Contract - 12-05-2017 - 9143 - Amendment to Professional Services Agreement for Local Health Officer.AS -9143 Motion Items 7.
BOCC Agenda
Meeting Date: 12/05/2017
Amendment to Professional Services Agreement for Local Health Officer (3)
Submitted For: Chris DesRosier. Health /Human Services
Submitted By: Paula Timmons, Health /Human Services
Department: Health /Human Services
Information
Subject and Summary Statement
Pursuant to RCW 70.05.050, Cowlitz County must have an experienced physician licensed to practice
medicine and surgery or osteopathic medicine in Washington State and who is qualified or provisionally
qualified in accordance with the standards prescribed in RCW 70.05.051 through 70.05.055 to hold the
office of local health officer. This Professional Services Agreement for Local Health Officer services will
continue the relationship between Cowlitz County and Dr. Jennifer Vines, MD, MPH.
This Amendment #3 to the Professional Services Agreement for Local Health Officer services with Dr.
Jennifer Vines, MD, MPH is to amend the contract language and to extend through December 31, 2018.
Prior BoCC Approval December 20, 2016.
Will Staff Attend Y / N
Yes
Department Recommendation
It is the recommendation of the Health Department that the Cowlitz County Board of Commissioners
move to approve and execute Amendment (3) to Professional Services Agreement with Dr. Jennifer
Vines, MD, MPH for local health officer services.
Fiscal Impact
Expenditure Required $: Y
Budget Sufficient Y -N: N
Amendment Required Y -N: N
Source of Funds - Fund /Dept.: 14301
Grant Y -N: N
Attachments
LHO Vines 15 -16 (3)
LHO Vines 15 -16 (2)
LHO Vines 15 -16 (1)
LHO Vines 15 -16
Form Review
Inbox Reviewed By Date
t'Tz COGuf
UPERSO NAL SERVICES AGREEMENT
Contract Number: LHO Vines 15 -16
SHINGt Amendment Number: 3
THIS AMENDMENT is entered into between COWLITZ COUNTY, a political subdivision of the State of
Washington, (hereinafter called "County" or "Cowlitz County ") and
Name: Jennifer Vines, MD, MPH
Address 2940 NE Cesar Chavez Blvd
Portland, OR 97212
Phone: (503) 453 -5879
hereinafter called "Contractor').
This Modification amends the original Agreement only as set forth expressly below. ALL OTHER
TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in
full force and effect:
Attachment A - Scope of Work
Attachment B - Compensation
Attachment C - General Conditions
Attachment D - Special Terms and Conditions and Retirement Status Form
Attachment E - Business Associate Agreement
Extend Contracted Agreement from December 31, 2017 to December 31, 2018.
copies of which are attached hereto and incorporated herein by this reference as if fully set
forth.
The term of this Agreement shall commence on the 1 It day of March 2015 and shall, unless
terminated as provided elsewhere in the Agreement, terminate on the 31s' day of December,
2017.
IN WITNESS WHEREOF, the parties have executed this Agreement on this
I
day of
I> -Cz 4--v, - , 2017.
Print name:
Title:
Optional for Commissioner Approval)
ATTEST:
Tiffanyb treim, glerk of the Board
2014 -ver. 3]
COWLITZ COUNTY:
Title: Joe Gardner, Chairman
BOCC approval subject to Board ratification or
authorization)
CONTRACT HAS BEEN APPROVED AS TO
FORM BY COWLITZ COUNTY
PROSECUTING ATTORNEY
PERSONAL SERVICES AGREEMENT ATTACHMENT A
SCOPE OF WORK
The Contractor shall provide professional services at the request of, and in consultation with,
the COUNTY, including the following elements:
The Contractor will perform the functions, powers, authorities and duties as specified in RCW
70.05.070.
1. The Contractor shall work three (3) days per month onsite. In the event of illness or other
unavoidable scheduling conflicts, the Contractor may work remotely if necessary. The focus
of functions may include the following services and activities as the Health Officer for the
Cowlitz County local health jurisdiction:
a. Enforce public health statues, rules and regulations of the State Board of Health, State
Department of Health and local health rules, regulations and ordinances including
communicable disease control and environmental health;
b. Consultation to insure County compliance with applicable Washington state statues,
rules, respective county coeds and contractual obligations;
c. Participate in local rule making for rules promulgated under the State Department of
Health as well as other State authorities;
d. Provide medical direction during public health emergencies, assures the public is
protected from diseases, assures isolation, quarantine and other control measures are
ordered and implemented in accordance with state RCWs and WACs;
e. Consultation on issues related to communicable disease(s);
f. Consultation on issues related to emergency preparedness plans and activities;
g. Consultation regarding evaluation, monitoring and treatment of Tuberculosis (TB), and
provision of in- clinic care for patients with TB who are under the care of the County and
community medical providers;
h. Be available twenty -four hours a day, seven days a week to provide support and
consultation. Respond within twenty -four hours of being notified of non - urgent individual
communicable disease consultation phone calls and emails in 80% of cases, and
respond to 90% of urgent consultation request situation within 30 minutes;
i. In the event of being on leave, arrange back -up health officer coverage;
j. In consultation with the County, prioritize public health issues, identify best practice
approaches, assess current health & human services departments actives, and develop
capacity of the County's Health & Human Services Departments with the end of putting
in place a system and plan that will insure the goals of the program;
k. Develop and maintain effective relationships with the medical community, media, elected
officials, and other community leaders;
I. Provide medically sound and appropriate consultation for the improvement of the County
Health & Human Services Departments programs and services;
m. Review as appropriate, the County's departmental medical policy, including the County
employees health, and review the County's Health Department organizational structure;
n. Participate in the County Board of Health meetings as requested by the Director;
o. Attend as able, conferences called by the Washington State Secretary of Health or
his /her authorized representatives;
p. Collect, or delegate to be collected, such fees as are established by the Washington
State Board of Health or local Board of Health for the issuance or renewal of licenses or
permits or other fees;
q. Inform the public as to the causes, nature, and prevention of disease and disability and
the preservation, promotion and improvement of health with Cowlitz County;
LHO -Vines 15 -16 (3) 2 of 5
PERSONAL SERVICES AGREEMENT ATTACHMENT A
r. Advise on development and implementation of public health policy, regulations, and
provide information and recommendations regarding public health issues and activities;
s. Provide guidance and leadership in the development of diverse public health promotion
and education programs and the prevention of environmental hazards;
t. Participate in administrative appeals related to environmental health permit denials;
u. Identify emerging medical and environmental issues and confer with and make
recommendations to appropriate staff on health - related issues;
v. Coordinate with Environmental staff and the County Prosecuting Attorney's office in
using the Health Officer authority in various environmental health enforcement actives;
w. Conference with the Director and environmental staff to prioritize health issues, policies,
and priorities.
In the event the Contractor, or its agents or assigns, are unable to complete their work as
scheduled, the contract period and compensation may be adjusted by mutual agreement of the
County and the Contractor.
LHO -Vines 15 -16 (3) 3 of 5
PERSONAL SERVICES AGREEMENT ATTACHMENT D
SPECIAL TERMS AND CONDITIONS AND RETIRMENT STATUS FORM
Reporting. The Contractor shall submit written and/or verbal progress reports to the
County Project manager as set forth below:
With each request for payment.
Monthly.
Quarterly.
Semi - annually.
Annually.
Project completion.
Other (specify)
Progress reports shall include, at a minimum, the following:
Reports shall include any problems, delays or adverse conditions which will materially
affect the Contractor's ability to meet project objectives or time schedules together with a
statement of action taken or proposed to resolve the situation. Reports shall also
include recommendations for changes to the Scope of Work, if any. Payments may be
withheld if reports are not submitted.
LHO -Vines 15 -16 (3) 4 of 5
PERSONAL SERVICES AGREEMENT ATTACHMENT D
COUNTY RETAINS THIS FORM
Individual contractors and service providers must complete and sign
2. WA Department of Retirement Systems: Independent Contractor Verification and State
Retirement Status Reporting Form [WAC 415 -02 -110, DRS Email 13 -011, DRS Email 09-
001]
Section 1: INDIVIDUAL CONTRACTOR COMPLETES THIS SECTION AND SIGNS
Did you retire from one of the State of Washington Retirement Systems? YES NJ NO
Did you retire before age 65 using the 2008 early retirement factors (ERF)? YES NO
Will you be receiving direct compensation for your services? Nr YES NO
Will you be receiving indirect compensation for your services? YES NO
CONTRACTOR (Full, individual name of contractor): J Q tit hL ( tom V I yw S
Signature: - Social Security No: 2 '(a 91 2Date: l
Section 2: COU TY COMPEETES THIS SECTION AND RETAINS FOR AUDIT PURPOSES:
Use Member Reporting Verification (MRV) to verify the past retirement membership)
Contractor has been a member of a Washington State Retirement System YES NO
If YES, what system and plan?
Teachers' Retirement System (TRS) Planl Plan 2 Plan 3
School Employees' Retirement System (SERS) Plan 2 Plan 3
Public Employees' Retirement System (PERS) Plan 1 Plan 2 Plan 3
Public Safety Employees' Retirement System (PSERS) Plan 2
Law Enforcement Officers' &
Fire Fighters' Retirement System (LEOFF) Plan 1 Plan 2
Washington State Patrol
Retirement System (WSPRS) Plan 1 Plan 2
Judicial Retirement System (JRS)
2. Is the contractor a retiree of a Washington State Retirement System? YES
NO
3. Did the contractor retire before age 65 using the 2008 ERF? YES
NO
I have verified the information above using MRV or by contacting DRS, and I have
evaluated the individual Contractor, Independent Contractor or Service Provider under
WAC 415 -02 -110 and /or DRS Form -MS 344 (R 5/09), and the Internal Revenue Service
rules governing independent contractor status.
COUNTY OFFICIAL /DEPARTMENT REPRESENTATIVE:
Date:
COUNTY RETAINS THIS FORM
LHO -Vines 15 -16 (3) 5 of 5