HomeMy WebLinkAboutCrisis Clinic Crisis Lines - GF-1217 - 1217 - 2-1-1 Line, 24 hr and teen link•
CITY OF AUBURN - AGREEMENT FOR SERVICES
THIS AGREEMENT made and entered into this 2 day of i V
2012, by and between the CITY OF AUBURN, a municipal corporation of the Late of
Washington, hereafter referred to as "CITY ", and "CRISIS CLINIC" which is located:at 9725 3'd
Avenue NE, Suite 300. Seattle, WA 9'8115 -2030; a non - profit corporation •organized under the
laws of the State, of ;Washington; hereafter referred to as "AGENCY."
WHEREAS, The AGENCY provides a valuable service to the CITY and its residents
through the provision of telephone referral services through the Crisis Line; and
WHEREAS, the 'CITY is interested in continuing support of Crisis Clinic, including
development of additional resources and service sites, for'Iow.income residents;
WHEREAS, the CITY entered into a Joint Funding Memorandum of Understanding with
the cities of Burien, Covington, Des Moines, Renton, SeaTac and Tukwila ( "Cities ") to jointly
fund and monitor a single contract with Crisis 'Clinic for Telephone Services; and
•
WHEREAS, it is the City's responsibility to enter into an agreement with Crisis Clinic on
behalf of the Cities "which are party to said Memorandum of Understanding;
NOW, THEREFORE, In consideration . of the covenants and conditions of this
Agreement, the parties agree as follows:
I. PURPOSE
The purpose of this' Agreement is to 'provide for an appropriation to the AGENCY for
providing services as set forth in this Agreement to Auburn residents during the 2012 — 2013
term.
II. SCOPE OF SERVICES
The AGENCY .agrees to provide services, as described in the Exhibits incorporated
herein by this reference as if fully set forth.
City of Auburn Agreement: GF -1217, Crisis Clinic Crisis Lines - 2 -1 -1 Line, 24 Hr. and Teen Link
- January 1, 2012
Page 1 of 8
III. TERM
The term of this Agreement shall commence on January 1, 2012 and shall expire on
December 31, 2012.
IV. PERFORMANCE REPORTS. AND COMPENSATION
A. The AGENCY shall provide to the City within 15 days of •the close of each
calendar quarter a status . report containing program statistics regarding the type
and level of services provided to the City of Auburn, as well as financial
information pertaining to the contract agreement and expenditures. Format and
contents of these reports are set forth in Exhibits 1 to 4 to this Agreement, which
are incorporated herein by this reference.
B. The AGENCY shall _prepare and submit to the City two program evaluation
reports in the format commonly. referred to as "outcomes reports" which will
show the intended linkages between the activities conducted and the changes
the activities will produce. These reports shall contain information as set forth in
Exhibit 4 to this Agreement, and shall be submitted to the City at the end of the
first and last quarters.
C. As full and total payment for the services provided under this Agreement, the
CITY agrees to pay the AGENCY up to $55,227.00 per a year as set forth in
the Exhibits. The CITY will pay an amount equal to one - quarter of the total
amount within thirty (30) days following the CITY's receipt of quarterly invoices.
The required format and content of quarterly invoices is set forth in the Exhibits
to this Agreement, and is, incorporated herein by this reference.
City of Auburn Agreement: GP-1217, Crisis Clinic Crisis Lines - 2 -1 -1, 24Hr. and Teen Link
January 1, 2012
Page 2 of 8
V. INDEMNIFICATION
The AGENCY agrees to defend, indemnify, and hold harmless the CITY, its elected and
appointed officials, employees and agents from and against any and all claims, demands and /or
causes of . action of any kind or character whatsoever arising out of or relating to services
provided. by the AGENCY, its employees, volunteers or agents concerning any and all claims by
any persons for alleged injury or damage to persons or property to the extent caused by the
negligent acts, errors or omissions of the AGENCY, its employees, volunteers or agents or
representatives. In the event that any suit or claim for damages . based upon such claim, action,
loss or damage is brought against the CITY, the AGENCY shall defend the same as its sole
costs and expense; provided that the CITY retains the right to participate in said suit if any
principle of governmental or;public law is involved; and if final judgment be rendered against the
CITY and /or its officers, elected officials, agents and employees or any of them or jointly
against the CITY and the AGENCY and their respective officers, agents, volunteers, employees
or any of them, the AGENCY shall fully satisfy the same and shall reimburse the CITY any
costs and expense which the CITY has incurred as a result of such claim or suit. The
provisions of this section shall survive the expiration or termination of this Agreement.
VI. INDEPENDENT CONTRACTOR/ASSIGNMENT
The parties agree and understand that the AGENCY is an independent contractor and
not the agent or employee of the CITY and that no liability shall attach to the CITY by reason of
entering into this Agreement except as provided herein. The services required under this
Agreement may not be assigned or subcontracted by the AGENCY without the prior written
consent of the.CITY.
City of Auburn Agreement: GF -1217, Crisis Clinic Crisis Lines - 2 -1 -1 Line, 24 Hr. and Teen Link
January 1, 2012
Page 3 of 8
VII. INSURANCE
The AGENCY shall procure and maintain for the duration of this Agreement insurance
against claims for injuries to persons or property which may arise from or in connection with
services provided by the AGENCY, it agents, employees or volunteers under this Agreement.
The AGENCY agrees to provide comprehensive general liability insurance and shall maintain
liability limits of not less than ONE MILLION DOLLARS ($1,000,000), combined single limit
coverage per occurrence for bodily injury, personal injury and property damage. Where
professional services are provided as part of the services rendered pursuant to this Agreement,
as shown in Exhibit 1, the AGENCY shall also provide and maintain professional liability
coverage including errors and omissions coverage in the minimum liability amount of ONE
MILLION DOLLARS ($1,000,000) combined single limit per occurrence for bodily injury,
personal injury and property damage. Any deductibles or self insured retentions in either policy
must be declared to and approved by the CITY. At the option of the CITY either: The insurer
shall reduce or eliminate such deductibles or self insured retentions as respects the CITY, its
officials and employees; or, the AGENCY shall procure a bond guaranteeing payment of losses
and related investigations, claim administration and defense expenses. The policies are to
contain or be endorsed to contain the following provisions:
1) GENERAL LIABILITY COVERAGE
The CITY, its elected and appointed officials, employees and agents are to be covered
as additional insured as respects: liability arising out of services and activities performed
by or on behalf of AGENCY, its employees, agents and volunteers.' The coverage shall
contain no special limitations on the scope of protection afforded to the CITY, its elected
and appointed officials, employees or agents.
City of Auburn Agreement: GF -1217, Crisis Clinic Crisis Lines - 2 -1 -1, 24Hr. and Teen Link
January 1, 2012
Page 4 of 8
2) GENERAL LIABILITY AND PROFESSIONAL-LIABILITY COVERAGES
(a) The AGENCY's insurance coverage shall be primary insurance as, respects the
CITY, its officials, employees and agents. Any insurance or self insurance
maintained by the CITY, its officials, employees, or agents shall be in excess of the
AGENCY's insurance and shall not contribute with it.
(b) Any failure to comply with reporting provisions of the policy shall not affect coverage
provided to the CITY, its-officials, employees or agents.
(c) Coverage shall, state that the AGENCY's insurance shall apply separately to each
insured against whom claim is bought or suit is brought except with respect to the
limits to the insurer's liability.
(d) Each insurance policy required by this clause shall be endorsed to state that
coverage shall not be suspended, voided, canceled, reduced in coverage, or in limits
except after thirty (30) days prior written notice by certified mail return receipt
requested has been given to the CITY. The AGENCY agrees to provide copies of
the Certificates of Insurance to the CITY at the time that this Agreement takes
effect.
(e) The AGENCY shall furnish the CITY with Certificates of Insurance and with original
endorsements affecting coverage required by this clause. The certificate and
endorsements for each insurance policy are to be signed by a person authorized by
that ,insurer to bind coverage on its behalf. The CITY reserves the right to require
complete, certified copies of all required insurance policies at any time.
(f) The AGENCY shall include all volunteers, employees and agents under its policies or
shall furnish separate certificates and , endorsements for each. All coverage for
volunteers shall be subject to all the requirements stated herein.
City of Auburn Agreement: GF -1217, Crisis Clinic Crisis Lines - 2 -1 -1 Line, 24 Hr. and Teen Link
January 1, 2012
Page 5 of 8
VIII. NONDISCRIMINATION
The AGENCY shall not discriminate under any services or programs to which this
Agreement may apply directly or through contractual or other arrangements on the grounds of
any protected class status as defined by any national, state or local laws or ordinances
including but not limited to race, color, 'creed,, religion, national origin, sex, sexual orientation,
age, or the presence of any sensory, mental or physical handicap.
IX. BOOKS AND RECORDS
The AGENCY agrees to maintain separate accounts and records in accordance with
State Auditor's procedures, including personnel,: property, financial and programmatic records
which sufficiently reflect direct and indirect costs and services performed under this Agreement.
The AGENCY agrees to maintain all books and records relating to this Agreement for a period
of three (3) years following the date that this Agreement is expired or otherwise terminated.
The parties agree that the CITY OF AUBURN may inspect such documents upon good cause
at any reasonable time within the three (3) year period.
X. TERMINATION OF AGREEMENT
This Agreement may be terminated by either party upon thirty (30) days written notice
should the other party fail substantially to perform in accordance with, its terms through no fault
of the other.
XI. GENERAL PROVISIONS
A. The AGENCY agrees to submit a report to the CITY no later than the last
quarterly invoice date, describing the progress and activities performed for the
previous year's scope of services.
B. This Agreement shall be governed by the laws, regulations and ordinances of
the City of Auburn, the State of Washington and where applicable, Federal laws.
City of Auburn Agreement: GF -1217, Crisis Clinic Crisis Lines - 2 -1 -1, 24Hr. -and Teen Link
January 1, 2012
Page 6 of 8
C. The AGENCY agrees to conduct its activity in such a manner as to coincide with
the goals identified in the attached Memorandum of Understanding. The Agency
understands that the performance indicators established in the Memorandum will
be used by the City as a measurement tool in determining if the goals have been
achieved.
D. The CITY and the AGENCY respectively bind themselves, their successors,
volunteers, assigns and legal representatives to the other party to this
Agreement and with respect to all covenants to this Agreement.
E. This Agreement represents the entire and integrated Agreement between the
CITY and the AGENCY and supersedes all prior negotiations. This Agreement
may be amended only by written instrument signed by both the CITY and the
AGENCY.
F. Should it become necessary to enforce any term or obligation of this Agreement,
then all costs of enforcement including attorney's fees and expenses and court
costs shall be paid to the substantially prevailing party.
G. The AGENCY agrees to comply with all local, state and federal laws applicable
to its performance under this Agreement.
REMAINDER OF PAGE INTENTIONALLY BLANK
City of Auburn Agreement: GF -1217, Crisis Clinic Crisis Lines - 2 -1 -1 Line, 24 Hr. and Teen Link
January 1, 2012
Page 7of8
ATTEST:
Danielle E. Daskam,
City Clerk
Daniel B. Heid,
City Attorney
STATE OF WASHINGTON
PETER B. LEWIS
MAYOR
CRISIS -CLINI
A /
BY: iv
TITLE: E ecati've Direciv✓'
)ss
COUNTY OF KING )
On this 22 day of _ e-b. .,..2012,.before,me,. the undersigned, a
Notary Public in and for the State of Washington,. ersonally' appeared k2zthle67'G,u4wi ,
to me known to be the .Xee-u.4ive D v —. - of the Crisis Clinic, the non- profit
corporation that executed the within .- and foregoing instrument, and - acknowledged said
instrument to be the free and voluntary act and deed, of, said non-profit corporation.forthe uses
and purposes therein .mentioned, and on oath stated that he /she is authorized to execute said
instrument on behalf of-said non - profit corporation. .
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the
date hereinabove set forth.
Gore( i Letrl 6'5
NOTARY ,PUBLIC in,and for the State of
Washington, residing in Shor%irte_ Wiq
MY COMMISSION expires: /./.2/./.2.04 .2•Ilf
City of Auburn Agreement: GF =1217, Crisis Clinic Crisis Lines - 2 -1 -1, 24Hr. and Teen Link
January 1, 2012
Page 8 of 8
CITY OF AUBURN - MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is an addendum to the agreement for services
between the City of Auburn and Crisis Clinic, the original of which was executed on the 22
day of FeAoyv av , 2012. All other terms and conditions of the agreement for services shall
remain in full foe and effect except as specifically amended by this Memorandum of
Understanding.
I. It is the goal of the City of Auburn to improve the living conditions of all Auburn
residents.
II. The grant funds provided to the Agency during the 2012 year are provided with the
objective of achieving the results established by the City Council in the areas
of Abused and Neglected Children, Victims of Domestic and Sexual Assault,
Poverty Reduction, Substance Abuse and Health Fitness.
III. Agencies receiving funding from the City of Auburn agree to participate in the
conceptual development of the One Stop Center and to collaborate with other
agencies concerning the delivery of services to clients when the Center is
operational. The nature and extent of the collaboration to be determined when
the One Stop Center is operational.
IV. The City of Auburn will utilize the following performance measures in evaluating
the effectiveness of reaching this goal.
Abused and Neglected Children: The City of Auburn will fund human service providers
that increase supportive services to children who are neglected and abused, specifically the
number of children who are victims of on -going and repeated neglect and abuse, within the
city of Auburn by 15% over the next three (3) years.
Victims of Domestic and Sexual Assault: The City of Auburn will fund human service
providers that increase the number of Auburn residents, who are victims of domestic
violence, that make the transition to a safe environment and self- determining lifestyle by
15% within the next three (3) years.
Poverty Reduction: The City of Auburn will fund human service providers who increase
the number of Auburn residents no longer living in poverty by 15% within the next three (3)
years.
Substance Abuse: The City of Auburn will fund human service providers to develop
strategies that increase the successful completion of treatment programs by Auburn
residents who have serious behavioral and health problems due to substance, abuse -and
chemical dependency by 15% within a three (3) year period.
�t`�•`'' ;ate..
Physically and Mentally Fit: The City of Auburn will fund human service; p Q s •
- �- v c�er'sotClat
increase the availability, accessibility and use of health care to its low income pes�cien .e Icy`
15% within a three (3) year period. ,yA °• �� "
City of Auburn Agreement: GF -1217, CRISIS CLINIC — 2 -1 -1 Line, 24 Hr. and Teen Link
January 1, 2012
Page 1 of 2
ATTEST:
Danielle'E. •Daskam,
City Clerk
APPR¢b D O M:
Da i i,et B. Heid,
City Attorney
STATE OF WASHINGTON
COUNTY OF KING
CI
PETER B. LEWIS
MAYOR
CRISIS CLINI
BY: /1
SCE: Executive Director
)`
)ss
On this ot7 ` day of r , 2012, before me, ;the 'undersigned, a
Notary Public in and for ^ thee.; of Washington, personally :. appeared
)elPirl - 56U tit 1NiGI< , to ..me' known to be the. Executive Director of CRISIS
CLINI , the no /- profit corporation that executed the within and foregoing instrument, and
acknowledged aid instrument to be the free and voluntary act and deed of said non - profit
corporation for the uses and purposes therein. mentioned, and on, oath stated that ..'he/she is
authorized to execute said instrument on behalf of said non- profit corporation.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the
date hereinabove set forth.
NOTARY PUBLIC'in: and 'for the State of
Washington, residing in ,5/0r9,1; h8 ri4
'MY COMMISSION EXPIRES:' / /•'2. /f
City of Auburn Agreement: GF -1217, CRISIS CLINIC — 2 -1 -1 Line, 24 Hr. and Teen Link
January 1, 2012
Page 2 of 2
HUMAN SERVICE AGREEMENT
2012 INVOICE FOR CONTRACTED SERVICES
To: CITY OF AUBURN, ATTN: COMMUNITY SERVICES
25 WEST MAIN STREET, AUBURN WA 98001
Agency: Crisis Clinic
9725 3nd Ave NE, Suite 300
Seattle WA 98115 -2030
Program: Crisis Lines: 2 -1 -1, 24 Hr. & Teen Link
Amount Requested: $
Invoice for:
Attachments:
13,806.75
EXHIBIT COVER PAGE
GF • 1217
Contact, Title: Coral Letnes, Program Mgr.
Phone: 206 -436 -2981 x 613
Email: cletnes @crisisclinic.org
❑ 1st Quarter, January to March — Due: April 15, 2012
❑ 2nd Quarter, April to June — Due: July 15, 2012
❑ 3'd Quarter, July to September — Due: October 17, 2012
❑ 4th Quarter, October to December — Due: January 31, 2012
❑ Quarterly Service Report - Exhibit 1
❑ Quarterly Financial Report — Exhibit 2
❑ Demographic Report (2nd and 4th Quarters only) — Exhibit 3
❑ Outcomes Report (1St Qtr. identified and 4th Qtr. data due) — Exhibit 4
❑ Proof of Insurance (1St Quarter or if expired)
❑ Logic Model (1st Quarter only) — Suggested Template
I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to
Auburn residents.
Signature of Authorized Representative Date
The City of Auburn will issue payment upon this invoice within forty -five (45) business days of receipt. To
ensure prompt payment, please submit this form and all required attachments by the date listed above.
FOR CITY OF AUBURN USE ONLY:
Contract Amount:
$55,227.00
Payments Year to Date:
Payment this invoice:
Authorized to Pay:
Signature
CITY OF AUBURN
Contract Balance:
Date
COVER PAGE — MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST
CITY OF AUBURN
2012 Quarterly Financial Report
Agency: Crisis Clinic
Program: Crisis Lines: 2 -1 -1, 24 Hr. & Teen Link
Report for _ 1st Qtr /Jan -Mar _ 2nd Qtr /Apr -Jun
2012 Exhibit 2 -
Date:
3rd Qtr /Jul -Sep
4th Qtr /Oct -Dec
Requested
Reimburement:
2012 Annual Budget Summary for joint Agreement
Cost Categories
Budget
Award
This -
Request
Cumulative
to date
Award
Balance
1a
Personnel /Agency Services,
Crisis Line and 2 -1 -1
$48,056.00
City of Burien
NA .
$8,000
1b
Personnel /Agency Services,
Teen Link
$7,171.00
$2,000
$2,671
City of Des Moines -
2
Office /Operating Supplies
$1,000
City of Renton
$5,000
$14;746
3
Consultant or Purchased
Services
$2,000
.$4,000
NA
City of Tukwila
4
Direct Client Assistance
$1,500
Pro. ram Totals:
$14,710
,$33;346 -
5
Communications
$55,227
6
Travel & Training
7
Intra- Agency Support
8
Other per Detail- '
.
Grand Total
$55,227.00
Requested
Reimburement:
2012 Annual Budget Summary for joint Agreement
24 Hour Line;
2 71 -1: Line
Teen Link
City of Auburn
$1,000
$1;000
$1,000
City of Burien
NA .
$8,000
$1,000
City of Covington
$2,400
$2,000
$2,671
City of Des Moines -
$1,700
$2,100 -
$1,000
City of Renton
$5,000
$14;746
-NA .
City of SeaTac
$2,000
.$4,000
NA
City of Tukwila
$2,610 - .
$1,500
$1,500
Pro. ram Totals:
$14,710
,$33;346 -
$7,171
Grand Total of Fundin .: -
$55,227
CITY OF AUBURN
2012 Demographic Report
Agency: Crisis Clinic
Program: Crisis Lines: 2 -1 -1, 24 Hr. & Teen Link
2012 Exhibit 3
Date:
Cate • o
1 s
2"'
3"
4
Total YTD
Client
Residence"
"List all clients
served in this
category.
In all other
categories list
participating
cities' clients
only.
Auburn
-
--
Burien
Covin • ton
-
-
-
--
Des Moines
-
-
-
--
Renton
-
-
-
--
SeaTac
-
-
-
--
Tukwila
-
-
-
--
Uninco •orated. Kin. Coun
-
-
-
--
Other:
-
-
-
--
Unknown
-
-
-
--
TOTAL
_____
Client
Income
Level
30% of median or below
-
-
-
--
50% of median or below
-
-
-
--
80% of median or below
-
-
-
--
Above 80% of median
-
-
-
--
Unknown
-
-
-
--
TOTAL
-
-
-
--
Client
Gender
Female
-
-
-
--
Male
-
-
-
--
Client
Age
0-4
-
-
-
--
5 -12
-
-
-
--
13 -17
-
-
-
--
18 -34
-
-
-
--
35-54
-
-
-
--
55-74
-
-
-
--
75+
-
-
-
--
Unknown
-
-
-
--
TOTAL
-
-
-
--
Ethnicity/
Cultural
Background
Asian /Pacific Islander
-
-
-
--
Black/African American
-
-
-
--
His•anic/Latino
-
-
-
--
Native American/ Alaskan Native
-
-
-
-
-
-
--
--
White /Caucasian
Other
-
-
-
--
Unknown
-
-
-
--
TOTAL
-
-
-
--
Condition
Disablin• Condition
-
-
-
--
ESL
Limited En.lish S.eakin•
-
-
-
--
Household
Female- Headed Household
-
-
-
-
-
-
--
--
Male- Headed Household
will not be re uired for contract corn • liance.
•
2012 Crisis Line
Service Unit
Description:
Total;Projected:'='
-
F {minimum clients served .
All Fundin• Sources
1 Qtr.
2 Qtr
3 Qtr.
'
4 h _ Qtr
Service Unit
/Performance Measure
= 'Incor`iing`Calls ' '-
'
Incoming Calls
�:Incoming, Calls' i
Incoming
Calls
': Incoming
Calls
Auburn
Covington
206
�t. .
'' -'
F
Des Moines
' 154
Renton .
•:.;:;: `r,..:,' < :° :440
r •
SeaTac
206 `
rtf
Tukwila
:15
Totals
.' 1,263
r
...
2012 Exhibit 1
CITY OF AUBURN — JOINT HUMAN SERVICE AGREEMENT
2012 SCOPE OF SERVICES AND QUARTERLY SERVICE UNIT REPORT
Agency Information:
Crisis Clinic
9725 — 3rd Ave. NE, Ste. 300 (206) 461 -8368 fax
Seattle, WA 98115 - 2030
Contact: Coral Letnes Title: Business Manager E -mail: cletnes @crisisclinic.org
Are professional services (e.g., counseling, case management) provided as part of this Agreement? No
(206) 436 -2981
Contract Information:
Contract Amount: $55,227.00
Program Name:
Description of Services:
Telephone Services: 24 -hour Crisis Line, 2 -1 -1 Community Information Line, and Teen Link
Telephone services, referral and advocacy calls will be reported as a courteously, these services
co
L
c
eqi
co
M.
Funder Re i ortin • to: Ci of Auburn
Re s ortin Period:
to
Date Form Com i leted:
Agency: Crisis Clinic
Program:
Contact Person:
E -mail: _
Phone:
CITY OF AUBURN
OUTCOMES REPORT - EXHIBIT4
i1St Qtr Due: Outcome identified, indicators given, data collection, method(s).explained
• 14th Qtr: -Due: Outcome: results
OUTCOME: (What change do you expect to see ?)
MEASURABLE INDICATORS: (How will you know change has occurred ?)
DATA COLLECTION METHOD(S):
OUTCOME RESULTS: (Narrative) highlight your data, include your interpretation of the data and attach any graphics if available.
USE ADDITIONAL PAGES AS NEEDED
Pro ram Evaluation Lo • is Model
PROCESS
RESOURCES
ACTIVITIES
OUTPUTS
Phone:
OUTCOME
OUTCOMES
INDICATORS
GOAL
E -mail:
Phone:
CITY OF AUBURN
i of Auburn
e • ortin • Period•
to
LOGIC MODEL REPORT - Suggested Template
Date Form Corn s leted:
Agency:
Program:
Contact Person:
E -mail:
Phone: