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HomeMy WebLinkAboutbocc.con.362.2017 - BOCC CONTRACT # 361- RESOLUTION OF THE BOARD OF COUNTY 6,444•ativa) COMMISSIONERS("BOCC)OF PITKIN COUNTY, COLORADO, APPROVING AN INTERGOVERNMENTAL AGREEMENT BETWEEN PITKIN COUNTY ("PITKIN") AND ASPEN SCHOOL DISTRICT('ASD"), ASPEN VALLEY HOSPITAL ("AVIV)AND CITY OF ASPEN ("COA")FOR THE PURCHASE OF VITAL MENTAL.HEALTH SERVICES RESOLUTION NO.O ( -2017 RECITALS: 1. Pursuant to Title 29. Article 1,part 2. Colorado Revised Statutes, as amended(the "Intergovernmental Relations Statutes")and Articla XIV, Section 18 of the Colorado Constitution,governments may contract with one another to provide any function, service or facility lawfully authorized to each of the contracting units and any such contract may provide for the joint esereise of the function, service or facility. including the establishment of a separate legal entity to do so. 2. Pursuant to Section 2.8 3 (Actions)of the Pitkin County Home Rule Chartet ("I WC") official action by formal resolution shall he required for all actions of the Board not requiring ordinance power on matters of significant impottance affecting citizens 3. Pitkin County("Pitkin") and Aspen School District("ASD"), Aspen Valley Hospital CAVIL-land City of Aspen("COA")wish to enter into an • intergovernmental agreement for the purposes of pooling their financial resources to purchase vital mental health services: and 4. Pakm and ASD, AVII and COA are governments authorized to enter into agreements pursuant to C.R.S. §29-1-203 for purposes including the provision of any firnetton,sen ice, or facility lawfully authorized to each:and 5. The BOCC finds that it is in the best interests of the citizens of Pitkin and ASO. AVH and COA to enter into this agreement in order to ensure the health and welfare of the people who Eve,work and play in Pitkin County. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Pitkin County. Colorado that Pitkm County is authorized to enter into an Intergovernmental Agreement with Aspen School District, Aspen Valley Hospital and City of Aspen in substantially the same form satisfactory to the County Attorney, and authorizes the Chair or designee, to sign the resolution and the agreement on behalf of the County. TINS FORM SIIOUl .1) ALWAYS BE ON A SEPARATE PAGE. INTRODUCED AND FIRST READ ON THE C. DAY OF (_t iU 6FV , 2017. ANDS.ET FOR SECOND READING AND PUBLIC HEARING ON THEY '_DAY OFv (.4m1Te12017. NOTICE OF PUBLIC HEARING AND TITLE AND SHORT SUMMARY OF,THE RES .EDON PUBLISHEDPUBLISHEDIN TIIE ASPEN TIMES WEEKLY ON THE `,7"1-' DAY OF 1/r u 2017. NOTICE OF PUBLIC' HEARING AND THE FULL TEXT OF THE RESOLUTION POSTED ON TIIE OFFI r PITKIN COUNTY WEBSITE (ww .pitkincountv.com ) ON THE ,i7,01‘• DAY 4 1 _-Vu( Y 2017. ADOPTED-4 E�FER FINAL READING AND PUBLIC HEARING ON THE csk 64— DAY OF 1<�4 . .M r 2017. PUBLISHED BY TITLE AND SHORT�1 SUMMARY-DEER ADOPTION, IN TIIE ASPEN TIMES WEEKLY ON THE % DAY OF11. tlaLr� , 2017- POSTED BY TITLE AND SHORT SUMMARY ON THE OFFJ6k PITK[N COUNTY WEBSITE (u�tvw.vitkincounly.com ) ON THE�j l DAY OF .C(,.6'Jgti// 2017. ATTEST: BOARD OF COUNTY COMMISSIONERS 1I �Q BY•_l LI.l. ' ), I By:�C _l,(a Jeanette Jones George Newman, Chir Deputy County Clerk Date' IZ- LI - 2JI { APPROVED AS TO FORM: MANAGER APPROVAL. Johr 1yjr ttorney Jon Peacock, County Manager INTERGOVERNMENTAL AGREEMENT For The Purchase of Vital Mental Health Services THIS INT.E. GOVERNMENTAL AGREEMENT (the "Agreement") is made this /7"a' day of I JC G.ZYrtibe. r , 2017 by and between the Board of County Commissioners of Pitkin County, Colorado, whose address is 123 Emma Road, Suite 106, Basalt, CO 81621 ("the County"), Aspen Valley Hospital ("AVIV), Aspen School District ("ASH"), and the City of Aspen. ("COA"), and hereinafter severally referred to by name or collectively as the "Participating Members' RECITALS 1. This Agreement is entered into pursuant to, inter cilia, C.R.S. §§ 29-1-201, et seq., and Article XIV, Section 18 of the Colorado Constitution. 2. Mental Health and Substance use have long been identified as the most significant health issues facing the people who live, work and play in Pitkin County. High rates of suicide, mixed messages surrounding the promotion of our "party town", high rates of depression and anxiety, sleep disturbances,financial pressures, lack of psychiatric care, lack of specialized support for marginalized populations and the high cost of treatment, as well as other issues have inspired a number of different non-profit and private providers to try to step up and respond. Although there are many assets within the community along the system of care, gaps still remain, and many of our most vulnerable residents fall through the cracks of a fragmented system. 3 The local funding stakeholders of Pitkin County engaged in a focused strategic planning process with the purpose of rapidly improving access to mental health and substance use programs and services for all county residents by changing the way funding is allocated to programs. These Funders (Pitkin County, Aspen School District, Aspen Valley Hospital and Pitkin County— "Participating Members") have committed to improving or creating new funding strategies and to using funding strategically to strengthen the system of care and improve service delivery. 4. The Participating Members strive to create system of care change that rapidly improves access to mental health and substance use services for Pitkin County residents by defining funding methods and applying financial resources to support programs that reflect system of care priorities, provide needed services and demonstrate collaboration 5. Participating Members have historically supported mental health and substance use providers through both charitable and support contributions and contracts for services as ways to address the health, safety and wellbeing of their residents 1 6. Participating Members desire to establish a sustainable, integrated, high- quality system of care and are committed to realigning funding and human resources to address ongoing unmet Mental Health needs 7. In July, 2017, Pitkin County, on behalf of the strategic funders' advisory committee, issued a Request for Proposals (RFP) for the provision of integrated, collaborative mental health and substance use prevention, intervention, treatment and case management services. Participating Members selected Mind Springs Health (MSH) (in collaboration with Mountain Family Health Centers (MFHC)based on their proposal f community mental health, crisis services, integrated health services and school based services. 8 Participating Membeis agree to collectively pool their funding to support the selected vendor in 2018 (MSH and MFHC) for specified community mental health, crisis stabilization, integrated behavioral health care and school based services. This will require that the members redeploy funding that is currently being applied in accordance with contracts, agreements or contribution arrangements for behavioral health sci vices provided to members and their departments, including: in Pitkin County- Public Health, Human Services, Healthy Community Fund. Sheriff's Office, Communications Center and Jail. Departments in the City of Aspen include the Aspen Police Department and City Manager's office. Departments in the Schools include the Superintendent's office, Special Education, and School Counselors. Finally, the departments at Aspen Valley Hospital include the Emergency Department and Patient Care and Intensive Care Unit (inpatients). At each member's option, contribution arrangements or other contracts may he continued in order to fulfill existing commitments such as capital campaigns or other financial support for behavioral health services not otherwise included in this IGA. 9 Participating Members reached an agreement on an initial funding model for 2018 based on historic funding contributions, to provide integrated, collaborative mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs and agree to consider future funding models and RFP's as they are submitted. 10. Participating Members already have existing relationships with the vendors selected for 2018 and it is believed that this agreement will serve to enhance and strengthen these relationships. 10. Participating Members have agreed to refine the funding model for 2019 to ensure an adequate and equitable distribution of responsibility for future financial support for integrated, collaborative mental health and substance use prevention, intervention,crisis stabilization, treatment and case management programs 11. The Participating Members do hereby collectively determine and declare that this Intergovernmental Agreement is necessary, proper and convenient for the continued fostering and preservation of the public health, safety and wellbeing. AGREEMENT NOW, THEREFORE, for and in consideration of the mutual promises and agreements of the parties and other good and valuable consideration, the adequacy and sufficiency of which is hereby acknowledged, the parties agree as follows ARTICLE 1 —TERM AND EFFECT 1. Effect of IGA—Except as expressly provided herein, this IGA shall replace and supersede all prior agreements of any kind between all or any of the Participating Members and any or all other Participating members hereto, to the extent and for the limited purpose as such other agreements may be related to the provision of funding collaborative and integrated mental health and substance abuse prevention, intervention, crisis stabilization, treatment and case management programs. 2. Term—The initial term of this IGA shall commence on January, 1, 2018 and will be in effect until any one of the parties terminates the agreement per paragraph 13 of Article III. ARTICLE 11—FISCAL AGENT AGREEMENT I. Pitkin County agrees to be the fiscal agent providing payment to Mind Springs Health (and Mountain Family Health Centers) in the amount of$488,000 in 2018 for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment, and case management programs per the contract and approved in the County's 2018 budget (See Exhibit A- 2018 Scope of Work). 2. The Participating Members agree to provide funding in return for collaborative and integrated mental health and substance use prevention, intervention,crisis stabilization, treatment and case management programs as follows. By October each year Mind Springs Health (and Mountain Family Health Centers) will provide the County with a budget to fund collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment, and case management programs for the next fiscal year. The share for each entity will be determined as follows: 3 a In-Kind Contributions: Pitkin County shall provide, at no cost, space in the Schultz Health and Human Services Building to Mind Springs Health for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs. The value of this space is recognized as $59,766 per year ii. Aspen School District shall provide, at no cost, space in the Aspen Middle School for Mind Springs Health a youth and family clinician. The value of this space is recognized as $45,000 per year h. Participating Members will provide cash funding to Pitkin County for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs: Any changes to the total amount or the formula in subsequent fiscal veal contributions will be approved by the managers of Participating Members and will replace the list below; i. In 2018, Aspen Valley Hospital agrees to pay $73,275 of the provision of collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers it. In 2018, Aspen School district agrees to pay $40,000 for the provision of a school based youth and family clinician provided by Mind Springs Health. iii. In 2018, City of Aspen agrees to pay $70,550 for the provision of collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers iv In 2018, Pitkin County agrees to pay $304,507 for the provision of collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers c. Pitkin County will pay Mind Springs Health monthly based on invoices of actual expenses less other revenues. d. Participating Members will seek other funding partners and grants to continue to support these essential community services and address gaps in service 4 a. Quality Assurance- Participating Members are committed to woilung together to ensure that relevant performance measures are developed and utilized for the purpose of on-going evaluation of services provided by the vendor(s) in accordance with the representations made in the vendor(s) response to the RFP and in order to meet the needs of the community i. Pitkin County Public Health will be responsible for contract compliance with the selected vendors ii Participating Members agree to meet monthly to review performance measures, along with financial expenditures and budget compliance, during the first six months, then quarterly thereafter in. Participating Members agree to assign staff to participate in monthly operations reviews (protocols. issues, needs, communication,debriefs, etc) with vendors iv. Participating Members agree to develop performance measures with the vendor and to support the measurement process by providing data as necessary from the perspective of each member's operations. ARTICLE III—GENERAL PROVISIONS 1. Assignability. This agreement is not assignable by either party 2. Modification This Agreement may be changed or modified only in writing by an agreement approved by the respective Boards of the Governments and signed by authorized officers of each party. 3. Entire Agreement. This Agreement constitutes the entire Agreement between the parties and all other promises and agreements relating to the subject of this Agreement, whether oral or written, are merged herein. 4 Severability. Should any one or more sections or provisions of this Agreement he judicially adjudged invalid or unenforceable, such judgment shall not affect, impair, or invalidate the remaining provisions of this Agreement, the intention being that the various sections and provisions hereof arc severable. 5. Notices. Any notice required or permitted under this Agreement shall be in writing and shall be provided by electronic delivery to the e-mail addresses set forth below and by one of the following methods 1) hand-delivery or 2) registered or certified mail, postage pre-paid to the mailing addresses set forth below Each party by notice sent under this paragraph may change the address to which future notices should be sent. Electronic delivery of notices shall he considered delivered upon receipt of confirmation of delivery on the part of the sender. 5 Nothing contained herein shall be construed to preclude personal service of any notice in the manner prescribed for personal service of a summons or other legal process. To: Jon Peacock With copies to: Pitkin County Manager Pitkin County Attorney's Office 123 Emma Road 123 Emma Road. Suite 204 Basalt, CO 81621 Basalt. CO 81621 970-920-5067 attorney@'pitkincountv.com To: Steve Barwick City of Aspen Attorney City Manager 130 South Galena Street 130 South Galena Street Aspen, CO 81611 Aspen, CO 81611 970-920-5212 970-920-5212 To: Dave Ressler Aspen Valley Hospital Attorney Chief Executit e Officer 0401 Castle Creek Road 0301 Castle Creek Road Aspen. CO 81611 Aspen, CO 81611 970-925-1142 970-544-1261 To: John Maloy Aspen School District Attorney Superintendent 235 High School Road 235 High School Road Aspen, CO 81611 Aspen, CO 81611 970-925-3760 970-925-3760 6. Goi'ernment Immunity. The parties agree and understand that both parties are relying on and do not waive, by any provisions of this Agreement, the monetary limitations or terms or any other rights, immunities, and protections provided by the Colorado Governmental immunity Act, C.R.S. 24-10-101,et seq.. as from time to time amended or otherwise available to the parties or any of their officers, agents, or employees. 7. Current Year Obligations. The parties acknowledge and agree that any payments provided for hereunder or requirements for future appropriations shall constitute only currently budgeted expenditures of the parties. The parties' obligations under this Agreement are subject to each individual party's annual right to budget and appropriate the sums necessary to provide the services set forth herein. No provision of this Agreement shall be construed or interpreted as creating a multiple fiscal year direct or indirect debt or other financial obligation of either or both parties within the meaning of any constitutional or statutory debt limitation. 6 This Agreement shall not be construed to pledge or create a lien on any class or source of either parties' bonds or any obligations payable from any class or source of each individual party's money. 8. Binding Rights and Obligations. The rights and obligations of the parties under this Agreement shall be binding upon and shall inure to the benefit of the parties and their respective successors and assigns. 9. Agreement made in Colorado. This Agreement shall be construed according to the laws of the State of Colorado, and venue for any action shall be in the District Court in and for Pitkin County, Colorado. 10. Attorney Fees. In the event that legal action is necessary to enforce any of the provisions of this Agreement, the substantially prevailing party, whether by final Judgment or out of court settlement, shall recover from the other party all costs and expenses of such action or suit including reasonable attorney's fees 11. No Waiver. The waiver by any party to this Agreement of any term or condition of this Agreement shall not operate or he construed as a waiver of any subsequent breach by any party. 12. Authority. Each person signing this Agreement represents and warrants that said person is fully authorized to enter into and execute this Agreement and to bind the party it represents to the terms and conditions hereof. 13. Termination Prior to Expiration of Term Any Party has the right to terminate or withdraw from this Agreement, with or without cause, by giving written notice to the other Parties of such termination and specifying the effective date thereof. Such notice shall be given at least ten (10) days before the effective date of such p% termination. Termination of the Agreement relieves the cancelling or withdrawing Party of any further responsibility under this Agreement except for specifically identified obligations of a continuing nature based upon pass performance under the Agreement. The foregoing Agreement is approved by the Board of County Commissioners of Ptrkin County, Colorado at its regular meeting held on the )-oJ day of lf;C Udigout✓ , 2017 The foregoing Agreement is approved by\Aspen School District at its regular meeting held on the i'd' day of "et rY . 2�. '10l I 7 ASPEN SCHOOL DISTRICT By: Date:__ Sheila Wills, Chair The foregoing Agreement is approved by Aspen Valley Hospital at its regular meeting held on the day of , 2017. ASPEN VALLEY HOSPITAL DISTRICT By: Date: Mindy Nagle, Chair The foregoing Agreement is approved by City of Aspen at its regular meeting held on the day of , 2017. CITY OF ASPEN By: Date- Steve ate Steve Skadron, Mayor In Witness whereof, the parties hereto have caused this agreement to be executed as of the day and year first above written. BOARD OF COUNTY COMMISSIONERS APPROVED AS TO FORM OF P11 KIN COUNTY, COLORADO c \ i By: Lata. By: Chair County Attorney Manager Approval: By. ii01111P __— J -acock, County Manager 8 Counterpart to IGA by Aspen School District Approved January 8, 2018 INTERGOVERNMENTAL AGREEMENT For The Purchase of Vital Mental Health Services ,',,,,,A�tt"THIS 1N3RGOVERNMENTAL AGREEMENT(the"Agreement')is made this ev-- day of PP e...P.w hips 2017 by and between the Board of County Commissioners of Pitkin County, Colorado, whose address is 123 Emma Road, Suite 106,Basalt, CO 81621 ("the County"), Aspen Valley Hospital ("AVH"),Aspen School District("ASO"), and the City of Aspen. ("COA"),and hereinafter severally referred to by name or collectively as the"Participating Members". RECITALS I. This Agreement is entered into pursuant to,infer alias C.R.S. §§29-1-201, et seq.,and Article XIV,Section 18 of the Colorado Constitution. 2. Mental Health and Substance use have long been identified as the most significant health issues facing the people who live,work and play in Pitkin County.High rates of suicide,mixed messages surrounding the promotion of our'party town",NO rates of depression and anxiety,sleep disturbances,financial pressures,lack of psychiatric care,lack of specialized support for marginalized populations and the high cost of treatment,as well as other issues have inspired a number of different non-profit and private providers to try to step up and respond.Although there are many assets within the community along the system of care,gaps still remain,and many of our most vulnerable residents fall through the cracks of a fragmented system. 3. The local funding stakeholders of Pitkin County engaged in a focused strategic planning process with the purpose of rapidly improving access to mental health and substance use ptograms and services for all county residents by changing the way funding is allocated to programs. These Funders(Pitkin County,Aspen School District, Aspen Valley Hospital and Pitkin County—"Participating Members')have committed to improving or creating new funding strategies and to using finding strategically to strengthen the system of care and improve service delivery. 4. The Participating Members strive to create system of care change that rapidly improves access to mental health and substance use services for Pitkin County residents by defining funding methods and applying financial resources to support programs that reflect system of care priorities,provide needed services and demonstrate collaboration. 5. Participating Members have historically supported mental health and substance use providers through both charitable and support contributions and contracts for services as ways to address the health,safety and wellbeing of their residents. 1 6. Participating Members desire to establish a sustainable,integrated,high- quality system of care and are committed to realigning funding and human resources to address ongoing unmet Mental Health needs 7. In July, 2017,Pitkin County, on behalf of the strategic hinders' advisory committee, issued a Request for Proposals (RFP)for the provision of integrated, collaborative mental health and substance use prevention, intervention,treatment and case management services. Participating Members selected Mind Springs Health(MSH) (m collaboration with Mountain Family Health Centers(MFHC)based on their proposal f community mental health, crisis services,integrated health services and school based services 8. Participating Members agree to collectively pool their finding to support the selected vendor in 2018 (MSH and MFHC)for specified community mental health, crisis stabilization, integrated behavioral health care and school based services.This will require that the members redeploy funding that is currently being applied in accordance with contracts,agreements or contribution arrangements for behavioral health services provided to members and their departments,including hi Pitkin County-Public Health, Human Services,Healthy Community Fund, Sheriff's Office, Communications Center and Jail Departments in the City of Aspen include the Aspen Police Department and City Manager's office. Departments in the Schools include the Superintendent's office, Special Education, and School Counselors. Finally,the departments at Aspen Valley Hospital include the Emergency Department and Patient Care and Intensive Care Unit (inpatients).At each member's option, contribution arrangements or other contracts may be continued in order to fulfill existing commitments such as capital campaigns or other financial support for behavioral health services not otherwise included in this IGA. 9. Participating Members reached an agreement on an initial funding model for 2018 based on historic funding contributions,to provide integrated, collaborative mental health and substance use prevention,intervention,crisis stabilization,treatment and case management programs and agree to consider future funding models and RFP's as they are submitted. 10. Participating Members already have existing relationships with the vendors selected for 2018 and it is believed that this agreement will serve to enhance and strengthen these relationships. 10. Participating Members have agreed to refine the funding model for 2019 to ensure an adequate and equitable distribution of responsibility for future financial support for integrated,collaborative mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs 2 11. The Participating Members do hereby collectively determine and declare that this Intergovernmental Agreement is necessary, proper and convenient for the continued fostering and preservation of the public health, safety and wellbeing. AGREEMENT NOW, THEREFORE, for and in consideration of the mutual promises and agreements of the parties and other good and valuable consideration, the adequacy and sufficiency of which is hereby acknowledged, the parties agree as follows ARTICLE 1 —TERM AND EFFECT 1. Effect of IGA—Except as expressly provided herein, this IGA shall replace and supersede all prior agreements of any kind between all or any of the Participating Members and any or all other Participating members hereto, to the extent and for the limited purpose as such other agreements may be related to the provision of funding collaborative and integrated mental health and substance abuse prevention, intervention, crisis stabilization, treatment and case management programs. 2 Term—The initial term of this IGA shall commence on January, 1, 2018 and will be in effect until any one of the parties terminates the agreement per paragraph 13 of Article III. ARTICLE 11 —FISCAL AGENT AGREEMENT 1. Pitkin County agrees to be the fiscal agent providing payment to Mind Springs Health (and Mountain Family Health Centers) in the amount of$488,000 in 2018 for collaborative and integrated mental health and substance use prevention, intervention,crisis stabilization, treatment, and case management programs per the contract and approved in the County's 2018 budget(See Exhibit A- 2018 Scope of Work). 2. The Participating Members agree to provide funding in return for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs as follows By October each year Mind Springs Health (and Mountain Family Health Centers) will provide the County with a budget to fund collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment, and case management programs for the next fiscal year. The share for each entity will be determined as follows 3 a In-Kind Contributions: i. Pitkin County shall provide, at no cost,space in the Schultz Health and Human Services Building to Mind Springs Health for collaborative and integrated mental health and substance use prevention,intervention,crisis stabilization,treatment and case management programs.The value of this space is recognized as $59,766 per year. ii. Aspen School District shall provide, at no cost,space in the Aspen Middle School for Mind Springs Health a youth and family clinician. The value of this space is recognized as $45,000 per year. b. Participating Members will provide cash funding to Pitkin County for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization,treatment and case management programs:Any changes to the total amount or the formula in subsequent fiscal year contributions will be approved by the managers of Participating Members and will replace the list below; i. In 2018,Aspen Valley Hospital agrees to pay$73,275 of the provision of collaborative and integrated mental health and substance use prevention, intervention,crisis stabilization, treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers ii. In 2018,Aspen School district agrees to pay$40,000 for the provision of a school based youth and family clinician provided by Mind Springs Health. iii. In 2018,City of Aspen agrees to pay$70,550 for the provision of collaborative and integrated mental health and substance use prevention,intervention,crisis stabilization,treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers iv. In 2018,Pitkin County agrees to pay$304,507 for the provision of collaborative and integrated mental health and substance use prevention,intervention,crisis stabilization,treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers c. Pitkin Count will pay Mind Springs Health monthly based on invoices of actual expenses less other revenues. d Participating Members will seek other funding partners and grants to continue to support these essential community services and address gaps in service. 4 a. Quality Assurance-Participating Members are committed to working together to ensure that relevant performance measures are developed and utilized for the purpose of on-going evaluation of services provided by the vendor(s)in accordance with the representations made in the vendor(s) response to the RPP and in order to meet the needs of the community. i. Pitkin County Public Health will he responsible for contract compliance with the selected vendors ii. Participating Members agree to meet monthly to review performance measures,along with financial expenditures and budget compliance,during the first six months,then quarterly thereafter iii. Participating Members agree to assign staff to participate in monthly operations reviews(protocols, issues, needs, communication,debriefs,etc)with vendors iv. Participating Members agree to develop performance measures with the vendor and to support the measurement process by providing data as necessary from the perspective of each member's operations ARTICLE III—GENERAL PROVISIONS 1. Assignability_ This agreement is not assignable by either party. 2 Modification This Agreement may be changed or modified only in writing by an agreement approved by the respective Boards of the Governments and signed by authorized officers of each party. 3. Entire Agreement. This Agreement constitutes the entire Agreement between the parties and all other promises and agreements relating to the subject of this Agreement,whether oral or written,are merged herein. 4. Severability. Should any one or more sections or provisions of this Agreement be judicially adjudged invalid or unenforceable, such judgment shall not affect, impair,or invalidate the tenanting provisions of this Agreement,the intention being that the various sections and provisions hereof are severable. 5. Notices. Any notice required or permitted under this Agreement shall be in 'writing and shall be provided by electronic delivery to the e-mail addresses set forth below and by one of the following methods 1)band-delivery or 2)registered or certified mail, postage pre-paid to the mailing addresses set forth below. Each party by notice sent under this paragraph may change the address to which future notices should be sent. Electronic delivery of notices shall be considered delivered upon receipt of confirmation of delivery on the part of the sender. 5 • Nothing contained herein shall be construed to preclude personal service of any notice in the manner prescribed for personal service of a summons or other legal process. To: Jon Peacock With copies to: Pitkin County Manager Pitkin County Attorney's Office 123 Emma Road 123 Emma Road, Suite 204 Basalt, CO 81621 Basalt,CO 81621 970-920-5067 attomey(roitkincounty.com To: Steve Barwick City of Aspen Attorney City Manager 130 South Galena Street 130 South Galena Street Aspen,CO 81611 Aspen, CO 81611 970-920-5212 970-920-5212 To: Dave Ressler Aspen Valley Hospital Attorney Chief Executive Officer 0401 Castle Creek Road 0401 Castle Creek Road Aspen,CO 81611 Aspen, CO 81611 970-925-1142 970-544-1261 To: John Maloy Aspen School District Attorney Superintendent 235 High School Road 235 High School Road Aspen,CO 81611 Aspen, CO 81611 970-925-3760 970-925-3760 6. Government Immunity. The parties agree and understand that both parties are relying on and do not waive,by any provisions of this Agreement, the monetary limitations or terms or any other rights, immunities, and protections provided by the Colorado Governmental Immunity Act,C.R.S. 24-10-101, et seq., as from time to time amended or otherwise available to the parties or any of their officers, agents, or employees 7. Current Year Obligations. The parties acknowledge and agree that any payments provided for hereunder or requirements for future appropriations shall constitute only currently budgeted expenditures of the parties. The parties' obligations under this Agreement are subject to each individual party's annual right to budget and appropriate the sums necessary to provide the services set forth herein No provision of this Agreement shall be construed or interpreted as creating a multiple fiscal year direct or indirect debt or other financial obligation of either or both parties within the meaning of any constitutional or statutory debt limitation. 6 This Agreement shall not be construed to pledge or create a lien on any class or source of either parties' bonds or any obligations payable from any class or source of each individual party's money. 8 Binding Rights and Obligations. The rights and obligations of the parties under this Agreement shall be binding upon and shall inure to the benefit of the parties and their respective successors and assigns. 9. Agreement made in Colorado. This Agreement shall be construed according to the laws of the State of Colorado,and venue for any action shall be in the District Court in and for Pitkin County,Colorado. 10.Attorney Fees. In the event that legal action is necessary to enforce any of the provisions of this Agreement, the substantially prevailing party,whether by final judgment or out of court settlement, shall recover from the other party all costs and expenses of such action or suit including reasonable attorney's fees. II No Waiver, The waiver by any party to this Agreement of any term or condition of this Agreement shall not operate or be construed as a waiver of any subsequent breach by any party 12. Authority. Each person signing this Agreement represents and warrants that said person is fully authorized to enter into and execute this Agreement and to bind the party it represents to the terms and conditions hereof. 13. Termination Prior to Expiration of Term. Any Party has the right to terminate or withdraw from this Agreement, with or without cause, by giving written notice to the other Parties of such termination and specifying the effective date thereof. Such notice shall be given at least ten (10) days before the effective date of such termination.Termination of the Agreement relieves the cancelling or withdrawing Party of any further responsibility under this Agreement except for specifically identified obligations of a continuing nature based upon pass performance under the Agreement The foregoing Agreement is approved by the Board of County Commissioners of Pi�km County,Colorado at its regular meeting held on the n0`t day of ' IA;d,bwiny ,^_017 The foiegoing Agrecm__cgqt is approved by Aspen School District at its regular meeting held on the V"- day of i(i.µ./G_r�/ , 241-7. 200(8 l 7 This Agreement shall not be construed to pledge or create a lien on any c1: : .r source of either parties'bonds or any obligations payable from any clan• .r source of each individual party's money. 8. Binding Rights and Obligations. The rights and obligations o e parties under this Agreement shall be binding upon and shall inure to the .enefit of the parties and their respective successors and assigns. 9, Agreement made in Colorado. This Agreement :.11 be construed according to the laws of the State of Colorado,and venue any action shall be in the District Court in and for Pitkin County,Colorado. 10. Attorney Fees. In the event that le:. action is necessary to enforce any of the provisions of this Agreement,Pr .ubstantially prevailing party,whether by final judgment or out of court settLent,shall recover from the other party all costs and expenses of such acts, or suit including reasonable attorney's fees. 11, No Waiver. The w er by any party to this Agreement of any term or condition of this Agreeme• shall not operate or be construed as a waiver of any subsequent breach by an .arty. 12. Autho_a , Each person signing this Agreement represents and warrants that said pe . is fully authorized to enter into and execute this Agreement and to bind the , it represents to the terms and conditions hereof. The foregoing Agreement is approved by the Board of County Commissioners of Atkin County,Colorado at its regular meeting held on the ' day of Ut t;2017 The foregoing Agreement is approved ay Aspen School District at its regular meeting held on theta' day of +.U,v[e.v y , 2017. ASPEN SCHOOL DIST,IIICT By:F..,._� l'./✓i _(i Date. Nig Sheila Wills,Chair ((( The foregoing Agreeme t is approved by Aspen Valley Hospital at its regular meeting held on the g day of elitlA.W1 ,201-7. ,e/ 7 EXHIBIT A Pitkin County Mental Health Strategic Funding 2018 Scope of Services with Mind Springs Health Contract Community Based Mental Health Team-$171,468 • 1.0 FTE Licensed Therapist:Rapid Response Mobile Unit Team Member-intensive, community based, outpatient treatment focused on high risk individuals who might not come into a clinic setting Includes peer counseling,case management and therapy services Intensive Stabilization Program Team Member-after crisis intervention,serve as a bridge between cnsis services and standard outpatient services. • 1 0 FTE Case Manager:Rapid Response Mobile Unit Team Member(see above). Intensive Stabilization Program Team Member(see above) • 60 Hrs of Advanced Psychiatric Nurse Practitioner time for Jail individuals who need mental health interventions,but did not meet the state's JBBS critena.Nurse can prescribe meds to individuals needing medication management. Integrated Care Team-$197,818 • 2 0 Behavioral Health Specialists:This staff will work in the Mt.Family Basalt Clinic, and expand the current behavioral health program there They will provide outpatient(6 sessions)services for families,substance use disorders,trauma,hypnosis,animal assisted and other evidence based therapies • 2.0 Patient Care Coordinators.Care Coordinators will work in the Mt.Family Basalt Clmrc,one will be a patient educator,and the other a social health advocate.The patient educator will advocate for the patient and family,facilitating culturally appropriate communication between patient and providers and will identify and decrease barriers to behavior change and improve access to needed services The social health advocate will provide care coordination to patients who are at most risk for health detenoration and/or poor outcomes.The social health advocate will assess the determinants of health and assist the patient in addressing bathers and increase access to services. • Telepsych(4 hours)to link patients to psychiatric care School Based Licensed Therapists—118,715 • 1 FTE Aspen School District Therapist-on-sight therapist for students with depression, trauma,and/or anxiety,substance abuse and consultation with school staff to facilitate assessment by a multidisciplinary team-available to all three schools 9 Counterpart to IGA by City of Aspen Approved December 18, 2017 INTERGOVERNMENTAL AGREEMENT For The Purchase of Vital Mental Health Services ,,,,,,,,,,rr—,�THIS GOVERNMENTAL AGREEMENT(the"Agreement")is made this ev" day o A »Away 2017 by and between the Board of County Commissioners of Pitkin County, Colorado,whose address is 123 Emma Road, Suite 106,Basalt, CO 81621 ("the County"), Aspen Valley Hospital CAW"),Aspen School District("ASD"), and the City of Aspen.("COA"),and hereinafter severally referred to by game or collectively as the'Participating Members". , RECITALS 1. This Agreement is entered into pursuant to,inter alio,CALS. §§29-1-201, etseq., and Article XIV,Section 18 of the Colorado Constitution. 2. Mental Health and Substance use have long been identified as the most significant health issues facing the people who live,work and play in Pitkin County.High rates of suicide,mixed messages surrounding the promotion of our"party town",high rates of depression and anxiety,sleep disturbances,financial pressures,lack of psychiatric care,lack of specialized support for marginalized populations and tbahigh cost of treatment,as well as other issues have inspired a number of different non-profit and private providers to try to step up and respond.Although there are many assets within the community along the system of care,gaps still remain,and many of our most vulnerable residents fall through the cracks of a fragmented system. 3. The local funding stakeholders of Pitkin County engaged in a focused strategic planning process with the purpose of rapidly improving access to mental health and substance use programs and services for all county residents by changing the way funding is allocated to programs. These Funders(Pitkin County,Aspen School District, Aspen Valley Hospital and Pitkin County—"Participating Members")have committed to improving or creating new funding strategics and to using funding strategically to strengthen the system of care and improve service delivery. 4. The Participating Members strive to create system of care change that rapidly improves access to mental health and substance use services for Pitkin County residents by defining funding methods and applying financial resources to support programs that reflect system of care priorities,provide needed services and demonstrate collaboration. 5. Participating Members have historically supported mental health and substance use providers through both charitable and support contributions and contracts for services as ways to address the health,safety and wellbeing of their residents. 6. Participating Members desire to establish a sustainable, integrated, high- quality system of care and are committed to realigning funding and human resources to address ongoing unmet Mental Health needs 7. In July,2017,Pitkin County,on behalf of the strategic funders' advisory committee,issued a Request for Proposals(RFP)for the provision of integrated, collaborative mental health and substance use prevention, intervention,treatment and case management services Participating Members selected Mind Springs Health(MSH) (in collaboration with Mountain Family Health Centers (MFHC)based on their proposal f community mental health,crisis services,integrated health services and school based services. 8. Participating Members agree to collectively pool their funding to support the selected vendor in 2018(MSH and MFHC) for specified community mental health, crisis stabilization,integrated behavioral health care and school based services.This will require that the members redeploy funding that is currently being applied in accordance with contracts,agreements or contribution arrangements for behavioral health services provided to members and their departments,including: iii Pitkm County-Public Health, Human Services,Healthy Community Fund, Sheriffs Office,Communications Center and Jail Departments in the City of Aspen include the Aspen Police Department and City Manager's office. Departments in the Schools include the Superintendent's office, Special Education, and School Counselors. Finally,the departments at Aspen Valley Hospital include the Emergency Department and Patient Care and Intensive Care Unit (inpatients).At each member's option, contribution arrangements or other contracts may be continued m order to fulfill existing commitments such as capital campaigns or other financial support for behavioral health services not otherwise included in this IGA. 9. Participating Members reached an agreement on an initial funding model for 2018 based on historic funding contributions,to provide integrated, collaborative mental health and substance use prevention,intervention,crisis stabilization,treatment and case management programs and agree to consider future funding models and RFP's as they are submitted. 10. Participating Members already have existing relationships with the vendors selected for 2018 and it is believed that this agreement will serve to enhance and strengthen these relationships 10. Participating Members have agreed to refine the funding model for 2019 to ensure an adequate and equitable distribution of responsibility for future financial support for integrated, collaborative mental health and substance use prevention, intervention, crisis stabilization,treatment and case management programs. 2 11. The Participating Members do hereby collectively determine and declare that this Intergovernmental Agreement is necessary, proper and convenient for the continued fostering and preservation of the public health, safety and wellbeing AGREEMENT NOW, THEREFORE, for and in consideration of the mutual promises and agreements of the parties and other good and valuable consideration, the adequacy and sufficiency of which is hereby acknowledged, the parties agree as follows: ARTICLE 1—TERM AND EFFECT Effect of IGA—Except as expressly provided herein, this IGA shall replace and supersede all prior agreements of any kind between all or any of the Participating Members and any or all other Participating members hereto, to the extent and for the limited purpose as such other agreements may be related to the provision of funding collaborative and integrated mental health and substance abuse prevention, intervention, crisis stabilization, treatment and case management programs. 2. Term—The initial term of this IGA shall commence on January, 1, 2018 and will be in effect until any one of the parties terminates the agreement per paragraph 13 of Article III. ARTICLE 11—FISCAL AGENT AGREEMENT 1 Pitkin County agrees to be the fiscal agent providing payment to Mind Springs Health (and Mountain Family Health Centers) in the amount of$488,000 in 2018 for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment, and case management programs per the contract and approved in the County's 2018 budget(See Exhibit A- 2018 Scope of Work). 2. The Participating Members agree to provide funding in return for collaborative and integrated mental health and substance use prevention, intervention,crisis stabilization, treatment and case management programs as follows. By October each year Mind Springs Health (and Mountain Family Health Centers) will provide the County with a budget to fund collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment, and case management programs for the next fiscal year. The share for each entity will be determined as follows: 3 • a. In-Kind Contributions: i. Pitkin County shall provide, at no cost,space in the Schultz Health and Human Services Building to Mind Springs Health for collaborative and integrated mental health and substance use prevention,intervention, crisis stabilization,treatment and case management programs.The value of this space is recognized as $59,766 per year. ii. Aspen School District shall provide, at no cost, space in the Aspen Middle School for Mind Springs Health a youth and family clinician. The value of this space is recognized as$45,000 per year. b. Participating Members will provide cash funding to Pitkin County for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization,treatment and case management programs:Any changes to the total amount or the formula in subsequent fiscal year contributions will be approved by the managers of Participating Members and will replace the list below; i. In 2018,Aspen Valley Hospital agrees to pay$73,275 of the provision of collaborative and integrated mental health and substance use prevention,intervention, crisis stabilization, treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers ii. In 2018,Aspen School distnct agrees to pay$40,000 for the provision of a school based youth and family clinician provided by Mind Springs Health. iii. In 2018,City of Aspen agrees to pay$70,550 for the provision of collaborative and integrated mental health and substance use prevention, intervention,crisis stabilization,treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers iv. In 2018,Pitkin County agrees to pay$304,507 for the provision of collaborative and integrated mental health and substance use prevention,intervention, crisis stabilization,treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers c. Pitkin County will pay Mind Springs Health monthly based on invoices of actual expenses less other revenues. d Participating Members will seek other funding partners and grants to continue to support these essential community services and address gaps in service. 4 a. Quality Assurance-Participating Members are committed to working together to ensure that relevant performance measures are developed and utilized for the purpose of on-going evaluation of services provided by the vendor(s) in accordance with the representations made in the vendor(s) response to the RFP and in order to meet the needs of the community. i. Pitkin County Public Health will be responsible for contract compliance with the selected vendors ii. Participating Members agree to meet monthly to review performance measures, along with financial expenditures and budget compliance, during the first six months,then quarterly thereafter in. Participating Members agree to assign staff to participate m monthly operations reviews(protocols, issues,needs, communication, debriefs, etc)with vendors iv. Participating Members agree to develop performance measures with the vendor and to support the measurement process by providing data as necessary from the perspective of each member's operations. ARTICLE III—GENERAL PROVISIONS 1. Assignability. This agreement is not assignable by either party. 2. Modification. This Agreement may be changed or modified only in writing by an agreement approved by the respective Boards of the Governments and signed by authorized officers of each party. 3. Entire Agreement. This Agreement constitutes the entire Agreement between the parties and all other promises and agreements relating to the subject of this Agreement,whether oral or written, are merged herein. 4. Severability. Should any one or more sections or provisions of this Agreement be judicially adjudged invalid or unenforceable, such judgment shall not affect, impair,or invalidate the remaining provisions of this Agreement,the intention being that the various sections and provisions hereof are severable. 5. Notices. Any notice required or permitted under this Agreement shall be in writing and shall be provided by electronic delivery to the e-mail addresses set forth below and by one of the following methods 1)hand-delivery or 2)registered or certified mail, postage pre-paid to the mailing addresses set forth below. Each party by notice sent under this paragraph may change the address to which future notices should be sent. Electronic delivery of notices shall be considered delivered upon receipt of confirmation of delivery on the part of the sender. 5 Nothing contained herein shall be construed to preclude personal service of any notice in the manner prescribed for personal service of a summons or other legal process. To: Jon Peacock With copies to: Pitkin County Manager Pitkin County Attorney's Office 123 Emma Road 123 Emma Road,Suite 204 Basalt, CO 81621 Basalt, CQ 81621 970-920-5067 attomeyapitkincountv.com To: Steve Barwick City of Aspen Attorney City Manager 130 South Galena Street 130 South Galena Street Aspen,CO 81611 Aspen, CO 81611 970-920-5212 970-920-5212 To: Dave Ressler Aspen Valley Hospital Attorney Chief Executive Officer 0401 Castle Creek Road 0401 Castle Creek Road Aspen,CO 81611 Aspen, CO 81611 970-925-1142 970-544-1261 To: John Maloy Aspen School District Attorney Superintendent 235 High School Road 235 High School Road Aspen,CO 81611 Aspen, CO 81611 970-925-3760 970-925-3760 6. Government Immunity. The parties agree and understand that both parties are relying on and do not waive,by any provisions of this Agreement,the monetary limitations or terms or any other rights,immunities,and protections provided by the Colorado Governmental Immunity Act, C.R.S. 24-10-101, et seq.,as from time to time amended or otherwise available to the parties or any of their officers, agents,or employees. 7. Current Year Obligations. The parties acknowledge and agree that any payments provided for hereunder or requirements for future appropriations shall constitute only currently budgeted expenditures of the parties. The parties' obligations under this Agreement are subject to each individual party's annual right to budget and appropriate the sums necessary to provide the services set forth herein. No provision of this Agreement shall be construed or interpreted as creating a multiple fiscal year direct or indirect debt or other financial obligation of either or both parties within the meaning of any constitutional or statutory debt limitation. 6 This Agreement shall not be construed to pledge or create a lien on any class or source of either parties' bonds or any obligations payable from any class or source of each individual party's money. 8 Binding Rights and Obligations The rights and obligations of the panics under this Agreement shall be binding upon and shall inure to the benefit of the parties and their respective successors and assigns. 9. Agreement made in Colorado This Agreement shall be construed according to the laws of the State of Colorado,and venue for any action shall he in the District Court in and for Pitkin County.Colorado. 10. Attorney Fees In the event that legal action is necessary to enforce any of the provisions of this Agreement,the substantially prevailing party, whether by final judgment or out of court settlement, shall recover from the other party all costs and expenses of such action or suit including reasonable attorney's fees 11 No Waiver. The waiver by any party to this Agreement of any term or condition of this Agreement shall not operate or be construed as a waiver of any subsequent breach by any party. 12. Authority Each person signing this Agreement represents and warrants that said person is fully authorized to enter into and execute this Agreement and to bind the party it represents to the terms and conditions hereof. 13. Termination Prior to Expiration of Term. Any Party has the right to terminate or withdraw from this Agreement, with or without cause, by giving written notice to the other Parties of such termination and specifying the effective date thereof. Such notice shall be given at least ten (10) days before the effective date of such termination Termination of the Agreement relieves the cancelling or withdrawing Party of any further responsibility under this Agreement except for specifically. identified obligations of a continuing nature based upon pass performance under ‘4j ,.- the Agreement. t% The foregoing Agreement is approved by the Board of County Commissioners of Betikin County.Colorado at its regular meeting held on the 'uA day of I-;:'f lila uv[r ,2017 The foregoing Agreement is approved Aspen School District at its regular meeting held on they day of CA-Vw6r 1 ,2Ct . 2OC� 7 The foregoing Agreement is approved by [other governmental entity] at its regular meeting held on the day of ,2017. In Witness whereof,the parties hereto have caused this agreement to be executed as of the day and year first above written. ASPEN VALLEY HOSPITAL By: Date: ASPEN SCHOOL DISTRICT By: Date: [Title] CITY OF ASPEN By: Ivreiv Date. I2 •ZZ 11-- ASsr mile] Y� BOARD OF COUNTY COMMISSIONERS APPROVED AS TO FORM OF PITKIN COUNTY,COLORADO Ry By: Chair County Attorney Manager Approval: By: Jon Peacock,County Manager EXHIBIT A Pitkin County Mental Health Strategic Funding 2018 Scope of Services with Mind Springs Health Contract Community Based Mental Health Team-$171,468 • 1.0 FTE Licensed Therapist:Rapid Response Mobile Unit Team Member-intensive, community based,outpatient treatment focused on high risk individuals who might not come into a clinic setting Includes peer counseling,case management and therapy services.Intensive Stabilization Program Team Member-after crisis intervention,serve as a bridge between crisis services and standard outpatient services. • 1.0 FTE Case Manager:Rapid Response Mobile Unit Team Member(see above). Intensive Stabilization Program Team Member(see above) • 60 Hs of Advanced Psychiatric Nurse Practitioner time for Jail:individuals who need mental health interventions,but did not meet the state's JBBS criteria.Nurse can prescribe meds to individuals needing medication management. Integrated Care Team-$197,818 • 2.0 Behavioral Health Specialists:This staff will work in the Mt Family Basalt Clinic, and expand the current behavioral health program there.They will provide outpatient(6 sessions)services for families,substance use disorders,trauma,hypnosis,animal assisted and other evidence based therapies. • 2.0 Patient Care Coordinators:Care Coordinators will work in the Mt.Family Basalt Clinic,one will be a patient educator,and the other a social health advocate.The patient educator will advocate for the patient and family,facilitating culturally appropriate communication between patient and providers and will identify and decrease barriers to behavior change and improve access to needed services The social health advocate will provide care coordination to patients who are at most nsk for health deterioration and/or poor outcomes.The social health advocate will assess the determinants of health and assist the patient in addressing barriers and increase access to services. • Telepsych(4 hours)to link patients to psychiatric care School Based Licensed Therapists—118,715 • 1 FTE Aspen School District Therapist:-on-sight therapist for students with depression, trauma,and/or anxiety,substance abuse and consultation with gchool staff to facilitate assessment by a multidisciplinary team-available to all three schools 9 Counterpart to IGA by Aspen Valley Hospital Approved January 8, 2018 INTERGOVERNMENTAL AGREEMENT For The Purchase of Vital Mental Health Services _�,,tt THIS IN RGOVERNMENTAL AGREEMENT(the"Agreement")is made this dayof b)ems , 2017 by and between the Board of County Commissioners of Pitkin County, Colorado, whose address is 123 Emma Road, Suite 106,Basalt,CO 61621 ("the County"),Aspen Valley Hospital ("AVM), Aspen School District("ASD"), and the City of Aspen. ("COA"),and hereinafter severally referred to by name or collectively as the'Participating Members". , RECITALS 1. This Agreement is entered into pursuant to,inter alio, C.R.S.§¢29-1-201, et seq.,and Article XIV,Section 18 of the Colorado Constitution. 2. Mental Health end Substance use have long been identified as the most significant health issues facing the people who live,work and play in Pitkin County.High rates of suicide,mixed messages surrounding the promotion of our party town",high rates of depression and anxiety,sleep disturbances,financial pressures,lack of psychiatric care,lack of specialized support for marginalized populations and tha high cost of treatment,as well as other issues have inspired a number of different non-profit and private providers to try to step up and respond.Although there are many assets within the community along the system of care,gaps still remain,and many of our most vulnerable residents fall through the cracks of a fragmented system. 3. The local funding stakeholders of Pitkin County engaged in a focused strategic planning process with the purpose of rapidly improving access to mental health and substance use ptograrns and services for all county residents by changing the way funding is allocated to programs. These Funders(Pitkin County,Aspen School District, Aspen Valley Hospital and Pitkin County—"Participating Members")have committed to improving or creating new funding Strategies and to using funding strategically to strengthen the system of care and improve service delivery. 4. The Participating Members strive to create system of care change that rapidly improves access to mental health and substance use services for Pitkin County residents by defining funding methods and applying financial resources to support programs that reflect system of care priorities,provide needed services and demonstrate collaboration. S. Participating Members have historically supported mental health and substance use providers through both charitable and support contributions and contracts for services as ways to address the health,safety and wellbeing of their residents. 1 6. Participating Members desire to establish a sustainable, integrated,high- quality system of care and are committed to realigning funding and human resources to address ongoing unmet Mental Health needs: 7. In July, 2017,Pitkin County,on behalf of the strategic funders' advisory committee,issued a Request for Proposals(RFP)for the provision of integrated, collaborative mental health and substance use prevention,intervention,treatment and case management services. Participating Members selected Mind Springs Health(MSH) On collaboration with Mountain Family Health Centers (MFHC)based on their proposal f community mental health, crisis services,integrated health services and school based services 8. Participating Members agree to collectively pool their funding to support the selected vendor in 2018 (MSH and MFHC)for specified community mental health,crisis stabilization,integrated behavioral health care and school based services.This will require that the members redeploy funding that is currently being applied in accordance with contracts,agreements or contribution arrangements for behavioral health services provided to members and their departments,including: in Pitkin County-Public Health, Human Services,Healthy Community Fund, Sheriffs Office,Communications Center and Jail.Departments in the City of Aspen include the Aspen Police Department and City Manager's office.Departments in the Schools include the Superintendent's office, Special Education, and School Counselors. Finally,the departments at Aspen Valley Hospital include the Emergency Department and Patient Care and Intensive Care Unit (inpatients).At each member's option, contribution arrangements or other contracts may be continued in order to fulfill existing commitments such as capital campaigns or other financial support for behavioral health services not othenvise included in this IGA. 9. Participating Members reached an agreement on an initial funding model for 2018 based on historic funding contributions,to provide integrated, collaborative mental health and substance use prevention, intervention, crisis stabilization,treatment and case management programs and agree to consider future funding models and RFP's as they are submitted. 10. Participating Members already have existing relationships with the vendors selected for 2018 and it is believed that this agreement will serve to enhance and strengthen these relationships. 10. Participating Members have agreed to refine the funding model for 2019 to ensure an adequate and equitable distribution of responsibility for future financial support for integrated,collaborative mental health and substance use prevention, intervention, crisis stabilization,treatment and case management programs. 2 I 1 The Participating Members do hereby collectively determine and declare that this Intergovernmental Agreement is necessary,proper and convenient for the continued fostering and preservation of the public health, safety and wellbeing. AGREEMENT NOW, THEREFORE, for and in consideration of the mutual promises and agreements of the parties and other good and valuable consideration, the adequacy and sufficiency of which is hereby acknowledged, the parties agree as follows: ARTICLE 1—TERM AND EFFECT Effect of IGA—Except as expressly provided herein, this IGA shall replace and supersede all prior agreements of any kind between all or any of the Participating Members and any or all other Participating members hereto, to the extent and for the limited purpose as such other agreements may be related to the provision of funding collaborative and integrated mental health and substance abuse prevention, intervention, crisis stabilization, treatment and case management programs 2. Term—The initial term of this IGA shall commence on January, 1. 2018 and will be in effect until any one of the parties terminates the agreement per paragraph 13 of Article III ARTICLE 11 —FISCAL AGENT AGREEMENT 1. Pitkin County agrees to be the fiscal agent providing payment to Mind Springs Health (and Mountain Family Health Centers) in the amount of$488,000 in 2018 for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment, and case management programs per the contract and approved in the County's 2018 budget(See Exhibit A- 2018 Scope of Work). 2 The Participating Members agree to provide funding in return for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment and case management programs as follows. By October each year Mind Springs Health (and Mountain Family Health Centers) will provide the County with a budget to fund collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization, treatment, and case management programs for the next fiscal year. The share for each entity will be determined as follows. 3 a. In-Kind Contributions: i. Pitkin County shall provide, at no cost,space in the Schultz Health and Human Services Building to Mind Springs Health for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization,treatment and case management programs.The value of this space is recognized as $59,766 per year ii. Aspen School District shall provide, at no cost,space in the Aspen Middle School for Mind Springs Health a youth and family clinician The value of this space is recognized as$45,000 per year. b. Participating Members will provide cash funding to Pitkin County for collaborative and integrated mental health and substance use prevention, intervention, crisis stabilization,treatment and case management programs:Any changes to the total amount or the formula in subsequent fiscal year contributions will be approved by the managers of Participating Members and will replace the list below; i In 2018,Aspen Valley Hospital agrees to pay$73,275 of the provision of collaborative and integrated mental health and substance use prevention, intervention, cnsis stabilization, treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers ii. In 2018,Aspen School district agrees to pay$40,000 for the provision of a school based youth and family clinician provided by Mind Springs Health. iii. In 2018,City of Aspen agrees to pay$70,550 for the provision of collaborative and integrated mental health and substance use prevention,intervention,crisis stabilization,treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers iv. In 2018,Pitkin County agrees to pay$304,507 for the provision of collaborative and integrated mental health and substance use prevention,intervention, crisis stabilization,treatment and case management programs provided by Mind Springs Health and Mountain Family Health Centers c. Pitkin County will pay Mind Springs Health monthly based on invoices of actual expenses less other revenues. d. Participating Members will seek other funding partners and grants to continue to support these essential community services and address gaps in service. 4 a. Quality Assurance-Participating Members are committed to working together to ensure that relevant performance measures are developed and utilized for the purpose of on-going evaluation of services provided by the vendor(s) in accordance with the representations made in the vendor(s) response to the RFP and in order to meet the needs of the community. i Pitkin County Public Health will be responsible for contract compliance with the selected vendors ii Participating Members agree to meet monthly to review performance measures,along with financial expenditures and budget compliance, during the first six months,then quarterly thereafter iii. Participating Members agree to assign staff to participate in monthly operations reviews (protocols, issues, needs, communication, debriefs,etc)with vendors iv. Participating Members agree to develop performance measures with the vendor and to support the measurement process by providing data as necessary from the perspective of each member's operations. ARTICLE III-GENERAL PROVISIONS 1. Assignability. This agreement is not assignable by either party. 2 Modification. This Agreement may be changed or modified only in writing by an agreement approved by the respective Boards of the Governments and signed by authorized officers of each party. 3. Entire Agreement. This Agreement constitutes the entire Agreement between the parties and all other promises and agreements relating to the subject of this Agreement,whether oral or written, are merged herein. 4. Severability. Should any one or more sections or provisions of this Agreement be judicially adjudged invalid or unenforceable,such judgment shall not affect, impair,or invalidate the remaining provisions of this Agreement,the intention being that the various sections and provisions hereof are severable. 5. Notices. Any notice required or permitted under this Agreement shall be in writing and shall be provided by electronic delivery to the e-mail addresses set forth below and by one of the following methods 1)hand-delivery or 2)registered or certified mail, postage pre-paid to the mailing addresses set forth below. Each party by notice sent under this paragraph may change the address to which future notices should be sent. Electronic delivery of notices shall be considered delivered upon receipt of confirmation of delivery on the part of the sender. 5 Nothing contained herein shall be construed to preclude personal service of any notice in the manner prescribed for personal service of a summons or other legal process. To: Jon Peacock With copies to: Pitkin County Manager Pitkin County Attorney's Office 123 Emma Road 123 Emma Road, Suite 204 Basalt, CO 81621 Basalt,CQ 81621 970-920-5067 attomev(2 pitkincounty.com To: Steve Barwick . City of Aspen Attorney City Manager 130 South Galena Street 130 South Galena Street Aspen,CO 81611 Aspen, CO 81611 970-920-5212 970-920-5212 To: Dave Ressler Aspen Valley Hospital Attorney Chief Executive Officer 0401 Castle Creek Road 0401 Castle Creek Road Aspen, CO 81611 Aspen, CO 81611 970-925-1142 970-544-1261 To: John Maloy Aspen School District Attorney Superintendent 235 High School Road 235 High School Road Aspen, CO 81611 Aspen, CO 81611 970-925-3760 970-925-3760 6. Government Immunity. The parties agree and understand that both parties are relying on and do not waive,by any provisions of this Agreement,the monetary limitations or terms or any other rights, immunities, and protections provided by the Colorado Governmental Immunity Act,C.R.S. 24-10-101, et seq., as from time to time amended or otherwise available to the parties or any of their officers, agents, or employees. 7. Current Year Obligations. The parties acknowledge and agree that any payments provided for hereunder or requirements for future appropriations shall constitute only currently budgeted expenditures of the parties. The parties' obligations under this Agreement are subject to each individual party's annual right to budget and appropriate the sums necessary to provide the services set forth herein. No provision of this Agreement shall be construed or interpreted as creating a multiple fiscal year direct or indirect debt or other financial obligation of either or both parties within the meaning of any constitutional or statutory debt limitation. 6 This Agreement shall not be construed to pledge or create a lien on any class or source of either genies' bonds or any obligations payable from any class or sourer of each individual party's money. 8. Binding Rights and Obligations The rights and obligations of the panics under this Agreement shall be binding upon and shall inure to the benefit of the parties and their respective successors and assigns. 9. Agreement made in Colorado. This Agreement shall be construed according to the laws of the State of Colorado,and venue for any action shall he in the District Cour in and for Pukin County,Colorado. 10. Attorney.Pecs. In the event that legal action is necessary to enforce any of the provisions of this Agreement,the substantially prevailing party, whether by final judgment or out ol court settlement,shall recover from the other puny all costs and expenses of such action or suit including reasonable attorney's fees. I I No Waiver The waiver by any party to this Agreement of any term or condition of tins Agreement shall not operate or be construed as a waiver of any subsequent breach by any party. 12. Authority Each person signing this Agreement represents and warrants that said person is fully authorized to enter into and execute this Agreement and to hind the party it represents to the terms and Londrbons hereof. II Termination Prior to Expiration of Term. Any Party has the right to terminate or withdraw from this Agreement, with or without cause, by giving written notice to the other Parties of such termination and specifying the effective date thereof. Such nonce shall be given at least ten (101 days before the effective date of such termination Termination of the Agreement relieves the cancelling or withdrawing .YJ^ Party of any further responsibility under this Agreement except for specifically identified obligations of a continuing nature based upon pass performance under the Agreement. The foregoing Agreement is approsed by the Board of County Commissioners of 1,'ukin County,Colorado at its regular meeting held on the 2,./fa- day of • -s,'f dautt[✓.. 2017 The foregoing Agreement is approved ) Aspen School District at its regular meeting held on the day ol 0. ie 6-1 ,2&t7 2atfr 7 ASPEN VALLEY HOSPITAL DISTRICT By: Date: I h 1 (Cr y a av The foregoing Agreement is,.4pproved by City of Aspen al its regular mating held on the fey4 day of l✓P 1 2tr.be, 2017. CITY OF ASPEN By: Date: Steve Skadron,Mayor In Witness whereof,the parties hereto have caused this agreement to be executed as of the day and year first above written. BOARD OF COUNTY COMMISSIONERS APPROVED AS TO FORM OF PIITTIC N COUNTY,COLORADO BY: l dt (4 ) By: Chad County A Manager Approval: By. on Peat Co anger Effective 09-06-2017 This repeals allpreelous rerrlons of This template previously posted to PCIN 8 EXHIBIT A Pitkin County Mental Health Strategic Funding 2018 Scope of Services with Mind Springs Health Contract Community Based Mental Health Team-$171,468 • 1.0 FTE Licensed Therapist Rapid Response Mobile Unit Team Member-intensive, community based, outpatient treatment focused on high risk individuals who might not come into a clinic setting.Includes peer counseling,case management and therapy services.Intensive Stabilization Program Team Member-after crisis intervention,serve as a bridge between crisis services and standard outpatient services. • 1.0 FTE Case Manager Rapid Response Mobile Unit Team Member(see above) Intensive Stabilization Program Team Member(see above). • 60I-Irs of Advanced Psychiatric Nurse Practitioner time for Jail:individuals who need mental health interventions,but did not meet the state's JBBS criteria.Nurse can prescribe meds to individuals needing medication management Integrated Care Team-$197,818 • 2.0 Behavioral Health Specialists:This staff will work in the Mt.Family Basalt Clinic, and expand the current behavioral health program there.They will provide outpatient(6 sessions)services for families,substance use disorders,trauma,hypnosis, animal assisted and other evidence based therapies. • 2.0 Patient Care Coordinators: Care Coordinators will work in the Mt.Family Basalt Clinic,one will be a patient educator,and the other a social health advocate.The patient educator will advocate for the patient and family,facilitating culturally appropriate communication between patient and providers and will identify and decrease barriers to behavior change and improve access to needed services The social health advocate will provide care coordination to patients who are at most nsk for health deterioration and/or poor outcomes.The social health advocate will assess the determinants of health and assist the patient m addressing barriers and increase access to services. • Telepsych(4 hours)to link patients to psychiatric care School Based Licensed Therapists—118,715 • 1 FTE Aspen School District Therapist-on-sight therapist for students with depression, trauma,and/or anxiety,substance abuse and consultation with school staff to facilitate assessment by a multidisciplinary team-available to all three schools 9