Contract No. 1992-33 MOU Between KIBSD and KODIAK ISLAND MENTAL HEALTH CENTERKodiak
Area
Native
Association
Issuing Office Contractor
Kodiak Area Native Association Kodiak Is. Mental
402 Center Avenue 316 Mission Road,
Kodiak, AK 99615 Kodiak, AK 99615
c`12 -33/ -
402 Center Avenue
Kodiak, Alaska 99615
Phone (907) 486-5725
Health Ctr.
Suite 119
The Kodiak Area Native Association requests extended consultation
services from Dr. William Earl of the Kodiak Island Mental Health
Center to continue in the planning and implementation of the Five
Year Mental Health Plan. The consultation will include appropriate
organizational development including but not restricted to program
planning, staff development, interdepartmental role development,
supervision, and project implementation.
In order to provide coverage for special events, (ie. Gathering,
Bridges Program, Teaching), Dr. Earl is requested to provide
services up to twenty (20) hours per week in these instances.
In return for the services provided, Kodiak Area Native Association
agrees to pay the Kodiak Island Mental Health Center $500.00 per
day (8 working hours) through and including March 31, 1993. This
contract may be extended beyond this time period, or provisions may
be changed with mutual written consent of the issuing office and
contractor. This contract may be terminated within thirty (30)
days by written petition of either party.
F-TOTGUM—r-TH . -. -.
Contractor:
Kodiak Area Native Association
Kelly imeono
President
3114V - — R-3�
Dates— Date
Serving the communities of: Akhiok • Karluk • Kodiak • Larsen Bay • Old Harbor • Ouzinkie • Port Lions
Kodiak
Area
Native
Association
February 22, 1993
Mr. Jerome Selby, Mayor
Kodiak Island Borough
710 Mill Bay Road
Kodiak, Alaska 99615
Dear Jerome,
402 Center Avenue
Kodiak, Alaska 99615
Phone (907) 486-5725
Your signature is needed, please, on the attached contract so we
may continue the professional services provided by Dr. William
Earl, of Kodiak Island Mental Health Center. As you are aware,
Dr. Earl is our consultant for the development of KANA"s 5 Year
Mental Health Plan. As Mayor of Kodiak Island Borough your
signature is necessary on the attached Contract between Kodiak
Island Mental Health Center and KANA.
It would be greatly appreciated if you'd return this contract to
my attention after you have signed it so that I may complete the
remaining paperwork.
Should you have need for any additional information or any
concerns please do not hesitate to call either Lauren Salamone,
Community Health Services Manager, or myself at 486-5725.
Thank you.
Sincerely,
rODIAK AREA NATIVE ASSOCIATION
ELLY STMEONOFF,t\ J IDENT
Martha Randolph,
Administrative ssistant
enclosure
Serving the communities of: Akhiok • Karluk • Kodiak • Larsen Bay • Old Harbor • Ouzinkie • Port Lions
Kodiak
Area
Native
Association
Nook mg-1
Kodiak Area Native Association
402 Center Avenue
Kodiak, Alaska 99615
h1
402 Center Avenue
Kodiak, Alaska 99615
Phone (907) 486-5725
Kodiak Is. Mental Health Cntr.
316 Mission Road, Suite 119
Kodiak, Alaska 99615
The Kodiak Area Native Association requests extended consultation
services from Dr. William Earl of the Kodiak Island Mental Health
Center to continue in the planning and implementation of KANA's
Five Year Mental Health Plan. The consultation will include
appropriate organizational development including but not
restricted to program planning, staff development, para-
professional role development, inter departmental role/model
development, and implementation. The average weekly consultation
is up to two (2) days per week.
In order to provide coverage for special events (i.e. Gathering,
Bridges program) Dr. Earl is requested to provide services up to
twenty (20) hours per week in these instances.
Special provision is also requested for September 1992 VRT
training. At this time, the Kodiak Island Mental Health Center
has agreed to provide two (2) days of VRT training per Koniag
village (12 days) free of charge as an outreach project. KAVA
agrees to pay all travel and per diem expenses along with any
overtime spent in the villages due to weather at regular contract
rate.
In return for the services provided, Kodiak Area Native
Association agrees to pay the Kodiak Island Mental Health Center
$500.00 per day (8 working hours) through and including September
30, 1992. This contract may be extended beyond this time period,
or provisions may be changed with mutual written consent of the
issuing office and contractor. This contract may be terminated
within thirty (30) days by written petition of either party.
Contractor:
J ome Selby, Ma r
Kodiak Island Borough
'? _
Date
Kodiak Area Native Association
Kelly Srimeonof£, Jre" d
President/Acting Health Dir.
August 3, 1992
Date
Serving the communities of: Akhiok 9 Karluk 9 Kodiak 9 Larsen Bay • Old Harbor • Ouzinkie • Port Lions
(..ONTRACT CONTROL!� EET
Policy requires that each contract originating within KAVA, in
which KANA is the contractor and another party is the contractee,
be approved by the Department Director first, the Director of
Finance second and then by the President prior to being signed by
the intended contractee. If contractee is providing personal
services to KAVA and does not have a certificate of insurance for
workman's, compensation KAVA is responsible and liable to furnish
the workman's compensation for contractee. If contractee has a
rental agreement with KANA proof of liability insurance needs to
be provided by contractee. Each contract must be assigned a
control number by the Director of Finance. Attach this control
sheet to the cover of your contract, complete the information
requested, sign your name as the originator, and submit the
contract, with this sheet to the Finance Department.-
PURPOSE
epartment:
PURPOSE OF CONTRACT: Continue development of KANA's Five Year Mental
Health Plan; organizational development.
CONTRACTEE: Kodiak Island Mental Health Center
CONTRACTEZ NAILING ADDRESS: 316 Mission Rdad, Griffin Building, Suite 119
CERTIFICATE OF INSURANCE:
YES (ATTACH)
Kodiak, Alaska 99615
(WORKMAN'S COMP) CHECK ONE
XXX NO (SEE PROCEDURE)
CERTIFICATE OF INSURANCE OTHER: (RENTAL AGREEMENT) CHECK ONE
YES (ATTACH)
NO (SEE PROCEDURE)
TOTAL AMOUNT OF CONTRACT: $500•/day - not to exceed $15,000.00
TIME PERIOD OF CONTRACT: Contract expires on October 1, 1992 at 8:00 a.m.
SOCIAL SECURITY/ EMPLOYER I.D. NUMBER: Federal I.D. # 92-0038166
CONTRACT CONTROL HUMBER:
A. ORIGINATORt
B. DEPARTMENT DIRECTOR:
C. DIRECTOR OF
D. PRESIDENT:
DATE
K)July 30, 1992
After the above tial been completed, it is the responsibility of
the originator to obtain the signature of the contractee or
his/her legal agent. Contracts will be signed by the President
after they are signed by the contractee only if they have
received prior approval and the control sheet has been properly
completed with the appropriate attachments.
c- �3
KODIAK ISLAND BOROUGH SCHOOL DISTRICT
722 Mill Bay Road
Kodiak, Alaska 99615
Office of the Superintendent
(907) 486-9233
MEMORANDUM OF AGREEMENT NO. 923-7
between the
KODIAK ISLAND BOROUGH
KODIAK ISLAND MENTAL HEALTH CENTER
316 Mission Road, Suite #119
Kodiak, Alaska 99615
and the
KODIAK ISLAND BOROUGH SCHOOL DISTRICT
PURPOSE: To provide continued services to Special Education students, primarily
those identified with serious emotional disabilities, as per their
Individual Education Programs.
PERIOD COVERED: July 1, 1992 - August 15, 1992
PAYMENT: Will be rendered upon submission of an itemized billing with documentation
as specified in Attachment A.
ITEMS TO BE PAID:
Professional Services
TOTAL AMOUNT NOT TO EXCEED:
AMOUNT TO BE PAID:
$27,824.02
ACCOUNT CODE:
60.92.293..400.15
$27,824.02
OTHER CONDITIONS:
1. Services to be provided in conformance with applicable Special Education
regulations.
2. Contractor will submit an itemized billing with required documentation to
the District no later than September 15, 1992.
3. Refer to Attachment A for details of Program Budget and requirements.
AGREED TO B
E. Iver
President, School Board
Date: G�sf�9Z
Date:
Attest
� Borough Clerk
gpohn Witteveen
erinteendennt/�, Q f
Date: �/U!�//!i
Jamqrry Nagan 61
Dir, ctor, Special Education Services
Date: G/L/ Z97_
ATTACHMENT A
MEMORANDUM OF AGREEMENT NO. 923-7
between the
KODIAK ISLAND BOROUGH SCHOOL DISTRICT
and the
KODIAK ISLAND MENTAL HEALTH CENTER
This document shall detail the program budget and requirements of the agreement
between the Kodiak Island Borough School District and the Kodiak Island Mental
Health Center under Memorandum of Agreement No. 923-7. Services shall be
provided to Special Education students, primarily those identified with serious
emotional disabilities, as per their Individual Education Programs, from on or
about June 29, 1992 to on or about August 7, 1992.
Budget Detail:
Personnel
counselor (1) - Carolyn Sapp
35 days, $336.70 per day (salary/benefits)
Not to exceed $11,784.50
Instructor (1)
32 days, salary at $159 per day, plus benefits at 11.13% (WC, UEI, FICA),
for a total of $176.70 per day
Not to exceed $5,654.40
Aide II (3)
6.5 hours per day, 32 days
Salary at $10.04 per hour, plus benefits at 11.138 (WC, UEI, FICA),
for a total of $11.16 per hour
Not to exceed $6,963.84
Aide II (1)
(If over 15 students attending as per their IEP)
6.5 hours per day, 32 days
Salary at $10.04 per hour, plus benefits at 11.138 (WC, UEI, FICA),
for a total of $11.16 per hour
Not to exceed $2,321.28
Miscellaneous Program Supplies/Materials
Not to exceed $500.00
Indirect Costs
(Director, Misc. Clinical staff, Pool costs)
Not to exceed $600.00
Billing Requirements Detail:
The following items must be submitted with the billing:
Calendar of days worked by Counselor and Instructor
Time sheets for hours worked by Aides
Daily student attendance record
Receipts for all supplies and materials