HomeMy WebLinkAboutRes-2021-108 interlocalBOARD OF COUNTY COMMISSIONERS
COUNTY OF KITTITAS
STATE OF WASHINGTON
RESOLUTTON NO. 2021-lo[
A RESOLUTION AUTHORIZING EXECUTION OF AN INTERLOCAL AGREEMENT
BETWEEN CENTRAL WASHINGTON UNIVERSITY AND KITTITAS COUNTY
WHEREAS, RCW 39.34, the lnterlocal Cooperation Act, provides the capability for
public agencies to cooperate by providing services and facilities for mutual advantage; and
WHEREAS, The County has received a federal grant from Department of Justice
(DOJ), Bureau of Justice Assistance (BJA) to develop and implement and evidence-based
medication assisted treatment program (MAT Program); and
WHEREAS, Consistentwith the University's instructional, scholarship, public service,
and research objectives, and consistent with its status as a non-profit, tax-exempt
educational institution, the University will provide professional services to the County to
assist with the evaluation of this MAT Program; and
WHEREAS, the University to arrange for Assistant Professor Dr. Roger Schaefer, to
act as the Program Evaluator of the County's MAT program to perform the duties as
described with the lnterlocal agreement;
NOW, THEREFORE, BE lT HEREBY RESOLVED, that the Board of County
Commissioners of Kittitas County, Washington authorizes the execution of the lnterlocal
Agreement between Central Washington University and Kittitas County pursuant to the
authority granted by Chapter 39.34 RCW.
ADOPTED this \ffi.day of 2021
BOARD OF C COMMISSIONERS
KI INGTON
ABSENT
Commissioner
A {%'D AS TO FORM
rzz*q+
D6ug tas/n Mitchell, Deputy Prosecuting Attorney
A perk of the Boa
Ef Deputy Clerk of
rd- Julie Kjorsvik
RESOLUTION
the B oard- Mandy Buchholz
15062
INTERLOCAL AGREEMENT
BETWEEN
THE STATE OF WASHINGTON
CENTRAL WASHINGTON UNIVERSITY
AND
KITTITAS COUNTY
THIS AGREEMENT is made and entered into by and between Central Washington
University, hereinafter referred to as "University'' and Kittitas County, hereinafter referred to
as "County," pursuant to the authority granted by Chapter 39.34 RCW.
- The County has received a federal grant from the Department of Justice (DOJ),
Bureau of Justice Assistance (BJA) to develop and implement an evidence-based
medication assisted treatment program (MAT Program). Consistent with the University's
instructional, scholarship, public service, and research objectives, and consistent with jts
status as a non-profit, tax-exempt, educational institution, the University will provide
professional services to the County to assist with the evaluation of this MAT program.
lT lS THE PURPOSE OF THIS AGREEMENT for the University to arrange for
Assistant Professor,,Dr. Roger $chaefer, to act as the Program Evaluatoi of the Count/s
MAT program to perlorm the duties as described herein.
THEREFORE, IT IS MUTUALLY AGREED THAT:
ST"ATEMENT OF WORK
As the designated Program Evaluator, Dr. Roger Schaefer shall do all things necessary for
or incidental to the performance of the duties of Program Evaluator as set tortn in the Sdope
of work, Attachment "A", which is attached hereto and incorporated herein.
PERIOD OF PERFORMANCE
Subject to its other provisions, the period of performance of this Agreement shall commence
on May 15,2A21 and be completed on September 30, 2023 uniess terminated sooner or
extended, as provided herein.
PAYMENT
Compensation for the work provided in accordance with this Agreement has been
established under the terms of RCW 39. 34. The parties have determined that the cost of
accomplishing the work herein will not exceed $6,250 annually, for a not-to-exceed total of
$18,750 over the term of this Agreement. Payment for satisfaCtory performance of the work
shall not exceed this amount unless the parties mutually agiee to a higher amount.
Compensation for services shall be based on the following rates and in accordance wiih the
following terms' or as set forth in accordance with the budget in Attachment ,,8,, which isattached hereto and incorporated herein
EILLINJ PROCEDURE
The university shall submit invoices accompanied by a general ledger report no more oftenthan monthly' Payment to the university roi approvJc aio comptet;d w;[;i1 be made bycheck by the county within 30 days or reieipt oi n" invoice. upon expiration of theAgreement, any claim for payment not already ni"o* rrr"rr be submitteo witnil 30 days afterthe expiration date or the end of the fiscar yeai, which"uui i, earlier.
REpORpq, MA|NTENANpE
The parties to this Agreement shall each maintain books, records, documents and otherevidence which sufficiently and properly reflect arr oiiect and indirect costs expended byeither party in the performance of the services described herein. These records shall besubject to inspection, review or audit_by p"rronnri oi notn parties, other personnel dulyauthorized by either party, the office of the'state nuoitorlund federal officials so authorizedby law' All books, records, documents, and other material relevant to this Agreement will beretained for six years after expiration and the office of the state Auditor, federal auditors,and any persons duly authorized by the parties in"ri nuu" full access' ,no g," right toexamine any of these materials during this period.
Records and other,documents, in any medium, furnished by one party to this agreement tothe other party, will remain th-e prop"erty sf the rrrnisr.ring party, unless othenrise agreed.The receiving party will not disclose or make available"ihis material to any third partieswithoui first giving notice to the furnishing n"rt;";;;;;ing it a reasonabte opportunity torespond' Each parly will utilize reuson"bT"'security pio."our*, and protections to assurethat records and documents provided by the ;il r;;;r" not erroneously disclosed tothird parties.
RIGHTS IN DATA
Unless othenruise provided, data which originates from this Agreement shall be co-owned bythe university and the. .county' county-
"rt no*bJg"r in"t data collected during thisevaluation may be used by Dr. schaefei to
"urnoidei r*uiu* publications. All data usedfor such legitimate. academic purposes shall be plo.*ur*o in a manne, ft,"i completelydeidentifies the data and is consistent with the tiusiness Associate Agreement attachedhereto as Exhibit "D" and incorporated by reference. Data shall include, birt *t n* limited to,reports, documents, pamphtets, advertisements, noors magazines, surveys, studies,computer programs, films, tapes, and/or..sound reproductions. ownership includes the rightto copyright, patent, register, and the abirity to transfer tnese rights.
INDEPENDENT CApAC|TY
The employees or agents of each party who are engaged in the pedormance of thisAgreement shall continue .to. be employees or agents of that parly and shall not beconsidered for any purpose to be emproyees or agenis of the other party.
rNpEMNtFtCArloN
Each party to this Agreement shall be responsible for its own acts or omissions and forthose of its officers, employees, and agents. Neither party shall be responsible for the acts
or omissions of persons or entities not a party to this Agreement.
AG REEM ENT CHAN9 ES. MOpt qtcATtgNS AN D AM END,M ENTq
This Agreement rnay be changed, modified, or amended by written agreement executedby both parties.
TERMINATION
Either party may terminate this Agreement upon 30 days' prior written notification to theother party. lf this Agreement is so terminated, the pariies shall be liable only forperformance rendered or costs incurred in accordance with the terms of this Agreementprior to the effective date of termination.
TERMINATION FOR CAUSE
lf for any cause, either party does not fulfill in a timely and proper manner its obligationsunder this Agreem_ent, or if either party violates any of these terms and conditions, theaggrieved party will give the other party written notice of such failure or violation. Theresponsible party will be given the opportunity to correct the violation or failure within 15working days' lf failure or violation is not corrected, this Agreement may be terminatedimmediately by written notice of the aggrieved party to the other.
F"ORCE MAJEgRE
Either party may cancel this Agreement without obligation or liability to the other party in theevent that it becomes impossible or impracticable for that party to perform its obligations
hereunder by reason-of force majeure beyond that party's reasonable controt, includr:ng butnot fimited to fire, flood, earthquake, pandemic, or bther acts of God, war, invaiion,
hostilities, rebellion, insurrection, or prohibitory or injunctive orders of any competent judiciai
or other govemmental authority, civilor military. ln the event of such caniellation, the parties
shall be liable only for performance rendered br costs incurred in accordance with the terms
of this Agreement prior to the effective date of termination.
DISP.I'TES
ln the event that a dispute arises under this Agreement, it shall be determined by a DisputeBoard in the following manner: Each party to this Agreement shall appoint one member to
the Dispute Board. The members so appointed shailJointly appoint an additional member tothe Dispute Board. The Dispute Board shall review ihe'iacts, agreement terms andapplicable statutes and rules and make a determination of the disputJ. The determination
of the Dispute Board shall be final and binding on the parties hereto. As an alternative tothis process, either of. the parties may request intervention by the Governor, as frovided byRCW 43.17.330, in which event the Governor's process will control.
GOVEBNANCF
This Agreement is entered into pursuant to and under the authority granted by the laws ofthe state of Washington and any applicable federal laws. fhe provisi-ons of thii Agreement
shall be construed to conform to those laws"
ln the event of an inconsistency in the terms of this Agreement, or between its terms andany applicable statute or rule, the inconsistency shall be resolved by giving precedence in
the following order:
a. Applicable state and federalstatutes and rules;b. Statement of Work, Attachment "A";
c. Budget, Attachment "B";
d. Project Narrative, Attachment "C"; and
e. - Any other provisions of the agreement, including materials
reference.
incorporated by
AqStcNMENT
The work to be provided under this Agreement, and any claim arising there under, is not
assignable or delegable by either party in whole or in pad, without thelxpress prior written
consent of the other party, which consent shall not be unreasonably withheld.
WAIVER
A failure by either party to exercise its rights under this Agreement shall not preclude that
qafiy from subsequent exercise of such rights and shall nof constitute a waivei of any otherrights under this Agreement unless stated to be such in a writing signed by an authorized
representative of the party and attached to the original Agreement.
SEVERABIftTY
lf any provision of this Agreement or any provision of any document incorporated by
reference shall be held invalid, such invalidi$ shall not atfeit the other provisions of thisAgreemeni which can be given eflect without the invalid provision, if such remainder
conforms to the requirements of applicable law and the iundamental purpose of this
agreement, and to this end the provisions of this Agreement are declared io be severable.
GoNTRACT MANAGEMF,NT
The program manager for each of the parties shall be responsible for and shafi be thecontact person for all communications and billings regarding the performance of this
Agreement.
The Program Manager for University: Roger Schaefer, Ph.D., Assistant professor, Lawand Justice, Central Washington University, 400 E University Way, Ellensburg WA
98926 (509) 963-3529, Roger.$chaefer@cwu.edu.
lftg.froogm Manager.for county: Edward L. Buntin, Corrections Lieutenant #J80,Kittitas county sheriffs office, (s0g) 962-7g27, ejward.uuntin@co.kittitas.wa,us.
This Agreement contains all the terms and conditions agreed upon by the parties. No otherunderstandings, oral or othenruise, regarding the subjeJt r"tt"i or this Agreement shall bedeemed to exist or to bind any of the [ur$"s hereto.
lN wlrNEss WHEREOF, the parties have executed this Agreement.
Central Washington University Kiftitas County
5118t2021
Signature
s
ry(l'
;
$Kevin Archer, Dean, College of
Graduate Studies & Research
u*b'RATIFIED this of
Clayton Myers, Sheriff
2021.
BOARD OF COUNTY COMMISSIONERS
KITT co WASHI
ABSENT
Commissioner
D AS TO FORM:
i)'l
Douglas
lllll\l
dul\)a
Jplerk of the Board- Jutie Kjorsvik
dDeputy Clerk of the Board- Mandy Buchholz
Prosecuting Attorney
Attachment 'oA' - Scope of Work
The Kittitas county Jail has been awarded grant funds to devef op and implement a medication assistedtreatment program' The grant narrative outlines specific aspects of the proposed program including theduties ofa program evaluator. The grant narrative does not specify an evaluator; however, it doesoutline what aspects ofthe program need to be evaluated.
The evaluation parameters are discussed on pages 15 through 1g in the grant narrative, a copy of whichis attached hereto as Attachment "C". Below is a summary of the expected evaluator duties andresponsibilities.
ln accordance to the expectations associated with federal grant monies, the program made possiblethrough BJA funds will be subject to a formal evaluation. The program evaluation will be conducted in amanner that is fully aligned with the standards and best practices utilized by, and within the realm ofsocial science evaluation' Further, the program evafuation will adhere to the guidelines, expectation. andparameters defined by the central washington university lnstitutional Review Board (lRB] and Humansubjects Review council {HRsc}, Per the grant narrative, the evaluation will examine both the processand the outcomes of the MAT program; and wiil emproy a mixed methods research design.
The specific tasks are outtined below:
1) Design and implement an evaluation study that examines the following; lntake assessment andbaseline data; treatment progress rnetrics; implementation procedures and integrity;stakeholder perceptions; correctional outcomes; and challenges and barriers.2'l communicate with Kittitas county sheriffs office, jail and prJgrr* administrators, treatmentproviders, custody staff, and BJA facilitators.3) submit the necessary appllcations and engage in the proper review process for approval formthe centralwashington University lnstitutional Review Board {lR8) and Human subjects Reviewcouncil {HsRc)' ln the event that another IRB/HsRc has granted approval, the proper reciprocityprocedures must be followed to ensure that Dr. schaefer of fully aligned with expectation ofCentral Washington Un iversity.4| Maintain rigorous ethical, methodological, and scientific standards throughout the entirety ofevaluation process - both during and after the completion of the grant funded MAT program.5) oversee data collection, acquisitlon, and analysis. These tasks include but are not limited tosurvey creation and validation; conducting interviews and focus groups, direct observation,record data analysis, instrumentation (item inclusion), and necessary foilow_up.6) overseeingfco-authoring a final report based on the analysis of all data collected throughout theprogram evaluation process' This final report will be submitted as a deliverable to the D6JIBJA.co-authors for this report will include but is not limited to Dr, Roger schaefer (programevaluator); Lieutenant Ed Buntin (grant administrator); superintendent steve panattoni.7) Upon the completion and submission of the final report, Dr. Schaefer will work with Kittitascounty Jail administrators and staff to develop a plan to full utilize the findings of the evaluation* compfeting the evidence_based cycle.
Attachment*B" - Budget
$4,699 Schaefer salary
$1,551 Schaefer benefits
$o ,254 Total Cost per Year
Attachment "C"
Program Narrative: Kittitas County Jail MAT program
Statement of the Problem
Kittitas County SherifFs Office requests consideration for funding through the Bureau of
Justice Assistance's (BJA) Comprehensive Opioid, Stimulant, and. Substance Abuse program
(COSSAP) under Category l, Subcategory 1c as a rural county with a population af fewer than
100,000. if funded, Kittitas Counly Sheriff s ofFrce proposes to expand and enhance evidence-
based medication-assisted treatment (MAT), as well as recovery support services within the
Kittitas County Jail. Kittitas County SherifFs Office serves those incarcerated, which includes
American lndians/Alaskan Natives, Veterans, pregnatrt and post-partum women, and
uninsurecUunderinsured populations. This information will be tracked and reported throughout
the process.
Kittitas County Sheriffs Office currently contracts with Whatcom Countyjail, U.S
Immigration and Custouts Enforcement (ICE), Washington Department of Conections (DOC),
and the U.S Marshals Service, of whom all house inmates regularly iaside our jail. With this
grant, Kittitas County Sheriff s Office will procure a contract with a MAT provider in
Washington state. Due to shortage of treatment provid.ers in Kittitas Counfy and the number of
inmates housed under contract, Kittitas County Sheriffs Office is seeking a MAT partner thaf
can provide services within the jail, the county, and major cities across the state of Washington.
A pa*ner with an extensive reach will ensure a smooth transition from jail MAT to community
treatment regardless of the inrnate's home location.
Kiuitas County Sheriffs Office currently participates in the state of Washington's
Division of Behavioral Health and Recovery PBHR) Hub and Spoke project. The Hub and
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Spoke model connect a network of comnunity providers around a central hub, currently located
in Yakima, Washington, offering a MAT component to all patients seeking treaknent. Kittitas
County Jail participates in this program as a Spoke, providing treatrnent referrals to the state-
funded Hub entity. While participation in this program has created an avenue for access where
one did not previousty exist the Hub entity can only provide minimal services in the Jail on a
pafi-time basis, Cun-ently the program seryes approximately 12-19 inmates on a part-tirne basis,
but a full-time program is needed to adequately address the needs of the estinated 30% of
inmates (28+ inmates based on the average daily population) in need of keatment. A full-time
Nurse Care Manager $fCM) and peel support specialist on-site would allow for adequate
coverage of MAT treahnent, care coordination, and community referrals to support services.
Kittitas County Jail is located in Ellensburg, Washington. As of July 2}lg, Kittitas
Counfy has an estimated population af 47,935t . A comparison of demographics between our
larger community and the jail population we intend to serve is illustrated in the Table I below.
Table L Kittitas County und Jail Population Demagrnphics
County Population Jail Average Daily Population
Total 47,935 95
White non-Hispanic 83.8%69.82%
Hispanic or Latino 8.9%17.59%
Asian 2.3%0.39%
African American 1.2%3.85%
American Indian 1.3%1.69%
I u's Census Bureau. (201 8]. Quiekf*cts: Kiftitas counry. ln (/.s census Bureaa . Retrieved .l?om
https:llwrvw.ccnsus.govlquickftcts/faetlrableikittitascounfywashingtorl BZAAl,fizt7
2 ofll
In Kittitas County injury and poisoning are among the leading causes of hospitalization
among adults ages 25-64, not including hospitalizaiions for pregnancy and childbirth. These rates
are conceming as they are ail significantly higher than the state rates2. Drug overdose deaths are
a largely preventable cause of premature death in a population. Prescripticn drug abuse-
particularly opiates-has reached epidemic levels within the United States.l The indicator for drug
misuse in a population is the number of drug poisoning deaths per 100,000 population. There
were I I total deaths due to drug overdose in Kittitas County (combined years20l4-16) including
all prescription and intravenous drug use.a The raortaliry rate due to all drug overdoses is I per
100,000, InZaL6, the morfality rate for opiate overdose is less than 1.6 per 100,000.5 Kittitas
County has the fifth lowest rate of death due to drug poisoning in the state6. While the county
appeaffi to be addressing the opioid epidemic successfully, it is important to note that
incarcerated individuals are disproportionately affected by substance use disorder compared to
the general population. At point of intake, over 3AYa of newly incarcerated individuals reported
experiencing a substance use disorder to a corections departrnent staff member. The acrual
representation may be higher when disclosure is moved to a medical setting.
Program-specific Priority Area - A lack of accessibllity to treatment providers and facilities
] Washington Statc Departucnt ofl Heafth, Ccnter for Health Statisiics. VfA Hospital Disehargc Data, Comprehcnsive Hospitalizarion Abslrsct
Repcrting system {cHARs} 1987-2015- community Flealdr Assessment Tool (aHAT), Augusr, 2016.I Centers ltn Disease Conrrol and Prevention. lncrea-.ses in drug and opioid overdose diatbs ]Unit"d Stut.r, Zaa}-za4.Morbidiry and Mortality
Wcckly Report iMMWR) 64(501 {Centers for Discasc Control and Prcvcntion),2016: 1378-82. A}ailable sr:
https.:/,/rvww.cdc.gov/mmwy'prcviedmmwrhtnllmm6450a3.htm (Accessed Februory 3, 201 g)
' University of Wisconsin Population Health lnstitute. Couary Hsalrh Rankings and Roadmaps. 2018, Avaitable
ot:htlp:l/www'countyheallhrankings.orgiapplwashingtoa,r20 I 8/rankings/kittitaslcountlfhctcislovcrall/snap shot {Accessed January 2?, 20 I g).
5 Washington State Depmtment of Health, Center foi llealth Statisricsl Washington Siate Drug Overdose qru*erly Repofi: Drug overdose
Deaths 201 7 First Three Qua*ers and 2016 lvlaps. Community Health dssessment lool {CHAT), Februsry tz,zff8. {A"ccesseriMarch 3 t, z0lgl6 University oflVisconsin Population Health Institute. Counry Health Rankings and Roadmap". 10t L Available
at;htip:l/wrvw.countyhealfhrankings.orglapp/washirgton/201 Slrankings&inins/countylfactors/overalUsnap shot (Accessed January 22, 20 i g).
3al2O
Kittitas County is currently experiencing a shortage of providers for primary, mental, and
dental healthcare. The ratio of Kittitas County residonrs to primary care physicians is 1570: l.
This is higher than the state's ratio of i 190: l. 7 The ratio of residents to rnental health providers
is 7 I 0: I ' That is more than twice as many residents per mental health provider as the state ratio
of 360:l' sThe ratio of residents to dentists is 2,700:1. Again, this is nearly fwice the state ratio of
1250:1. e
Due to the shortage of primary and mental health care providers, residents are unable to
receive the necessary medical attention to treaf substance abuse disorders. According to the NIH,
individuals who use illicit drugs are rRore likely to commit crimes, and it is common for many
offense$, including violent crimes, to be commifted by individuals who had used drugs or alcohol
prior to eommitting the crinte, or who were using af the time of the offense.lO once in the Kittitas
Couniy Jail, due to limited budgets and staff, unforhrnately inmates can only receive minimum
care for ttreir addictions. To address the provid.er shortage and other rural challenges Kittitas
County Sheriff s offrce proposes to expand and enhance evidence-based keatment as well as
recovery support services within the Kittitas County Jail and it has been determined to a
contractor should be used to deliver services to best serve the inmates at Kittitas County Jail. By
identifying a provider group that can provide borh jail full+ime on-site MAT services and
establish a local presence the proposed project will impacr the inmates upon release and the
greater community.
4afZA
oJP Policy Priorify Areas - Povertyo Rural Community, and eualified Opportunity Zoncs
Kittitas county ra'ked secoud worst in the stafe for income inequarify. ll The us census
Bureau detennines who is in poverty by comparing a set of money income thresholds (lowest
amouut of income an individual can survive on) to overall farnily size and composition.
Figure L Kittitas County poverty &
Incr*nrpr.rry
H W8iilnrton ll3,lst$ff unn"o srtcs (rs.l7x)
nr***r Itqe*
500d
'fr-hir,tlAFllitmnnk{ronF5.0BX,
lrfind her (itt"sl*l
This measure does not vary by geographic area but is adjusted for inflation. In Kittitas
County, 22To of rcsidents are living in household with income below the federal poverty line.rl
In Kittitas county, approximately 39%of households have housing costs that amount to over
30% percent of the household's income, Kittitas County ranks third worst in the state for this
measure.l4
oul
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The Kittitas County is a designated rural as defined by the Federal Office of Rur.al Health
Policy and cousidered outside an urbanized area as defined by CMS - Rural Health Clilics
Prograrnl5' Figure 2 below displays the location of Kittitas County Jail in relation to the
couttty's fwo census tract Qualified Opportunity Zones (53037975500 and,53037975600)r6.
Figure 2. Kittitas Coun{v - Qualified Opportuttiq, Zones
Rctrievcd Forn: CDFI Inforrlation Mapping SystcmlT
.ol;
(-.. ).
fi'
t:
a'
u.l
*!
&t*ortyco*r
e0ll.20tC UC C.nrs rha !t0l:076!00
ilfllt Qsr&dr Y6
Oql}i.d OpFffdry Ze:Y6Potsldm: 5ll?ta{|eb,.mt*1. &?01Pdwt' tur lll: 11 9c
UamCotnm ntb(161: ; IClrtroodlMon: il$jhlrry*hnTct U,splcymd F Hxint UffidqDilRtaio: : el
30lt,20tt UC C.e. lEcG 6l0tt9?!6na
tatrllc Ootfiod: Ys
O{0tl.rl Optoftnlt| Zm:!sPo!.rrx6, 191.1
t artfi hfft lIl: y tiPr{(y Re {t}i tr rC
Um{itofnd ith {%}: 4 r*
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I
Due to shortage of treatment providers in Kittitas Counfy and the number of inmates
housed under contract, Kittitas County Sheriff's Office is seeking a MAT partner that can
provide services within the jail, the county, and major cities across the state of Washington. A
partner with a commihnent to serving the Ellensburg, WA area and an extensive reach will
ensure a smooth transition &om the Jail MAT Program to community treatment regardless of the
f i Am I Rtrra.l? - Repo*.^(2020, April 24). \t Rnrat Heatth InJbnuation Hub (RIJ\hub).Rerricved from htrps://rvwrv.mralhealthinfo.org/am-i-
rural/reporr?lat=46.99713&lng=- r 20. s4940&adtJe205%z0wo/ozostho/ozaAve%zco/oz01llensbur{o/o2.c%z0w Ay0209g926&exacr=l
'" Intemal Rcvcnue Servicc. {2018, Julyg), Designatcd Qualifiett Opporturrity Zoncs urrder Interni'l RcvenueCorle $ 14002-2 Norice l0l8-4g.
Iu /RS. Retrieved from hrrps/lmvw.irs.gov/pub/irs-drop/n-t 84g.ntif:
" Community Development Financi8l lnstilutions Fund, Reirieved April ?4, ?0?0, from
https ://mvw.cinrs.cdfi firnd,gov/preparatioil/?confi g=confi g_nnrtc. xml
I rl
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inmate's home location. This commitment to increasing MAT access to the greater community,
in addition to the inmates at the Kittitas County Jail, will impact both of Kittitas County's
Qualifi ed Opportunity Zones.
Drug treatment has been shown to be both less expensive and more effective at reducing
recidivism, drug abuse, and crime compared to prisonls. Dr. Nora D Volkow, the director of the
National Institute on Drug Abuse, stated "Detox alone in jail or prison is not treatment. Without
proven treatment and therapeutic follow-up in a community setting, addicted offenders are at a
high risk of relapse despite a long period of forced sobriety." re By instituting evidence-based
treafment in the jail setting, along with a clear path for care coordination post-release, the
proposed program should have a positive impact on the public safety20 of the area surrounding
the Kittitas County Jail,
Program Design and Implementation
With the size and complexity of the Kittitas Counfy Jail in mind, as well as best practice
grridelines published by SAMHSA and other organizations for cutting operational costs in jails
related to inmates going through withdrawal, reducing overdose rates post-release, and lowering
the rate of recidivism the following rninimum qualifications will be used to identify a partner to
provide onsite medication-assisted treatment fsr inmates with substance use disorder. The
Kittitas County Jail has researched available MAT organization and reviewed programs offered
in other jail programs in the State of Washington. The Kittitas County Jail is confident an
organization with all minimum qualifications can be procured for this project.
r3 National Admissions to Substaaee Abuse Treatment Services. 2005- Treatmenr Episode Data Sei TTEDS) Highlights-20O5: Hairison, Paige M.,
and Allen J. Beck.2006. Prisoners in 2005. Washingron, DC: Bureau of Justice Statistics1'Narional Instirute on Drug Abuse. NIDA announces recommendatiors to treat drug abusers, $aye money, and rcduce crime, Press releasc July
24, 2A06. Onlioe at: hrqr:/ldrugabuse.govlnewsroom/064,{R7 -24.brml
:n Natarajan, Nila, et al. "subsrance Abuie Treatment and Public Safety." Justice policy lnstitute . , Jan, 2008.
www justicegol icy. org/image#up load108_0 l_rep*drugtx_ac-ps.pdf
7 of2A
Minimum Qualifications:
. 5+ years providing MAT to patients in an Office Based Opioid Treatment (OBOT) setting,
r Staff experience with correctional medicine and correctional healthcare partners.
o 1+ year of experience providing MAT to inmates in correctional facilities.
r Experience providing 24/7 on call consultation to jails and medical oversight fo providers,
nurses, and medical assistants conducting MAT related activities inside of the jail.
r Ability to accept new patients at outpatient clinics within 72 hours of release,
r A currently established or comrnitment to establish an outpatient clinic in Ellensburg, WA.
r Presuilptive and definitive internal laboratory operations to rapidly diagnose and treat opioid
use disorder {OUD), alcohol use disorder {AUD), mental health disorders, Hepatitis C, and
sexually transrnitted infections (STI),
r Accepts Medicaid, Medicare, and private insurance in addition to self-pay at clinics.
r Must have significant X-DEA/Buprenorphine Waiver capacity.
r Evidence of corporate financial stability and experience with rapid operational expansion.
c Actively networked with eommunity-based ar ganizations state-wide.
Screening
Curent Kittitas County Sheriff s Office staff collect urine samples from individuals entering
the jail per standard intake protocol. Currently inmates are referred to the Hub and Spoke
treatrnent as resources allow. Under the proposed project, all inmates will be screened for a
possible OUD concem would be referred to the MAT partner organization, The MAT partner
organizatian staff will begin with a general assessment for all substance use disorders (SUDs)
utilizing MDA validated screening tools fNIDA quick screen, NIDA Modified ASSIST). If
8of20
opioids are a primary substance of abuse, both the DSM 5 Criteria for the Diagnosis of Opioid
Use Disorder and the Clinical Opioid Withdrawal Scale will be utilized. Assessmenr for other
SUDs and withdrawals will also occur during initial screening. For example, if alcohol is
identified as a substance of abuse, the DSM 5 Criteria for the Diagnosis of Alcohol Use Disorder
and the Clinical lnstitute Withdrawal Assessment for Aicohol willbe used. A combination of
screening/assessment instruments as well as the individual characteristics of each patient will be
used to identify appropriate and willing candidates for MAT. The screening flow is demonstrated
in Figure 3 belor,v.
Figure 3, Inmateflota
' 6A|N-SS. Utingdrugicreen
' SUohtrrory
While local MAT program medication options may include buprenorphine HCL, Naltrexone
HCL, and Vivitrol IM, the Jail MAT program will only offer Buprenorphine HCL at this time,
Onsite Sewiees
Intake: A full-time onsite Nurse Care Manager (lrlCM) will assist each inmate who has been
pre-screened using an evidence-based screening tool provided by the MAT partner organization,
and identified as a candidate for MAT by the jail correctional or medical staff, to complete new
Scro.ntg
Srrlst llc.
lllsordor
aasrda& lo
not
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Blrorder
Asa?ldieadw
t,s6 Oisardcf
,f,i'ttsl ilc SUD
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Assmsfr€ri
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Witidrrwal $cats
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classlficatlon lot
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9of20
patient paperwork. Forms include a Consent to Treat and a Consent to Release lnformation,
allowing patient data to be shared befween the jail and the MAT partner organization.
lnduction: A licensed, X-DEA waivered provider and NCM will operate from inside the jail
to conduct a medical exam of each inmate who has completed the new pati.ent paperwork. If the
provider diagnoses the inmate with substance use disorder and confirms the inmate is a candidate
for MAT, the provider will prescribe an appropriate dose of medication and the NCM will handle
documentation, registration, and induction dosing. In addition to inducting ner,v patients, the
provider will review patient charts weekly and refill or adjust prescriptions as appropriate.
Dosing: The NCM will prepare medication doses, administer balloon dosing (3 times per
week) or daily dosing if medically appropriate, directly to all inmates on the MAT program, and
maintain accurate electronic medical record (EMR) documentation. The dosing schedule will be
determined by command staff in collaboration wirh the MAT partner organizationduring the
implementation planning phase,
Care Coordination: The Peer Support Specialist will coordinate scheduling of ongoing care
for inmates at the MAT partner organization's local clinic, starting irnmediately post-release.
Care coordination includes appointrnent scheduling, documentation, financial counseling,
referrals to servicesn and communication with the patient to ensure smooth transition from onsite
services to outpatient services.
Staff Training; The MAT partner organization will deliver initial and refresher training ro all
command and corrections staff on opioid use disorder, withdrawal symptoms, medication
information, dosing protocols, and the role of behavioral counseling. Scheduling and the final
content of training seminars will be deterrnined by command staff during the implementation
L0 of 20
planning phase. Medical staff will be on call for phone-based clinical consultation as needed for
any questions or issues related to MAT that come up after hours for medicat or correctional staff.
Post-Release Coordination and Sewices
MAT partner organization prescribing staff and the NCM will meet with individuals
cuffently incarcerated and establish a provider/patient relationship. Once the individual is
released from jail, helshe will have had rheir first appointment or will attend their first
appointment, scheduled with the MAT partner organization. If there is any time lapse between
release and appointment, ihe individual will receive reminder call.
An appointment will be already scheduled at the MAT partner organization in Ellensburg and
transportation waiting for these individuals, as needed, upcn release from custody. The MAT
partner organization will also aid in the application process for insurance for the uninsured so
that care and the individual's medication can be paid for after their release from the Kittitas
County Jail. The MAT partner organization will need to ensure flexibility in their scheduling as
well and will be able to accommodate changes in release dates.
Ongoing medication-assisted treatment and appropriate lab testing with a licensed addiction
medicine provider and medical staff at the MAT partner organization's Ellensburg clinic
location. Addiction to all substances, including opioids, methamphetamines, alcohol, marijuana,
and tobacco is treated along with prescribing of medications where appropriate, including
Suboxone@ / buprenorphine, Vivitrol@ /naltrexone, disulfram, acamprosate, gabapentin,
carbamazepine, and pregabalin. Costs are to be covered by insurance, including Medicaid.
42 CFR part 2 Compliant
11 of 20
Kittitas Counry Sheriffs Office has developed 42 CFR part2 compliant consent forms that
encompass all requirements set forth by the Legal Information Institute and the L,egal Action
Center. All staff are fully kained in the utilization of consant forms prior to start of work.
Ongoing training is provided annually, or sooner, as rules change. The elements of each consent
are fully understood. We utilize rwo types of consent forms: Consent to Treat and Consent to
Release Information. Each consent fonn has the Prohibition on Redisclosure statement. All
pafticipants will be fuily informed of their right to sign, revoke, and/or limit the consent form.
These forms will be maintained within participant file and datelevent of expiration will be
monitored. The initiating site will maintain the original consent fonn and a copy will be provided
to the referent. No participant information will be disclosed without a valid consent form being
completed, unless otherwise allowed by law {medical emergency, mandatory duty to report,
etc,).
Under 42 CFR Part2, Subparts 34 and 35 disclosures may also be made to other correctional
facilities and to judicial agencies when participation in a program is a condition of their release
or parole. AII elements of these subparts will be followed and documented within the participant
file.
Capabilities and Competencies
Our initial concems focus primarily on being able to appropriately staff the jail with qualified
and culturally informed personnel. A MAT partner organization will need to have developed a
list of appropriate candidates for the positions needed with the ability to have a full sraff no later
tha;n12/0112020 and will be able to provide services by 12/31/2020.
Kittitas Counfy Sheriff s Office will seek a MAT partner organization that consists of
medical providers carrying certifications in Addiction and Emergency Medicine, lnternal,
t2ot20
OB/G)aN, and FamilyMedicine, among other specialties. The potential MAT partner
organization will also need to employ social workers, caseworkers, counselors, ancl rnental health
practitiouers. This diverse staffwill lead to a holistic approach driving positive outcomes,
including family stability, stable housing, improved overall health, and reduced rates of
recidivism
Kittitas County Sheriffs Office praject Leud:
Kittitas County Sheriffs Office has identified Lieutenant Edward Buntin as the Project
Lead. Lieutenant Buntin will oversee the budget, project contracts, correctional staff, arid other
grant duties. As project lead. Lieutenant Buntin will work closely as the point of contact with
Kittitas County leadership, BJA grant staff, MAT partner organizatiou, and his local cornrnunity
fo make sure the scope and direction of the project is completed.
Lieuteilant Buntin was hired with the Sherifls Office in January 2005. He has worked as
a Control Room Operator, Corrections Officer, Corporal, Sergeant and has been the Lieutenant
since 2015. Lierttenant Buntin graduated from the Washingon State Corrections Officer
Academy in 2005 and continues to attend regular education events and in 2018 received a
Middle Management Certification from the Washington State Criminal Justice Training Center.
Lieutenant Buntin is responsible for the planning, organization, and d.irecting of the
activities for corrections staff to insure the lawful and proper care of inmates. In his duties,
Lieutenant Buntin maintains effective working relationships with administrative personnel,
public agencies, and the general public to accomplish work under the guidance of State and
Federal laws and regulations, Sherift's Of1ice and County polices, regulations and procedures,
Other duties include inventory control, training for staff, overseeing civilian law enforcement
clerks, volunteer (Ministry, Narcotics Anonymous, Alcoholics Anonymous, etc.) programs,
L3 of 2A
civilian cooks, performance evaluations, disciplinary actions and performances! policy,
purchasing, complaints, grants, and more.
Program Evaluator
The Program Evaluator is responsible for managing all program evaluation activities and serves
as the liaison to BJA projecf evaluators. The Prograrn Evaluator will work with the Kittitas
County Sheriff s Office Project Iead and the MAT partner organization Program Coordinator to
develop, implement, and oversee the BJA program evaluation.
Program Coordinetor (MAT Partner Orgnni4ation) :
The Program Coordinator will serve as an administrative professional specialized in
managing, coordinating, implementing, and evaluating the MAT Partner Organization's medical
services. Responsibilities will include, but are not limited to, ensuring implementation of policies
and practices, facilitating positive relations within the grant program team and extemal parties,
providing relevant project i;rformation updates, communicating between Kittitas County
Sheriff s Offrce and the MAT Partner Organization, and creating presentations, summaries, and
reports to ensure communication and program transparency for stakeholders.
Medical Staff (MAT partner Organization)
Mid-Level Provider
A provider with one of the following credentials: medical doctor [\iIDlDO), physician
assistant (PA-Cs), or nurse practitioners (ARNP, CRNP). The provider will need to have
received up to 24 hours of training and received their DEA waiver to prescribe buprenorphine.
Established connections with agencies, such as the Arnerican Society of Addiction Medicine
1,4 af 2A
(ASAM), and continued education regarding the most up-to-date, evidence-base treatment
available is preferred.
Nurse Care Manager fNCM)
The NCM's responsibility will be to overseeing health, wellness, and medical prosesses
for patients undergoing reatment at the Kitritas County Jail. The NCM will also provide
screening, triage, crisis intervention, medical services, case coordilation, ancl education and
referral services. The NCM shall utilize best practices to engage ald help motivate patients to
commit to treatment and to assist patients to identii/ and problem-solve individual and systemic
barriers to treatment.
Peer Support Specialist
The Peer Suppo* Specialist will provide support for those who are going through
treatment or are new to recovery utilizing their life experiences and recovery. The peer Support
Specialist will interface with patients individually and with the members' care team. The peer
Support Specialist will work patients to prepare for their transition into the community including
but not limited to, coordinating transportation, providing referrals to communify organizations,
scheduling treatment follow-up, and applying for health insurance.
PIan for Collecting the Data Required for this Solicitation's Performance Measures
Kittitas CounS Sheriff s Office believes strong program evaluation can help identifli the
best investments as well as determine how to establish and sustain them as evid.ence-based best
practice. Due to this commitment to ihe utilization of evidence-based practice, Kittitas County
sherifls office is proposing the inclusion of a formal program evaluation.
15 of 20
The Program Evaluator would be in continuous contact with all providers to gather the
required infomration including cornpleting surveys. Open lines of communication are to be
established between the jail site, the MAT off-site clinic, and federal program staff to ensure
appropriate steps are being taken to conduct evaluation.
Evaluation Development 7l
The Program Evaluator will work with all program parhrers to ensure communication and
completion of evaluation cornponents. Figure 4 displays an overview for the development of the
progratn's evaluation plan, while Figure 5 highlights the standards to be used during lhe
development,
Figure 4. Steps to Evaluation Develapment
I
Describe the
Program
T
f 'ffin"
Share
Results
Evaluation. ln Center.[or Disease
I
^l
Evaluation
Design
-
f "'?:ffiro:"
Fign'e 5. Evaluation Standards
rr CDC guidclinc citation: progmm
Conn'ol and Preyerrr'ar. Retrieved May 4,2t)20,
16 of 20
The evaluation of this prograrn will involve a mixed method approach consisting of
participant interviews, MAT retention rates, and process metrics. The main thenres of the
evaluation will focus on the irnpact to program participants and Kittitas County's treatruent and
recovery population. Tlie logic rnodel below, Figure 6, displays the relationship of the program's
resources, participants, activities, anticipated products along with the programs intended effects
highlighted in the short tenn, intermediate, and long-term outcomes/impacts portion.
Figtu"e 6. Evaltmtion Logic Model
pFle.r Ivrl!ntiorPlan for trirtir.t Courtv Corfctiont
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disord€r
During the first month of the contract period, the Progam Evaluator will collaborate with the
Kittitas County Sheriffs Office and BJA progmm staff to develop a formal evaluation protocol,
The formal evaluation protocol will define metrics and methodology of data collection. Potential
data collection tools include, but are not lirnited to:
1. Kittitas County Correctional Data
L7 ot20
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2. Treatment Inforniation
3. Survey tool to assess the quality of treatment and self-reportecl changes in OUD
klowledge, confidence, and readiness for transition into the coirununity.
4. Comrnunity transition and treatment retention rates.
5, Process notes such as annual summary repofis, quarterly proglam rnonitoring rneeting
notes, ol'contract deliverables to identify the successes and challenges ofdelivering the
progrum along with opportunities for irnprovement.
The Prograrn Evalualion will communicate infonnation regarding all aspects of the program
evaluatiou to staffto ensure clear expectations for the final program evaluation report. The
Program Evaluator will plovide Kittitas County Sheriff s Office, the MAT partner, and BJA staff
with arnple opportunity to provide insight and feedback to the report's methodology, fonnat, and
focus.
Data Collection
The NCM and Peer Support Specialist will complete the intake assessn'lent to establish
baseline data. Feriodic benchmark data collection, via intcrviews or surveys, will bc conducted if
all required data cannot be coliected from pa$ners. Table 2 provides a potential outline for
evaluation metrics and data collection.
Table 2. Potential Data Collection
Potential Metrics
Percent of individuals screened for OUD
Percent of lndividuals diagnosed with OUD
Percent of Individuals offered MAT
Percent of lndividuals who initiate MAT
Average Length of Stay
Percent of individuals who remain on MAT at the tirne of release to the cornrnunity
Percent of Individuals who have an appointment scheduled with a cornmunity MAT
provider when released
a Percent of a or on
18 of 20
a
a
a
Percent of individuals insurcd at thc time of release
Decrcase number of discipiinary repofis
Decrease incidence of contraband corrfiscation
Individuttl Level Data
Data Element Description Sourcc
Detention Twe Pretrial, sentenced Kittitas County Jail
Demographiss Age, gender, race/ethnicify Kittilas County Jail
Date oldetention Entry mmldd/yyyy Kittitas County Jail
Rssult of OUD Screenine positive/negativc Kittitas County Jail
Result of OUD Assessment OUD diasnosis ves/no MAT Partner Organization
Rcsult of MAT Assessment MAT recommended (yeslno)MAT Partner Organizatiou
Receiving MAT at time of
arrest
yes/no and type of MAT MAT Partner Organization
Date initiated MAT mm/dd/wyv MAT Partner Orsanization
Fonn of MAT initiated Methadone,
b uprenorph ine/naloxone,
buprenomhine, XR-NTX
MAT Parlner Organization
Dose of MAT at time of
discharge ffom treatment or
detention release
Methadone
(mg)/buprenorph i ne/naloxone
(mg)
MAT Partner Organization
Date of discharge fiom
treatment
mmlddlyyyy MAT Pa$ner Organization
Reason for discharge from
treatment
Released frorn
incarceratiorrlthcil ity
transfer/patient request/medically
advised (describe)/non-medically
advised/death (cause)lother
(describe)
MAT Partner Organization
Date of detention release rnrn/dd/ww Kittitas Corinty Jail
Location to which released Other correctional
facility/community
Kittitas County Jail
Legal status at release Pretrial/post-trial Kinitas County Jail
If released to community,
form ofrelease
Pretrial: bond/citation, post-trial:
"time serued"/charges dismissed
Kittitas County Jail
Referal to community MAT
provider made prior to release
yes/no MAT Partner Organization
Appointment with
community MAT provider
made prior to release
Yes (rnnr/ddIyyyy)Iuo MAT Partner Organization
Insurance Status at the tirne
of Relcasc
MedicaidiMedicaid eligible and
uninsurcd privatcly
insured/Medicare/lvfedicaid
ineligible and uninsured
MAT Partner Organization
19 of 20
Date seen by comniunity
MAT provider
mm/ddiyyyy MAT Partner Organization
Date first post-release MAT mn/dd/yyyy MAT Partrier Organization
filled.
Correctional system level data
entiye coyrectional time
Data Element Description Source
Deaths due to suicide #Kittitas County Jail
Deaths due to opioid
overdose
#Kittitas County Jail
Incidence ofconhaband
drugs confiscated within
facility
Non-prescribed
buprenorphine/illicit opioids/all
illicit druss
Kittitas Counfy Jail
Assaults # assaults on
staff/inmates/visitors
Kittitas Counfy Jail
Disciplinary r€ports #, twe Kittitas Counfy Jail
Annual Recidivism rate Rate of people who are released
and re-offend within a given
year, by type ofre-offense (new
Kittitas County Jail
violation
Community level data
cowectional cntchment area over the time
Data Element Description Source
Annual deaths due to opioid
overdose among total
population
# deaths, by gender State and Local Public
Health
Annual deaths due to opioid
overdose among individuals
released from correctional
setting within 12 months
# total post-release overdose
deaths/post'release MAT
participant deaths
State and lncal Public
Health
20 ot 2A
Busn,less Assocu.rr AnneNDuu
EXHIBIT "D" To rHe CoNrnecr ro wHICH rr is ATTACHED
This Addendum is incorporated into the contract to which this document is attached between
Kittitas County Washinglon on behalf of the Office or Department thereof ("Covered Entiry")
and the other party or parties thereto ("Business Associate"). The singular shall include the plural
and the plural the singular as required by the context.
The Business Associate acknowledges and agrees that Protected Health Information (PHI) in any
format, including electronic PHI (ePHI), can be used, shared, created, retained or transferred
only within the parameters of this document and the Department of Health and Human Services
Privacy Regulations, Code of Federal Regulations, ("CFR"), Title 45, Sections 160 and 164, or
as required by law.
CFR Title 45, Sections 160 and 164 and any applicable Washington statutory law ('?CW') or
Administrative Code ("WAC") provision (Federal and State statutory or regulatory standards
applicable to this addendum are collectively referred to as "law") are by way of reference: an
integral part of this Addendum as if incorporated in full. Business Associate is charged with the
knowledge of and agrees to abide by the terms and conditions of law. To the extent that any
applicable provision of RCW or WAC provides for or mandates any standard differing frorn
those of Federal law, the standard more restrictive of disclosure shall control subject to federal
preemption; this applies throughout this Addendum without regard to any fu*her explicir
reference to RCW or WAC provisions.
This Addendum is effective upon signing of this aftachment or the confract to which it is
attached, whichever is prior in time.
r. P{IRPq,SE
The Covered Entity needs to make available and/or disclose to the Business Associate certain
PHI for management, administation, and legal responsibilities during the normal course of
business between the pa*ies as referenced in the contract or other agreement to which this
documeni is attached and incorporated by reference. This document is intended to define and
incorporate but not limit the obligations of the Business Associate with regard to its use and
protection of that PHI.
tI. RESPOL\TSTBILITIES OF EUEINESS ASSOqTATE
The Business Associate hereby a_qrees to do the following:
A. Use and.lJisclosure: Use andlor disclose PHI only as permitted or required by this
Addendum, Health Insurance Portability and Accountability Act (HIPAA), and the
Health Information Technology for Economic and Clinical Health Act (Division A, Title
)ilII of the American Recolery and Reinvestment Act of 2009, Pub. Law 111-5, 2009
HR 1) ("HITECH"). The Business Associate shall usc and disclose PHI only if zuch usc
or disclosure, respectively, is in compliance with each applicable requirement of 45 CFR
$ 164.50a(e) or other law. The Business Associate is directly responsible for ful1
B^ A. A- A*achment Page 1 of 5
compliance with the privacy provisions of law that apply to the Business Associate to the
same extent as the Covered Entity.
B. Security: Implement administrative, physical. and. technical safeguards that reasonably
and appropriately protect the confidentiality, integrity, and availability of the PHI that it
creates, receives, maintains, or transmits on behalf of the Covered Entity as required by
law. The Business Associate is directly responsible for compliance with the security
provisions of HIPAA and HITECH to the same exten! as the Covered Entity.
C. lmoroper Disclosures: Report all unauthorized or otherwise improper disclosures of pHI,
or security incident, to the Covered Entity within two (2) days of the Business
Associate's knowledge of such event.
D. Notice of Breach: Within two (2) business days of tbe discovery of a breach as defined at
45 CFR *164.4A2 notify the Covered Entity of any breach of unsecured PHI. Notification
shall by the most rapid means reasonably possible, such as telephonic notice made
directly to an applopriate person within the covered entity and not including a voice mail
or similar message . Written notification shall follow within that fwo (2) period by fax and
be confirmed by direct contact with the intended recipient, and include fhe identification
of each individual whose unsecured PHI has been, or is reasonably believed by the
Business Associate to have been, accessed, acquired., or disclosed during such breach; a
brief description of what happened, including the date of rhe breach and the date of the
discovery of the breach, if known; a description of the types of unsecured pHI that were
involved in the breach (such as whether full name, social security number, date of birth,
home address, account number, diagnosis, disability code, or other types of information
were involved); any steps individuals should lake to protect themselves from potential
harm resulting from the breach; a brief description of what the Business Associate is
doing to investigate the breach, to mitigateharmto individuals, and to protect against any
further breaches; the contact procedures of the Business Associate for individuals to ask
questions or learu additional infbrmation, which shall include a toll free number! an e-
mail address, Web site, or postal address; and any other information required to be
provided to the individual by the Covered Entity pursuanr to 45 CFR g 164.404, as
amended. A breach shall be treated as discovered in aceordance with the tenns of 45 CFR
$ 164'410. The information shall be updated promptly and provided to the Covered Enrify
as requested by the Covered Entity.
E. Mitisation: Mitigate, to the extent practicable, any hannful effect that is known to
Business Associate of a use or disclosure of PHI by Business Associate in violation of the
requirements of this Addendum or the law.
F. Agents: Ensure that any agent, including all of its employees, representatives, and
subcontractors, to whom it provides PHI received from, or created or receivecl by
Business Associate on behalf of Covered Entity agrees to the same restrictions and
B. A. A. Artachment Page 2 of 5
conditions that apply through this Addendum to Business Associate with respecr to such
information.
G. Right of Access:
1. From time to time upon reasonable advance notice, or upon a reasonable
determination by Covered Entity that Business Associate has potentially or actually
breached this Addendutn, make internal practices, books, and records relating to the
use and disclosure of PHI received from, or created or received by Business Associate
on behalf of Covered Entify available to the Covered Entity, or at the request of the
Covered Eatity to the Secretary of Department of Health and Human Services, for the
purpose of determining compliance with HIPAA, HITECH, andlor this Addendum.
2. From time to time upon reasonable advance notice, or upon a reasonable
detennination by Covered Entity that Business Associate has potentially or actually
breached this Addendum, to permit Covered Entity to respond to a request by an
lndividual for an accounling of disclosures of PHI in accordance with 45 CFR
$ 164.528, or to pennit Covered Entity to respond to a request by an lndividual for
access to PHI in accordance with 45 CFR S164.524.
H. Documentation of Disclosures: Document such disclosures of PHI and infonnation
related fo such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of PHI in accordance with 45
CFR $ 164'528. Shculd an individual make a request to Covered Entity for an accounting
of disclosures of his or her PHI pursuantto 45 CFR $ 764.528, Business Associate agrees
to promptly provide an accounting, as specified under 42 U.S.C. g 17935(c) (l) and 45
CFR $ 164.528, of disclosures of PI{I that have been made by the Business Associate
acting on behalf of the Covered Entity, The accounting shall be provided by the Business
Associate to the Covered Entity or to the individual, as directed by the Covered Entity.
I. Amendme{rts: Make any amendments to PHI that the Covered Entity directs or agrees to
pursuant to 45 CFR 9164526 at the request of Covered Entity, within five (5) business
days of written request by Covered Entity.
I' Other: To the extent the Business Associate is to carry out one or more of the covered
entities obligations under Subpart E of 45 CFR 164, comply with the requirements of
Subpart E that apply to the covered entity in the perforunance of such obligations.
NI. PER}"IITTED USES AND DISCLOSURES BY,BUStr.{ESS ASSOCIATE
A' Except as otherwise limited in this Addendum or by law, Business Associate may use
Protected Health Information for the proper management and administration of the
Business Associate or to carry out ihe legal responsibilities of the Business Associate.
The Business Associate shall limit its use and disclosure of, and fequests for, pHI to the
minimum necessary as determined in accordance with 42 U.S.C. $ 17935(bX1),
B. A. A. Attachment Page 3 of 5
B. Except as otherwise limited in this Addendurn or by law, Business Associate may use
PHI to provide Data Aggregation services to Covered Entity as permitted by a5 CFR g
l6a.s0a.(e)(2XiXB).
IV. TERM ANT}TION
A. Term: This Addendum shallbecome effective on the Effective Date and shall continue in
effect until all obligations of the parties have been met, unless terminated as provided
herein or by mutual agreement of rhe parties
B. Tennination for Cause: Upon Covered Entity's knowledge of a material breach by
Business Associate, Covered Entity may provide an opportunity for Business Associate
to cure the breach or end the violation and terminate this Addendum if Business
Associate does not cure the breach or end the violation within five (5) business days of
receipt of written notice by fhe Covered Entity, or immediatelyterminate this Addendum
if Business Associate has breached a material term of this Addendum and cure is not
possible.
C. Other Termination: This Addendum may be terminatedby Covered Entity without cause
upon thirty {30) days prior written notice to the other party, which notice shall specifu the
date of termination.
D. Effect of remrination: Except as provided in paragraph B. of this section, upon
termination of this Addendum, for any reason, Business Associate shall retum or destroy
all PHI received from Covered Entity, or created or received by Business Associate on
behalf of Covered Entity. This provision shall apply to PHI that is in the possession oi
subcontraetors or agents of Business Associate. Business Associate shall retain no copies
of the PHI. Deskuction must be by means that meet or exceed the standards of law.
v
ln the event that Business Associate deterrnines that retLrning or destroying the PHI is
not feasible, Business Associate shall extend the protections of this Addendum to such
PHI and limit fu*her disclosures of such PHI to those purposes that make return or
destruction infeasible, for so long as Business Associate maintains such PHI. Business
Associate must provide written notice of the conditions that make return or destruction
not feasible; if Covered Entity does not concur in that assessrnent, Business Associate
shall refurn or destroy the PHI within five (5) business days.
MISCELLANEOUS
A. Defense and Indemnification: Business Associate shall defend, indemniff and hold
harmless Covered Entity from and against all claims, liabilities, judgments, fines,
assessments, penalties, awards or other expecses, of any nature whatsoever, including
without limitation attorneys'fees, expertwitness fees, and costs of investigation,
litigation, or dispute resolution, relating to or arising out of any breach of this Addendum
by Business Associate, its employees, offrcers, agents, or sub-contractors. This provision
B. A, A. Aftaclunent Page 4 of 5
is supplemental to and to be interpreted and applied in a manner consistent with, any
indemnification provision of the agreement to which this Addendun, is atlached.
B. Reimbursement for Costs Incurred Due to Breach: Business Associate shall reimburse
Covered Entity, without limitation, for all costs of investigafion, dispute resolution,
notification of individuals, the media, and the goverffnent, and expenses incurred in
responding to any audits or other investigation relating to or arising out of a breach of
unsecured PHI by the Business Associate, including mitigation.
C. Regulatorv References: A reference in this Addendurn to a Section in the Department of
Health and Human Services Privacy Regulations, CFR, Title 45, Sections 160 and 164
rueans tbe Section as in effect or as amended, and for which compliance is required.
D. Ameldmeqt: Changes in the law are automatically incorporated herein without need for
explicit amendment. The Parties agree this this Addendum may be amended from time to
time if otherwise necessary for Covered Entity to comply with the requirements of the
Department of Health and Fluman Services Privacy Regulations, CFR, Title 45, Sections
160 and 164 and, other provisions of law.
E" Notice.S: Whenever Covered Entity or Business Associate is required. to give notice to the
other parfy, notice shall be in writing, posted in the US Mail, and deemed delivered after
three (3) business days except as described in ti. D., above.
F. Survival: The obligations of the Business Associate shall survive the termination of this
Addendum.
G. InterpretaJion: Any arnbiguity in this Addendum shall be resolved in favor of a meaning
that permits Covered Entity to comply with the Department of Health and Human
Services Privacy Regulations, CF& Title 45, Sections 160 and 164 andother provisions
of law. Any provision of the Underlying Agreement that is directly contradictory to one
or more terms of this Addendum is superseded by the terms of this Addendum to the
extent necessary for the parties' cornpliance with HIpAA.
B. A. A. Attachnent Page 5 of 5
Kittitas County
Review Form
Grants & Contract Agreement
Today's Date
June 16,2021
Agenda Date
Fund/Depa$rnent
30 / Sheriff
Contract/Gran t Information
Financial Information
Washington/GrantContract Interlocal BetweenAgency:Kittitas CentralandAgreementCounty
Period Begin Date: 05/1512021 Period End Date: 09130/2023
Amount: Total amount through 9130123 will be $ 1 8,750 split between the 3 years
2021 amount: $3,125; 2022 amount: $6,250; 2023 amount: $6,250
Total Grant/Contract
2021 pro-rated.
Grant/Contract Number: SH2l-018
prograrn (MAT Program). Consistent with the University's objectives, and consistent with its status as a non-profit,
tax-exempt, educational institution, the University will provide professional services to the County to assist with the
evaluation of this MAT Program. As the designated Program Evaluator, Dr. Roger Schaefer shall design and
implement an evaluation sfudy that examines intake assessment and baseline data, treatment progress metrics,
irnplementation procedures and integrity; communicate with Kittitas County SherifPs Office and all entities
involved with the MAT prograrn; submit the necessary applications and engage in the proper review process for
approval form the Cenhal Washington University Institutional Review Board and Human-subjects Riview
Council; maintain rigorous ethical, rnethodological, and scientific standards throughout the enlirety of evaluation
process; oversee data collection, acquisition, and analysis; overseeing/co-authoring a final report based on the
analysis of all data collected throughout the program evaluation process or submit to DOJ/BjA; and after
SurnmContract/Grant The receivedhas federalary:from the JusticeofCountygrantDepartment (DOJ),
ofBureau AssiJustice stance to and a11(BJA)basedevidence-assistedmedication treatrnentdevelopirnplement
of the final Drcompletion Schaefer workwill Kittitaswithreport Jail istratorsadmin staffand to develo aCountyp
tultto tzeutil the of the evaluation.
Total Arnount: through g 130123 will
be $18,750 split between the 3
yews.2021pro-rated.
2021 amount: $3,125
2022 amount: $6,250
2023 amount:$6,250
State Funds $0 Federal Funds: through 9/30123
will be $18,750 split between the 3
years.2021 pro-rated.
2021 amount: $3,125
2022 amount: $6,250
2023 amount:$6,250
Percentage County Funds Matchins Funds $0 CFDA#
In-Kind $
Explain
I! Equipment being purchased? No Who ownq equipment? na
New Personnel beins hired? No Contact HR hiring - reporting requirements - na
Future impacts or liability to Kittitas County
Grant/Contract Review Page 1
Bud Information
Pass Th Information
Prosecutor Review
Budget Amendrnent Needed?
New Division Created? No
Yes[ attach budger form No [| Why not: BA already submitted for
2021
Revenue Code N/A
Expense Code 001301 23554 I 0 I
Agency to Pass Throueh NA
Amount to Pass Throueh $o
Sub-Contract Approved Date
Auditor Facilities MaintEnance
Information Services Human Resource
Prosecutor Treasurer
Has the Prosecutor reviewed this agreement?YesE No cAtvIAS# 51732
Coun De cted
Submitted
Signature: &*-, *+ya Date: 1- I f- tr
Department: Sferiff -
ment of Information
Grant/Contract Review page2
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer Date