HomeMy WebLinkAboutWalla Walla County Amendment 1Service Agreement #ZZ-20 Amendment# 1
Between
WALLA WALLA COUNTY DEPARTMENT OF COMMUNITY HEALTH
And
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
Agrcent-ent 22-20 by and between Walla Walla County Department of Community Health,hereinafter "county," and KITTITAS couNTy puBLIc HEALTI{ DEPARTMENTheleinafter "Conttactor," is amended as follows and in the attached Exhibit A Statement ofwork, Exhibit B Budget, arrd Exhibit F Repofting Requirements.
Amendment l:Arnends Statement of WorJr and Budget eligible tasks
Adds $14,000 in funding, for a new total of $32,500
Replaces Exhibit E Report Forrn with Exhibit F
Attachments: Exhibit A - Statement of Work
Exhibir B - Budget
Exhibit F - Reporting Requ ircments
Exhibit G - YCCTPP Z0Z2-Z3Implementation Guide, page 2g
All otheL conditions of Selvice agreement #22-20 remain in full force and effect.
By theil signaturcs below, theparties agrce to the tenns and conditions of this Agreement and alldoouments incotporated by re6rence. the parties signing below certiry that theiare authorizedto sign this Agrcement.
IN wITNEss WHEREOF, the parties hercto have signed this Agrecment.COUNTY: C9NTRACToR:
2L
Walla Walla County Board of Cornnrissioners
c/o Departnrent of Conrrnuuity I{ealth
314 W Main Street
Date
Director
E
Walla Walla, WA 99362
Phone: (509) 524-2650 Fax: (509) 524-2642
Namc &
Telephone Nurnber / Ernail Address: 509'962-7515 / chelsey.loeffors@co.kittitas.wa,us
Mailing Address (srrccr addrus rcquircd iu addirion to po Box.): 507 N, Nanurn, #102
CFDA#(fapplicablc): n/a
Ellensburg, WA 98926-2886
UBI#:
22-20,1 GT&C Kittitas YCCTPP
State Industlial Account ID # (ifappticabte):004.093.00
I of I
ExhibitA
STATEMENT OF WORK
Grantee Name:
Agreenrent Nurnber:
I(ittitas County Public Health Department
22-20 Anrend. 1 Contract Pedod: 07t0112022-06/3012023
Taslr
Number
TasldActivity/
Description Delivera bles/Ou tcomGs Due Date/Time
Frame
I Monthly Report Com p lete m onthly leport provided by YCCTPP
contractor and enrail to coordinatol
l5th of the month
for the previous
month in the
contract)Quartelly
Repolt.
Cornplete quafierly report provided by YCCTPP
contl'actor that focuses on narrative successes and
ohallenges for subcontractor.
The l5th ofthe of
each month on a
quafterly basis,
starting September
2022
3 AnnualReport Cornplete annual rcport provided YCCTPP
contractor that includes data fiom rnonthly and
quarterly repolts to surnrnarize year progress,
and chal
A month ly Y CCTPP subcontlactors rneetings
and attend a rninimunr of 3 Southeast Regional
Plevention Netwolk meetings
Completed no later
than 25 calendar
days after period of
performance
4 Attend YMPEP
regional
meetings and
trainings
Monthly until June
30,2023
5 State
collaboration
Attend at least 2 Practice co llaborative rneetings.
Optional to ioin a state workgroup meetins
Before June 30th
2023
6 Assisr with
Assessments
Provide requested data and input to assist with
completion of Needs assessment,Netwolk Eq ut ty
Assessment,and additional assessments that are
DOH.
Througlrout contract
7 Assist with
Workplans
Assist with cornpl eti on of Regional wotkplan and
and NetwolkAdmi Plan
Completed before
Decenber2022
8 PSE Goals Identify and complete network activities for at least
two identified goals in the workplano Schools
a and
September 2022-
June 3Oth 2023
9 Cessation Promote cessation tool andS resoufces Throughout contractt0Youth
Empowennent
Support youth ernpowennent clubs, and bring club to
Promote and Positive Comrnunity Norms
rnedi
Iuly 2022-lune2023
ll Media September 2022-
June 30th 2023l2Data gathering Ensnle a mlnt m uln of 66%of schools ln county sign
for FIeal
Starting in second
lralf of contract year
l3
(optional)
Policy Maker
Outreach
Reach out to local policy makers to educate on
lln of on
June30,2023
22-20.1 EXI{IBIT A SOW Kittitas yCCTpp Page I of I
Exhibit B
BUDGET
Agency Narne:
Agreenrent Nurnber
Kittitas County Public l-lealth Department
22-20 Anrend.l Conrr.acr period: 07/01/2022 - 068A\023
Linc Item/Description Eligible Tasl<s from
sow
Arvard Amendment
I
Total
Award
SFY23 Youth Tobacco Vapor
Ploclucts
t-l 3 $ 6,000 $6,ooo
SFYz3 Dedicated Cannabis
Accoulrt
1-13 $12,500 $12,500
SFY23 Tobacco Prevention
Proviso
r- 13 $l4,ooo $14,000
$18,500 $ 14,000 $32,500TOTAL
Please relbrence 2022-23lmplernentation Guide for specific guidance on etigible expenses.
Funded By
WA State Departmertt ol'l-lealth Youth Cannabis and Comrnercial Tobaceo prevention program
22-20.1 EXIIIBIT B Budget I(iuitas YCCTpp Page I of I
Dxhibit F'
Contmctor Nalne:
Agreement Number:
Kittitas County Public Health Depaffment
22-20 Amend.l ContmctPeriod: 7/|/ZOZ2-6/30t2023
Qrralterly repofts at'e a new rcquirernent this year to help addr.ess specific challenges, bar.riersyou arc experiencing' success, technical assiJtance needs, ad prrcceis evaluation r.lquests forDOI{' Tlrese rcpofts are due Septenrber 2022,Decernber2}Zi,March 2022, &June 2022, butcan be completed morc often.
To access the quafterly reporting i.or.ms click on the Iink_
Annual rcpofts are another new requirelnent this year based on rnonthly and quafterly repoftspreviously subrnitted and is due 25 days after the petioo oip.irorrun.". Report guidelines andexpectations will be prnvided by coordinator once DOH provides mor€ information.
YCCTPP Reporting forms Fy 22-23
Repofting forms arc due by the l5tl'of the rnorrth following the end of the service month.
To access leporting fonns clicl< on the link-
22-20.1Exhibit F l(itritas yCCTpp Page I ofl
Whof Con I Do with My Funding?Activities and items that contractors have proposed the annual workpran and annual budget and have been approved by DoHcontract manager do not require additional approval to implement unless there are changes made to original proposal or theitem is media which requires following the media process.Dedicated StateCannabis FundingDedirated State tommercialTobacco FundingAdditional GommerciatTobacco FundingC[)C TobaccoFundingElectronic EquipmentSubscriptionsln centives-l,lonetary Youlhlncentives- llonetaryln centives-l'lon lloneta ryPromotional ltemsFoodYCCTPP Coordinator/Staff travel t0conferencelmeetingl,letwork l''lembers Travel to conferenceRegistration f o r conference/trainingNetuork TrainingsRental Space for Heetings and TrainingsVapor Productscase-by-casecase-by-caseIcase-by-caser'case-by-casecase-by-case*r**r't*,acase-by-casecase-by-case(case-by-casecase-by-caser'r't/case-by-caset/case-by-caser'case-by-casecase-by-caser'case-by-casecase-by-caser't/case-by-casei/case-by-caser'case-by-casecase-by-caset/case-by-casecase-by-case,/r'./case-by-caser'casrby-caser'2022-23IMPLEMENTAIION GUIDE - 2B