:
Contractor shall pay the prevailing rate of wages to all workers, laborers, or mechanics
employed in the performance of any part of the Work in accordance with RCW 39.12
and the rules and regulations of the Department of Labor and Industries. The schedule
of prevailing wages rates for the locality or localities of the Work is determined by the
Industrial Statistician of the Department of Labor and Industries. It is the Contractor's
responsibility to verify the applicable prevailing wage rate. It is understood that the
Contractor is responsible for obtaining and completing all required government forms
and submitting same to the proper authorities.
Disputes regarding prevailing wage rates shall be referred for arbitration to the Director
of the Department of Labor and Industries. The arbitration decision shall be final and
conclusive and binding on all parties involved in the dispute as provided for by RCW
39.12.060.
32. Debarment Certification:
The Contractor certifies that it:
32.1 Is not presently debarred, suspended, proposed for debarment, declared
ineligible or voluntarily excluded from covered transactions by any Federal
department or agency.
32.2 Has not within a three-year period preceding the execution of this contract
with Kittitas County, been convicted of or had a civil judgment rendered
against them for commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public or private
agreement or transaction, violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, tax evasion, receiving
stolen property, making false claims, or obstruction of justice.
32.3 Is not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (Federal, State, or local) with commission of any of
the offenses enumerated in paragraph 32.2 of this section.
32.4 Has not within a three-year period preceding the preceding the execution
of this contract with Kittitas County had one or more public transactions
(Federal, State, or local) terminated for cause of default.
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EXHIBIT "A"
SCOPE OF WORK
In addition to providing all material and labor, the Contractor shall perform the following:
Implement the Community Prevention Wellness Initiative (CPWI) community-
based mentoring program.
o Produce 12 mentor/mentee matches by June 30, 2019.
o Work with the Cascade Prevention Coalition in developing and delivering
mentor services in the CPWI community. This includes recruitment of
mentors and mentees, mentor training, home visits, and coordination of
activities for matches.
■ Eligibility for mentees shall be determined based on application and
parent/guardian consent.
■ Eligibility for mentors is based on a seven fold background check
process, in home interview, and training.
o Regularly attend Cascade Prevention Coalition meetings. Collaborate
with coalition partners, including participation in community events as
appropriate.
o Participate in required Division of Behavioral Health and Recovery
(DBHR) training.
o Meet program delivery requirements using the Washington State Mentors
program model (as required by DBHR.)
o Complete reporting requirements in the Minerva system for each month by
the 15th day of the following month.
• Ensure accurate and unduplicated reporting
• Ensure proper training of staff and designated staff for back-up
Minerva data entry to meet report due dates.
• Ensure all required demographic information is provided for
individual participants, population reach, aggregate, environmental
and mentoring or 1 -to -1 services in Minerva.
o Media materials and publications developed shall be submitted to the
County for DBHR approval prior to publication (DBHR responds within 5
working days). The Department of Social and Health Services (DSHS)
must be cited as the funding source in newsreleases, publication and
advertising messages created with or about DSHS funding. The funding
source shall be cited as Washington State Department of Social and
Health Services. The DSHS logo may also be used in place of the above
citation. Messaging specifically directed to youth does not require DSHS
logo or funding credit. The contractor does not need to receive prior
approval for newsletters and factsheets, news coverage resulting from
interviews with reporters including online news coverage, newspaper
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editorials or letters to the editor, social media posts, statewide messages
developed by DSHS for local distribution, or current SAMHSA-sponsored
medial campaigns (Talk. They Hear You.)
o A criminal background check is required for all staff members, case
managers, outreach staff members, etc. or volunteers who have
unsupervised access to children, adolescents, vulnerable adults, and
persons who have developmental disabilities.
o Ensure all services and activities provided by the Contractor shall be
designed and delivered in a manner sensitive to the needs of all diverse
populations. Initiate actions to ensure or improve access, retention, and
cultural relevance of prevention or other appropriate services, for ethnic
minorities and other diverse populations in need of prevention services as
identified in their needs assessment. Take the initiative to strengthen
working relationships with other agencies serving these populations.
o Ensure that continuing education is provided for employees.
o Only one source of funds may be used for these activities at any given
time. Each cost reimbursement Prevention service provided must be
billed only one (1) time through the source selected for funding this
expense. At no time may the same expense be billed through more than
one (1) funding source.
o Funds cannot be used to supplant current funding of existing activities.
o Contractor must maintain records which adequately identify the source
and application of funds provided for financially assisted activities. These
records must contain information pertaining to grant or sub-grant awards
and authorizations, obligations, unobligated balances, assets, liabilities,
outlays or expenditures, and income.
o Per 45 CFR 74.36 and 45 CFR 92.34 and the HHS Grants Policy
Statement, any copyrighted or copyrightable works developed under this
cooperative agreement/grant shall be subject to royalty-free, nonexclusive
and irrevocable license to the government to reproduce, publish, or
otherwise use them and to authorize others to do so for General
Government purposes. Income earned from any copyrightable work
developed under this grant must be used as program income.
o Program income accrued under this award must be used in accordance
with the additional costs alternative described in 45 CFR 74.24(b)(1) or 45
CFR 92.25(g)(2) as applicable. Program income must be used to further
the grant objectives and shall only be used for allowable costs as set forth
in the applicable OMB circulars A-102 and A-110.
o No part of any appropriation contained in this Act shall be used, other than
for normal and recognized executive-legislative relationships, for publicity
or propaganda purposes, for the preparation, distribution, or use of any kit,
pamphlet, booklet, publication, radio, television, or video presentation
designed to support or defeat legislation pending before the Congress,
except in presentation to the Congress itself or any State legislature.
Professional Services Agreement
Page 15
o No part of any appropriation contained in this Act shall be used to pay the
salary or expenses of any grant or contract recipient, or agency acting for
such recipient, related to any activity designed to influence legislation or
appropriations pending before the Congress or any State legislature.
o Where a conference is funded by a grant or cooperative agreement the
recipient must include the following statement on all conference materials
(including promotional materials, agenda, and internet sites): "Funding for
this conference was made possible (in part) by Grant SP020155 and/or
T1010056 from SAMHSA. The views expressed in written conference
materials or publications and by speakers and moderators do not
necessarily reflect the official policies of the Department of Health and
Human Services; nor does mention of trade names, commercial practices,
or organizations imply endorsement by the U.S. Government."
o If federal funds are used by the Contractor to attend a meeting,
conference, etc. and meal(s) are provided as part of the program, then the
per diem applied to the Federal travel costs (M&IE allowance) must be
reduced by the allotted meal cost(s).
o 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.
o 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.
o Prepare appropriate financial statements, including a schedule of
expenditures of federal awards.
o Comply with 2 CFR Part 200, Subpart F audit requirements. Comply with
the applicable requirements of 2 CFR Part 200, including any future
amendments to 2 CFR Part 200, and any successor or replacement Office
of Management and Budget (OMB) Circular or regulation.
o 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 Rehabilitation
Act of 1973; Title II 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 Non-Discrimination Regulations at
28 CFR Part 42, Subparts C, D, E, and G, and 28 CFR Parts 35 and 39.
(Go to www.ojp.usdoj.gov/ocr/ for additional information and access to the
aforementioned Federal laws and regulations.)
o If it is determined by KCPHD, or during the course of a required audit, that
the Contractor has been paid unallowable costs under any applicable
Program Agreement, KCPHD may require the Contractor to reimburse
KCPHD in accordance with 2 CFR Part 200.
Professional Services Agreement
Page 16
o If the Contractor is subject to 2 CFR, Part 200, Subpart F, a copy of the
completed Single Audit is required and corrective action must be taken for
any audit finding, per 2 CFR, Part 200, Subpart F requirements. If the
Contractor is not subject to 2 CFR, Part 200, Subpart F, KCPHD shall
perform Contractor monitoring in compliance with federal requirements.
o Termination of this contract shall not be grounds for a fair hearing for the
service applicant or a grievance for the recipient if similar services are
immediately available in the County.
o In the event of termination of this contract, the Contractor shall provide all
requested data to KCPHD in order to ensure all prevention data on
services provided have been entered into the Substance Use Disorder
Prevention and Mental Health Promotion Online Reporting System also
called "Minerva". Final payments will be withheld until required Minerva
reporting is complete.
o Applicants and recipients of services shall be informed of their right to a
grievance in the case of denial or termination of service, or failure to act
upon a request for services with reasonable promptness.
o Permission shall be given for KCPHD to conduct on site visits or
inspections. KCPHD will conduct at least one on site visit annually to
monitor fiscal and programmatic compliance with performance criteria for
the purpose of documenting that the Contractor is fulfilling the
requirements of this agreement.
o Subcontractor is responsible for ensuring no conflicts of interests exist that
would interfere with the performance of its obligations under this
Agreement. Should a conflict arise, the Subcontractor must immediately
provide notice to the Contractor in writing. If a material conflict is
identified, the Contractor reserves the right to terminate this Agreement;
such termination of the Agreement shall be in writing and effective upon
the receipt of such notice by the Subcontractor.
o Contractor must comply with the HIPAA Business Associate Agreement
and Compliance as outlined in Exhibit D.
o Contractor must comply with the Data Security Requirements as outlined
in Exhibit E.
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FXHIRIT "R"
COMPENSATION
As full compensation for satisfactory performance of the work, the County shall pay
Contractor compensation not to exceed $28,151.88 according to the table below
($6,881.48 must be spent prior to June 30, 2018). The Contractor agrees to:
• Submit invoices, at least quarterly, to the County within thirty (30) days following
the last day of the month or quarter being invoiced.
• Submit invoices for actual expenses incurred during the billing period. (The
County will not pay invoices for an equal monthly or quarterly amount based on
full contract compensation.) Service costs incurred must be within the period of
performance of this contract.
• Provide detail of expenses being billed for, and supporting documentation for
those expenses. Supporting documentation can include, but is not limited to,
receipts, invoices, or purchase orders. For payroll expenses, supporting
documentation needs to show exact salary and benefit expenses and/or
timesheets from the billing period.
• Stay within 10% of the amounts budgeted in the table below. Budget variances
of more than 10% must receive prior approval and must be requested at least 1
month (30 days) in advance.
• Funds may not be used for food or refreshments. Administrative costs are also
not allowed.
■ Any funds not spent during the duration of this agreement may not be carried
forward.
• Kittitas County reserves the right to withhold reimbursements to the Contractor if
reporting obligations are not met.
• If the Contractor claims and is reimbursed for expenditures that are later found to
be claimed in error or found to be unallowable costs, the County shall recover
those costs with the full cooperation of the Contractor.
■ Only one source of funding may be used at any given time. At no time may the
same expense be billed through more than one funding source. Work performed
and invoiced may not be charged to any other contract or fund source. Funding
for this contract is from the Dedicated Marijuana Account—Fund 315—State, BARS
code 334.04.6X, state fiscal years 2018 (7/1/17-6/30/18) and 2019 (7/1/18-6/30/19)
from the Division of Behavioral Health and Recovery of the Department of Social
and Health Services.
Contractor DUNS number: 927664052
Professional Services Agreement
Page 18
Expenditure Description Amount
Salary (Crystal Church) Salary ($30/hour) and $7,969.20 (salary)
payroll taxes (8% of salary) $1,113.76 (taxes)
8 hours/week (.2 FTE) for 15
months.
Benefits (Crystal Church)
Stipend: Calvana Ca
Travel
Professional Services
Program Supplies
Printi
Professional Services Agreement
Page 19
$300 per month for 15 $180
months at .2 FTE
..........
Stipend for $12,550.00
Two Ellensburg to Cle Elum
$1,800.72
trips per week at 56 miles
each for 15 months. 54.5
cents per mile x 56 miles x
2/week x 65 weeks
Media targeting the CPWI
$3000.00
area
Supplies directly used for
$787.80
the program including
Constant Contact
Copies, paper, ink, etc.
$750.40
Total
28,151.88
EXHIBIT "C"
PROOF OF INSURANCE
The Contractor shall secure and maintain in effect at all times during performance of
the Work such insurance as will protect Contractor, its Support and the Additional
Insured's from all claims, losses, harm, costs, liabilities, damages and expenses arising
out of personal injury (including death) or property damage that may result from
performance of the work or this Agreement, whether such performance is by
Contractor or any of its Support.
All insurance shall be issued by companies admitted to do business in the State of
Washington and have a rating of A-, Class VII or better in the most recently published
edition of Best's Reports unless otherwise approved by the County. If an insurer is not
admitted, all insurance policies and procedures for issuing the insurance policies must
comply with Chapter 48.15 RCW and 284-15 WAC.
The Contractor shall provide proof of insurance for:
1) _Commercial General „Liability Insurance.
• Coverage limits not less than:
• $1,000,000 per occurrence per project
• $2,000,000 general aggregate
• $1,000,000 products & completed operations aggregate
• $1,000,000 personal and advertising injury, each offense
■ Certificate Holder — Kittitas County
• The Certificate must name the County as additional insured as
defined in the Agreement
• Sixty (60) days written notice to the County of cancellation
of the insurance policy.
2) Stop Gap/Employers Liability.
• Coverage limits not less than:
• $1,000,000 each accident
• $1,000,000 disease — policy limit
• $1,000,000 disease — each employee
■ Thirty (30) days written notice to the County of cancellation
of the insurance policy.
3) Commercial Automobile Liability Insurance.
• Automobile Liability for owned, non -owned, hired, and leased
vehicles, with an MCS 90 endorsement and a CA 9946
endorsement attached if `pollutants' are to be transported.
• Coverage limits not less than:
Professional Services Agreement
Page 20
• $1,000,000 combined single limit
• Thirty (30) days written notice to the County of cancellation
of the insurance policy.
4) Workers' Compensation.
* Workers' Compensation in amounts required by law.
Contractor shall furnish the County a Certificate of Insurance with Endorsement as
evidence that policies providing insurance required by this Agreement are in full force
and effect. Contractor hereby waives all rights of recourse, including any right to which
another may be subrogated, against Kittitas County for personal injury, including death,
and property damage. Contractor's insurance policies required above shall be primary
insurance and shall be non-contributing with any other insurance maintained by Kittitas
County.
The Contractor shall assume full responsibility for all loss or damage from any cause
whatsoever to any tools, Contractor's employee -owned tools, machinery, equipment, or
motor vehicles owned or rented by the Contractor, or the Contractor's agents, suppliers
or contractors as well as to any temporary structures, scaffolding and protective fences.
The Contractor shall have sole responsibility for ensuring the insurance coverage and
limits required are obtained by subcontractors.
NOTE: No contract shall form until and unless a copy of the Certificate of Insurance
with Endorsement, properly completed and in the amount required, is attached hereto.
Professional Services Agreement
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EXHIBIT "D"
HIPAA Compliance
Preamble: This section of the Contract is the Business Associate Agreement as required
by H I PAA.
2. Definitions.
a. "Business Associate," as used in this Contract, means the "Contractor' and generally
has the same meaning as the term "business associate" at 45 CFR 160.103. Any
reference to Business Associate in this Contract includes Business Associate's
employees, agents, officers, Subcontractors, third party contractors, volunteers, or
directors.
b. "Business Associate Agreement" means this HIPAA Compliance section of the
Contract and includes the Business Associate provisions required by the U.S.
Department of Health and Human Services, Office for Civil Rights.
c. "Breach" means the acquisition, access, use, or disclosure of Protected Health
Information in a manner not permitted under the HIPAA Privacy Rule which
compromises the security or privacy of the Protected Health Information, with the
exclusions and exceptions listed in 45 CFR 164.402.
d. "Covered Entity" means DSHS, a Covered Entity as defined at 45 CFR 160.103, in
its conduct of covered functions by its health care components.
e. "Designated Record Set" means a group of records maintained by or for a Covered
Entity, that is: the medical and billing records about Individuals maintained by or for a
covered health care provider; the enrollment, payment, claims adjudication, and case
or medical management record systems maintained by or for a health plan; or Used
in whole or part by or for the Covered Entity to make decisions about Individuals.
f. "Electronic Protected Health Information (EPHI)" means Protected Health Information
that is transmitted by electronic media or maintained in any medium described in the
definition of electronic media at 45 CFR 160.103.
g. "HIPAK means 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).
h. "HIPAA Rules" means the Privacy, Security, Breach Notification, and Enforcement
Rules at 45 CFR Parts 160 and Part 164.
"Individual(s)" means the person(s) who is the subject of PHI and includes a person
who qualifies as a personal representative in accordance with 45 CFR 164.502(g).
"Minimum Necessary" means the least amount of PHI necessary to accomplish the
Professional Services Agreement
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purpose for which the PHI is needed.
k. "Protected Health Information (PHI)" means individually identifiable health
information created, received, maintained or transmitted by Business Associate on
behalf of a health care component of the Covered Entity 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 the past, present, or future payment for provision of
health care to an Individual. 45 CFR 160.103. PHI includes demographic
information that identifies the Individual or about which there is reasonable basis to
believe can be used to identify the Individual. 45 CFR 160.103. PHI is information
transmitted or held in any form or medium and includes EPHI. 45 CFR 160.103.
PHI does not include education records covered by the Family Educational Rights
and Privacy Act, as amended, 20 USCA 1232g(a)(4)(B)(iv) or employment records
held by a Covered Entity in its role as employer.
"Security Incident" means the attempted or successful unauthorized access, use,
disclosure, modification or destruction of information or interference with system
operations in an information system.
m. "Subcontractor" as used in this HIPAA Compliance section of the Contract (in
addition to its definition in the General Terms and Conditions) means a Business
Associate that creates, receives, maintains, or transmits Protected Health
Information on behalf of another Business Associate.
n. "Use" includes the sharing, employment, application, utilization, examination, or
analysis, of PHI within an entity that maintains such information.
3. Compliance. Business Associate shall perform all Contract duties, activities and tasks
in compliance with HIPAA, the HIPAA Rules, and all attendant regulations as
promulgated by the U.S. Department of Health and Human Services, Office of Civil
Rights.
4. Use and Disclosure of PHI. Business Associate is limited to the following permitted
and required uses or disclosures of PHI:
a. Duty to Protect PHI. Business Associate shall protect PHI from, and shall use
appropriate safeguards, and comply with Subpart C of 45 CFR Part 164 (Security
Standards for the Protection of Electronic Protected Health Information) with respect
to EPHI, to prevent the unauthorized Use or disclosure of PHI other than as provided
for in this Contract or as required by law, for as long as the PHI is within its
possession and control, even after the termination or expiration of this Contract.
b. Minimum Necessary Standard. Business Associate shall apply the HIPAA Minimum
Necessary standard to any Use or disclosure of PHI necessary to achieve the
purposes of this Contract. See 45 CFR 164.514 (d)(2) through (d)(5).
c. Disclosure as Part of the Provision of Services. Business Associate shall only Use
or disclose PHI as necessary to perform the services specified in this Contract or as
Professional Services Agreement
Page 23
required by law, and shall not Use or disclose such PHI in any manner that would
violate Subpart E of 45 CFR Part 164 (Privacy of Individually Identifiable Health
Information) if done by Covered Entity, except for the specific uses and disclosures
set forth below.
d. Use for Proper Management and Administration. Business Associate may Use PHI
for the proper management and administration of the Business Associate or to carry
out the legal responsibilities of the Business Associate.
e. Disclosure for Proper Management and Administration. Business Associate may
disclose PHI for the proper management and administration of Business Associate or
to carry out the legal responsibilities of the Business Associate, provided the
disclosures are required by law, or Business Associate obtains reasonable
assurances from the person to whom the information is disclosed that the information
will remain confidential and used or further disclosed only as required by law or for
the purposes for which it was disclosed to the person, and the person notifies the
Business Associate of any instances of which it is aware in which the confidentiality
of the information has been Breached.
Impermissible Use or Disclosure of PHI. Business Associate shall report to DSHS in
writing all Uses or disclosures of PHI not provided for by this Contract within one (1)
business day of becoming aware of the unauthorized Use or disclosure of PHI,
including Breaches of unsecured PHI as required at 45 CFR 164.410 (Notification by
a Business Associate), as well as any Security Incident of which it becomes aware.
Upon request by DSHS, Business Associate shall mitigate, to the extent practicable,
any harmful effect resulting from the impermissible Use or disclosure.
g. Failure to Cure. If DSHS learns of a pattern or practice of the Business Associate
that constitutes a violation of the Business Associate's obligations under the terms of
this Contract and reasonable steps by DSHS do not end the violation, DSHS shall
terminate this Contract, if feasible. In addition, If Business Associate learns of a
pattern or practice of its Subcontractors that constitutes a violation of the Business
Associate's obligations under the terms of their contract and reasonable steps by the
Business Associate do not end the violation, Business Associate shall terminate the
Subcontract, if feasible.
h. Termination for Cause. Business Associate authorizes immediate termination of this
Contract by DSHS, if DSHS determines that Business Associate has violated a
material term of this Business Associate Agreement. DSHS may, at its sole option,
offer Business Associate an opportunity to cure a violation of this Business Associate
Agreement before exercising a termination for cause.
Consent to Audit. Business Associate shall give reasonable access to PHI, its
internal practices, records, books, documents, electronic data and/or all other
business information received from, or created or received by Business Associate on
behalf of DSHS, to the Secretary of DHHS and/or to DSHS for use in determining
compliance with HIPAA privacy requirements.
Professional Services Agreement
Page 24
j. Obligations of Business Associate Upon Expiration or Termination. Upon expiration
or termination of this Contract for any reason, with respect to PHI received from
DSHS, or created, maintained, or received by Business Associate, or any
Subcontractors, on behalf of DSHS, Business Associate shall:
(1) Retain only that PHI which is necessary for Business Associate to continue its
proper management and administration or to carry out its legal responsibilities;
(2) Return to DSHS or destroy the remaining PHI that the Business Associate or any
Subcontractors still maintain in any form;
(3) Continue to use appropriate safeguards and comply with Subpart C of 45 CFR
Part 164 (Security Standards for the Protection of Electronic Protected Health
Information) with respect to Electronic Protected Health Information to prevent
Use or disclosure of the PHI, other than as provided for in this Section, for as
long as Business Associate or any Subcontractors retain the PHI;
(4) Not Use or disclose the PHI retained by Business Associate or any
Subcontractors other than for the purposes for which such PHI was retained and
subject to the same conditions set out in the "Use and Disclosure of PHI" section
of this Contract which applied prior to termination; and
(5) Return to DSHS or destroy the PHI retained by Business Associate, or any
Subcontractors, when it is no longer needed by Business Associate for its proper
management and administration or to carry out its legal responsibilities.
k. Survival. The obligations of the Business Associate under this section shall survive
the termination or expiration of this Contract.
5. Individual Rights.
a. Accounting of Disclosures.
(1) Business Associate shall document all disclosures, except those disclosures that
are exempt under 45 CFR 164.528, of PHI and information related to such
disclosures.
(2) Within ten (10) business days of a request from DSHS, Business Associate shall
make available to DSHS the information in Business Associate's possession that
is necessary for DSHS to respond in a timely manner to a request for an
accounting of disclosures of PHI by the Business Associate. See 45 CFR
164.504(e)(2)(ii)(G) and 164.528(b)(1).
(3) At the request of DSHS or in response to a request made directly to the Business
Associate by an Individual, Business Associate shall respond, in a timely manner
and in accordance with HIPAA and the HIPAA Rules, to requests by Individuals
for an accounting of disclosures of PHI.
(4) Business Associate record keeping procedures shall be sufficient to respond to a
Professional Services Agreement
Page 25
request for an accounting under this section for the six (6) years prior to the date
on which the accounting was requested.
b. Access
(1) Business Associate shall make available PHI that it holds that is part of a
Designated Record Set when requested by DSHS or the Individual as necessary
to satisfy DSHS's obligations under 45 CFR 164.524 (Access of Individuals to
Protected Health Information).
(2) When the request is made by the Individual to the Business Associate or if DSHS
asks the Business Associate to respond to a request, the Business Associate
shall comply with requirements in 45 CFR 164.524 (Access of Individuals to
Protected Health Information) on form, time and manner of access. When the
request is made by DSHS, the Business Associate shall provide the records to
DSHS within ten (10) business days.
c. Amendment.
(1) If DSHS amends, in whole or in part, a record or PHI contained in an Individual's
Designated Record Set and DSHS has previously provided the PHI or record that
is the subject of the amendment to Business Associate, then DSHS will inform
Business Associate of the amendment pursuant to 45 CFR 164.526(c)(3)
(Amendment of Protected Health Information).
(2) Business Associate shall make any amendments to PHI in a Designated Record
Set as directed by DSHS or as necessary to satisfy DSHS's obligations under 45
CFR 164.526 (Amendment of Protected Health Information).
6. Subcontracts and other Third Party Agreements. In accordance with 45 CFR
164.502(e)(1)(ii), 164.504(e)(1)(i), and 164.308(b)(2), Business Associate shall ensure
that any agents, Subcontractors, independent contractors or other third parties that
create, receive, maintain, or transmit PHI on Business Associate's behalf, enter into a
written contract that contains the same terms, restrictions, requirements, and conditions
as the HIPAA compliance provisions in this Contract with respect to such PHI. The same
provisions must also be included in any contracts by a Business Associate's
Subcontractor with its own business associates as required by 45 CFR 164.314(a)(2)(b)
and 164.504(e)(5) .
7. Obligations. To the extent the Business Associate is to carry out one or more of
DSHS's obligation(s) under Subpart E of 45 CFR Part 164 (Privacy of Individually
Identifiable Health Information), Business Associate shall comply with all requirements
that would apply to DSHS in the performance of such obligation(s).
8. Liability. Within ten (10) business days, Business Associate must notify DSHS of any
complaint, enforcement or compliance action initiated by the Office for Civil Rights based
on an allegation of violation of the HIPAA Rules and must inform DSHS of the outcome
of that action. Business Associate bears all responsibility for any penalties, fines or
Professional Services Agreement
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sanctions imposed against the Business Associate for violations of the HIPAA Rules and
for any imposed against its Subcontractors or agents for which it is found liable.
9. Breach Notification.
a. In the event of a Breach of unsecured PHI or disclosure that compromises the
privacy or security of PHI obtained from DSHS or involving DSHS clients, Business
Associate will take all measures required by state or federal law.
b. Business Associate will notify DSHS within one (1) business day by telephone and in
writing of any acquisition, access, Use or disclosure of PHI not allowed by the
provisions of this Contract or not authorized by HIPAA Rules or required by law of
which it becomes aware which potentially compromises the security or privacy of the
Protected Health Information as defined in 45 CFR 164.402 (Definitions).
c. Business Associate will notify the DSHS Contact shown on the cover page of this
Contract within one (1) business day by telephone or e-mail of any potential Breach
of security or privacy of PHI by the Business Associate or its Subcontractors or
agents. Business Associate will follow telephone or e-mail notification with a faxed
or other written explanation of the Breach, to include the following: date and time of
the Breach, date Breach was discovered, location and nature of the PHI, type of
Breach, origination and destination of PHI, Business Associate unit and personnel
associated with the Breach, detailed description of the Breach, anticipated mitigation
steps, and the name, address, telephone number, fax number, and e-mail of the
individual who is responsible as the primary point of contact. Business Associate will
address communications to the DSHS Contact. Business Associate will coordinate
and cooperate with DSHS to provide a copy of its investigation and other information
requested by DSHS, including advance copies of any notifications required for DSHS
review before disseminating and verification of the dates notifications were sent.
d. If DSHS determines that Business Associate or its Subcontractor(s) or agent(s) is
responsible for a Breach of unsecured PHI:
(1) requiring notification of Individuals under 45 CFR § 164.404 (Notification to
Individuals), Business Associate bears the responsibility and costs for notifying
the affected Individuals and receiving and responding to those Individuals'
questions or requests for additional information;
(2) requiring notification of the media under 45 CFR § 164.406 (Notification to the
media), Business Associate bears the responsibility and costs for notifying the
media and receiving and responding to media questions or requests for
additional information;
(3) requiring notification of the U.S. Department of Health and Human Services
Secretary under 45 CFR § 164.408 (Notification to the Secretary), Business
Associate bears the responsibility and costs for notifying the Secretary and
receiving and responding to the Secretary's questions or requests for additional
information; and
Professional Services Agreement
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(4) DSHS will take appropriate remedial measures up to termination of this Contract.
10. Miscellaneous Provisions.
a. Regulatory References. A reference in this Contract to a section in the HIPAA Rules
means the section as in effect or amended.
b. Interpretation. Any ambiguity in this Contract shall be interpreted to permit
compliance with the HIPAA Rules.
11. Insurance.
a. DSHS certifies that it is self-insured under the State's self-insurance liability program,
as provided by RCW 4.92.130, and shall pay for losses for which it is found liable.
The Contractor certifies that it is self-insured or insured through a risk pool and shall
pay for losses for which it is found liable.
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EXHIBIT "E"
DATA SECURITY REQUIREMENTS
1. Definitions. The words and phrases listed below, as used in this Exhibit, shall each
have the following definitions:
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a. "Authorized User(s)" means an individual or individuals with an authorized
business requirement to access DSHS Confidential Information.
b. "Hardened Password" means a string of at least eight characters containing
at least one alphabetic character, at least one number and at least one
special character such as an asterisk, ampersand or exclamation point.
c. "Unique User ID" means a string of characters that identifies a specific user
and which, in conjunction with a password, passphrase or other mechanism,
authenticates a user to an information system.
2. Data Transport. When transporting DSHS Confidential Information
electronically, including via email, the Data will be protected by:
a. Transporting the Data within the (State Governmental Network) SGN or
Contractor's internal network, or;
b. Encrypting any Data that will be in transit outside the SGN or Contractor's
internal network. This includes transit over the public Internet.
3. Protection of Data. The Contractor agrees to store Data on one or more of the
following media and protect the Data as described:
a. Hard disk drives. Data stored on local workstation hard disks. Access to
the Data will be restricted to Authorized User(s) by requiring logon to the local
workstation using a Unique User ID and Hardened Password or other
authentication mechanisms which provide equal or greater security, such as
biometrics or smart cards.
b. Network server disks. Data stored on hard disks mounted on network
servers and made available through shared folders. Access to the Data will
be restricted to Authorized Users through the use of access control lists which
will grant access only after the Authorized User has authenticated to the
network using a Unique User ID and Hardened Password or other
authentication mechanisms which provide equal or greater security, such as
biometrics or smart cards. Data on disks mounted to such servers must be
located in an area which is accessible only to authorized personnel, with
access controlled through use of a key, card key, combination lock, or
comparable mechanism.
For DSHS Confidential Information stored on these disks, deleting unneeded
Data is sufficient as long as the disks remain in a Secured Area and
otherwise meet the requirements listed in the above paragraph. Destruction
of the Data as outlined in Section 5. Data Disposition may be deferred until
the disks are retired, replaced, or otherwise taken out of the Secured Area.
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c. Optical discs (CDs or DVDs) in local workstation optical disc drives.
Data provided by DSHS on optical discs which will be used in local
workstation optical disc drives and which will not be transported out of a
Secured Area. When not in use for the contracted purpose, such discs must
be locked in a drawer, cabinet or other container to which only Authorized
Users have the key, combination or mechanism required to access the
contents of the container. Workstations which access DSHS Data on optical
discs must be located in an area which is accessible only to authorized
personnel, with access controlled through use of a key, card key, combination
lock, or comparable mechanism.
d. Optical discs (CDs or DVDs) in drives or jukeboxes attached to servers.
Data provided by DSHS on optical discs which will be attached to network
servers and which will not be transported out of a Secured Area. Access to
Data on these discs will be restricted to Authorized Users through the use of
access control lists which will grant access only after the Authorized User has
authenticated to the network using a Unique User ID and Hardened Password
or other authentication mechanisms which provide equal or greater security,
such as biometrics or smart cards. Data on discs attached to such servers
must be located in an area which is accessible only to authorized personnel,
with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
e. Paper documents. Any paper records must be protected by storing the
records in a Secured Area which is only accessible to authorized personnel.
When not in use, such records must be stored in a locked container, such as
a file cabinet, locking drawer, or safe, to which only authorized persons have
access.
Remote Access. Access to and use of the Data over the State
Governmental Network (SGN) or Secure Access Washington (SAW) will be
controlled by DSHS staff who will issue authentication credentials (e.g. a
Unique User ID and Hardened Password) to Authorized Users on Contractor
staff. Contractor will notify DSHS staff immediately whenever an Authorized
User in possession of such credentials is terminated or otherwise leaves the
employ of the Contractor, and whenever an Authorized User's duties change
such that the Authorized User no longer requires access to perform work for
this Contract.
g. Data storage on portable devices or media.
(1) Except where otherwise specified herein, DSHS Data shall not be stored
by the Contractor on portable devices or media unless specifically
authorized within the terms and conditions of the Contract. If so
authorized, the Data shall be given the following protections:
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(a) Encrypt the Data with a key length of at least 128 bits
(b) Control access to devices with a Unique User ID and Hardened
Password or stronger authentication method such as a physical token
or biometrics.
(c) Manually lock devices whenever they are left unattended and set
devices to lock automatically after a period of inactivity, if this feature is
available. Maximum period of inactivity is 20 minutes.
Physically Secure the portable device(s) and/or media by
(d) Keeping them in locked storage when not in use
(e) Using check-in/check-out procedures when they are shared, and
(f) Taking frequent inventories
(2) When being transported outside of a Secured Area, portable devices and
media with DSHS Confidential Information must be under the physical
control of Contractor staff with authorization to access the Data.
(3) Portable devices include, but are not limited to; smart phones, tablets,
flash memory devices (e.g. USB flash drives, personal media players),
portable hard disks, and laptop/notebook/netbook computers if those
computers may be transported outside of a Secured Area.
(4) Portable media includes, but is not limited to; optical media (e.g. CDs,
DVDs), magnetic media (e.g. floppy disks, tape), or flash media (e.g.
CompactFlash, SD, MMC).
h. Data stored for backup purposes.
(1) DSHS data may be stored on portable media as part of a Contractor's
existing, documented backup process for business continuity or disaster
recovery purposes. Such storage is authorized until such time as that
media would be reused during the course of normal backup operations. If
backup media is retired while DSHS Confidential Information still exists
upon it, such media will be destroyed at that time in accordance with the
disposition requirements in Section 5. Data Disposition
(2) DSHS Data may be stored on non-portable media (e.g. Storage Area
Network drives, virtual media, etc.) as part of a Contractor's existing,
documented backup process for business continuity or disaster recovery
purposes. If so, such media will be protected as otherwise described in
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this exhibit. If this media is retired while DSHS Confidential Information
still exists upon it, the data will be destroyed at that time in accordance
with the disposition requirements in Section 5. Data Disposition.
4. Data Segregation.
a. DSHS Data must be segregated or otherwise distinguishable from non-DSHS
data. This is to ensure that when no longer needed by the Contractor, all
DSHS Data can be identified for return or destruction. It also aids in
determining whether DSHS Data has or may have been compromised in the
event of a security breach. As such, one or more of the following methods
will be used for data segregation.
b. DSHS Data will be kept on media (e.g. hard disk, optical disc, tape, etc.)
which will contain no non-DSHS data. And/or,
c. DSHS Data will be stored in a logical container on electronic media, such as a
partition or folder dedicated to DSHS Data. And/or,
d. DSHS Data will be stored in a database which will contain no non-DSHS
data. And/or,
e. DSHS Data will be stored within a database and will be distinguishable from
non-DSHS data by the value of a specific field or fields within database
records.
When stored as physical paper documents, DSHS Data will be physically
segregated from non-DSHS data in a drawer, folder, or other container.
g. When it is not feasible or practical to segregate DSHS Data from non-DSHS
data, then both the DSHS Data and the non-DSHS data with which it is
commingled must be protected as described in this exhibit.
5. Data Disposition. When the contracted work has been completed or when no
longer needed, except as noted in Section 3. Protection of Data b. Network
Server Disks above, Data shall be returned to DSHS or destroyed. Media on
which Data may be stored and associated acceptable methods of destruction are
as follows:
Data stored on:
Server or workstation hard disks, or
Removable media (e.g. floppies, USB
flash drives, portable hard disks) excluding
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Will be destroyed by:
Using a "wipe" utility which will overwrite
the Data at least three (3) times using
either random or single character data, or
optical discs
Paper documents with sensitive or
Confidential Information
Paper documents containing Confidential
Information requiring special handling (e.g.
protected health information)
Optical discs (e.g. CDs or DVDs)
Magnetic tape
Degaussing sufficiently to ensure that the
Data cannot be reconstructed, or
Physically destroying the disk
Recycling through a contracted firm
provided the contract with the recycler
assures that the confidentiality of Data will
be protected.
On-site shredding, pulping, or incineration
Incineration, shredding, or completely
defacing the readable surface with a
coarse abrasive
Degaussing, incinerating or crosscut
shredding
6. Notification of Compromise or Potential Compromise. The compromise or
potential compromise of DSHS shared Data must be reported to the DSHS
Contact designated in the Contract within one (1) business day of discovery. If
no DSHS Contact is designated in the Contract, then the notification must be
reported to the DSHS Privacy Officer at dshsprivacyofficer@dshs.wa.gov.
Contractor must also take actions to mitigate the risk of loss and comply with any
notification or other requirements imposed by law or DSHS.
7. Data shared with Subcontractors. If DSHS Data provided under this Contract
is to be shared with a subcontractor, the Contract with the subcontractor must
include all of the data security provisions within this Contract and within any
amendments, attachments, or exhibits within this Contract. If the Contractor
cannot protect the Data as articulated within this Contract, then the contract with
the sub -Contractor must be submitted to the DSHS Contact specified for this
contract for review and approval.
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