HomeMy WebLinkAboutAgreements/Contracts - Renew (002)WaC/,z- uyi
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Grant Behavioral Health & Wellness
September 20., 2022
Board of Grant County Commissioners
PO Box 37
Ephrata,, WA 98823
Re: Signature for Beneficiary Agreement with Health Care Authority — Agreement G247
Dear Board of County Commissioners:
Please see the attached Beneficiary Agreement for review and approval.
840 E. Plum Street
Moses Lake, WA 98837
Phone: (509) 765-9239
Fax: (509) 765-1582
Contractor: Health Care Authority
Term of Contract: Agreement End Date — 6/30/23
Payment Amount: $677.,947.34
Purpose: These funds are being distributed by Washington State Health Care Authority for Behavioral Health
workforce stabilization efforts for recruitment and retention.
ting�permissio:n to Docu' Sign electronicaylly with YHe
Thank you for your consideration.
Dell Anderson, M.Ed,, LMHC
Executive Director
Ext. 5472
L
SEP'J�2 0
DocuSign Envelope ID: BB15A7BB-FD69-4E23-BE47-1C58B94AOD08 IC22-206
This Beneficiary Agreement ("Agreement") is made by and between the Washington State Health Care Authority ("HCA")
and the non -hospital-based community behavioral health treatment agency ("Beneficiary") identified below. HCA and
Beneficiary may be individually referred to as a "party" or collectively referred to as "parties."
To be valid, this Agreement must be signed by Beneficiary's authorized representative and returned electronically to HCA
before midnight October 31, 2022. Beneficiaries may rely on DocuSign's verification or their sent email timestamp as
verification of receipt by HCA. Additional information and the timelines for Agreements after October 31, 2022 will be
posted to HCA's website at:
https://www.hca.wa.g_ov/billers-providers-partners/program-information-providers/contractor-and-provider-resources
BENEFICIARY NAME
DOING BUSINESS AS (DBA)
HCA Agreement Number:
Washington State
BENEFICIARY AGREEMENT
G247
Health Care Au000thorilty
Behavioral Health Workforce
Stabilization Funding
Beneficiary National PI Number:
1689677833
This Beneficiary Agreement ("Agreement") is made by and between the Washington State Health Care Authority ("HCA")
and the non -hospital-based community behavioral health treatment agency ("Beneficiary") identified below. HCA and
Beneficiary may be individually referred to as a "party" or collectively referred to as "parties."
To be valid, this Agreement must be signed by Beneficiary's authorized representative and returned electronically to HCA
before midnight October 31, 2022. Beneficiaries may rely on DocuSign's verification or their sent email timestamp as
verification of receipt by HCA. Additional information and the timelines for Agreements after October 31, 2022 will be
posted to HCA's website at:
https://www.hca.wa.g_ov/billers-providers-partners/program-information-providers/contractor-and-provider-resources
BENEFICIARY NAME
DOING BUSINESS AS (DBA)
Grant County
Renew
BENEFICIARY ADDRESS
CITY- STATE ZIP + 4
840 E Plum St
Moses Lake WA 98823
BENEFICIARY CONTACT
BENEFICIARY CONTACT EMAIL
Dell Anderson
daanderson@grantcountywa.gov
HCA ADDRESS
CITY STATE ZIP + 4
Cherry Street Plaza
626 8th Avenue SE
PO Box 42730
Olympia WA 98504-0001
HCA CONTACT
HCA CONTACT EMAIL
Kimberly Wright
Behavioral Health Policy and Planning Supervisor
HCADBHRinformation@hca.wa.gov
AGREEMENT START DATE
AGREEMENT END DATE
BEHAVIORAL HEALTH
WORKFORCE STABILIZATION
FUNDING PAYMENT
06/30/2023
$677,947.34
I. RECITALS
WHEREAS, the COVID-19 public health emergency created ongoing behavioral health treatment access issues resulting
from workforce shortages and adverse impacts of the emergency; and
WHEREAS, the American Rescue Plan Act of 2021 established the Coronavirus State Fiscal Recovery Fund and Coronavirus
Local Fiscal Recovery Fund, which together make up the Coronavirus State and Local Fiscal Recovery Funds ("SLFRF")
program; and
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DocuSign Envelope ID: BB15A7BB-FD69-4E23-BE47-1 C58B94AOD08
WHEREAS, the SLFRF program provides support to state, territorial, local, and tribal governments responding to the
economic and public health impacts of COVID-19; and
WHEREAS, in Laws of 2022, Chapter 297, Section 215(104) the Washington State Legislature appropriated a portion of
SLFRF for one-time assistance payments ("Behavioral Health Workforce Stabilization" funds, or "BHWS") to non -hospital-
based community behavioral health treatment providers receiving payment for Medicaid services contracted through the
Medicaid managed care organizations or behavioral health administrative service organizations; and
WHEREAS, beneficiaries of the BHWS include Indian health care providers that have received payments from managed
care organizations or behavioral health administrative organizations with or without a contract; and
WHEREAS, HCA notified Beneficiary of its eligibility to receive BHWS funds ("Payment") and Beneficiary affirmed its desire
to receive Payment and provided HCA with the National PI Number in this Agreement.
THEREFORE, the Parties agree as follows:
Ile AGREEMENT
1. AMENDMENTS. Beneficiary agrees to execute amendments to this Agreement if HCA determines it is necessary to
comply with state or federal requirements.
2. COMPLIANCE WITH LAWS, REGULATIONS, AND GUIDANCE.
2.1. AUDITS. Beneficiary will cooperate in audits or reviews conducted by HCA, other state officials, and federal
officials, or their designees, to ensure compliance with this Agreement.
2.2. CERTIFICATIONS. Beneficiary will notify HCA immediately if, during the term of this Agreement, Beneficiary learns
its certification to any of the statements in Section III of this Agreement (Beneficiary Certifications) was erroneous
on the date their authorized representative signed this Agreement or has become erroneous due to a change in
circumstances.
2.3. CONFLICTS BETWEEN REGULATIONS. The parties intend this Agreement will comply with local, state, and federal
laws, regulations, executive orders, policies, procedures, and directives regarding Beneficiary's receipt and use
of the Payment funds. Should there be conflict between any of those authorities and this Agreement, the most
restrictive will govern.
2.4. FEDERAL ASSISTANCE LISTING 21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS. Beneficiary
understands its use of Payment funds must adhere to official federal guidance issued or to be issued for Federal
Assistance Listing 21.027 Coronavirus State and Local Fiscal Recovery Funds, incorporated by reference in this
Agreement. Additional information can be found at the U.S. Department of Treasury website at
www.treasurygov/slfrp and the official U.S. Government website SAM.gov at
https://sam.gov/fal/873dl8612d254bl9b9a535ec690lb5a
2.5. GOVERNING LAW. This Agreement will be construed and interpreted in accordance with Washington State laws,
rules, policies, and executive orders.
2.6. INCORPORATION BY REFERENCE. All statutes and regulations referenced in this Agreement are incorporated by
reference, with the same force and effect as if they were given in full text. Additionally, the exclusion of a specific
applicable provision of any such statute or regulation from this Agreement does not relieve the parties from their
obligation to comply with any such applicable provisions.
2.7. UNIFORM GUIDANCE. The Payment is "other financial assistance" as defined in 2 C.F.R. § 200.1 administered as
direct payments for specified use. Beneficiary is responsible for compliance with the applicable provisions of
2 C.F.R. Part 200, including conflict of interest requirements.
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DocuSign Envelope ID: BB15A7BB-FD69-4E23-BE47-1 C58B94AOD08
3. DISCLAIMER. HCA disclaims all responsibility or liability to Beneficiary or third persons for the actions of Beneficiary
or third persons resulting in any way from Beneficiary's acceptance or use of the Payment.
4. DISPUTES AND REMEDIES.
4.1. ATTORNEYS' FEES AND COSTS. The parties will bear their own costs, expert fees, attorneys' fees, and other fees
incurred in connection with this Agreement and any action or proceeding arising out of or relating to this
Agreement.
4.2. DISPUTE PROCESS. The dispute resolution process in this section will precede any action in a judicial or quasi-
judicial tribunal.
4.2.1. Requests for dispute resolution must be emailed simultaneously to the parties as identified in Section II
Subsection 9 Notices.
4.2.2. Requests for dispute resolution must clearly state:
The disputed issue(s); and
An explanation of the positions of the parties; and
Additional facts if necessary to describe the nature of the dispute; and
The relief requested.
4.2.3. The non -requesting party in the dispute may provide a rebuttal, following the format in Section II
Subsection 4 Disputes and Remedies §4.2.1 and 4.2.2.
4.2.4. The HCA Director or their delegate will determine the date, time, duration, and format for the parties to
present their views on the disputed issue(s) (Dispute Resolution Conference). The HCA Director or their
delegate will consider the information provided during the conference and will provide a written decision
on the disputed issue(s) within thirty (30) calendar days of the conference. The Director or Director's
delegate may require an additional sixty (60) calendar days for their review. If the additional time is
needed, they will notify the parties in writing and provide the anticipated completion date.
4.2.5. The HCA Director may appoint a delegate to represent them at the dispute conference. The HCA Director
will retain final decision-making authority regarding the disputed issue(s). Under no circumstances will
the HCA Director's delegate issue a final decision on the disputed issue(s) without approval of the HCA
Director.
4.3. RECOUPMENT.
4.3.1. Payment funds are subject to recoupment if, after investigation or audit, HCA, other state officials, or
federal officials determine Beneficiary provided HCA false or misleading information pertinent to this
Agreement, including if Beneficiary does not meet the criteria specified in Section III, Subsection 1 through
3.5; or Beneficiary used Payment funds in a manner other than authorized by this Agreement, and/or
federal requirements for receipt and/or use of SLFRF.
4.3.2. Beneficiary will receive an initial written notice of recoupment with an opportunity to request
reconsideration before HCA provides a final notice of recoupment. If Beneficiary receives an initial notice
of recoupment and does not submit a request for reconsideration perthe instructions in the notice or does
not request dispute resolution as allowed in this Agreement, the initial notice will be deemed the final
notice.
4.3.3. The final notice of recoupment will constitute a debt to HCA. The debt is delinquent if it has not been paid
by the date specified in RCA's written notice to Beneficiary unless other satisfactory arrangements have
been made. Interest, penalties, and administrative fees may accrue on delinquent debt, as allowed by law.
4.3.4. Funds for payment of the debt must not come from federally sponsored programs.
4.3.5. HCA may pursue other forms of remediation in conjunction with, or as an alternative to, recoupment.
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DocuSign Envelope ID: BB15A7BB-FD69-4E23-BE47-1 C58B94AOD08
Nothing in this Agreement limits HCA's ability to recover Payment funds through judicial or other
processes under law. If HCA seeks judicial or other processes under law to recover Payment funds, then to
the extent permitted by law, HCA's rights and remedies under this Agreement are cumulative to, and not
exclusive of, rights or remedies otherwise available to HCA.
4.4. VENUE. The venue for any action between the parties relating to this Agreement is the Superior Courtin Thurston
County, Washington.
5. FUNDING PROVISIONS.
5.1. COST SHARING. There are no matching, level of effort, or earmarking compliance responsibilities associated with
the Payment.
5.2. DELIVERY OF PAYMENT. If Beneficiary's National PI number can receive funds through ProviderOne, HCA will
disburse the Payment to Beneficiary's ProviderOne account. If Beneficiary does not have a ProviderOne account,
or the applicable ProviderOne account cannot receive payments, Beneficiary will provide the HCA Contact with
Beneficiary's Statewide Vendor Number to receive the Payment.
5.3. USE OF PAYMENT FUNDS.
5.3.1. ELIGIBLE USE. In accordance with Laws of 2022, Chapter 297, Section 215(104)(c), Beneficiary will use
Payment funds only to cover costs during the Eligible Use Timeframe (defined below) that:
a. Support immediate workforce and retention and recruitment needs; or
b. Are incurred due to the COVID-19 public health emergency; or
c. Support other recruitment efforts to begin adding new staff and rebuilding lost capacity; or
d. Are necessary investments to help stabilize the community behavioral health workforce, including,
but not limited to, childcare stipends, student loan repayment, tuition assistance, or relocation
expenses.
5.3.2. ELIGIBLE USE TIMEFRAME.
a. Expenses identified in Section II Subsection 5 Funding Provisions §5.3.1 Eligible Use incurred by
Beneficiary on or after March 3, 2021 are eligible under this Agreement. "Incurred" means Beneficiary
has incurred an obligation, which has the same meaning given to "financial obligation" in
2 CFR 200.1.
b. Beneficiary will expend all Payment funds received by June 30, 2023.
6. HEADINGS. The headings or captions of sections or subsections in this Agreement are for convenience and are not
intended to define or limit their contents, nor are they to affect the construction of or to be taken into consideration
in interpreting this Agreement.
7. INTEGRATION. Any amendment to this Agreement shall be in writing and shall be signed by Beneficiary's authorized
representative and an authorized representative of HCA. No other understandings, oral or otherwise, regarding the
subject matter of this Agreement will be deemed to exist or to bind either Party.
8. NO ASSIGN MENT. Beneficiary shall not assign this Agreement to a third party without the prior written consent of HCA.
HCA may withhold its consent at its sole discretion.
9. NOTICES. Whenever one party is required to give notice to the other under this Agreement, it will be deemed given if
delivered by email, as follows:
9.1. In the case of notice to the Beneficiary, notice will be sent to:
Beneficiary contact name Dell Anderson
Beneficiary contact email daanderson@grantcountywa.gov
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DocuSign Envelope ID: BB15A7BB-FD69-4E23-BE47-1 C58B94AOD08
9.2. In the case of notice to HCA, send notice to both email addresses below:
Attention: Contract Administrator
Health Care Authority, Division of Legal Services
contracts@hca.wa.gov and HCADBHRinformation(@hca.wa.gov
9.3. Notices are effective on the date delivered as evidenced by the sender's email system or the date returned to
sender for non -deliverable address.
9.4. Either party may change its address for notification purposes by sending notice in accord with this section,
stating the change and its effective date, which shall be effective no earlier than the tenth (10th) business day
following the effective date of the notice.
10. RECORD KEEPING, ACCESS, AND DISCLOSURE.
10.1. DISCLOSURE. This Agreement is a "public record" as defined by Washington's Public Records Act,
RCW 42.56.010(3). Beneficiary consents to HCA, other state officials, and the federal government publicly
disclosing details of this Agreement, the Payment, and Beneficiary's use of the Payment, without notice to
Beneficiary.
10.2. MAINTENANCE OF AND ACCESS TO RECORDS. "Records" are all records created, utilized, or maintained,
including cost documentation, and information required to substantiate Beneficiary's use of Payment funds and
compliance with Beneficiary's obligations in this Agreement, whether paper or electronic.
10.2.1. Beneficiary will maintain records in a manner consistent with 2 CFR §200.334, as applicable.
10.2.2. Beneficiary will provide access to records described in this section, during reasonable hours, to HCA,
other state officials, federal officials, and their designees.
10.2.3. Unless otherwise notified by HCA, Beneficiary will maintain all records related to this Agreement for a
period of six (6) years after Payment funds have been expended by Beneficiary or returned to HCA.
11. REPORTING. Beneficiary will comply with reporting obligations once established by HCA, on Beneficiary's use of
Payment funds.
12. SEVERABILITY. If any provision of this Agreement is held invalid, such invalidity will not affect the other provisions of
this Agreement that can be given effect without the invalid provision, and to this end the provisions this Agreement
are declared severable.
13. SURVIVORSHIP. Provisions in this Agreement which by their nature are intended to survive the expiration,
cancellation, or termination of this Agreement will survive the expiration, cancellation, or termination of this
Agreement.
14. WAIVER. Waiver of any breach or default of this Agreement is not a waiver of any prior or subsequent breach or default.
No provision of this Agreement will be held to be waived, modified, or deleted except by written agreement signed by
authorized authorities of the parties.
III. BENEFICIARY CERTIFICATIONS
By signing this Agreement, the authorized representative of the Beneficiary is providing the certifications set out below.
Nothing contained in the Beneficiary Certifications will be construed to require establishing a system of records to render
in good faith the Beneficiary Certifications. The knowledge and information of the Beneficiary's authorized representative
is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.
If Beneficiary's authorized representative is unable to certify the statements set out below, please notify HCA.
1. Beneficiary is a small business, public nonprofit institution/organization, private nonprofit institution/organization,
or an Indian health care provider receiving payment from managed care organizations or behavioral health
administrative service organizations with or without a contract.
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Certificate`Of Completion
Envelope Id: BB15A7BBFD694E23BE471 C58B94AOD08
Status: Sent
Subject: Please DocuSign: Provider Relief Workforce Stabilization Contract - Grant County Dba Renew
Business Name: Grant County Dba Renew
Source Envelope:
Document Pages: 6
Signatures: 0
Envelope Originator:
Certificate Pages: 4
Initials: 0
Meagan Metzger
AutoNav: Enabled
626 8th Ave SE
Envelopeld Stamping: Enabled
Olympia, WA 98501
Time Zone: (UTC -08:00) Pacific Time (US & Canada)
meagan.metzger@hca.wa.gov
IP Address: 147.55.195.70
Record Tracking
Status: Original
Holder: Meagan Metzger
Location: DocuSign
9/19/2022 7:01:50 PM
meagan.metzger@hca.wa.gov
Signer Events
Signature
Timestamp
Dell Anderson
Sent: 9/19/2022 7:01:51 PM
daanderson@grantcountywa.gov
Viewed: 9/20/2022 9:21:14 AM
Executive Director
County of Grant
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 9/20/2022 9:21:14 AM
ID: f50acfb6-20c9-4b2c-8c59-60e5aa158b18
In Person Signer Events
Signature
Timestamp
Editor Delivery Events
Status
Timestamp
Agent Delivery Events
Status
Timestamp
Intermediary Delivery Events
Status
Timestamp
Certified Delivery Events
Status
Timestamp
Carbon Copy Events
Status
Timestamp
Kimberly Wright
HCADBHRinformation@hca.wa.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events
Signature
Timestamp
Notary Events
Signature
_Timestamp
Envelope Summary Events
Status
Timestamps
Envelope Sent
Hashed/Encrypted
9/19/2022 7:01:51 PM
Certified Delivered
Security Checked
9/20/2022 9:21:14 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on: 5/22/2019 6:49:33 AM
Parties agreed to: Dell Anderson
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From time to time, CloudPWR OBO Washington State Health Care Authority -Sub Account (we,
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