Approve Amendment #3 with Health Care Authority Contract K3962, treatment and recovery support services to individuals in the CJTA. BEFORE THE BOARD OF COUNTY COMMISSIONERS
LEWIS COUNTY, WASHINGTON
IN THE MATTER OF: RESOLUTION NO. 21-252
APPROVING AMENDMENT #3 BETWEEN HEALTH
CARE AUTHORITY (HCA) CONTRACT K3962 AND
LEWIS COUNTY TO PROVIDE TREATMENT AND
RECOVERY SUPPORT SERVICES TO INDIVIDUALS
IN THE CJTA
WHEREAS, the Board of County Commissioners (BOCC), Lewis County,
Washington, has reviewed amendment #3 between Health Care Authority and
Lewis County for the period of July 1, 2021, through June 30, 2023; and
WHEREAS, amendment will extend the original contract K3962 with Washington
State Health Care Authority (HCA) to provide treatment and recovery support
services to individuals involved in the criminal justice system; and
WHEREAS, increased funding $253,738.000 ($126,869.00 for SFY 2022 and
$126,869.00 for SFY 2023) from July 1, 2021, through June 30, 2023; and
WHEREAS, it appears to be in the best public interest to authorize the execution
of said contract for Lewis County.
NOW THEREFORE BE IT RESOLVED amendment #3 between Washington State
Health Care Authority (HCA) and Lewis County to continue to provide treatment
and recovery support services to individuals involved in the criminal justice
system from July 1, 2021, through June 30, 2023, is hereby approved and the
Director of Public Health & Social Services is authorized to sign the same.
DONE IN OPEN SESSION this 13th day of July, 2021.
Page 1 of 2 Res. 21-252
APPROVED AS TO FORM: BOARD OF COUNTY COMMISSIONERS
Jonathan Meyer, Prosecuting Attorney LEWIS COUNTY, WASHINGTON
Eric Eisenberg Gary Stamper
By: Eric Eisenberg, Gary Stamper, Chair
Chief Civil Deputy Prosecuting Attorney
ATTEST: Esc°"R TF qsF;• Lindsey R. Pollock, DVM
Lfo se R. Pollock, DVM, Vice Chair
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Rieva Lester •syJ.v.,..��..,• Sean D. Swope
Rieva Lester, Sean D. Swope, Commissioner
Clerk of the Lewis County Board of
County Commissioners
Page 2 of 2 Res. 21-252
Amendment #3
Criminal Justice Treatment Account and Recovery Support
Services State Appropriations
between
Washington State Health Care Authority (HCA)
and Lewis County Public Health & Social Services
Description
This amendment is to continue the current Criminal Justice Treatment Account
(CJTA) contract with the Washington State Health Care Authority (HCA) and funded
through the Division of Behavior Health and Recovery (DBHR). HCA has decided to
amend the previous CJTA contracts in order to maintain a continuity of services rather
than entering into a brand new contract. The contract agreement provides CJTA funds to
provide treatment and recovery support services to individuals involved in the criminal
justice system in accordance with RCW 71.24.580.
HCA Contract Number: K3962
Increased funding effective July 1, 2021 to June 30, 2023
Recommendation
Approve resolution
Budget Impact
Fund: PH112501
Impact: 1040SREV 33601S
Amount: $253,738.000 ($126,869.00 for SFY 2022 and $126,869.00 for SFY 2023)
Cover Letter
Tony Walton
Criminal Justice Behavioral Health Administrator
Health Care Authority
P.O. Box 42730
Olympia, WA 98504-2730
Other
HCA Contact E-mail Addresses: tony.waltonAhca.wa.gov
Rachelle.amerine(c hca.wa.gov
Submitted by: Alison Puckett
DocuSign Envelope ID:COC6FDB4-94EC-41FA-A91A-D1767B044613
Washington State A CONTRACT HCA Contract No.: K3962
Health Care r uthoritY AMENDMENT Amendment No.: 3
THIS AMENDMENT TO THE CONTRACT is between the Washington State Health Care Authority and the party
whose name appears below, and is effective as of the date set forth below.
CONTRACTOR NAME CONTRACTOR doing business as (DBA)
Lewis County
CONTRACTOR ADDRESS CONTRACTOR CONTRACT MANAGER
360 NW North Street Name: Alison Puckett
Chehalis, WA 98532-1925 Email: alison.puckett@lewiscountywa.gov
Amendment Start Date Amendment End Date Contract End Date
July 1, 2021 June 30, 2023 June 30, 2023
Prior Maximum Contract Amount Amount of Increase Total Maximum Compensation
$233,478 $253,738 $487,216
WHEREAS, HCA and Contractor previously entered into Contract for Criminal Justice Treatment Act
(CJTA) Funded Treatment and Recovery Support Services, and;
WHEREAS, HCA and Contractor wish to amend the Contract pursuant to Section 4.3 to: 1) extend the
term; 2) update the total maximum compensation; and 3) update Deliverables Tables;
NOW THEREFORE, the parties agree the Contract is amended as follows:
1. The Term of the Contract is amended to extend the end date from June 30, 2021 to June 30,
2023.
2. Section 3.3 Compensation, subsection 3.3.1 is amended to include the following new section:
3.3.1 .3 Schedule A-1, Statement of Work (2021-2023) is $253,738, and includes
any allowable expenses. The Maximum Compensation includes
$137,628 CJTA funding, $116,110 Supplemental CJTA funding, and $0
State Drug Court funding.
3. Section 3.3 Compensation, subsection 3.3.2, Deliverables Tables for July 1, 2021 through June
30, 2023 are added as follows:
HCA Contract No. K3962 Page 1 of 3
Amendment No. 3
DocuSign Envelope ID:COC6FDB4-94EC-41FA-A91A-D1767B044613
Deliverables Table
July 1, 2021 through June 30, 2022
# Deliverable Due Date (Quarterly) Maximum
Amount
1 Submit an updated county Criminal October 1, 2021 $31,717.25
Justice Treatment Account (CJTA)
Plan that was approved by the local
CJTA panel and signed by County
Legislative Authority that indicates
how the CJTA Supplemental will be
utilized.
2 Submit quarterly progress reports January 1, 2022 $31,717.25
3 Submit quarterly CJTA Revenue and April 1, 2022 $31,717.25
Expenditure Reports
4 Submit monthly and/or quarterly July 1, 2022 $31,717.25
Programmatic Treatment Reports
through Secure File Transfer (SET)
process
State Fiscal 2022 Total Maximum Compensation $126,869
Deliverables Table
July 1, 2022 through June 30, 2023
# Deliverable Due Date (Quarterly) Maximum
Amount
1 Submit an updated county Criminal October 1, 2022 $31,717.25
Justice Treatment Account (CJTA)
Plan that was approved by the local
CJTA panel and signed by County
Legislative Authority that indicates
how the CJTA Supplemental will be
utilized.
2 Submit quarterly progress reports January 1, 2023 $31,717.25
3 Submit quarterly CJTA Revenue and April 1, 2023 $31,717.25
Expenditure Reports
4 Submit monthly and/or quarterly July 1, 2023 $31,717.25
Programmatic Treatment Reports
through Secure File Transfer (SFT)
process
State Fiscal Year 2023 Total Maximum Compensation $126,869
4. This Amendment will be effective July 1, 2021 ("Effective Date").
HCA Contract No. K3962 Page 2 of 3
Amendment No. 3
DocuSign Envelope ID:COC6FDB4-94EC-41FA-A91A-D1767B044613
5. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Contract.
6. All other terms and conditions of the Contract remain unchanged and in full force and effect.
The parties signing below warrant that they have read and understand this Amendment and have authority to
execute the Amendment. This Amendment will be binding on HCA only upon signature by both parties.
CONTRAC OR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
AW\-- Ak4/Lo.-%
HCA SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
i—DocuSigned by:
ea-a421.,, �„,",,,,, Rachelle Amerine, Contracts Administrator 6/16/2021
'-71E17FEBBC774E7...
HCA Contract No. K3962 Page 3 of 3
Amendment No. 3
DocuSign
Certificate Of Completion
Envelope Id:COC6FDB494EC41FAA91AD1767B044613 Status:Delivered
Subject:DocuSign Notice: K3962-03-GSR-Lewis County.pdf,K3962-03-Lewis County-CJTA.pdf
Source Envelope:
Document Pages:9 Signatures: 1 Envelope Originator:
Certificate Pages:5 Initials:0 Lisa Nelson
AutoNav: Enabled 626 8th Ave SE
Envelopeld Stamping:Enabled Olympia,WA 98501
Time Zone:(UTC-08:00)Pacific Time(US&Canada) Lisa.Nelson@HCA.WA.GOV
IP Address: 198.239.16.24
Record Tracking
Status:Original Holder: Lisa Nelson Location:DocuSign
6/16/2021 3:39:38 PM Lisa.Nelson@HCA.WA.GOV
Signer Events Signature Timestamp
Rachelle Amerine °0 ,9natlbj Sent:6/16/2021 3:45:23 PM
rachelle.amerine@hca.wa.gov '`4'�' _it"�'^ Viewed:6/16/2021 8:08:06 PM
Contracts Administrator
-71E 7FEBBC774E7 Signed:6/16/2021 8:10:44 PM
CloudPWR OBO Washington State Health Care
Authority Sub Account Signature Adoption:Pre-selected Style
Security Level: Email,Account Authentication Using IP Address: 147.55.199.235
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Alison Puckett Sent:6/16/2021 8:10:45 PM
alison.puckett@lewiscountywa.gov Viewed:6/17/2021 9:30:14 AM
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted:6/17/2021 9:30:14 AM
ID:8dd5f3c4-dafc-415f-ae07-8e349def0594
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Jerry Nichols COPIED Sent:6/16/2021 3:45:24 PM
jerry.nichols@hca.wa.gov
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tony Walton COPIED Sent:6/16/2021 3:45:24 PM
tony.walton @hca.wa.gov
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 6/16/2021 3:45:24 PM
Certified Delivered Security Checked 6/17/2021 9:30:14 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on:5/22/2019 6:49:33 AM
Parties agreed to:Alison Puckett
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BOCC AGENDA ITEM SUMMARY
Resolution: BOCC Meeting Date: July 13, 2021
Suggested Wording for Agenda Item: Agenda Type: Deliberation
Approving Amendment #3 between Health Care Authority (HCA) Contract K3962 and Lewis County
to provide treatment and recovery support services to individuals in the CJTA
Contact: Susan Caldwell Phone: 3607401224
Department: PHSS - Public Health & Social Services
Description:
Approving amendment #3 to the current Criminal Justice Treatment Account (CJTA) with the
Washington State Health Care Authority (HCA) to provide treatment and recovery support services
to individuals involved in the criminal justice system.
Approvals: Publication Requirements:
Publications:
User Status
none
Erik Martin Pending
J.P. Anderson Pending
PA's Office Pending
Tammy Martin Pending
Additional Copies: Cover Letter To:
Sandi Andrus, Stacey Loflin, Grace Jimenez, Tony Walton/ Criminal Justice Behavioral
Michelle Sauter, Sherry Dokken, Jill Nielson, Health Administrator Health Care Authority
Susan Caldwell, Mike Baum P.O. Box 42730 Olympia, WA 98504-2730
tony.walton@hca.wa.gov
Rachelle.amerine@hca.wa.gov