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CALL TO ORDER
Mayor Barb Tolbert
PLEDGE OF ALLEGIANCE
ROLL CALL
Mayor Barb Tolbert – Ashleigh
APPROVAL OF THE AGENDA
Council member Marilyn Oertle
INTRODUCTION OF SPECIAL GUESTS AND PRESENTATIONS
Recognizing IT Director Bryan Terry
Mayor Barb Tolbert
PUBLIC COMMENT
For members of the public who wish to speak to the Council about any matter not on the Public Hearing
portion of the meeting. Please limit remarks to three minutes.
PUBLIC HEARING
NEW BUSINESS
1. Appointment of Heather Logan to fill vacated seat of ATTACHMENT A
Councilmember Jesica Stickles
Staff Presentation: Paul Ellis
Council Liaison: Council member Marilyn Oertle
2.Mobile Integrated Health ATTACHMENT B
Staff Presentation: Paul Ellis
Council Liaison: Council member Marilyn Oertle
Arlington City Council Special Meeting
Tuesday, September 7, 2021 at 5:30 pm
City Council Chambers – 110 E Third Street
SPECIAL ACCOMMODATIONS: The City of Arlington strives to provide accessible meetings for people with disabilities. Please contact the
ADA coordinator at (360) 403-3441 or 711 (TDD only) prior to the meeting date if special accommodations are required.
3. Selection of Mayor Pro Tem ATTACHMENT C
Presentation: Mayor Barb Tolbert
Council Liaison: Council member Marilyn Oertle
COMMENTS FROM COUNCILMEMBERS
INFORMATION/ADMINISTRATOR & STAFF REPORTS
MAYOR’S REPORT
EXECUTIVE SESSION
RECONVENE
ADJOURNMENT
Council member Marilyn Oertle/Mayor Barb Tolbert
City of Arlington Council Agenda Bill Item: NB #1 Attachment A COUNCIL MEETING DATE: September 7, 2021 SUBJECT: Appointment to fill vacated seat of Council member Jesica Stickles ATTACHMENTS: None DEPARTMENT OF ORIGIN Administration; Paul Ellis, City Administrator 360-403-4603 EXPENDITURES REQUESTED: None BUDGET CATEGORY: N/A BUDGETED AMOUNT: N/A LEGAL REVIEW: DESCRIPTION: Discussion regarding the appointment of Heather Logan to City Council Position #1, previously held by Jesica Stickles, and vacated by Ms. Stickles September 1, 2021. HISTORY: Council member Jesica Stickles served on City Council from 2014 to 2021. She resigned September 1, 2021, before her December 31, 2021 term ended, leaving a vacant Council seat that will last only until the election. Heather Logan is running unopposed for that seat. Because the appointee will only serve until the election, and because it appears Heather Logan is running unopposed, the City Attorney and
I move to temporarily suspend the City Council rules of procedure, and to appoint Heather Logan to City Council Position #1, to fill the vacant seat of Council member Jesica Stickles.
City of Arlington Council Agenda Bill Item: NB #2 Attachment B COUNCIL MEETING DATE: September 7, 2021 SUBJECT: Mobile Integrated Health Program ATTACHMENTS: Washington State Health Care Authority Agreement and Draft Professional Service Agreement with Kaitlyn Goubeau, LICSW DEPARTMENT OF ORIGIN Administration; Paul Ellis, City Administrator 360-403-4603 EXPENDITURES REQUESTED: $750,000 over three years BUDGET CATEGORY: Mobile Integrated Health Program BUDGETED AMOUNT: $750,000 Grant Funded LEGAL REVIEW: DESCRIPTION: The Mobile Integrated Health Program is a pilot program funded 100% with a grant from the Washington State Health Care Authority. This program will utilize interns who are obtaining their Master’s Degrees in social officers and North County Regional Fire Authority emergency medical staff. The interns will identify the
Professional Services Agreement with Kaitlyn Goubeau, to provide services for the Mobile Integrated
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INTERAGENCY AGREEMENT
for
Mobile Integrated Health
HCA Contract Number: K5545
THIS AGREEMENT is made by and between Washington State Health Care Authority (HCA) and City of
Arlington,(Contractor), pursuant to the authority granted by Chapter 39.34 RCW.
City of Arlington N/A
CONTRACTOR ADDRESS Street City State Zip Code
238 N Olympic Ave, Arlington WA 98223
Barbara Tolbert 360-403-3441 btolbert@arlingtonwa.gov
Behavioral Health Programs and Recovery
Supports (BHPRS)
Division of Behavioral Health and
Recovery (DBHR)
Matthew, Gower, Contract Manager
Health Care Authority
626 8th Avenue SE
Olympia, WA 98504
(360) 725-9556 Matthew.gower2@hca.wa.gov
CONTRACT START DATE CONTRACT END DATE TOTAL MAXIMUM CONTRACT AMOUNT
PURPOSE OF CONTRACT:
The Contractor will provide support for individuals experiencing behavioral health distress. A community based
mobile crisis team is an important and needed link in the behavioral health care continuum for its ability to address
the emotional and symptomatic concerns of individuals experiencing behavioral health crises while remaining in
their own environment. Mobile crisis services are intended to support and stabilize an individual that has
experienced a mental health event that does not rise to the level of inpatient hospitalization and to provide an
alternative to arrest or incarceration.
Contract. This Contract will be binding on HCA only upon signature by both parties.
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1. DEFINITIONS
“American Indian/Alaska Native (AI/AN)” means any individual defined at 25 U.S.C. §
1603(13), § 1603(28), or § 1679(a), or who has been determined eligible as an Indian, under 42
C.F.R. § 136.12. This means the individual is a member of a Tribe or resides in an urban center
and meets one or more of the following criteria: Is a member of a tribe, band, or other organized
group of Indians, including those tribes, bands, or groups terminated since 1940 and those
recognized now or in the future by the state in which they reside, or who is descendant, in the first
or second degree, of any such member; Is an Eskimo or Aleut or other Alaska Native; Is
considered by the Secretary of the Interior to be an Indian for any purpose; or Is determined to be
an Indian under regulations issued by the Secretary. The term AI/AN also includes an individual
who is considered by the Secretary of the Interior to be an Indian for any purpose or is considered
by the Secretary of Health and Human Services to be an Washington State Page 12 of 168
Contract No : «Contract» Health Care Authority Behavioral Health - Administrative Service
Organization Indian for purposes of eligibility for Indian health care services, including as a
California Indian, Eskimo, Aleut, or other Alaska Native.
“Authorized Representative” means a person to whom signature authority has been delegated in
writing acting within the limits of the person’s authority.
“Breach” means the unauthorized acquisition, access, use, or disclosure of Confidential Information
that compromises the security, confidentiality, or integrity of the Confidential Information.
“Business Days and Hours” means Monday through Friday, 8:00 a.m. to 5:00 p.m., Pacific Time,
except for holidays observed by the state of Washington.
“Confidential Information” means information that may be exempt from disclosure to the public or
other unauthorized persons under chapter 42.56 RCW or chapter 70.02 RCW or other state or
federal statutes or regulations. Confidential Information includes, but is not limited to, any information
identifiable to an individual that relates to a natural person’s health, finances, education, business,
use or receipt of governmental services, names, addresses, telephone numbers, social security
numbers, driver license numbers, financial profiles, credit card numbers, financial identifiers and any
other identifying numbers, law enforcement records, HCA source code or object code, or HCA or
State security information.
“Contract” or “Agreement” means the entire written agreement between HCA and the contractor,
including any exhibits, documents, or materials incorporated by reference. The parties may execute
this contract in multiple counterparts, each of which is deemed an original and all of which constitute
only one agreement. E-mail (electronic mail) or fax (facsimile) transmission of a signed copy of this
contract shall be the same as delivery of an original. Contract and Agreement may be used
interchangeably.
“Contractor” means City of Arlington, its employees and agents. Contractor includes any firm,
provider, organization, individual or other entity performing services under this Agreement. It also
includes any Subcontractor retained by Contractor as permitted under the terms of this Agreement.
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“Covered entity” means a health plan, a health care clearinghouse or a health care provider who
transmits any health information in electronic form to carry out financial or administrative activities
related to health care, as defined in 45 CFR 160.103.
“Data” means information disclosed, exchanged or used by Contractor in meeting requirements
under this Agreement. Data may also include Confidential Information as defined in this Contract.
“DBHR” means the HCA, Division of Behavioral Health and Recovery, and its employees and
authorized agents.
“Diversion” means services provided to a person prevented them from ending up in jail due to
behavior resulting from their behavioral health challenges, were involuntarily hospitalized due to
their behavioral health challenges, or needing to go to an emergency department (ED) for
services in resolving their crisis. A diversion still counts if a person is referred by the MIH team to
an ED for medical clearance as required for referral to the next step in care.
“HCA Contract Manager” means the individual identified on the cover page of this Contract who
will provide oversight of the Contractor’s activities conducted under this Contract.
“Health Care Authority” or “HCA” means the Washington State Health Care Authority, any
division, section, office, unit or other entity of HCA, or any of the officers or other officials lawfully
representing HCA.
“Indian Health Care Provider (IHCP)” means the Indian Health Service and/or any Tribe, Tribal
organization, or Urban Indian Health Program (UIHP).
"Overpayment" means any payment or benefit to the Contractor in excess of that to which the
Contractor is entitled by law, rule, or this Contract, including amounts in dispute.
“Proprietary Information” means information owned by Contractor to which Contractor claims a
protectable interest under law. Proprietary Information includes, but is not limited to, information
protected by copyright, patent, trademark, or trade secret laws.
“Protected Health Information” or “PHI” means individually identifiable information that relates to
the provision of health care to an individual; the past, present, or future physical or mental health or
condition of an individual; or past, present, or future payment for provision of health care to an
individual, as defined in 45 CFR 160.103. Individually identifiable information is information that
identifies the individual or about which there is a reasonable basis to believe it can be used to
identify the individual, and includes demographic information. PHI is information transmitted,
maintained, or stored in any form or medium. 45 CFR 164.501. PHI does not include education
records covered by the Family Educational Rights and Privacy Act, as amended, 20 USC
1232g(a)(4)(b)(iv).
“RCW” means the Revised Code of Washington. All references in this Contract to RCW chapters or
sections include any successor, amended, or replacement statute. Pertinent RCW chapters can be
accessed at: http://apps.leg.wa.gov/rcw/.
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“Services” means all work performed or provided by Contractor pursuant to this Contract.
“Statement of Work” or “SOW” means a detailed description of the work activities the Contractor is
required to perform under the terms and conditions of this Contract, including the deliverables and
timeline, and is attached as Schedule A.
“Subcontractor” means a person or entity that is not in the employment of the Contractor, who is
performing all or part of the business activities under this Agreement under a separate contract with
Contractor. The term “Subcontractor” means subcontractor(s) of any tier.
"Tribal Organization" means the recognized governing body of any Tribe; any legally
established organization of Indians which is controlled, sanctioned, or chartered by one or more
federally recognized Tribes or whose governing body is democratically elected by the adult
members of the Indian community to be served by such organization and which includes the
maximum participation of Indians in all phases of its activities.
"Tribe" means any Indian tribe, band, nation, or other organized group or community, including
any Alaska Native village or group or regional or village corporation as defined in or established
pursuant to the Alaska Native Claims Settlement Act (43 U.S.C. 1601 et seq.), which is
recognized as eligible for the special programs and services provided by the United States to
Indians because of their status as Indians.
"Urban Indian Health Program (UIHP)" means a nonprofit corporate body situated in an urban
center, governed by an urban Indian controlled board of directors, and providing for the maximum
participation of all interested Indian groups and individuals, that is operating a facility delivering
health care.
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2. STATEMENT OF WORK
Contractor will furnish the necessary personnel, equipment, material and/or service(s) and otherwise
do all things necessary for or incidental to the performance of work set forth in Schedule “A”
3. PERIOD OF PERFORMANCE
Subject to its other provisions, the period of performance of this Contract will commence on the Date
of Execution, and be completed on June 30, 2023, unless terminated sooner or extended upon
written agreement between the parties.
4. PAYMENT
Compensation for the work provided in accordance with this Agreement has been established under
the terms of RCW 39.34.130. The parties have determined that the cost of accomplishing the work
herein will not exceed $750,000. Payment for satisfactory performance of the work will not exceed
this amount unless the parties mutually agree to a higher amount. Compensation for services will be
based on the following rates or in accordance with the following terms, or as set forth in accordance
with the budget in Schedule "A".
5. BILLING PROCEDURE
Contractor must submit accurate invoices to the following address for all amounts to be paid by HCA
via e-mail to: acctspay@hca.wa.gov. Include the HCA Contract number in the subject line of the
email.
Invoices must describe and document to HCA’s satisfaction a description of the work performed, the
progress of the project, and fees. If expenses are invoiced, invoices must provide a detailed
breakdown of each type. Any single expense in the amount of $50.00 or more must be accompanied
by a receipt in order to receive reimbursement. All invoices will be reviewed and must be approved
by the Contract Manager or designee prior to payment.
Contractor must submit properly itemized invoices to include the following information, as applicable:
a. HCA Contract number [Enter HCA Contract #5545];
b. Contractor name, address, phone number;
c. Description of Services;
d. Date(s) of delivery;
e. Net invoice price for each item;
f. Applicable taxes;
g. Total invoice price; and
h. Payment terms and any available prompt payment discount.
Contractor will return incorrect or incomplete invoices for correction and reissue. The Agreement
number must appear on all invoices, bills of lading, packages, and correspondence relating to this
Agreement.
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Payment will be considered timely if made within thirty (30) calendar days of receipt of properly
completed invoices. Payment will be directly deposited in the bank account or sent to the address
Contractor designated in this Agreement.
Upon expiration or termination any claims for payment for costs due and payable under this
Agreement that are incurred prior to the expiration date must be submitted by Contractor within sixty
(60) calendar days after the expiration date. There will be no obligation to pay any claims that are
submitted sixty-one (61) or more calendar days after the expiration date (“Belated Claims”). Belated
Claims will be paid at HCA’s sole discretion, and any such potential payment is contingent upon the
availability of funds.
6. AGREEMENT CHANGES, MODIFICATIONS AND AMENDMENTS
This Agreement may be amended by mutual agreement of the parties. Such amendments are not
binding unless they are in writing and signed by an Authorized Representative of each party.
7. SUBCONTRACTING
Neither the Contractor nor any Subcontractor shall enter into subcontracts for any of the work
contemplated under this Agreement without obtaining HCA’s prior written approval. HCA shall have
no responsibility for any action of any such Subcontractors.
8. ASSIGNMENT
The work to be provided under this Agreement, and any claim arising thereunder, is not assignable
or delegable by either party in whole or in part, without the express prior written consent of the other
party, which consent will not be unreasonably withheld.
9. CONTRACT MANAGEMENT
The Contract Manager for each of the parties, named on the face of this Contract, will be responsible
for and will be the contact person for all communications and billings regarding the performance of
this Agreement. Either party must notify the other party within thirty (30) days of change of Contract
Management. Changes in Contract Management shall require an amendment.
10. DISALLOWED COSTS
The Contractor is responsible for any audit exceptions or disallowed costs incurred by its own
organization or that of its Subcontractors.
11. DISPUTES
In the event that a dispute arises under this Agreement, it will be determined by a Dispute Board in
the following manner: Each party to this Agreement will appoint one member to the Dispute Board.
The members so appointed will jointly appoint an additional member to the Dispute Board. The
Dispute Board will review the facts, Agreement terms and applicable statutes and rules and make a
determination of the dispute. The Dispute Board will thereafter decide the dispute with the majority
prevailing. The determination of the Dispute Board will be final and binding on the parties hereto. As
an alternative to this process, either of the parties may request intervention by the Governor, as
provided by RCW 43.17.330, in which event the Governor's process will control.
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12. GOVERNANCE
This Agreement is entered into pursuant to and under the authority granted by the laws of the state of
Washington and any applicable federal laws. The provisions of this Agreement will be construed to
conform to those laws.
In the event of an inconsistency in the terms of this Agreement, or between its terms and any
applicable statute or rule, the inconsistency will be resolved by giving precedence in the following
order:
12.1. Applicable state and federal statutes and rules;
12.2. Schedule A, Statement of Work; and
12.3. Any other provisions of the agreement, including materials incorporated by reference.
13. INDEPENDENT CAPACITY
The employees or agents of each party who are engaged in the performance of this Agreement will
not be considered for any purpose to be employees or agents of the other party.
14. RECORDS MAINTENANCE
The parties to this Agreement will each maintain books, records, documents and other evidence
which sufficiently and properly reflect all direct and indirect costs expended by either party in the
performance of the services described herein. These records will be subject to inspection, review or
audit by personnel of both parties, other personnel duly authorized by either party, the Office of the
State Auditor, and federal officials so authorized by law. All books, records, documents, and other
material relevant to this Agreement will be retained for six years after expiration and the Office of the
State Auditor, federal auditors, and any persons duly authorized by the parties will have full access
and the right to examine any of these materials during this period.
Records and other documents, in any medium, furnished by one party to this Agreement to the other
party, will remain the property of the furnishing party, unless otherwise agreed. The receiving party
will not disclose or make available this material to any third parties without first giving notice to the
furnishing party and giving it a reasonable opportunity to respond. Each party will use reasonable
security procedures and protections to assure that records and documents provided by the other
party are not erroneously disclosed to third parties.
15. RIGHTS IN DATA
Unless otherwise provided, data which originates from this Agreement will be "works for hire" as
defined by the U.S. Copyright Act of 1976 and will be owned by HCA. Data will include, but not be
limited to, reports, documents, pamphlets, advertisements, books, magazines, surveys, studies,
computer programs, films, tapes and/or sound reproductions. Ownership includes the right to
copyright, patent, register and the ability to transfer these rights.
16. CONFIDENTIALITY
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Each party agrees not to divulge, publish or otherwise make known to unauthorized persons
confidential information accessed under this Agreement. Contractor agrees that all materials
containing confidential information received pursuant to this Agreement, including, but not limited to
information derived from or containing patient records, claimant file and medical case management
report information, relations with HCA’s clients and its employees, and any other information which
may be classified as confidential, shall not be disclosed to other persons without HCA’s written
consent except as may be required by law.
17. SEVERABILITY
If any provision of this Agreement or any provision of any document incorporated by reference will be
held invalid, such invalidity will not affect the other provisions of this Agreement, which can be given
effect without the invalid provision if such remainder conforms to the requirements of applicable law
and the fundamental purpose of this agreement, and to this end the provisions of this Agreement are
declared to be severable.
18. FUNDING AVAILABILITY
HCA’s ability to make payments is contingent on funding availability. In the event funding from state,
federal, or other sources is withdrawn, reduced, or limited in any way after the effective date and
prior to completion or expiration date of this Agreement, HCA, at its sole discretion, may elect to
terminate the Agreement, in whole or part, orto renegotiate the Agreement subject to new funding
limitations and conditions. HCA may also elect to suspend performance of the Agreement until HCA
determines the funding insufficiency is resolved. HCA may exercise any of these options with no
notification restrictions.
19. TERMINATION
Either party may terminate this Agreement upon 30-days' prior written notification to the other party. If
this Agreement is so terminated, the parties will be liable only for performance rendered or costs
incurred in accordance with the terms of this Agreement prior to the effective date of termination.
20. TERMINATION FOR CAUSE
If for any cause, either party does not fulfill in a timely and proper manner its obligations under this
Agreement, or if either party violates any of these terms and conditions, the aggrieved party will give
the other party written notice of such failure or violation. The responsible party will be given the
opportunity to correct the violation or failure within 15 working days. If failure or violation is not
corrected, this Agreement may be terminated immediately by written notice of the aggrieved party to
the other.
21. WAIVER
A failure by either party to exercise its rights under this Agreement will not preclude that party from
subsequent exercise of such rights and will not constitute a waiver of any other rights 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.
22. ALL WRITINGS CONTAINED HEREIN
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This Agreement contains all the terms and conditions agreed upon by the parties. No other
understandings, oral or otherwise, regarding the subject matter of this Agreement will be deemed to
exist or to bind any of the parties hereto.
23. SURVIVORSHIP
The terms, conditions and warranties contained in this Agreement that by their sense and context are
intended to survive the completion of the performance, expiration or termination of this Agreement
shall so survive. In addition, the terms of the sections titled Rights in Data, Confidentiality, Disputes
and Records Maintenance shall survive the termination of this Agreement.
Schedules
Schedule A: Statement of Work (SOW)
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STATEMENT OF WORK
SCHEDULE A
The Contractor must provide the services and staff, and otherwise do all things necessary for or
incidental to the performance of work in the region (city, county, or counties), as set forth herein.
1. Purpose:
1.1 The Contractor will provide a two-year concept project titled Mobile Integrated Health
(MIH). This project will be operated in the City of Arlington, Washington in cooperation
with the North County Regional Fire Authority (NCRFA) as an effort to decrease
unnecessary emergency department visits and repeat hospitalizations, to reduce
unnecessary calls to 911 for police or emergency medical response, and to provide
mobile integrated health services for residents who cannot navigate resources through
typical means, thereby preventing homelessness and premature death.
1.2 The Contractor will hire a master’s level social worker to manage six (6) interns, who will
provide services in the field. The Contractor’s Program Coordinator will provide clinical
oversight, training, and case management for the interns. All interns will be second year
Master of Social Work students at regional schools. The interns will provide brief
therapeutic intervention, biopsychosocial assessment and referral, and community care
coordination.
1.3 A behavioral health crisis is defined as a turning point in the course of anything decisive
or critical, a time, a stage or an event or a time of great danger or trouble whose outcome
decides whether possible bad consequences will follow. Mobile crisis services are
intended to stabilize the person in crisis, prevent further deterioration and provide
immediate treatment and intervention in a location best suited to meet the of the
individual and in the least restrictive environment available.
1.4 The development and oversight of this service falls to the City of Arlington under the
guidance of its Mayor and a master’s prepared social worker who will supervise the hired
interns. All services provided will work to promote and enlist coordinated cooperation
from a multitude of community services including the medical services, crisis stabilization
/ crisis triage facilities, mobile crisis interventionist, fire and Emergence Medical Services
(EMS), law enforcement and other first responders as needed.
2. Program Overview:
2.1 These services are intended to provide an individual with a better chance of maintaining
stability in the community, avoiding arrest, re-arrest, hospitalization, or involuntary
detainment. This agreement includes expanding existing services that are provided
through traditional Mobile Crisis Response in a targeted effort of offering least restrictive,
trauma free alternatives.
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2.2 The Contractor will recognize that clients of the program will be any individual or family
who needs support after a crisis, accident, hospital discharge or other scenario.
2.3 The MIH team will be accessed by referral only, and only from existing programs,
including Arlington Fire Department, Arlington Police Department, the Arlington Domestic
Violence Coordinator, Arlington’s Code Enforcement Officer, Northwest Incident Support
(NWIS) and NCRFA.
2.4 The MIH program will augment the services currently provided by NWIS. They excel in
on-scene trauma and grief support, walking families through end-of-life care situations,
and connecting with families and children following homicide, suicide, severe trauma, and
other challenging situations.
3. The Contractor shall hire staff as described in section 1., Purpose.The Contractor will develop
a referral process detailing when and how to contact the MIH program, and how it will define
their scope of work. The scope of work for the MIH Program Coordinator will include the
following:
The MIH Program Coordinator will write policies and procedures for providing services
including:
3.1 Clinical oversight;
3.2 Triage and case management (suggest case load 20-25 per intern);
3.3 “Warm hand off” at crisis in the field to assigned intern for longer term care;
3.4 Referral process for accessing the Mobile Integrated Health Program;
3.5 Exclusionary from this program will only come after deliberating clinical review and written
justification. If an individual is excluded, they will have the opportunity to appeal that
decision;
3.6 When and how to refer clients to other community resources;
3.7 Training on the existing client management records system called Field Medical; and
3.8 Opportunity for cross training between programs.
4. The Contractor shall ensure services are provided that address the needs of the person in
crisis, prevent further deterioration and provide immediate treatment and intervention in a
location best suited to meet the needs of the individual and in the least restrictive environment
available:
4.1 Crisis services must be available on a 24-hour, seven (7) days a week basis.
4.2 Crisis services may be provided prior to completion of an intake evaluation.
4.3 Services are provided by or under the supervision of a Licensed Master Level Social
Worker (LICSW) Mental Health Professional (MHP).
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5. The Contractor will provide community outreach and education focusing on creating public
awareness of the MIH services in the form of outreach materials and community engagement
strategies providing instruction on how to request services. These will commence within 90
days from the start of the Contract.
6. The Contractor shall maintain all required metrics and documentation for reporting. Reports
are due based on the Deliverable and Payment Chart in section 12 in this Statement of Work.
The requirements for each report are listed below:
6.1 Contractor shall submit a startup report that will consist of a 200-300-word narrative and
implementation plan addressing the following items:
6.1.1 How the Contractor will provide service citywide, reporting numbers served, and
location where service was rendered. Assessment as to how the MIH services
will meet the City of Arlington’s needs and priorities which are unique to the City.
6.1.2 How to address the urban and rural needs of the City, considering the need for
timely response throughout the entire City by providing the proper level of care.
6.1.3 How services will be available on a twenty-four (24) hour, seven (7) day per week
basis that may be accessed without full completion of intake evaluations and/or
other screening and assessment processes.
6.1.4 How the Contract will enhance reporting capability to gather data on response
times, referral source, and outcome for all crisis services.
6.1.5 How the Contractor will provide communication outreach with the following entities
by providing both educational and outreach materials, webinars, and
presentations of services:
6.1.5.1 Crisis teams;
6.1.5.2 Behavioral health providers;
6.1.5.3 Law enforcement agencies;
6.1.5.4 Emergency departments;
6.1.5.5 Crisis settings;
6.1.5.6 Tribes;
6.1.5.7 Department of Social and Health Services administrations and other social
programs
6.1.5.8 Behavioral Health service providers;
6.1.5.9 First responders and ambulance companies; and
6.1.5.10 Community townhalls.
6.2 Quarterly reports shall consist of the following elements:
6.2.1 List of staff hired and their credentials;
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6.2.2 Number of services provided;
6.2.3 Number of service call abandoned;
6.2.4 Number of services that resulted in diversion from hospital or jail;
6.2.5 Number of services that were too acute for diversion; and
6.2.6 100–200-word narrative on success, barriers, lessons learned, and possible
change that resulted from lessons learned.
6.3 Yearly reports shall consist of the following:
6.3.1 Yearly counts for the data elements outlined in section 6.2 of this Statement of
Work;
6.3.2 A 500–600-word narrative on how the elements in the startup report in 4.1 were
achieved; and
6.3.3 A 200–300-word narrative on the continued need for the program if any.
7. Critical Incident Management System
7.1 The Contractor shall establish a Critical Incident Management System and shall include
policies and procedures for identification of incidents, reporting protocols and oversight
responsibilities. The Contractor shall designate a Critical Incident Manager responsible for
administering the Incident Management System and ensuring compliance with the
requirements of this section 8.
7.2 The Contractor shall submit an individual Critical Incident report for the following incidents
that occur:
8.2.1 To an Enrollee and occurred within a contracted behavioral health facility
(inpatient psychiatric, behavioral health agencies), FQHC, or by independent
behavioral health provider.
8.2.2 Abuse, neglect, or sexual/financial exploitation;
8.2.3 Death; and
8.2.4 Severely adverse medical outcome or death occurring within 72 hours of
transfer from a contracted behavioral facility to a medical treatment setting.
8.3 By an Enrollee, with a behavioral health diagnosis; or history of behavioral health
treatment within the previous 365 days. Acts allegedly committed, to include:
8.3.1 Homicide or attempted homicide;
8.3.2 Arson;
8.3.3 Assault or action resulting in serious bodily harm which has the potential to
cause prolonged disability or death;
8.3.4 Kidnapping; and
Washington State Page 14 of 16 HCA IAA K5545
Health Care Authority Revised 07/2020
8.3.5 Sexual assault.
8.3.6 Unauthorized leave from a behavioral health facility during an involuntary
detention.
8.4 Any event involving an Enrollee that has attracted or is likely to attract media coverage.
(Contractor shall include the link to the source of the media, as available).
8.5 The Contractor shall report critical incidents within one Business Day of becoming
aware of the incident and shall report incidents that have occurred within the last thirty
(30) calendar days, with the exception of incidents that have resulted in or are likely to
attract media coverage. Media related incidents should be reported to HCA as soon as
possible, not to exceed one Business Day.
8.6 The Contractor shall enter the initial report, follow-up, and actions taken into HCA
Incident Reporting System https://fortress.wa.gov/hca/ics/, using the report template
within the system.
8.7 If the system is unavailable the Contractor shall report Critical Incidents to
HCAMCPrograms@hca.wa.gov.
8. HCA may ask for additional information as required for further research and reporting. The
Contractor shall provide information within three (3) Business Days.
9. Funding:
Up to $750,000 for each SFY 22 for a total of $750,000.. The Contractor will be provided an
A-19 template to use for the element/sub-element categories when accounting for
expenditures.
10. Consideration. Total consideration payable to Contractor for satisfactory performance of the
work under this Contract is up to a maximum of $750,000.00 including all expenses and shall
be based on upon receipt and acceptance of reports and documents established in the
Performance and Payment Chart, below. If performance does not meet that required under
Schedule A, Statement of Work, payment may be earned after receipt and approval by the
HCA/DBHR Contract Manager of a corrective action plan that clearly and satisfactorily
describes how and when performance will be met.
11. Deliverable and Payment Chart: Any unspent funds cannot be carried over from one state
fiscal year to the other.
Washington State Page 15 of 16 HCA IAA K5545
Health Care Authority Revised 07/2020
# Deliverable Performance
Matric
Due Date Payment
1 Report on the startup of
the program detailing the
anticipated start date,
hiring completed, and how
startup funds were spent.
and timeliness of
report and the
program is
meeting its
execution of the
contract.
September 1, 2021,
through October 31, 2021,
with all the elements
outlined section 6.1
and timeliness of
report and the
program is
meeting its
objectives.
November 1, 2021,
through December 31,
2021, with all the elements
outlined section 6.1
and timeliness of
report and the
program is
meeting its
January 1, 2022, to March
31, 2022, with all the
elements outlined section
6.1
and timeliness of
report and the
program is
meeting its
objectives.
1, 2022, to June 30, 2022,
with all the elements
outlined section 6.1
and timeliness of
report and the
program is
meeting its
objectives.
during FY2022 as outlined
in section 6.2
and timeliness of
report. Meets
requirements in
Washington State Page 16 of 16 HCA IAA K5545
Health Care Authority Revised 07/2020
7 Quarterly report for July 1,
2022 to September 30,
2022, with all the elements
outlined section 6.1
and timeliness of
report and the
program is
meeting its
objectives.
October 1, 2022 to
December 31, 2022, with
all the elements outlined
section 6.1
and timeliness of
report and the
program is
meeting its
objectives.
January 1, 2023 to March
31, 2023, with all the
elements outlined section
6.1
and timeliness of
report and the
program is
meeting its
objectives.
1, 2023 to June 30, 2023,
with all the elements
outlined section 6.1
and timeliness of
report and the
program is
meeting its
objectives.
during FY2023 as outlined
in section 6.2
and timeliness of
report. Meets
requirements in
Page 1 of 11
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PROFESSIONAL SERVICES AGREEMENT
THIS AGREEMENT, is made and entered into in duplicate this 8th day of September,
2021, by and between the CITY OF ARLINGTON, a Washington municipal corporation,
hereinafter referred to as the "CITY" and Center for Justice Social Work, Kaitlyn Goubeau,
LICSW hereinafter referred to as the "PROFESSIONAL."
IN CONSIDERATION of the terms, conditions, and covenants contained herein, the
parties hereto agree as follows:
1. SCOPE OF SERVICES
The PROFESSIONAL shall perform such services and accomplish such tasks, including
the furnishing of all materials and equipment necessary for full performance thereof, as are
identified and designated as PROFESSIONAL responsibilities throughout this Agreement and as
detailed in Exhibit "A" Mobile Integrated Health Pilot Program attached hereto and incorporated
herein (the "Project").
2. TERM
The Project shall begin upon full execution of this Agreement and shall be completed no
later than September 8th 2021 and complete on July 31st 2023 -unless sooner terminated according
to the provisions herein.
3. COMPENSATION AND METHOD OF PAYMENT
3.1 Payments for services provided hereunder shall be made following the performance
of such services, unless otherwise permitted by law and approved in writing by the
CITY.
3.2 No payment shall be made for any service rendered by the PROFESSIONAL
except for services identified and set forth in this Agreement.
3.3 The CITY shall pay the PROFESSIONAL for work performed under this
Agreement as follows:
3.3.1 PROFESSIONAL shall submit monthly invoices detailing work performed
and expenses for which reimbursement is sought in accordance with the
deliverables and performance matrix in Exhibit A.
3.3.2 CITY shall approve all invoices before payment is issued. Professional may
bill monthly for a percentage of work completed in accordance with the due
date of deliverables. City must approve the percentage of completion.
Payment shall occur within thirty (30) days of receipt and approval of an
invoice.
3.4 CITY shall pay PROFESSIONAL for such services: (check one)
Page 2 of 11
PSA (Rev 2020.06.25)
Hourly: $_____________ per hour, plus actual expenses, but not to exceed a
total of $______________ without an amendment to this Agreement.
Fixed Sum: A total amount of $ ________________________________.
X Other: EXHIBIT A, fees for services invoiced monthly.
for all work performed and expenses incurred under this Agreement.
3.5 CITY reserves the right to withhold payment under this Agreement which is
determined, in the reasonable judgment of the City Administrator or his/her
designee to be noncompliant with this Agreement, the Scope of Services attached
hereto, City standards, or city, state or federal law.
4. REPRESENTATIONS
CITY has relied upon the qualifications of PROFESSIONAL in entering into this
Agreement. By execution of this Agreement, PROFESSIONAL represents it possesses the ability,
skill and resources necessary to perform the work and is familiar with all applicable current laws,
rules and regulations which reasonably relate to the Scope of Services detailed in Exhibit “A”
hereto.
5. STANDARD OF CARE
PROFESSIONAL shall exercise the degree of skill and diligence normally employed by
professional consultants engaged in the same profession, and performing the same or similar
services at the time such services are performed. PROFESSIONAL will be responsible for the
technical accuracy of its services and documents resulting therefrom, and CITY shall not be
responsible for discovering deficiencies therein. PROFESSIONAL agrees to correct any
deficiencies discovered without additional compensation, except to the extent such deficiencies
are directly attributable to deficiencies or omissions in City-furnished information.
6. REPRESENTATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
6.1 By executing this Agreement, the PROFESSIONAL certifies to the best of its
knowledge and belief, that it and its principles:
6.1.1 are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any federal
department or agency;
6.1.2 have not, within a three-year period preceding this proposal, been convicted
of or had a civil judgment rendered against them for commission of fraud
or a criminal offense in connection with obtaining, attempting to obtain, or
performing a public (federal, state, or local) transaction or contract under a
Page 3 of 11
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public transaction; violation of federal or state anti-trust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen
property;
6.1.3 are not presently indicted for or otherwise criminally or civilly charged by
a governmental entity (federal, state, or local) with commission of any of
the offenses enumerated in paragraph 6.1.2 of this certification; and
6.1.4 have not, within a three-year period preceding this application/proposal, had
one or more public transactions (federal, state, or local) terminated for cause
or fault.
6.2 Where the PROFESSIONAL is unable to certify to any of the statements in this
certification, such PROFESSIONAL shall attach an explanation to this Agreement.
7. REPORTS AND INSPECTIONS
7.1 The PROFESSIONAL at such times and in such forms as the CITY may require,
shall furnish to the CITY such statements, records, reports, data, and information
as the CITY may request pertaining to matters covered by this Agreement.
7.2 The PROFESSIONAL shall at any time during normal business hours and as often
as the CITY or State Auditor may deem necessary, make available for examination
all of its records and data with respect to all matters covered, directly or indirectly,
by this Agreement and shall permit the CITY or its designated authorized
representative to audit and inspect other data relating to all matters covered by this
Agreement. The CITY shall receive a copy of all audit reports made by the agency
or firm as to the PROFESSIONAL's activities. The CITY may, at its discretion,
conduct an audit at its expense, using its own or outside auditors, of the
PROFESSIONAL'S activities which relate, directly or indirectly, to this
Agreement.
8. INDEPENDENT CONTRACTOR RELATIONSHIP
8.1 The parties intend that an independent contractor relationship will be created by
this Agreement. The CITY is interested primarily in the results to be achieved;
subject to paragraphs herein, the implementation of services will lie solely with the
discretion of the PROFESSIONAL. No agent, employee, servant or representative
of the PROFESSIONAL shall be deemed to be an employee, agent, servant or
representative of the CITY for any purpose, and the employees of the
PROFESSIONAL are not entitled to any of the benefits the CITY provides for its
employees. The PROFESSIONAL will be solely and entirely responsible for its
acts and for the acts of its agents, employees, servants, subcontractors or
representatives during the performance of this Agreement.
Page 4 of 11
PSA (Rev 2020.06.25)
8.2 In the performance of the services herein contemplated the PROFESSIONAL is an
independent contractor with the authority to control and direct the performance of
the details of the work, however, the results of the work contemplated herein must
meet the approval of the CITY and shall be subject to the CITY's general rights of
inspection and review to secure the satisfactory completion thereof.
9. PROFESSIONAL’S EMPLOYEES/AGENTS
The CITY may at its sole discretion require the PROFESSIONAL to remove any
employee, agent or servant from employment on this Project. The PROFESSIONAL may however
employ those individual(s) on other non-CITY related projects.
10. HOLD HARMLESS/INDEMNIFICATION
10.1 PROFESSIONAL shall, at its sole expense, defend, indemnify and hold the CITY,
its officers, officials, employees and volunteers harmless from any and all claims,
actions, suits, liability, loss, or costs including attorney fees, caused by the wrongful
or negligent acts, errors or omissions of the PROFESSIONAL or the
PROFESSIONAL’s agents, employees or subcontractors in performance of this
Agreement, except for injuries and damages caused by the sole negligence of the
CITY or the CITY’s agents or employees.
10.2 PROFESSIONAL’s duty to indemnify and hold the CITY harmless against liability
for damages arising out of or caused by the concurrent negligence of CITY or
CITY’s employees or agents and PROFESSIONAL or PROFESSIONAL’s
employees or agents shall apply only to the extent of the negligence or wrongdoing
of PROFESSIONAL and PROFESSIONAL’s employees or agents.
10.3 Should a court of competent jurisdiction determine that this Agreement is subject
to RCW 4.24.115, then, in the event of liability for damages arising out of bodily
injury to persons or damages to property caused by or resulting from the concurrent
negligence of the PROFESSIONAL and the CITY, its officers, officials,
employees, and volunteers, the PROFESSIONAL's liability, including the duty and
cost to defend, hereunder shall be only to the extent of the PROFESSIONAL’s
negligence. It is further specifically and expressly understood that the
indemnification provided herein constitutes the PROFESSIONAL’s waiver of
immunity under Industrial Insurance, Title 51 RCW, solely for the purposes of this
indemnification. PROFESSIONAL certifies, by signing this Agreement, that this
indemnification provision was mutually negotiated. The provisions of this section
shall survive the expiration or termination of this Agreement.
10.4 No liability shall attach to the CITY by reason of entering into this Agreement
except as expressly provided herein.
11. INSURANCE
The PROFESSIONAL shall procure and maintain for the duration of the Agreement,
Page 5 of 11
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insurance against claims for injuries to persons or damage to property which may arise from or in
connection with the performance of the work hereunder by the PROFESSIONAL, its agents,
representatives, or employees.
11.1 Insurance Term. The PROFESSIONAL shall procure and maintain for the duration
of the Project, insurance against claims for injuries to persons or damage to property
which may arise from or in connection with the performance of the work hereunder
by the PROFESSIONAL, its agents, representatives, or employees.
11.2 No Limitation. The PROFESSIONAL’s maintenance of insurance as required by
the Agreement shall not be construed to limit the liability of the PROFESSIONAL
to the coverage provided by such insurance, or otherwise limit the CITY’s recourse
to any remedy available at law or in equity.
11.3 Minimum Scope of Insurance. PROFESSIONAL shall obtain insurance of the
types described below:
11.3.1 Automobile Liability insurance covering all owned, non-owned, hired and
leased vehicles. Coverage shall be written on Insurance Services Office
(ISO) form CA 00 01. If necessary, the policy shall be endorsed to provide
contractual liability coverage.
11.3.2 Commercial General Liability insurance shall be written on ISO occurrence
form CG 00 01 and shall cover liability arising from premises, operations,
independent contractors and personal injury and advertising injury. The
City shall be named as an insured under the PROFESSIONAL's
Commercial General Liability insurance policy with respect to the work
performed for the City using an additional insured endorsement at least as
broad as ISO CG 20 26.
11.3.3 Workers' Compensation coverage as required by the Industrial Insurance
laws of the State of Washington.
11.3.4 Professional Liability insurance appropriate to the PROFESSIONAL's
profession.
11.4 Minimum Amounts of Insurance. PROFESSIONAL shall maintain the following
insurance limits:
11.4.1 Automobile Liability insurance with a minimum combined single limit for
bodily injury and property damage of $1,000,000 per accident.
11.4.2 Commercial General Liability insurance shall be written with limits no less
than $2,000,000 each occurrence, $2,000,000 general aggregate.
11.4.3 Professional Liability insurance shall be written with limits no less than
$2,000,000 per claim and $2,000,000 policy aggregate limit.
Page 6 of 11
PSA (Rev 2020.06.25)
11.5 Other Insurance Provisions. The PROFESSIONAL’s Automobile Liability and
Commercial General Liability insurance policies are to contain, or be endorsed to
contain that they shall be primary insurance as respect the CITY. Any Insurance,
self-insurance, or self-insured pool coverage maintained by the CITY shall be
excess of the PROFESSIONAL’s insurance and shall not contribute with it.
11.6 Acceptability of Insurers. Insurance is to be placed with insurers with a current
A.M. Best rating of not less than A: VII.
11.7 Verification of Coverage. PROFESSIONAL shall furnish the City with original
certificates and a copy of the amendatory endorsements, including but not
necessarily limited to the additional insured endorsement, evidencing the insurance
requirements of the PROFESSIONAL before commencement of the work.
11.8 Notice of Cancellation. PROFESSIONAL shall provide the CITY with written
notice of any policy cancellation within two business days of their receipt of such
notice.
11.9 Failure to Maintain Insurance. Failure on the part of the PROFESSIONAL to
maintain the insurance as required shall constitute a material breach of contract,
upon which the CITY may, after giving five business days’ notice to the
PROFESSIONAL to correct the breach, immediately terminate this Agreement or,
at its discretion, procure or renew such insurance and pay any and all premiums in
connection therewith, with any sums so expended to be repaid to the CITY on
demand, or at the sole discretion of the CITY, offset against funds due the
PROFESSIONAL from the CITY.
11.10 City Full Availability of Professional Limits. If the PROFESSIONAL maintains
higher insurance limits than the minimums shown above, the CITY shall be insured
for the full available limits of Commercial General and Excess or Umbrella liability
maintained by the PROFESSIONAL, irrespective of whether such limits
maintained by the PROFESSIONAL are greater than those required by this
Agreement or whether any certificate of insurance furnished to the CITY evidences
limits of liability lower than those maintained by the PROFESSIONAL.
12. OWNERSHIP OF ASSETS
Title to all property furnished by the CITY shall remain in the name of the CITY and the
CITY shall become the owner of the work product and other documents, if any, prepared by the
PROFESSIONAL pursuant to this Agreement.
13. COMPLIANCE WITH LAWS
13.1 The PROFESSIONAL, in the performance of this Agreement, shall comply with
all applicable federal, state or local laws and ordinances, including regulations for
licensing, certification and operation of facilities, programs and accreditation, and
Page 7 of 11
PSA (Rev 2020.06.25)
licensing of individuals, and any other standards or criteria as described in this
Agreement to assure quality of services.
13.2 The PROFESSIONAL specifically agrees to pay any applicable business and
occupation (B & O) taxes which may be due on account of this Agreement.
14. NONDISCRIMINATION
14.1 The CITY is an equal opportunity employer.
14.2 Nondiscrimination in Employment. In the performance of this Agreement, the
PROFESSIONAL will not discriminate against any employee or applicant for
employment on the grounds of race, creed, color, national origin, sex, marital status,
age or the presence of any sensory, mental or physical handicap; provided that the
prohibition against discrimination in employment because of handicap shall not
apply if the particular disability prevents the proper performance of the particular
worker involved. The PROFESSIONAL shall ensure that applicants are employed,
and that employees are treated during employment without discrimination because
of their race, creed, color, national origin, sex, marital status, age or the presence of
any sensory, mental or physical handicap. Such action shall include, but not be
limited to: employment, upgrading, demotion or transfers, recruitment or
recruitment advertising, layoff or termination, rates of pay or other forms of
compensation, and programs for training including apprenticeships. The
PROFESSIONAL shall take such action with respect to this Agreement as may be
required to ensure full compliance with local, state and federal laws prohibiting
discrimination in employment.
14.3 Nondiscrimination in Services. The PROFESSIONAL will not discriminate against
any recipient of any services or benefits provided for in this Agreement on the
grounds of race, creed, color, national origin, sex, marital status, age or the presence
of any sensory, mental or physical handicap.
14.4 If any assignment and/or subcontracting has been authorized by the CITY, said
assignment or subcontract shall include appropriate safeguards against
discrimination. The PROFESSIONAL shall take such action as may be required to
ensure full compliance with the provisions in the immediately preceding paragraphs
herein.
15. ASSIGNMENT/SUBCONTRACTING
15.1 The PROFESSIONAL shall not assign its performance under this Agreement or
any portion of this Agreement without the written consent of the CITY, and it is
further agreed that said consent must be sought in writing by the PROFESSIONAL
not less than thirty (30) days prior to the date of any proposed assignment. The
CITY reserves the right to reject without cause any such assignment.
15.2 Any work or services assigned hereunder shall be subject to each provision of this
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Agreement and proper bidding procedures where applicable as set forth in local,
state and/or federal statutes, ordinances and guidelines.
15.3 Any technical/professional service subcontract not listed in this Agreement, must
have express advance approval by the CITY.
16. CHANGES OR AMENDMENTS
Either party may request changes to the scope of services and performance to be provided
hereunder, however, no change or addition to this Agreement shall be valid or binding upon either
party unless such change or addition be in writing and signed by both parties. Such amendments
shall be attached to and made part of this Agreement.
17. OWNERSHIP, MAINTENANCE AND INSPECTION OF RECORDS
17.1 All drawings, plans, specifications, and other related documents prepared by
PROFESSIONAL under this Agreement are and shall be the property of CITY, and
may be subject to disclosure pursuant to RCW Chapter 42.56 or other applicable
public records laws. The written, graphic, mapped, photographic, or visual
documents prepared by PROFESSIONAL under this Agreement shall, unless
otherwise provided, be deemed the property of the CITY. CITY shall be permitted
to retain these documents, including reproducible camera-ready originals of
reports, reproduction quality mylars of maps, and copies in the form of computer
files, for the CITY’s use. CITY shall have unrestricted authority to publish,
disclose, distribute and otherwise use, in whole or part, and reports, data, drawings,
images or other material prepared under this Agreement, provided that
PROFESSIONAL shall have no liability for the use of PROFESSIONAL’s work
product outside of the scope of its intended purpose, and the CITY agrees to
indemnify and hold the PROFESSIONAL harmless from such use.
17.2 The PROFESSIONAL shall maintain books, records and documents, which
sufficiently and properly reflect all direct and indirect costs related to the
performance of this Agreement and shall maintain such accounting procedures and
practices as may be necessary to assure proper accounting of all funds paid pursuant
to this Agreement. These records shall be subject at all reasonable times to
inspection, review, or audit, by the CITY, its authorized representative, the State
Auditor, or other governmental officials authorized by law to monitor this
Agreement.
17.3 The PROFESSIONAL shall retain all books, records, documents and other material
relevant to this Agreement, for six (6) years after its expiration. The
PROFESSIONAL agrees that the CITY or its designee shall have full access and
right to examine any of said materials at all reasonable times during said period.
PROFESSIONAL agrees to cooperate with the CITY to produce in a timely manner
any records in the possession of PROFESSIONAL relating to the performance of
this Agreement which are or may be the subject of a valid request under the Public
Records Act, RCW Chapter 42.56.
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18. OTHER PROVISIONS
If changes in state law necessitate that services hereunder be expanded, the parties shall
negotiate an appropriate amendment. If, after thirty (30) days of negotiation, an agreement cannot
be reached, this Agreement may be terminated by the City no sooner than sixty (60) days thereafter.
19. TERMINATION
19.1 Termination for Convenience. The CITY may terminate this Agreement, in whole
or in part, at any time, by at least five (5) days written notice to the
PROFESSIONAL.
19.2 Termination for Cause. If the PROFESSIONAL fails to perform in the manner
called for in this Agreement, or if the PROFESSIONAL fails to comply with any
other provisions of this Agreement and fails to correct such noncompliance within
five (5) days written notice thereof, the CITY may terminate this Agreement for
cause. Termination shall be effected by serving a notice of termination on the
PROFESSIONAL setting forth the manner in which the PROFESSIONAL is in
default. The PROFESSIONAL will only be paid for services performed in
accordance with the manner of performance set forth in this Agreement.
20. NOTICE
Notices, other than applications for payment, shall be given in writing to the persons
named below:
TO PROFESSIONAL;
Center for Justice Social Work
Kaitlyn Goubeau, LICSW
848 N. Sunrise Blvd
Unit A204
Camano Island, Washington 98282
21. ATTORNEYS FEES AND COSTS
If any legal proceeding is brought for the enforcement of this Agreement, or because of a
dispute, breach, default, or misrepresentation in connection with any of the provisions of this
Agreement, the prevailing party shall be entitled to recover from the other party, in addition to any
other relief to which such party may be entitled, reasonable attorney's fees and other costs incurred
in that action or proceeding.
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22. WAIVER
No officer, employee, agent or other individual acting on behalf of either party has the
power, right or authority to waive any of the conditions or provisions of this Agreement. No
waiver in one instance shall be held to be a waiver of any other subsequent breach or
nonperformance. Failure of either party to enforce at any time any of the provisions of this
Agreement or to require at any time performance by the other party of any provision hereof shall
in no way be construed to be a waiver of such provisions nor shall it affect the validity of this
Agreement or any part thereof.
23. JURISDICTION AND VENUE
This Agreement has been and shall be construed as having been made and delivered within
the State of Washington, and it is agreed by each party hereto that this Agreement shall be governed
by laws of the State of Washington, both as to interpretation and performance.
Any action of law, suit in equity, or judicial proceeding for the enforcement of this
Agreement or any provisions thereof, shall be instituted and maintained only in any of the courts
of competent jurisdiction in Snohomish County, Washington.
24. SEVERABILITY
24.1 If, for any reason, any part, term or provision of this Agreement is held by a court
of the United States to be illegal, void or unenforceable, the validity of the
remaining provisions shall not be affected, and the rights and obligations of the
parties shall be construed and enforced as if the Agreement did not contain the
particular provision held to be invalid.
24.2 If it should appear that any provision hereof is in conflict with any statutory
provision of the State of Washington, said provision which may conflict therewith
shall be deemed inoperative and null and void insofar as it may be in conflict
therewith, and shall be deemed modified to conform to such statutory provisions.
25. ENTIRE AGREEMENT
The parties agree that this Agreement is the complete expression of the terms hereto and
any oral representations or understandings not incorporated herein are excluded. Further, any
modification of this Agreement shall be in writing and signed by both parties. Failure to comply
with any of the provisions stated herein shall constitute material breach of contract and cause for
termination. Both parties recognize time is of the essence in the performance of the provisions of
this Agreement. It is also agreed by the parties that the forgiveness of the nonperformance of any
provision of this Agreement does not constitute a waiver of the provisions of this Agreement.
IN WITNESS WHEREOF the parties hereto have caused this Agreement to be executed
the day and year first hereinabove written.
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CITY: PROFESSIONAL:
CITY OF ARLINGTON Center for Justice Social Work
__________________________________
Barbara Tolbert, Mayor Kaitlyn Goubeau, LICSW
1 Washington State
Health Care Authority
Description of Services
HCA Contract #KXXX
EXHIBIT A
Mobile Integrated Health
Services Statement of Work
The Contractor must provide the services and staff, and otherwise do all things necessary for or
incidental to the performance of work in the region (city, county, or counties), as set forth herein.
Purpose: This Contract is for the purpose of providing funding for the creation of a two-year concept
project titled Mobile Integrated Health (MIH). This project will be operated in the City of Arlington, WA
in cooperation with the North County Regional Fire Authority (NCRFA) as an effort to decrease
unnecessary emergency department visits and repeat hospitalizations, to reduce unnecessary calls to
911 for police or emergency medical response, and to provide mobile integrated health services for
residents who cannot navigate resources through typical means, thereby preventing homelessness and
premature death.
This program will contract with a master’s level social worker to manage six interns, who will provide
services in the field. The Program Coordinator will provide clinical oversight, training, and case
management for the interns. All interns will be second year Master of Social Work students at regional
schools. They will provide brief therapeutic intervention, biopsychosocial assessment and referral, and
community care coordination
A behavioral health crisis is defined as a turning point in the course of anything decisive or critical, a
time, a stage or an event or a time of great danger or trouble whose outcome decides whether possible
bad consequences will follow. Mobile crisis services are intended to stabilize the person in crisis,
prevent further deterioration and provide immediate treatment and intervention in a location best
suited to meet the of the individual and in the least restrictive environment available.
The development and oversight of this service falls to the City of Arlington under the guidance of its
Mayor and a master’s prepared social worker who will supervise the hired interns. All services provided
will work to promote and enlist coordinated cooperation from a multitude of community services
including the medical services, crisis stabilization / crisis triage facilities, mobile crisis interventionist, fire
and emergence medical services (EMS), law enforcement and other first responders as needed.
Program Overview:
These services are intended to provide an individual with a better chance of maintaining stability in
the community, avoiding arrest, re-arrest, hospitalization, or involuntary detainment. This
agreement includes expanding existing services that are provided through traditional Mobile Crisis
Response in a targeted effort of offering least restrictive, trauma free alternatives.
The Contractor will recognize that clients of the program will be any individual or family who needs
support after a crisis, accident, hospital discharge or other scenario.
2 Washington State
Health Care Authority
Description of Services
HCA Contract #KXXX
The MIH team will be accessed by referral only, and only from existing programs, including Arlington
Fire Department, Arlington Police Department, the Arlington Domestic Violence Coordinator,
Arlington’s Code Enforcement Officer, Northwest Incident Support (NWIS) and NCRFA
The MIH program will augment the services currently provided by Northwest Incident Support
(NWIS). They excel in on-scene trauma and grief support, walking families through end-of-life care
situations, and connecting with families and children following homicide, suicide, severe trauma,
and other challenging situations.
Definitions
• Diversion means services provided to a person prevented them from ending up in jail due to
behavior resulting from their behavioral health challenges, were involuntarily hospitalized
due to their behavioral health challenges, or needing to go to an emergency department
(ED) for services in resolving their crisis. A diversion still counts if a person is referred by the
MIH team to an ED for medical clearance as required for referral to the next step in care.
Statement of work
1 Contractor shall hire staff as described in the purpose section. The Contractor will develop a referral
process detailing when and how to contact the MIH program, and how it will define their scope of
work. The scope of work for the program coordinator will include the following:
1.1 The Program Coordinator will write policies and procedures for providing services including:
1.1.1 clinical oversight
1.1.2 triage and case management (suggest case load 20-25 per intern)
1.1.3 “Warm hand off” at crisis in the field to assigned intern for longer term care
1.1.4 referral process for accessing the Mobile Integrated Health Program
1.1.5 Exclusionary from this program will only come after deliberating clinical review and written
justification. If an individual is excluded, they will have the opportunity to appeal that decision.
1.1.6 When and how to refer clients to other community resources
1.1.7 training on the existing client management records system called Field Med.
1.1.8 Opportunity for cross training between programs.
2 Contractor shall ensure services are provided that address the needs of the person in crisis, prevent
further deterioration and provide immediate treatment and intervention in a location best suited to
meet the needs of the individual and in the least restrictive environment available:
2.1 Crisis services shall be available on a 24-hour, seven days a week basis.
2.2 Crisis services may be provided prior to completion of an intake evaluation.
2.3 Services are provided by or under the supervision of a Master Level Social Worker (LICSW) Mental
Health Professional (MHP).
3 Washington State
Health Care Authority
Description of Services
HCA Contract #KXXX
3 Contractor will provide community outreach and education focusing on creating public awareness of
the MIH services in the form of outreach materials and community engagement strategies providing
instruction on how to request services. These will commence within 90 days from the start of the
contract
4 Contractor shall maintain all required metrics and documentation for reporting. Reports are due
based on the deliverable table in X.X. The requirements for each report are listed below:
4.1 Contractor shall submit a startup report that will consist of a200-300-word narrative and
implementation plan addressing the following items:
4.1.1 How contractor will provide service citywide, reporting numbers served, and location of where
service was rendered. Assessment as to how the MIH services will meet the city of Arlington
needs and priorities which are unique to the city.
4.1.2 How to address the urban and rural needs of the city, considering the need for timely response
throughout the entire city by providing the proper level of care.
4.1.3 How services will be available on a twenty-four (24) hour, seven (7) day per week basis that may
be accessed without full completion of intake evaluations and/or other screening and
assessment processes.
4.1.4 How contract will enhance reporting capability to gather data on response times, referral
source, and outcome for all crisis services.
4.1.5 How contractor will provide communication outreach with the following entities by providing
both educational and outreach materials, webinars, and presentations of services:
4.1.5.1 Crisis teams
4.1.5.2 Behavioral health providers
4.1.5.3 Law enforcement agencies
4.1.5.4 Emergency departments
4.1.5.5 Crisis settings
4.1.5.6 Tribes
4.1.5.7 Department of Social and Health Services administrations and other social
4.1.5.8 Behavioral Health service providers
4.1.5.9 First responders and ambulance companies
4.1.5.10 Community townhalls
4.2 Quarterly reports shall consist of the following elements:
4.2.1 List of staff hired and their credentials
4.2.2 Number of services provided
4.2.3 Number of service call abandoned
4.2.4 Number of services that resulted in diversion from hospital or jail
4.2.5 Number of services that were too acute for diversion
4.2.6 100–200-word narrative on success, barriers, lessons learned, and possible change that resulted
from lessons learned.
4.3 Yearly reports shall consist of the following:
4.3.1 Yearly counts for the data elements outlined in 4.2
4.3.2 A 500–600-word narrative on how the elements in the startup report in 4.1 were achieved.
4 Washington State
Health Care Authority
Description of Services
HCA Contract #KXXX
4.3.3 A 200–300-word narrative on how the program is meeting its objectives.
5 Funding: Up to $375,000 for each SFY 22 and SFY23 for a total of $750,000 over the biennium will
be provided to the city of Arlington for the purpose of funding their Mobile Integrated Health team
response services using General Fund-State dollars. Contractors will be provided an A-19 template
to use the element/sub-element categories contained in the template when accounting for
expenditures. The goal of this project will continue the work of the joint city and fire authority
Community Resource Paramedic program and will complement it with a social work program so that
we may offer physical, social and behavioral services to Arlington’s citizens and residents of NCRFA’s
service area who cannot navigate resources through typical methods.
6 Consideration. Total consideration payable to Contractor for satisfactory performance of the work
under this Contract is up to a maximum of $750,000.00 including all expenses and shall be based on
upon receipt and acceptance of reports and documents established in the Performance and
Payment Chart, below. If performance does not meet that required under the Performance and
Payment Chart, payment may be earned after receipt and approval by the DBHR Contract Manager
of a corrective action plan that clearly and satisfactorily describes how and when performance will
be met.
7 Deliverable and Payment Chart: Funds provided cannot be carried over from one state fiscal year to
the other.
Deliverables and Performance Metric
Metric
program detailing the anticipated
start date, hiring completed, and
how startup funds were spent.
timeliness of report
and the program is
meeting its
objectives.
execution of the
contract.
2021, through October 31, 2021,
with all the elements outlined
section 1.1
timeliness of report
and the program is
meeting its
objectives.
2021, through December 31,
2021, with all the elements
outlined section 1.1
timeliness of report
and the program is
meeting its
objectives.
2022, to March 31, 2022, with all
the elements outlined section 1.1
timeliness of report
and the program is
meeting its
objectives.
5 Washington State
Health Care Authority
Description of Services
HCA Contract #KXXX
5 Quarterly report for April 1, 2022,
to June 30, 2022, with all the
elements outlined section 1.1
timeliness of report
and the program is
meeting its
FY2022 as outlined in section 1.2 timeliness of
report. Meets
requirements in 1.1
to September 30, 2022, with all
the elements outlined section 1.1
timeliness of report
and the program is
meeting its
objectives.
2022 to December 31, 2022, with
all the elements outlined section
1.1
timeliness of report
and the program is
meeting its
objectives.
2023 to March 31, 2023, with all
the elements outlined section 1.1
timeliness of report
and the program is
meeting its
objectives.
to June 30, 2023, with all the
elements outlined section 1.1
timeliness of report
and the program is
meeting its
objectives.
FY2023 as outlined in section 1.2 timeliness of
report. Meets
City of Arlington
Council Agenda Bill
Item:
NB #3
Attachment
C
COUNCIL MEETING DATE:
September 7, 2021
SUBJECT:
Selection of Mayor Pro Tem
ATTACHMENTS:
None
DEPARTMENT OF ORIGIN
Administration; Paul Ellis, City Administrator 360-403-4603
EXPENDITURES REQUESTED: -0-
BUDGET CATEGORY: N/A
BUDGETED AMOUNT: N/A
LEGAL REVIEW:
DESCRIPTION:
Council member Jesica Stickles served as Mayor Pro Tem from January 2020 to August 31, 2021. She
resigned September 1, 2021, leaving a vacancy for Mayor Pro Tem. This selection by Council is for a
Mayor Pro Tem to serve until the second meeting in January 2022, when the two year selection for Mayor
Pro Tem will be made.
HISTORY:
The City Council is to select a Mayor Pro Tem every two years. The Council Rules of Procedure state as
follows:
Selecting Mayor Pro Tem and Alternate Mayor Pro Tem:
The Mayor Pro Tem will be selected by a majority vote of the Council members at the second meeting in
January in even years or when there is a vacancy. In selecting the Mayor Pro Tem, the Council will be
guided by the following principles:
• To preserve continuity in the office, the Mayor Pro Tem shall generally serve for a term of two (2) years.
• The Mayor Pro Tem should have served as a Council member for at least two (2) years before
appointment to the office of Mayor Pro Tem.
• In general, the appointment of Mayor Pro Tem will be to the eligible Council member who has served
the longest in office.
The Alternate Mayor Pro Tem will be the Council member who most recently served as Mayor Pro Tem.
ALTERNATIVES
RECOMMENDED MOTION:
I move to select Council member _________________ as the City’s Mayor Pro Tem, to serve until the January
18, 2022 Council meeting.