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HomeMy WebLinkAboutresolution.council.181-17 RESOLUTION NO. 181 SERIES OF 2017 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ASPEN, COLORADO,APPROVING AN INTERGOVERNMENTAL AGREEMENT BETWEEN THE CITY OF ASPEN, COLORADO,ASPEN VALLEY HOSPITAL,ASPEN SCHOOL DISTRICT,AND PITKIN COUNTY, COLORADO FOR MENTAL HEALTH AND SUBSTANCE USE SERVICES AND AUTHORIZING THE CITY MANAGER TO EXECUTE SAID DOCUMENT ON BEHALF OF THE CITY OF ASPEN, COLORADO. WHEREAS,there has been submitted to the City Council an intergovernmental agreement for mental health and substance use services, a copy of which document is annexed hereto and made a part . thereof. NOW,THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ASPEN, COLORADO: That the City Council of the City of Aspen hereby approves an intergovernmental agreement between the City of Aspen,Aspen Valley Hospital,Aspen School District, and Pitkin County for mental health and substance use services, a copy of which document is annexed hereto, and does hereby authorize the City Manager of the City of Aspen to execute said document on behalf of the City of Aspen. RESOLVED,APPROVED, AND ADOPTED this Ath day of December 2017, by the City Council for the City of Aspen, Colorado. Steven Skadron, Mayor I, Linda Manning, duly appointed and acting City Clerk do certify that the foregoing is a true and accurate copy of that resolution adopted by the City Council of the City of Aspen, Colorado, at a meeting held December 2017. Linda Manning, City Clerk INTERGOVERNMENTAL AGREEMENT For THIS INTERGOVERNMENTAL AGREEMENT (the "Agreement") is made this day of , 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 ("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 alia, 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. Funders 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 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 collaborative, 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) for their proposal of 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 community mental health, crisis services, integrated health care and school based services. This will include departments that have previously had contracts or made contributions to mental health agencies including; in Pitkin County- Public Health, Human Services, Healthy Community Fund, Sheriff's Office, Communications Center and Jail. Departments in the City of Aspen including Aspen Police Department and City Manager's office. Departments in the Schools including Superintendent's office, Special Education, School Counselors. 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, 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 response, treatment and case management programs. It. 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, 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 of Article 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, treatment and case management programs per the contract and approved in the County's 2018 budget. 2. The Participating Members agree to provide funding in return for collaborative and integrated mental health and substance use prevention, intervention, crisis response, 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, treatment and case management programs for the next fiscal year. The share for each entity will be determined as follows: 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 abuse prevention, intervention, 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. Cash funding for collaborative and integrated mental health and substance use prevention, intervention, 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 Exhibit A. 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, 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, 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, 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. e. Quality Assurance- Participating Members are committed to working together to ensure that high quality, best practices services are provided in a timely manner to ensure successful access to valued programs i. Pitkin County Public Health will be responsible for contract compliance with the selected vendors ii. Participating Members agree to meet monthly to review budget, expenditures and outcomes 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 metrics with the vendor and submit to Pitkin County Public Health data needed for outcome measures of success 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. 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 attorneyi nitkincounty.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 970-925-1120 970-925-1120 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. 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 be construed as a waiver of any subsequent breach by any party. 12. Authori . 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. The foregoing Agreement is approved by the Board of County Commissioners of Pitkin County, Colorado at its regular meeting held on the day of , 2017 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 r By: Date:jTitI (�-- �55 BOARD OF COUNTY COMMISSIONERS APPROVED AS TO FORM OF PITKIN COUNTY, COLORADO By: By: Chair County Attorney Manager Approval: By: Jon Peacock, County Manager Effective 09-06-2017 This repeals all previous versions of this template previously posted to PCIN RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS. (`BOCC") OF PITKIN COUNTY, COLORADO, APPROVING AN INTERGOVERNMENTAL AGREEMENT BETWEEN PITKIN COUNTY ("PITKIN") AND ASPEN SCHOOL DISTRICT ("ASD"), ASPEN VALLEY HOSPITAL ("AVH") AND CITY OF ASPEN ("COA") FOR THE i PURCHASE OF VITAL MENTAL HEALTH SERVICES RESOLUTION NO. dy�_-2017 RECITALS: 1. Pursuant to Title 29, Article 1, part 2, Colorado Revised Statutes, as amended (the "Intergovernmental Relations Statutes') and Article 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 exercise 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 Charter ("HRC' official action by formal resolution shall be required for all actions of the Board not requiring ordinance power on matters of significant importance affecting citizens. 3. Pitkin County ("Pitkin") and Aspen School District ( "ASD"), Aspen Valley Hospital ("AVH") and 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. Pitkin and ASD, AVH and COA are governments authorized to enter into agreements pursuant to C.R.S. § 29-1-203 for purposes including the provision of any function, service, or facility lawfully authorized to each; and 5. The BOCC finds that it is in the best interests of the citizens of Pitkin and ASD, AVH and COA to enter into this agreement in order to ensure the health and welfare of the people who live, work and play in Pitkin County. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Pitkin County, Colorado that Pitkin 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 thg resolution and the agreement on behalf of the County. THIS FORM SHOULD ALWAYS BE ON A SEPARATE PAGE. INTRODUCED AND FIRST READ ON THE � DAY OF I eY 2017. 4ND'4 T FOR SECOND READING AND PUBLIC HEARING ON THE DAY OF V-,CetmWy 2017. NOTICE OF PUBLIC HEARING AND TITLE AND SHORT SUMMARY OF,'!: HE I,ES6 UTION PUBLISHED IN THE ASPEN TIMES WEEKLY ON THE DAY OF L s vx, e/ , 2017. NOTICE OF PUBLIC HEARING AND THE FULL TEXT OF THE RESOLUTION POSTED ON THE OFFIPITKIN COUNTY WEBSITE (v .nitkincountv.com ) ON THE DAY O �j.e Y 2017. ADOPT ER FINAL READING AND PUBLIC HEARING ON THE — DAYOF .2 Y 2017. PUBLISHED BY TITLE AND SHORTS TER ADOPTION, IN THE ASPEN TIMES WEEKLY ON THE DAY O W Y 2017. POSTED BY TITLE AND SHORT SUMMARY ON THE OFF PITKIN COUNTY WEBSITE (w .pitkincountv.cotn) ON THE AWDAY OF wer 2017. BOARD OF COUNTY COMMISSIONERS APPROVED AS TO FORM: John ttomey By: 4�C.Ci,eanvn. 6,40 George Nemnan,C air Date: 1 Z - LI - 2014 MANAGER APPROVAL Jon Dcifcock, County Manager (ATTACHMENT B) INTERGOVERNMENTAL AGREEMENT For The Purchase of Vital Mental Health Services THIS INRGOVERNMENTAL AGREEMENT (the "Agreement") is made this 6L day o , 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 ("AVE"), Aspen School District ("ASD"), and the City of Aspen. ('COX'), and hereinafter severally referred to by name or collectively as the "Participating Members". RECITALS 1. This Agreement is entered into pursuant to, inter alia, C.R.S. §§ 29-1-201, et seg., 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 ora "party town", high rates of depression and anxiety, sleep disturbances, financial pressures, lack of psychiatric care, lack of specialized support for marginalized populations and thehigh 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 cue, 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 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: 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 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. 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 agreement's 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 of Article 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: 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 Corral 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. - 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 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. Assienability. 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. 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 Pitkin County Manager 123 Emma Road Basalt, CO 81621 970-920-5067 To: Steve Barwick City Manager 130 South Galena Street Aspen, CO 81611 970-920-5212 To: Dave Ressler Chief Executive Officer 0401 Castle Creek Road Aspen, CO 81611 970-544-1261 To: John Malay Superintendent 235 High School Road Aspen, CO 81611 970-925-3760 With copies to: Pitkin County Attorney's Office 123 Emma Road, Suite 204 Basalt, CO 81621 attomeyR.Pitkincounty com City of Aspen Attorney 130 South Galena Street Aspen, CO 81611 970-920-5212 Aspen Valley Hospital Attorney 0401 Castle Creek Road Aspen, CO 81611 970-925-1142 Aspen School District Attorney 235 High School Road Aspen, CO 81611 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. 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 more 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 Pitldn 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. The foregoing Agreement is approved by the Board of County Commissioners of PW n County, Colorado at its regular meeting held on the 9'day of tin w t ee, 2017 The foregoing Agreement is approved by Aspen School District at its regular meeting held on the _ day of , 2017. ASPEN SCHOOL DISTRICT By Date: Sheila Wills, Chav 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 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 PITKIN COUNTY, COLORADO By: C h ) By: Char CAttoo Manager Approval: By�� JOn PeaC , Co anger Effective 09-06-2017 This repeals all'previous versions of this template previously posted to PC7N 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 His 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, tmuma, 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 soci4l 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 m needed services. The social health advocate will provide care coordination to patients who are at most risk 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 cue School Based Licensed Therapists —118.715 • I 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 • .6FTE Basalt School District Therapists: available to all three schools: focus on students with depression, trauma and/or atixiety, substance use 10 ATTTACHMENT C 1. EYWOse - To create system of care change that rapidly improves access to mental health and substance abuse 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. 2. Vision Statement - Pitkin County will be a thriving, vibrant, healthyand strong community made up of fulfilled residents who have access to an integrated, effective, and affordable system of mental health and substance abuse treatment services, regardless of their ability to pay. 3. Values — This work will be informed and guided by our common values and belief in: 1. Effective stewardship of all resources 2. Innovation in solving complex problems 3. Evidence -based strategies 4. Program measurement that validates effectiveness 5. Strategically focused change 6. A biopsychosocial view of health issues 7. An integrated, high quality system of care as the best method to deliver a continuum of services 8.People who live, work and play in Pitkin County comprise our community 9. The continuum of care must include early identification, prevention and intervention, and aftercare 10.Highly coordinated services I l.Partnerships with consumers 12. Supporting families 13. High functioning and productive collaborations to effect collective impact 14. Promotion of the view that mental illness is a legitimate diagnosis and that it is this committee's intent to foster the de - stigmatization of mental illness and substance abuse by improving STRATEGIC INITIATIVE TEAM CHARTER h 1n {i�Ni Subject: Mental Health/Substance Abuse Strategic Funding Effective Date: April 25, 2017 Y�®U1VT Core Focus: Prosperous Economy -------- - <�,�«� - Strategic Plan Success factor: ` References () (1) Affordable and Quality Healthcare , Options Revision Date(s): 1. EYWOse - To create system of care change that rapidly improves access to mental health and substance abuse 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. 2. Vision Statement - Pitkin County will be a thriving, vibrant, healthyand strong community made up of fulfilled residents who have access to an integrated, effective, and affordable system of mental health and substance abuse treatment services, regardless of their ability to pay. 3. Values — This work will be informed and guided by our common values and belief in: 1. Effective stewardship of all resources 2. Innovation in solving complex problems 3. Evidence -based strategies 4. Program measurement that validates effectiveness 5. Strategically focused change 6. A biopsychosocial view of health issues 7. An integrated, high quality system of care as the best method to deliver a continuum of services 8.People who live, work and play in Pitkin County comprise our community 9. The continuum of care must include early identification, prevention and intervention, and aftercare 10.Highly coordinated services I l.Partnerships with consumers 12. Supporting families 13. High functioning and productive collaborations to effect collective impact 14. Promotion of the view that mental illness is a legitimate diagnosis and that it is this committee's intent to foster the de - stigmatization of mental illness and substance abuse by improving access to resources and education and awareness for our 4. Definitions - community Continuum of Care- A concept involving a system that guides and tracks patients over time through a comprehensive array of health services spanning all levels and intensity of care. System of Care- An organizational philosophy and framework that involves collaboration across agencies, patients and their families for the purpose of improving services and access and expanding the array of coordinated community-based, culturally and linguistically competent services and supports for patients and their families. Biopsychosocial- A model with the broad view that attributes disease outcome to the intricate, variable interaction of biological factors (genetic, biochemical, etc), psychological factors (mood, personality, behavior, etc.), and social factors (cultural, familial, socioeconomic, medical, etc.) Risk factors -are characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes. Protective factor- A characteristic at the biological, psychological, family, or community (including peers and culture) level that is associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk factor on problem outcomes. 5. Background. Mental Health and Substance Abuse have long been identified as the most significant health issues facing the people in Pitkin County. High rates of suicide, mixed messages surrdunding the promotion of our "party town", high rates bf depression and anxiety, sleep disturbances, financial pressures, lack of psychiatric care, lack of specialized support for vulnerable populations and the high cost of treatment, as well as other issues have inspired a number of different non-profit and private providers trying to step up and respond. Theresult has been the development of a fragmented, uncoordinated and ineffective system of care. The funding stakeholders of Pitkin County engaged in a focused strategic planning process with the purpose of rapidly improving access to mental health and substance abuse services for all county residents by changing the way funding is allocated to programs. Funders have committed to improving or creating new funding strategies and to using funding strategically to strengthen the system of care and improve service delivery. Agencies in Pitkin County spend more than nine million dollars annually on mental health and substance abuse treatment and local funders dedicate more than 1 million (of that nine million) to address these needs through local programs. Given the resources committed, stakeholders agreed that outcomes are falling short. Fragmentation and the lack of cohesion in the Mental Health/Substance Abuse system of care threatens funding and fundraising as well as quality of care. Local collaboration of services is inconsistent and coordination at the service level is weak. Competition for financial supports among funded programs creates barriers to effective coordination of services. When many programs seek donors for similar services the pool of donors is diluted and create unsustainable, fragmented services. Frequently the "strings' attached to funding are not the ones that provide the best data to assess the impact of the funding. Accountability for the use of funding has been minimal and impact measures that are built into funding grants and required for future allocations are inadequate or lacking. Representatives of the school system noted that although they have identified ways to improve mental health indicators for students, the nature of their fiscal structure limits their flexibility to apply funds to these strategies. The belief that collaboration among providers and funders would be critical to creating system change formed the basis for the chosen strategic planning methods. In preparation for the planning sessions, the organizing committee invited input from funded agencies, community members, regional planning meetings and stakeholders. Community stakeholders had an important voice in the process as a result and an expectation for collaborative work was established. System assessment identified a rich array of quality services that have the potential to create an exemplary service delivery system. Stakeholders noted that the providers are highly valued and essential to community health. With the goal of building an integrated, coordinated, high-quality system of care, funders identified methods to allocate future funding that will exploit opportunities for improvement and resolve service gaps. The team identified a risk that agencies that do not meet the new funding requirements may not receive future funning and may lose the ability to function at their current level. Funding stakeholders emphasized their intent to support providers in understanding andOmeeting the necessary level of programmatic rigor td maintain their eligibility for future funding and that developing collaborative strategies will be essential. The strategic planning committee will continue to meet to launch the implementation of the strategic funding plan and the group will charter a steering committee for long-term work. They will develop a common RFP for use in making funding decisions that will highlight key values of an integrated system of care. Funding applicants will need to: a. demonstrate that they are evidence -based or reflect a promising practice b. identify and fully describe collaborative aspects of the proposal C. specify outcome measures and reporting processes d. agree to participate in regular program review meetings with funders e. highlight ways that they reduce fragmentation and duplication of services, and increase integration and coordination of services f. illustrate howthey will improve access and affordability of services g. detail how they can enable early identification and intervention of MH/SA needs h. when providing clinical mental health services, please illustrate that the organization has a Medicaid credential i. if providing crisis services, demonstrate rapid assessment (State requires 2 hour response time) and referral j. ability to accept and triage on M1 Holds or describe safe, legal and humane alternatives to M1. holds The stakeholders of Pitkin County are committed to realigning funding and human resources to solving this problem, as the system needs to be strengthened to effectively address ongoing unmet MH/SA needs. 6. Issue Statements - ISI: Pitkin County has a fragmented mental health/substance abuse system of care resulting in fragmented local funding and confusion about how to financially support the services and programs. IS2: Although the county has many resources, there is a public perception that there is a lack of services in the county. The team identified that improved messaging around available resources and best ways to access these resources may improve public opinion as well as use of services and programs. IS3: Coordination of care has been identified as a critical need to combat fragmentation of the system. "Hand off' of clients when they are referred from one point of service to another appears to be problematic with clients falling through the cracks and dropping from service, only to resurface later, often in greater distress. Various ideas around meeting this need were discussed including hiring a systems coordinator to work at the systemic level. IS4: Access to care at multiple points in the system was identified as a recurring issue. Early identification of a need for service was a critical first step in getting people in nded connected to the right service at the optimal time tor intervention but issues like access to EAP counseling, covered in -network providers, peer counseling for youth and the general affordability and acceptance of insurance all create barriers to access. IS5: In the area of Health Promotion/Prevention there is an absence of a cohesive strategy to reduce stigma, encourage the development of protective factors, promote healthy living conditions and facilitate early identification of Mental Health and Substance Abuse issues. I86: Treatment and Ongoing services suffer from the lack of care coordination, integration of services in the system of care and access to care. Aftercare services are not adequate currently to meet the need to supply peer and community support for - clients transitioning out of inpatient treatment and back into to the community. 7. Action Plan- GOAL. Establish a sustainable, integrated, -high-quality system of care ONE YEAR OBJECTIVES - '—------ SHORT-TERM TARGET DATES • Draft formal charter for a strategic initiative j ➢ May 2017 team to address Mental Health/Substance Abuse Strategic Funding • Evaluate opportunity to create a Mental Health ➢ August 2017 Initiative Coordinator to improve coordination, ongoing collaboration and to sustain high __quality system of care Develop a common RFP that defines ( ➢ August 2017 deliverables and includes a rubric to rate applications vis-a-vis their reflection of core values, system of care development goals and desiredoutcomes o Invite potential RFP writers to attend development meetings o Combine funding streams where appropriate and possible o Stakeholders will attend next large group meeting with agency specific funding data to facilitate planning o Craft RFP questions to reflect how the l contractor will address the outcomes • Establish a RFP review process and introduce ➢ September 2017 new process to the community o Meet in a small group with impacted Providers in advance of RFP implementation to clarify changes and encourage collaboration j__ _— _ • Contract Selection -- — ij ➢October 2017017 • Contract Implementation ➢- Januar�r 201.8 • Steering committee to review regional ➢ April 2018 population health data regularly to inform system of care development and: a) Revise RFP annually b) Update the Continuum of Care c) Support Contractors d) Continually identify stakeholders that need to be at the table e) Manage messaging about SOC development activities to the community and providers OUTCOMES: — 3 --- 1. Improve _messaging about the availability of mental health - substance abuse services and programs 2. Establish a cohesive strategy to reduce stigma and improve i engagement in mental health and substance abuse services and programs 3. Improve coordination and collaboration amongst providers Call, hospital, law enforcement, schools, primary care and crisis staff) i 4. Potential Mental Health Systems Coordinator to help reduce fragmentation and collect evidence -based data to help determine allocation of funds 5. Increase access along the continuum of care, including affordability 6. Increase care coordination for patients through prevention, early intervention/treatment and aftercare 8. Pitkin County Team Members - Jon Peacock Pitkin County Manager Karen Koenemann Director of Public Health Joe Disalvo Pitkin County Sheriff Nan Sundeen Director of Human Services Mitzi Ledingham Strategic Partnership Manager for Human Services Jordana Sabella Public Health Planner Susanne Morrison Program Manager, Aspen Community Foundation Andy Davies Cradle to Career Director, Aspen Community Foundation David Ressler CEO, Aspen Valley Hospital Lori Maloy Chief Clinical Officer, Aspen Valley Hospital Michelle Miscione Social Worker, Aspen Valley Hospital Richard Pryor Chief of Police, City of Aspen Ann Mullins City Councilor, City of Aspen Karen Harrington Director of Quality, City of Aspen Shirley Ritter Director of Kid's First, City of Aspen Tom Heald Assistant Superintendent, Aspen School District Katherine Sand Director of Aspen Family Connections Matt Hamilton Sustainability Director, Aspen Skiing Company Lisa Doak Assistant VP Student Services, Colorado Mountain College 9. Barriers to Progress- ➢ Funders may have different priorities, relationships with providers, interests that may lead them away from collective impact ➢ There is no roadmap for creating a collective funding strategy to build a Mental Health and Substance Abuse system of care ➢ There rray be unintended consequences in redirecting our funding as a result of lost private, state or federal funding 10. Measurement of Success- a. Reduced rate of suicide b. Bi -annual County Community Survey will show a 10% increase in satisfaction with community response to mental health and substance abuse c. Decrease assessment and referral time in crisis response and wait times in out-patient support services d. Increase the number of providers in the system of care who are actively collaborating (MOUS, referral protocol, shared data, etc.) e. Integrate mental health in public institutions (schools, jails, primary care, etc.) f. Reduce number of M1 holds placed by better assessment and local, wrap- around services g. Increase level of engagementlutilization of therapeutic services I. Portfolio of Currenf/On-GoingActivities- • Roaring Fork Valley Marijuana Council • Pitkin County Shared Detoxification Program • Valley View Hospital seeking regional detox • West Springs Mental Health Hospital Expansion CONTRACT # 3G1- � cfT RFSOLUTION OF THE BOARD OF COUN'T'Y L d•�� COMMISSIONERS("BOCC") OF PITKIN COUNTY, COLORADO,APPROVING AN INTERGOVERNMENTAL AGREEMENT B);r1VEEN PITKIN COUNTY("PITKIN-) AND ASPEN SCHOOL DISTRICT("ASD'),ASPEN VALLEY HOSPITAL ("AVH'h AND CITY OF ASPEN("COA")FOR THE PURCHASE OF VITAL MENTAL HEALTH SERVICES RESOLUTION NO.�-2017 RECITALS: 1. Pursuant to Title 29,Article 1,part 2,Colorado Revised Statutes, as amended(the "Intergovernmental Relations Statulcs')and Article 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 exercise 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 R0.1C Charter ("HRC")official action by formal resolution shall be required for all actions of the Board not requiring ordinance power on matters of significant importance affecting citizens. 3. Pitkin County("Pitkin")and Aspen School District ("ASD"),Aspen Valley Hospital ("AVH")and 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. Pitkin and ASD,AVH and COA arc governments authorized to enter into agreements pursuant to C.R.S. §29-1-203 for purposes including the provision of any function,service, or facility lawfully authorized to each;and 5. The BOCC finds that it is in the best interests of the citizens of Pitkin and ASD, AVH and COA to enter into this agreement in order to ensure the health arid welfare of the people who live,work and play in Pitkin County. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Pitkin County, Colorado that Pitkin 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 Char or designee,to sign thq resolution and the agreement on behalf of the County. 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 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 Zen (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 kin County,Colorado at its regular meeting held on the ^vim day of f.,6itaWr , 2017 The foregoing Agreement is approved by Aspen School District at its regular meeting held on the day of 2017. 7