AGREEMENT FOR THE USE OF CITY SPECIAL ALCOHOL FUNDS
This Agreement is entered into between the City of Lawrence, Kansas, a municipal corporation (hereafter “City”) and Heartland Community Health Center (hereafter the “Independent Agency”), on this ________ day of _______________________ 2013, for the purpose of establishing certain conditions on the receipt, expenditure and use of City funds received by the Independent Agency.
I. Use of City Funds
As a condition of the receipt of City funds amounting to $21,913 during City budget year 2013, the Independent Agency hereby agrees to use and expend all such funds pursuant to:
A) City of Lawrence Charter ordinance No. 33, which outlines the following uses for special alcohol and drug program funds:
1. Prevention of alcoholism and drug abuse, including but not limited to education, counseling, public informational efforts and related activities; or
2. Alcohol and drug detoxification efforts and related activities; or
3. Intervention in alcohol and drug abuse or treatment of persons who are alcoholics or drug abusers or are in danger of becoming alcoholics or drug abusers; or
4. Law enforcement, prosecution, court activities and programs, or portions thereof, related to apprehending, prosecuting, adjudicating or monitoring individuals who are alcoholics or drug abusers or are in danger of becoming alcoholics or drug abusers, including individuals who are or may be charged with violating laws related to alcohol or drug use; or
5. Education, counseling, public information efforts, and related and associated activities related to preventing drug abuse and alcohol abuse, including but not limited to efforts to encourage healthy youth and family development and related efforts which include as a partial element drug abuse and alcohol abuse education, counseling, or public information efforts; or
6. Programs, activities, or efforts related to preventing or intervening in drug abuse and alcohol abuse, including programs, activities, or efforts for which drug abuse and alcohol abuse prevention or intervention comprises a partial element of the complete program, activity or effort; or
7. Any program, activity, or effort, or a portion thereof, that the governing body determines seeks to discourage, prevent, intervene, or address issues related to alcohol or drug abuse. The appropriation of funds by the governing body for such a program, activity, or effort shall be conclusive of compliance with provisions of this ordinance, and separate findings shall not be required.
B) All applicable federal, state, and local laws; and
C) The application for funds, as approved and amended by the City Commission, which states:
1. The funds will be used toward the expenses related to AmeriCorps health coaches and electronic health records subscription fee.
2. The funds will be used to achieve the following program outcomes
a) All initial primary care encounters and all mental health encounters will include a screening to determine risk for alcohol/drug abuse;
b) Refer at-risk-patients to the clinical social worker and provide coaching on healthy behaviors while connecting them to needed resources;
c) 90% of all patients and clients who screen as at risk will be counseled for substance abuse within three visits;
d) The target populations will have the knowledge and skills to make individually appropriate choices about alcohol use;
e) The subscription fee will allow the clinical social worker to be recognized as a provider in the electronic health records and bill patients for services.
II. Independent Contractor
The Independent Agency further agrees that it is an independent contractor of the City, and that the employees, agents, and vendors of the Independent Agency are not employees of the City.
III. Disbursement of Funds
First half of funds will not be disbursed before April 1, 2013 and second half of funds will not be disbursed before October 1, 2013.
A) The Independent Agency shall request disbursement of funds as follows:
1. Requests for disbursements shall be made by the Independent Agency in writing, on the official letterhead of the agency;
2. Unless otherwise agreed to in writing, requests shall be submitted no more than twice each year:
a) A request for fifty percent (50%) of the Independent Agency’s total allocation shall be submitted on or after March 1, 2013;
b) A request for the remaining fifty percent (50%) of the Independent Agency’s total allocation shall be submitted on or after September 1, 2013.
3. The City retains the right to withhold the second disbursement of funds for failure to submit a six-month progress report by July 15, 2013.
B) The City retains the right to unilaterally adjust the amount of any disbursement if the City Commission determines that insufficient public funds exist to fully fund the agency at the level indicated in this agreement.
IV. Reporting Requirements
The Independent Agency shall provide written reports to the City as follows:
A) Two progress reports that describe the progress made towards meeting the goals and outcomes described in the Independent Agency’s Application for Funding shall be due as follows:
1. A report for activities from January through June shall be due July 15, 2013;
2. A cumulative report for activities from January through December shall be due February 15, 2014.
B) The following documents shall be on file with the City within nine months of the end of the agency’s last fiscal year:
1. The agency’s current IRS Form 990 (i.e. copy of Federal Tax Return) as well as a copy of the current corporate annual report filed with the Kansas Secretary of State – FORM NP (not-for-profit) filing.
2. A copy of the agency’s current financial audit. It is suggested that the agency adopt SFAS No. 117. This standard has been adopted by the Financial Accounting Standards Board as a preferred accounting method for non-profit corporations.
3. A copy of the Agency’s Annual Report that includes a summary of how the funds were used, to include an assessment of the agency’s annual accomplishments and outcomes.
C) The Independent Agency agrees to comply with K.S.A. 45-240, which requires not-for-profit entities receiving public funds to document and make available the receipt and expenditures of such funds. The requirements outlined in Section 4B are not meant to satisfy the terms of K.S.A. 45-240.
V. Access to Financial Records
In addition, the Independent Agency shall provide the City with reasonable access to financial records concerning the expenditure of City Funds.
VI. Withholding of Payment
The City shall retain the authority to withhold any and all payments to the Independent Agency if, in the sole judgment of the City, the proposed or continued use of the funds violates the terms of this Agreement, any applicable law, or is contrary to the appropriate use of public funds.
THE UNDERSIGNED, DULY REPRESENTING HEARTLAND COMMUNITY HEALTH CENTER, THE INDEPENDENT AGENCY OF THIS AGREEMENT, HEREBY AGREES TO THE CONDITIONS OF THIS AGREEMENT FOR THE RECEIPT, EXPENDITURE AND USE OF CITY FUNDS:
Signature: ____________________________________________
Print Name and Title: ____________________________________________
STATE OF KANSAS )
COUNTY OF DOUGLAS )
The foregoing Agreement was acknowledged before me this ___________ day of ____________, 2013 by __________________________________, representing ____________________________________ as the Independent Agency of this Agreement. In testimony whereof, I have hereunto set my hand and affixed my official seal on the day and year last above written.
________________________
Notary Public
My commission expires: ______________
THE UNDERSIGNED FOR THE CITY OF LAWRENCE, KANSAS:
Signature: ___________________________________________________________
Print Name and Title: Casey Toomay, Budget Manager
STATE OF KANSAS )
COUNTY OF DOUGLAS )
The foregoing Agreement was acknowledged before me this ___________ day of _____________, 2013 by Casey Toomay, representing the City of Lawrence, Kansas. In testimony whereof, I have hereunto set my hand and affixed my official seal on the day and year last above written.
____________________________
Notary Public
My commission expires: _______________