HomeMy WebLinkAbout2794 - Snohomish County Human Services - Agreement - First Responders Flex Fund - Ending Homeless ProgramREC,EIVED
FEB 2 8 2023
HUMAN SERVICES DEPARTMENT Sn_ohomish County Human Services ·
:coNTRACTS OIVISION3000 Rockefeller Avenue, MIS 305 I Everett, WA 98201
. (425) 388-7200 -
Contract Number: BH-23-62-08-200 Maximum Contract Amount: $9,295 ----------1
Title of Project / S~f'ilce: First Responders Flex Fund
l;nd Date: .12131/?023.
Status.
" . Det~~inatlon:--. Subre~ipient
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C)Z Agency i-,lame: City of Marysville
zO 1049 ·state Ave ti~ Ad~ress: ·
,__. ~z City, State& Zip: Marysville, WA 98270
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______________ IRS'Tax No./ EIN: 91-6Q01459
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u~ . Co-ntact Pe~o_n: Jim~awless -~------------Unique Entity Identifier: _07_6_6_5_86_7_3 ___ .,.......
Telephone: 360.363.8088 Email Address: Jlawless@marys.,;,lllewa:gov -----,----------
Funding Authority: Ending H_omelessness Program \
CFDA No. & Title: · N/A -------------------------------c-t
Fun cU rig Specifics: RCW 36,22:17~tand 43.185c
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Federa,I Agency: N/A Federal Award ID No:_N_IA_~---Federal ,Award Date:_N_IA __ _
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PrQgram _Division
. Behavioral Health
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Contact Person
Cleo Harris
Cor,tact Email
cleo.harris@snoco.or
Contac.t Phone
425-388-7423
Ad~ltional terms of this Contract are set out In. and governed by the. following, which are incorporated herein by reference:
Basic Terms and ConditionsHSD•2018: 103~20D, maintained on file at the Human Services Department:
Business Associate Agreement BAA-2018-103-200, maintained on file at the Human Services Department:
Specific Terms and Conditions.
Statement of Work/Project Description
Approved ~ntract Budget
App_roved_ Invoice
· Attached as Exhibit A
Attached as Exhibit B
-. Attached as Exhibit C
Attached as Exhibit D
In the event of a11y .inconsistency iri. this contract, the inconsistency sl:iall be resolved_ by givjng precedence in the following artier: (a)
appropri~te provisions of state and"fecteral law, (b) Speflfic Tertns and Conditions, (c) BasicTerm,s and C~!'.'ditlons, (d) Business Associate
Agreement, (e) other attachments Incorporated by referem;e, and (f) ·other documents incorporated by reference. · ·
THE ·coNTRACTING ORGAIIIIZATION IDENTI_FIED ABOVE (HEREINAFTER' REFERRED TO A~ AGENCY),. ANQ-SNOHOMISH
COUNTY (HEREIIIIAFTER REFER.RE:D TO_ AS>CpUIIITY), HERE;BY ACKNOWLEDGE AND-A~REE TO THE; TERMS OF THIS
CONTAACT. SIGNATURES_ FOR BOTH PARTIES ARE REQUIRED BELOW. BY SIGNING, THE AGENCY IS CERTIFYING THAT IT IS
NOT DEBARRED, SUSPENDED, OR OTHERWISE EXCLUDED FROM PARTICIPATING IN FEDERALLY FUNDED-PROGRAMS.
FOR THE CONTRACTING_ ORGANIZATION:
(Signature) ~2§2
(Title)
FOR SNOHOMISH COUNTY:
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Mary Jane Brell Vujovic, Director
Department of Hurrian Services
(Date)
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Snonomish County Human Services
3000 Rockefeller Avenue, M/S 305 I Everett, WA 98201
(425) 388-7200
Contract Number: BH-23-62-08-200 Maximum Contract Amount: $9,295
Title of Project / Service: First Responders Flex Fund
Start Date: 01/01/2023 End Date : 12/31/2023 Status
Determination: Subrecipient
Agency Name: City of Marysville
Address: 1049 State Ave
City, State & Zip : Marysville , WA 98270 IRS Tax No./ EIN: 91 -6001459
Contact Person : Jim Lawless Unique Entity Identifier: 076658673
Telephone: 360.363 .8088 Email Address: jlawless@marysvillewa .gov
Funding Authority: Ending Homelessness Program
CFDA No. & Title: N/A
Funding Specifics: RCW 36 .22 .1791 and 43 .185c
Federal Agency: N/A Federal Award ID No: N/A Federal Award Date: N/A
~ Program Division Contact Person Contact Email Contact Phone z ::::,
0 Behavioral Health Cleo Harris cleo .harris@snoco .or 425-388-7 423
0
Additional terms of this Contract are set out in and governed by the following, which are incorporated herein by reference:
Bas ic Terms and Conditions HSD -2018-103-200 , maintained on file at the Human Services Department:
Business Associate A reement BAA-2018-103-200 , maintained on file at the Human Services De artment:
Specific Terms and Conditions Attached as Exhibit A
Statement of Work/Project Description Attached as Exhib it B
Approved Contract Budget Attached as Exhibit C
Approved Invoice Attached as Exhibit D
In the event of any inconsistency in this contract , the inconsistency shall be resolved by giving precedence in the following order : (a)
appropriate provisions of state and .federal law, (b} Specific Terms and Conditions , (c) Basic Terms and Conditions , (d) Business Associate
Agreement , (e) other attachments incorporated by reference , and (f) other documents incorporated by reference .
THE CONTRACTING ORGANIZATION IDENTIFIED ABOVE (HEREINAFTER REFERRED TO AS AGENCY), AND SNOHOMISH
COUNTY (HEREINAFTER REFERRED TO AS COUNTY), HEREBY ACKNOWLEDGE AND AGREE TO THE TERMS OF THIS
CONTRACT. SIGNATURES FOR BOTH PARTIES ARE REQUIRED BELOW. BY SIGNING , THE AGENCY IS CERTIFYING THAT IT IS
NOT DEBARRED, SUSPENDED, OR OTHERWISE EXCLUDED FROM PARTICIPATING IN FEDERALLY FUNDED PROGRAMS.
FOR THE CONTRACTING ORGANIZATION:
(Signature)
(Title)
FOR SNOHOMISH COUNTY:
Mary Jane Brell Vujovic , Director
Department of Human Services
(Date)
EXHIBIT A
SPECIFIC TERMS AND CONDITIONS
FIRST RESPONDER FLEX FUNDS
I. DEFINITION OF TERMS
A. Access to Care Standards (ACS): The Division of Behavioral Health and
Recovery (DBHR) minimum eligibility requirements for Medicaid adults &
Medicaid older adults guidelines reflect the most restrictive eligibility criteria that
can be applied, pursuant to RCW 70.96A and 70.96B. North Sound Behavioral
Health Administrative Services Organization (BH-ASO) may expand coverage
based on availability of local resources.
B. Adjudicated Youth: Refers to a youth who has been determined by a juvenile
court judge to have committed a delinquent offense.
C. Advanced Directive: A written document that contains directions and
preferences for treatment and care during times an individual is having difficulty ·
communicating or making decisions.
D. Aging Population: Age 65 and older.
E. ASAM: Acronym for American Society of Addiction Medicine.
F. Behavioral Health: The prevention, treatment of, and recovery from substance
use disorders, mental health disorders, and/or problem and pathological
gambling disorders.
G. Case Management: Assistance to a recipient and family (or significant other)
to obtain, maintain, or develop appropriate resources.
H. Child: Refers to an individual under the age of ten (10).
I. Community Outreach and Intervention: Services to link individuals to treatment
and other appropriate support services.
J. Complaint: A verbal or written statement by a participant that expresses
dissatisfaction with some aspect of services covered under this Agreement, the
Primary Care Provider, or Agency.
K. Contingency Management: An evidence-based practice allowing individuals to
earn tangible rewards to reinforce positive behaviors such as service
Exhibit A
BH-23-62-08-200
City of Marysville
Page 1 of 11
attendance, abstaining from drugs and alcohol, and involvement in pro-social
activities.
L. Corrective Action/Compliance Review: When findings from monitoring efforts
or audits show that there are apparent violations of this Contract, the Agency
shall implement corrective action within specified timeframes determined by the
County.
M. Corrective Action Plan (CAP): A written plan specifying what Contractor is
required to do to be compliant. This includes required improvements and a
timeline for such action(s) to be accomplished.
N. Counselors: Personnel employed by the Agency who meet the criteria as
defined in WAC.
0. COVID-19: An infectious disease caused by severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2).
P. Cultural Competence: A set of congruent behaviors, attitudes and policies that
come together in a system or agency and enable that system or agency to work
effectively in cross-cultural situations. A culturally competent system of care
acknowledges and incorporates at all levels the importance of language and
culture, assessment of cross-cultural relations, knowledge and acceptance of
dynamics of cultural differences, expansion of cultural knowledge and
adaptation of services to meet culturally unique needs.
Q. Cultural Humility: The lifelong practice of being aware and thinking of one's own
values, beliefs, own biases, and social position within the context of the present
moment and be aware of and sensitive to historic realities like legacies of
violence and oppression against certain groups of people.
R. Direct Student Services (DSS): Include, face-to-face sessions with an
individual student and/or the student's family to address the student's needs.
S. Department of Social and Health Services (DSHS), or the department, or the
Department: DSHS of the State of Washington and its Secretary, officers,
employees, and authorized agents.
T. DSM 5: Acronym for the Diagnostic and Statistical Manual of Mental Disorders
fifth edition.
U. Evidenced Based Treatment: A program, policy or practice recognized by
research that, when applied in treatment, has improved outcomes for clients,
participants or communities.
Exhibit A
BH-23-62-08-200
City of Marysville
Page 2 of 11
V. Fair Hearing: A grievance hearing before the Washington State Office of
Administrative Hearings.
W. Family: Those the individual defines as family or those appointed/assigned
(e.g., parents, foster parents, guardians, siblings, caregivers, and significant
others).
X. Flex funds: Funds provided through a program that are used to procure goods
and/or services directly related to the needs of the participant as outlined in
Exhibit B.
Y. GAIN-SS: Acronym for Global Appraisal of Individual Needs Short Screening.
Z. Grievance: An expression of dissatisfaction about any matter. The term is also
used to refer to the overall process that includes grievances handled at the
. NSBHASO level and access to the state fair hearing process. Possible subjects
for grievances include, but are not limited to, the quality of care or services
provided, and aspects of interpersonal relationships such as rudeness, or
failure to respect the enrollee's rights.
AA. Hardship Insured: Individuals with insurance who cannot afford to pay
insurance deductibles or co-pays.
BB. HCA: Refers to the Health Care Authority.
CC. Healing Organization: An organizational system where staff policies,
procedures, services, and treatment models apply an understanding of trauma
embedded within them. Their approaches to providing services are trauma-
shielding or trauma-reducing.
DD. HIPAA: Acronym for "Health Insurance Portability and Accountability Act."
Additional information is outlined in the Business Associate Agreement as
referenced on the face sheet of this Contract.
EE. Housing Services: The services or activities designed to assist individuals or
families in locating, obtaining or retaining suitable housing. Component
services or activities may include tenant counseling, helping individuals and
families to identify and correct substandard housing conditions on behalf of
individuals and families who are unable to protect their own interests and
assisting individuals and families to understand leases, secure utilities and
make moving arrangements.
FF. Independent Peer Review: To assess the quality, appropriateness and
efficiency of treatment services provided in the state to individuals under the
program involved.
Exhibit A
BH-23-62-08-200
City of Marysville
Page 3 of 11
GG. Indirect Student Services (ISS): Include all contact with an individual student's
support system.
HH. Individual Treatment: Planned therapeutic or counseling activity provided to a
sole eligible individual by one (1) or more counselors.
II. Individual: Previously known as client, consumer, patient, or participant.
JJ. Labor Harmony Requirement: A "No Service Disruption Guarantee" outlined in
Exhibit E, as applicable.
KK. Low Income: Participants whose monthly income does not exceed 220% of the
national poverty index, or as negotiated in your Contract.
LL. MCO: Acronym for Managed Care Organization.
MM. Mental Disorder: A disorder as defined in RCW 71.34.020(13) for children and
RCW 71.05.020(26) for adults.
NN. Mental Health Professional (MHP): Personnel employed by the Agency who
meet the criteria as· defined in WAC.
00. NSBHASO: Acronym for "North Sound Behavioral Health Administrative
Services Organization."
PP. No Service Disruption Guarantee: An agreement to maintain services and
prevent a disruption of service caused by labor unrest. See "Labor Harmony
Requirement" above. Additional information is outlined in Exhibit E.,
Attachment A, as applicable.
QQ. Nurse Family Partnership (NFP): An evidence based, community health
program for vulnerable mothers pregnant with their first child.
RR. Outcome: An outcome defines changes that occur as a result of the program's
work. Examples include Short Term (a change in learning: awareness,
knowledge, skills, motivations); Intermediate (a change in action: behavior,
practice, decision-making, policies); Long Term (consequences: social,
economic, environmental).
SS. Outpatient Counseling: The provision of substance abuse treatment, mental
health treatment and other support services according to a prescribed plan in
a non-residential setting.
Exhibit A
BH-23-62-08-200
City of Marysville
Page 4 of 11
TT. Output: An output details what the program does and is usually a count of
something. Examples include Activities (the actual tasks done such as
screenings, assessments, workshops); Participation (who the program serves;
customers and stakeholders).
UU. Outreach/Education Services (OES): Training and information sharing to
Agency staff and external providers about the Student Support Advocate
program not directly related to a particular case management student.
W. Personal Information: Information identifiable to any person, including, but not
limited to, information that relates to a person's name, health, finances,
education, business, use or receipt of governmental services or other activities,
addresses, telephone numbers, social security numbers, driver license
numbers, other identifying numbers, and any financial identifiers.
WW.Quality Assurance: A focus on compliance to minimum requirements (e.g., ·
rules, regulations, and contract terms) as well as reasonably expected levels
of performance, quality, and practice.
XX. Recovery: The processes through which people are able to live, work, learn,
and participate fully in their communities.
YY. Referral: A process of directing an Individual to available specialty care or
services.
ZZ. Remote Learning: Also referred to as distance learning, gives learners who
aren't in a physical location for in-person education access to online training
materials.
AAA. RCW: Acronym for "Revised Code of Washington."
BBB. Resiliency: The personal and community qualities that enable individuals to
rebound from adversity, trauma, tragedy, threats, or other stresses, and to live
productive lives.
CCC. Shall: Compliance is mandatory.
DDD. SHP: Acronym for Supportive Housing Program.
EEE. Substance Use Disorder Professional (SUDP) (formerly CDP): Personnel
employed by the Agency who meet the criteria defined in WAC.
FFF. Substance Use Disorder Professional Trainee (SUDPT) (formerly CDPT):
Personnel employed by the Agency who meet the criteria defined in WAC.
Exhibit A
BH-23-62-08-200
City of Marysville
Page 5 of 11
GGG. Serious Mental Illness (SMI): According to Federal Register Vol. 58, No. 96,
May 20, 1993, persons aged 18 and over who currently, or at any time during
the past year, have a diagnosable mental, behavioral, or emotional disorder of
sufficient duration to meet diagnostic criteria specified within the current DSM,
that has resulted in functional impairment which substantially limits one or more
major life activities.
HHH. Strengthening Families Program 10-14: Refers to the evidence-based
prevention program developed at Iowa State University for families and young
adolescents.
Ill. Student Support Advocate (SSA): Personnel hired by the school district to
perform con.tracted services.
JJJ. Substance Use Disorder (SUD): Acronym for "Substance Use Disorder." This
definition replaces the definition for Chemical Dependency.
KKK. Telehealth: The distribution of health-related service and information via
electronic information and telecommunication technologies.
LLL. TILT Team: Refers the Trauma-Informed Leadership Team, the selected group
of staff dedicated to the advancement of Trauma-Informed Practices in the
school or agency.
MMM. Trauma: Refers to experiences that cause intense physical and psychological
stress reactions. It can refer to "a single event, multiple events, or a set of
circumstances that is experienced by an individual as physically and
emotionally harmful or threatening and that has lasting adverse effects on the
individual's physical, social, emotional, or spiritual well-being.
NNN. Trauma-Informed: A trauma-informed approach to the delivery of behavioral
health services includes an understanding of trauma and an awareness of the
impact it can have across setting, services, and populations. It involves viewing
trauma through an ecological and cultural lens and recognizing that context
plays a significant role in how individuals perceive and process traumatic
events, whether acute or chronic. Per SAMHSA, the three key elements of a
trauma-informed approach include: realizing the prevalence of trauma;
recognizing how trauma affects all individuals involved with the program,
organization, or system, including its own workforce; and responding by putting
this knowledge into practice.
000. Trauma-Informed Care: TIC is a strengths-based service delivery approach
"that is grounded in understanding of and responsiveness to the impact of
trauma, that emphasizes physical, psychological, and emotional safety for both
providers and survivors, and that creates opportunities for survivors to rebuild
Exhibit A
BH-23-62-08-200
City of Marysville
Page 6 of 11
a sense of control and empowerment. TIC also involves vigilance in anticipating
and avoiding institutional processes and individual practices that are likely to
retraumatize individuals who already have histories of trauma, and it upholds
the importance of consumer participation in the development, delivery, and
evaluation of services
PPP. Trauma-Informed System: An organizational system which has developed a
shared language to define, normalize, and address the impact of trauma on
clients and the workforce. The organization operates from a foundational
understanding of the nature and impact of trauma.
QQQ. Veteran: A veteran is defined as an individual that has served as a member of
the armed forces, active duty or reserves, for at least one day. This will also
include service in the National Guard, as well as Merchant Marines in support
of US resources in wartime. Veteran status may be verified through self-
identification, discharge certificate, or Department of Defense Form DD-214.
RRR. WAC: Acronym for 'Washington Administrative Code".
SSS. WSUE: Refers to Washington State University Extension, a division of
Snohomish County Parks & Recreation Department (PRD).
TTT. Youth: Means a person from age ten (10) through age seventeen (17).
II. PERFORMANCE STANDARDS AND LICENSING
A. The Agency shall meet the requirements of WAC, applicable local and state
rules, and state and federal statutes. In addition, the Agency shall meet the
applicable specific program requirements for licensure and certification to
perform contracted services. A copy of the certification shall be submitted to
the County upon request.
B. The Agency shall maintain relevant and appropriate licensure by the State of
Washington to provide behavioral health and/or community support services.
The Agency shall notify the County in writing within five (5) business days of
any change in licensure status. ·
Ill. COMPLIANCE WITH SPECIFIC LAWS AND REGULATIONS
A. All services provided under this Contract shall meet all standards set forth in
current, revised and replaced WAC's and RCW's.
B. The Agency shall meet all applicable standards for program operations set forth
in WAC and RCW. The Agency shall .ensure that WAC and RCW requirements
Exhibit A
8 H-23-62-08-200
City of Marysville
Page 7 of 11
are followed and are adjusted as the WAC and RCW are amended, revised,
eliminated or added.
C. The Agency shall operate and adhere to fidelity of the model of services utilized
by the Agency and as negotiated with the County.
D. The Agency must have policies and procedures in place to protect and
safeguard individually identifiable health information obtained in the course of
providing services under this Contract. The Agency shall not disclose an
individual's information, directly or indirectly, except to the extent allowed under
applicable state or federal laws and regulations. The Agency shall comply with
all terms and conditions of Federal Confidentiality of Substance Use Disorder
Patient Records, 42 CFR Part 2 and applicable provisions of the Health
Insurance Portability and Accountability Act (HIPM) and the Family
Educational Rights and Privacy Act (FERPA).
E. Staff and volunteers who have access to children or vulnerable adults are
required to have a background check per RCW and WAC. A background check
is required at the time of employment or commencement of volunteer duties.
An Agency shall conduct additional background checks if circumstances arise
that cause the Agency concern. The Agency shall ensure that all persons
convicted of crimes preventing contact with vulnerable populations are
prohibited from having access to those populations.
F. The Agency shall enter data as negotiated with the County. The Agency shall
make use of data and specific to the Agency systems or electronic records for
the purpose of evaluating and reporting individual and program service
outcomes.
G. The Agency shall comply with all terms and conditions of the Business
Associate Agreement.
IV. REIMBURSEMENT PROCEDURES
Services rendered under this Contract shall be reimbursed based on the attached
Budget (Exhibit C). Services shall be provided per the attached Statement of Work
(Exhibit B).
V. REIMBURSEMENT LIMITATION
A. The Agency shall utilize the contracted dollar amount to provide services
throughout the duration of this Contract.
B. The Agency shall be responsible for ensuring budget is maintained and that
invoices to the County do not exceed the budgeted amount as stated in Exhibit
Exhibit A
BH-23-62-08-200
City of Marysville
Page 8 of 11
C, Approved Contract Budget.
C. Utilization of County funding available to this program will be reviewed monthly
and the Contract allocation may be reduced and re-allocated at the discretion
of the County, where needed if expenditures are not sufficient to fully utilize
available funding.
D. The Agency certifies that work to be performed under this Contract will not
duplicate any work to be charged against any other contract, subcontract, or
source.
VI. REPORTING REQUIREMENTS
The Agency shall submit all required reports documenting performance in a timely
manner. All reports shall be completed on approved forms and in accordance with
procedures as issued by the County. In the event the Agency fails to maintain its
reporting obligations, the County reserves the right to withhold reimbursements to
the Agency or order payment stopped to the Agency in an amount proportional to
the data estimated to be outstanding until such time that the data is current.
VII. OTHER REVENUES
Revenues generated by the Agency from other funding sources (e.g. donations,
fund-raising) under this program, including fees collected from low-income
participants, shall be separately identified and recorded as project income. These
funds shall be used exclusively to provide increased levels of service.
VIII. SUBCONTRACTING
A. The Agency is prohibited from subcontracting any funding and/or services
contained within this Contract unless otherwise negotiated with the County.
B. All rules, regulations and requirements contained in the Basic Terms and
Conditions must be met for all subcontracts executed pursuant to this Contract.
All subcontracting arrangements require prior written approval from_the County.
IX. RECORDS RETENTION
The Agency shall retain all fiscal and clinical books, records, documents and other
materials relevant to this Contract in accordance with WAC.
Exhibit A
BH-23-62-08-200
City of Marysville
Page 9 of 11
X. LOCATION AND HOURS OF SERVICE
A. Services provided under this Contract shall be available in Snohomish County
for Snohomish County residents.
B. To ensure participants have consistent access to treatment services, the
Agency shall minimally maintain business hours from 9:00 AM through 5:00 PM
Monday through Friday, excluding recognized holidays or as negotiated with
the County. Any reduction in service hours shall be submitted in writing to the
County for approval, fifteen (15) calendar days prior to implementation.
C. The Agency shall notify the County within ten (10) days of change in personnel
which may affect the faithful execution of this Contract.
XI. ELIGIBILITY
A. County funds shall be the dollar of last resort for billing. The Agency shall
determine at time of intake if the individual has medical insurance, including
state-sponsored programs providing low-cost health care coverage through
private health plans, which covers substance use disorder treatment services.
If the individual has medical insurance that covers substance use disorder
treatment services, the medical insurance shall be used as the first source of
billing to pay for treatment services. The Agency shall ensure that only one
source of funding is used at any given time.
B. Termination of a 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.
C. The Agency shall have policies and procedures in place for participant
grievances in the case of denial or termination of service or failure to act upon
a request for services with reasonable promptness.
XII. MONITORING AND EVALUATION
The Agency shall cooperate with the County in monitoring activities a minimum of
once per year or more as deemed appropriate by the County.
XIII. INTERAGENCY COORDINATION
A. The Agency shall identify the primary agencies with whom they have regular
relationships and whose activities substantially affect the delivery of services
under this Contract. The Agency shall negotiate and execute working
agreements with these agencies to ensure coordinated services and
Exhibit A
BH-23-62-08-200
City of Marysville
Page 10 of 11
appropriate referral procedures.
B. Working agreements shall minimally address the following:
1. Program description;
-2. Referral procedures and timelines;
3. Release of information procedures;
4. Follow up procedures;
5. Procedures for exchanging information concerning program changes and
unavailability of services; and
6. Procedures for problem solving between two (2) agencies.
XIV. EMERGENCY PROCEDURES
The Agency shall have a plan for serving individuals during periods when normal
services may be disrupted. Disruption to normal services may include
earthquakes, floods, snowstorms, and other natural disasters. Particular attention
should be made for those individuals who are most at risk. When services are
delivered at the Agency's workplace the plan shall include contact information for
high-risk individuals, a list of emergency services, and stores of emergency
provisions.
XV. CONTINUING EDUCATION
The Agency shall ensure their staff is effectively trained to implement the services
they agree to provide under the terms of this Contract. The Agency is encouraged
to inquire about the availability of additional training funds and opportunities to
support their continuing education efforts.
XVI. MEETING PARTICIPATION
The Agency shall ensure they have representation at any County-sponsored
trainings or meetings. The County shall notify the Agency a minimum of two (2)
weeks prior to the event.
XVII. DEFINITIONS AND TERMS
The Agency shall utilize the definitions and terms in this Exhibit A as applicable
throughout this Contract or as negotiated with the County.
Exhibit A
BH-23-62-08-200
City of Marysville
Page 11 of 11
EXHIBIT B
STATEMENT OF WORK/ PROJECT DESCRIPTION
FIRST RESPONDERS FLEX FUND
I. DESCRIPTION
A. The Project shall assist Individuals to remove barriers to housing and/or abate
emergency situations through the provision of Fleix Fund assistance.
B. The Project shall serve eligible Individuals only. The individuals/families must
be experiencing homelessness or at risk of homelessness.
II. PROGRAM ACTIVITIES
In compliance with the terms of the Contract, the City shall perform the tasks and
services as follows:
A. The City shall develop and maintain a process to disburse Flex Funds to First
Responders/Social Workers, not to exceed the total amount included in the
Approved Project Budget (Exhibit C).
B. First Responders/Social Workers shall access Flex Funds in order to procure
goods and/or services directly related to the needs of Individuals, which cannot
be met through existing categorical services or formal/informal community
mechanisms. Examples of such purchases may include, but are not limited to
shelter, food, clothing, medical care, transportation, or other basic needs.
C. Flex Funds shall not be paid directly to the Individuals or used for the purchase
of alcohol, tobacco, vaping, products, marijuana products, firearms,
ammunition, or other weaponry.
D. The City shall utilize flex funds throughout the duration of this Contract and
shall not use these funds at the end of the year to "stock up" in lieu of providing
assistance to individuals and families to help end homelessness in real time
during the year.
E. The City shall submit supporting documentation for expenses covered by Flex
Funds with the Approved Invoice (Exhibit D) for reimbursement.
F. The City shall include receipts for services and purchases with the invoice as
supporting documentation. -
G. The City shall submit invoices by the tenth (10 th ) day of the month following flex
fund use. Exception: the December invoice must be submitted no later than
Exhibit B
BH-23-62-08-200
City of Marysville
Page 1 of2
January 5, 2024.
H. The County will review fund usage throughout this Contract period and may
reallocate unutilized funds to cities that are in need of additional funds.
I. Funds allocated to the First Responder Flex Fund are determined on an annual
basis based on funding availability and are not guaranteed.
Ill. REPORTS
The City shall submit a report each quarter providing information regarding the
number of individuals assisted, number of assistance activities and a description
of at least one individual or family that was able to remove a barrier to housing or
abate an emergency situation as a result of the Project. The quarterly narrative
shall be submitted with the monthly invoice.
Exhibit B
BH-23-62-08-200
City of Marysville
Page 2 of2
AGENCY NAME:
CONTRACT PERIOD:
EXHIBIT C
CONTRACT BUDGET -COST REIMBURSEMENT
FIRST RESPONDERS FLEX FUND
City of Marysville
1/1/2023 to 12/31/2023 -------
FUNDS AWARDED UNDER CONTRACT:
REVENUE SOURCE FUNDING PERIOD AMOUNT AMENDMENT
EHP 1/1/2023 to 12/31/2023 $ 9,295
TOTAL FUNDS AWARDED: $ 9,295 $ -
MATCHING RESOURCES:
TOTAL AMOUNT
$ 9,295
-
-
-
-
-
$ 9,295
N/A N/A
MATCH REQUIREMENTS FOR CONTRACT:
OTHER PROGRAM RESOURCES (Identify):
SOURCE
------
TOTAL MATCHING RESOURCES: N/A
% N/A AMOUNT: N/A
FUNDING PERIOD AMOUNT
. TOTAL OTHER RESOURCES: $ ------
Exhibit C
BH-23-62-08-200
City of Marysville
Page 1 of4
FUND FUND
CATEGORY SOURCE SOURCE
EHP
Salaries/Wages
Benefits
Suoolies/Minor Eauip.
Prof. Services
PostaQe
Telephone
Mileage/Fares
Meals
Lodging
Advertising
Leases/Rentals
Insurance
Utilities
Repairs/Maint.
Client Flex Funds
PrintinQ
Dues/Subscrip.
Regis./Tuition
Machinery/Equip.
Administration
Indirect
Miscellaneous
Flex Funds 9,295
Misc. Construction
Acquisition
Relocation
TOTAL $ 9,295 $ -$
EXPENDITURES
·FUND FUND FUND FUND
SOURCE SOURCE SOURCE SOURCE
-$ -$ -$
TOTAL
$ -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9,295
-
-
-
-
-$ 9,295
OTHER
RESOURCES
$ -
ExhibitC
BH-23-62-08-200
City of Marysville
Page 2 of4
)
AMOUNT
9,295
$ 9,295
EXPENDITURE NARRATIVE
CATEGORY NARRATIVE (provide justification describing each category supported with funds awarded under this contract)
Flex Funds Cost of Flex Funds distributed to First Responders
TOTAL
Exhibit C
BH-23-62-08~200
City of Marysville
Page 3 of4
l
DETAIL SALARIES / WAGES
%OFTIME MONTHLY
POSITION FUND SOURCE TO FUND TOTAL MONTHLY CHARGE TO
SOURCE FUND SOURCE
N/A
NOTE: Above figures may reflect rounding
#OF
MONTHS
TOTAL:
TOTAL CHARGE
TO FUND
SOURCE
$0
Exhibit C
BH-23-62-08-200
City of Marysville
Page 4 of 4
Invoice Jer: _______ _
INVOICE-Cost Reimbursement Contracts
Snohomish County Huma, Se-vices D~ma,t -3000 Rocka'ella-, M/S 305 , Eva-at , WA 98201
Actual : GJ Estimated :O
Controcting City a,d Address:
Otyof Maysville
1049 Stae Ave
Maysvi I le,WA 98270
AUTHORIZING SIGNATURE:
SUB AC00Unt Title OBJ
52 Flex Funds
TOTALS
Controct #: BH-23-62 -08-200
Projoct Title: First Responders Flex Fund
Controct Mc.11~: Cleo Harris (425)388 -7423 cleo .harris@snoco .org
Reporting Pa-i ad: To :
Date :
(sign in ink)
Current Expenditures Caitract To Date Total Caitract Budget Expenditures
$ 9,295.00
$ -$ -$ 9,295.00
REV IEWED FOR PAYMENT :
AUTHORIZED FUND :
ATTACH: CONTRACTOR CERTIFICATION FORM
--------
$
$
Caitract Budget
Balance
9,295.00
9,295.00
Exh ibit D
BH -23-62-08-200
City of Marysville
Page 1 of 2
~OHOMISH COUNTY
HUMAN SERVICES DEPARTMENT
3000 ROCKEFELLER, M/S 305
EVERETT, WA 98201
AGENCY CERTIFICATION FORM
Agency Certificatia,: I hereby CErtify undEJ" pe,aty of perjury tha theitansaid totas listoo hEJ"ein a-eproper
cha-gesfor rncterias, mErchaidise, or savicesfurnishoo to Snohomish County, aid tha al goods furnishoo a,d/or
!B"Vices ra,dEJ"oo have bea1 providoo without discriminaion on the grounds of ra:e, a-eoo, naional origin, hcndi~.
sex, or age.
AUTHORIZING SIGNATURE: -------------
VouchEJ" Invoice
Chock# Va,dor Refer .# Des::ri ption
(UseAdditiona ~as Nocessay) Total:
DATE:
Tota
Amount
---------
Cha-goo To:
Non-Gra,t Grcnt
Exhibit D
BH-23-62-08-200
City of Marysville
Page 2 of 2