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AG 17-059II RETURN TO: Sarah Bridgeford EXT: 2651 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: CD /CS 2. ORIGINATING STAFF PERSON: _SARAH BRIDGEFORD 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE ❑ CONTRACT AMENDMENT (AG #): ❑ OTHER EXT: 2651 3. DATE REQ. BY: ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT x HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL 5. PROJECT NAME: EMERGENCY SERVICES 6. NAME OF CONTRACTOR: WASHINGTON POISON CENTER ADDRESS: 155 NEE le' S-vvw Suitt 1 t S'eoM , WP 88125 TELEPHONE 2154- 1511 - 238C) E -MAIL: Recek A P,WAPC FAX: NI/t SIGNATURE NAME: 1 TITLE &vetvtl1Vt ©1 WAIN- 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE X ALL OTHER REFERENCED EXHIBITS x PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS 8. TERM: COMMENCEMENT DATE: 01/01/2017 COMPLETION DATE: 12/31 /2018 9. TOTAL COMPENSATION $_8,000.00 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ RETAINAGE: RETAINAGE AMOUNT: ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ RETAINAGE BY (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED ❑ PURCHASING: PLEASE CHARGE TO: 001 - 7300 - 083 - 562 -10 -410 10. DOCUMENT /CONTRACT REVIEW ❑ PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW 11. COUNCIL APPROVAL (IF APPLICABLE) 12. CONTRACT SIGNATURE ROUTING INITIAL / DATE REVIEWED :/ //7 COMMITTEE APPROVAL DATE: INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: SENT TO VENDOR/CONTRACTOR DATE SENT: j f j q /aol DATE REC'D: ,3 Ol 51- ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS 0/.2. ❑ LAW DEPARTMENT PIGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED COMMENTS: INITIAL / DATE SI NED .■ r L 1 'jam AG# (a -Q 1 DATE SENT: 0410 -11 CITY OF Federal Way HUMAN SERVICES AGREEMENT FOR EMERGENCY SERVICES CITY HALL 33325 8th Avenue South Federal Way. WA 98003 -6325 (253) 835-7000 wvw cityoffederaiway corn This Human Services Agreement ( "Agreement ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Washington Poison Center, a Washington nonprofit corporation ( "Agency "). The City and Agency (together "Parties ") are located and do business at the below addresses which shall be valid for any notice required under this Agreement: WASHINGTON POISON CENTER: Arti Patel 155 NE 100th Street, Ste. 100 Seattle, WA 98125 (206) 517 -2380 (telephone) apatel @wapc.org The Parties agree as follows: CITY OF FEDERAL WAY: Sarah Bridgeford 33325 8th Ave. S. Federal Way, WA 98003 -6325 (253) 835 -2651 (telephone) (253) 835 -2609 (facsimile) Sarah. Bridgeford @cityoffederalway.com 1. TERM. The term of this Agreement shall be for a period commencing on January 1, 2017 and terminating on December 31, 2018 ( "Term "). Funding for the second year of the Agreement is contingent upon satisfactory Agreement performance during the first year of the Agreement term and upon funding availability. This Agreement may be extended for additional periods of time upon the mutual written agreement of the City and the Agency. 2. SERVICES. The Agency shall perform the services more specifically described in Exhibit A, attached hereto and incorporated by this reference ( "Services "), in a manner consistent with the accepted professional practices for other similar services within the Puget Sound region in effect at the time those services are performed to the City's satisfaction, within the time period prescribed by the City and pursuant to the direction of the Mayor or his or her designee. The Agency warrants that it has the requisite training, skill, and experience necessary to provide the Services and is appropriately accredited and licensed by all applicable agencies and governmental entities, including but not limited to obtaining a City of Federal Way business registration. Services shall begin immediately upon the effective date of this Agreement. Services shall be subject, at all times, to inspection by and approval of the City, but the making (or failure or delay in making) such inspection or approval shall not relieve the Agency of responsibility for performance of the Services in accordance with this Agreement, notwithstanding the City's knowledge of defective or non - complying performance, its substantiality or the ease of its discovery. 3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days' written notice at its address set forth above. The City may terminate this Agreement immediately if the Agency fails to maintain required insurance, breaches confidentiality, or materially violates Section 12, and such may result in ineligibility for further City agreements. 4. COMPENSATION. 4.1 Amount. In return for the Services, the City shall pay the Agency an amount not to exceed a maximum amount and according to a rate or method as delineated in Exhibit B, attached hereto and incorporated by this reference. The City shall reimburse the Agency only for the approved activities and in accordance with the procedures as specified in Exhibit B. The Agency shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction resulting from this Agreement. HUMAN SERVICES AGREEMENT 1 4/2015 CITY OF �.. Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003 -6325 (253) 835-7000 www cityoffederalway corn 4.2 Method of Payment. On a quarterly basis, the Agency shall submit to the City an invoice for payment on a form provided by the City along with supporting documentation for costs claimed in the invoice and all reports as required by this Agreement. Payment shall be made on a quarterly basis by the City only after the Services have been performed and within forty-five (45) days after the City's receipt and approval of a complete and correct invoice, supporting documentation, and reports. The City will use the quantity of Services actually delivered, as reported on the Agency's reports, as a measure of satisfactory performance under this Agreement. The City shall review the Agency's reports to monitor compliance with the performance measures set forth in Exhibit A. Should the Agency fail to meet the performance measures for each quarter, the City reserves the right to adjust payments on a pro rata basis at any time during the term of this Agreement. Exceptions may be made at the discretion of the City's Human Services Manager in cases where circumstances beyond the Agency's control impact its ability to meet its service unit goals and the Agency has shown reasonable efforts to overcome these circumstances to meet its goals. If the City objects to all or any portion of the invoice, it shall notify the Agency and reserves the option to pay only that portion of the invoice not in dispute. In that event, the Parties will immediately make every effort to settle the disputed portion. 4.3 Final Invoice. The Agency shall submit its final invoice by the date indicated on Exhibit B. If the Agency's final invoice, supporting documentation, and reports are not submitted by the last date specified in Exhibit B, the City shall be relieved of all liability for payment to the Agency of the amounts set forth in said invoice or any subsequent invoice; provided, however, that the City may elect to pay any invoice that is not submitted in a timely manner. 4.4 Budget. The Agency shall apply the funds received from the City under this Agreement in accordance with the line item budget set forth in Exhibit B. The Agency shall request in writing prior approval from the City to revise the line item budget when the cumulative amount of transfers from a line item in any Project/Program Exhibit is expected to exceed ten percent (10 %) of that line item. Supporting documents are necessary to fully explain the nature and purpose of the revision, and must accompany each request for prior approval. All budget revision requests in excess of 10% of a line item amount shall be reviewed and approved or denied by the City in writing. 4.5 Non - Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment under this Agreement for any future fiscal period, the City will not be obligated to make payments for Services or amounts incurred after the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Services for which funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies. 5. INDEMNIFICATION. 5.1 Agency Indemnification. The Agency agrees to release, indemnify, defend, and hold the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including, without limitation, their respective agents, licensees, or representatives arising from, resulting from, or in connection with this Agreement or the performance of this Agreement, except for that portion of the claims caused by the City's sole negligence. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Agency and the City, the Agency's liability hereunder shall be only to the extent of the Agency's negligence. Agency shall ensure that each subcontractor shall agree to defend and indemnify the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers to the extent and on the same terms and conditions as the Agency pursuant to this paragraph. The City's inspection or acceptance of any of Agency's work when completed shall not be grounds to avoid any of these covenants of indemnification. 5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Agency waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 51 RCW, solely for the purposes of this indemnification. Agency's indemnification shall not be limited in any way by any limitation on the amount of damages, compensation or benefits payable to or by any third party under workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties further acknowledge that they have mutually negotiated this waiver. HUMAN SERVICES AGREEMENT - 2 - 4/2015 CITY OF ,�.., Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003 -6325 (253) 835 -7000 www crtyoffederalway com 5.3 City Indemnification. The City agrees to release, indemnify, defend and hold the Agency, its officers, directors, shareholders, partners, employees, agents, representatives, and subcontractors harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs, and /or litigation expenses to or by any and all persons or entities, including without limitation, their respective agents, licensees, or representatives, arising from, resulting from or connected with this Agreement to the extent solely caused by the negligent acts, errors, or omissions of the City. 5.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement with respect to any event occurring prior to such expiration or termination. 6. INSURANCE. The Agency agrees to carry insurance for liability which may arise from or in connection with the performance of the services or work by the Agency, their agents, representatives, employees or subcontractors for the duration of the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as follows: 6.1. Minimum Limits. The Agency agrees to carry as a minimum, the following insurance, in such forms and with such carriers who have a rating that is satisfactory to the City: a. Commercial general liability insurance covering liability arising from premises, operations, independent contractors, products - completed operations, stop gap liability, personal injury, bodily injury, death, property damage, products liability, advertising injury, and liability assumed under an insured contract with limits no less than $1,000,000 for each occurrence and $2,000,000 general aggregate. b. Workers' compensation and employer's liability insurance in amounts sufficient pursuant to the laws of the State of Washington; c. Automobile liability insurance covering all owned, non - owned, hired and leased vehicles with a minimum combined single limits in the minimum amounts required to drive under Washington State law per accident for bodily injury, including personal injury or death, and property damage. 6.2. No Limit of Liability. Agency's maintenance of insurance as required by the agreement shall not be construed to limit the liability of the Agency to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. The Agency's insurance coverage shall be primary insurance as respect the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall be excess of the Agency's insurance and shall not contribute with it. 6.3. Additional Insured, Verification. The City shall be named as additional insured on all commercial general liability insurance policies. Concurrent with the execution of this Agreement, Agency shall provide certificates of insurance for all commercial general liability policies attached hereto as Exhibit C and incorporated by this reference. At the City's request, Agency shall furnish the City with copies of all insurance policies and with evidence of payment of premiums or fees of such policies. If Agency's insurance policies are "claims made," Agency shall be required to maintain tail coverage for a minimum period of three (3) years from the date this Agreement is actually terminated or upon project completion and acceptance by the City. 6.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement. 7. CONFIDENTIALITY. All information regarding the City obtained by Agency in performance of this Agreement shall be considered confidential subject to applicable laws. Breach of confidentiality by the Agency may be grounds for immediate termination. All records submitted by the City to the Agency will be safeguarded by the Agency. The Agency will fully cooperate with the City in identifying, assembling, and providing records in case of any public records disclosure request. 8. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts, designs, design specifications, records, files, computer disks, magnetic media or material which may be produced or modified by Agency while performing the Services shall belong to the City upon delivery. The Agency shall make such data, documents, and files available to the City and shall deliver all needed or contracted for work product upon the City's request. At the expiration or termination of this Agreement all originals and copies of any such work product remaining in the possession of Agency shall be delivered to the City. HUMAN SERVICES AGREEMENT - 3 - 4/2015 CITY OF Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003 -6325 (253) 835 -7000 www cityoffederahvay coin 9. BOOKS AND RECORDS. The Agency agrees to maintain books, records, and documents which sufficiently and properly reflect all direct and indirect costs related to the performance of the Services and maintain such accounting procedures and practices as may be deemed necessary by the City to assure proper accounting of all funds paid pursuant to this Agreement. These records shall be maintained for a period of six (6) years after the termination of this Agreement and may be subject, at all reasonable times, to inspection, review or audit by the City, its authorized representative, the State Auditor, or other governmental officials authorized by law to monitor this Agreement. 10. INDEPENDENT CONTRACTOR. The Parties intend that the Agency shall be an independent contractor and that the Agency has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. The City shall be neither liable nor obligated to pay Agency sick leave, vacation pay or any other benefit of employment, nor to pay any social security or other tax which may arise as an incident of employment. Agency shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the Services and work and shall utilize all protection necessary for that purpose. All work shall be done at Agency's own risk, and Agency shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. The Agency shall pay all income and other taxes due except as specifically provided in Section 4. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Agency, shall not be deemed to convert this Agreement to an employment contract. 11. CONFLICT OF INTEREST. It is recognized that Agency may or will be performing services during the Term for other parties; however, such performance of other services shall not conflict with or interfere with Agency's ability to perform the Services. Agency agrees to resolve any such conflicts of interest in favor of the City. Agency confirms that Agency does not have a business interest or a close family relationship with any City officer or employee who was, is, or will be involved in the Agency's selection, negotiation, drafting, signing, administration, or evaluating the Agency's performance. 12. EQUAL OPPORTUNITY EMPLOYER. In all services, programs, activities, hiring, and employment made possible by or resulting from this Agreement or any subcontract, there shall be no discrimination by Agency or its subcontractors of any level, or any of those entities' employees, agents, sub - agencies, or representatives against any person because of sex, age (except minimum age and retirement provisions), race, color, religion, creed, national origin, marital status, or the presence of any disability, including sensory, mental or physical handicaps, unless based upon a bona fide occupational qualification in relationship to hiring and employment. This requirement shall apply to, but not be limited to, the following: employment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Agency shall comply with and shall not violate any of the terms of Chapter 49.60 RCW, Title VI of the Civil Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49 CFR Part 21, 21.5 and 26, or any other applicable federal, state, or local law or regulation regarding non - discrimination. 13. GENERAL PROVISIONS. 13.1 Interpretation and Modification. This Agreement, together with any attached Exhibits, contains all of the agreements of the Parties with respect to any matter covered or mentioned in this Agreement and no prior statements or agreements, whether oral or written, shall be effective for any purpose. Should any language in any Exhibits to this Agreement conflict with any language in this Agreement, the terms of this Agreement shall prevail. The respective captions of Sections of this Agreement are inserted for convenience of reference only and shall not be deemed to modify or otherwise affect any of the provisions of this Agreement. Any provision of this Agreement that is declared invalid, inoperative, null and void, or illegal shall in no way affect or invalidate any other provision hereof and such other provisions shall remain in full force and effect. Any act done by either Party prior to the effective date of the Agreement that is consistent with the authority of the Agreement and compliant with the terms of the Agreement, is hereby ratified as having been performed under the Agreement. No provision of this Agreement, including this provision, may be amended, waived, or modified except by written agreement signed by duly authorized representatives of the Parties. 13.2 Assignment and Beneficiaries. Neither the Agency nor the City shall have the right to transfer or assign, in whole or in part, any or all of its obligations and rights hereunder without the prior written consent of the other Party. If the non- HUMAN SERVICES AGREEMENT - 4 - 4/2015 CITY OF Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003 -6325 (253) 835-7000 www cityoffederalway corn assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. Subject to the foregoing, the rights and obligations of the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and assigns. This Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person or entity shall have any right of action or interest in this Agreement based on any provision set forth herein. 13.3 Compliance with Laws. The Agency shall comply with and perform the Services in accordance with all applicable federal, state, local, and city laws including, without limitation, all City codes, ordinances, resolutions, regulations, rules, standards and policies, as now existing or hereafter amended, adopted, or made effective. If a violation of the City's Ethics Resolution No. 91 -54, as amended, occurs as a result of the formation or performance of this Agreement, this Agreement may be rendered null and void, at the City's option. 13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in which performance is a factor. Adherence to completion dates set forth in the description of the Services is essential to the Agency's performance of this Agreement. Any notices required to be given by the Parties shall be delivered at the addresses set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice so posted in the United States mail shall be deemed received three (3) days after the date of mailing. Any remedies provided for under the terms of this Agreement are not intended to be exclusive, but shall be cumulative with all other remedies available to the City at law, in equity or by statute. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. Failure or delay of the City to declare any breach or default immediately upon occurrence shall not waive such breach or default. Failure of the City to declare one breach or default does not act as a waiver of the City's right to declare another breach or default. This Agreement shall be made in, governed by, and interpreted in accordance with the laws of the State of Washington. If the Parties are unable to settle any dispute, difference or claim arising from this Agreement, the exclusive means of resolving that dispute, difference, or claim, shall be by filing suit under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative process. If the King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any other appropriate court in King County, Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County, Washington and waives any objection that such courts are an inconvenient forum. If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney's fees and expenses incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, however nothing in this paragraph shall be construed to limit the Parties' rights to indemnification under Section 5 of this Agreement. 13.5 Execution. Each individual executing this Agreement on behalf of the City and Agency represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original and with the same effect as if all Parties hereto had signed the same document. All such counterparts shall be construed together and shall constitute one instrument, but in making proof hereof it shall only be necessary to produce one such counterpart. The signature and acknowledgment pages from such counterparts may be assembled together to form a single instrument comprised of all pages of this Agreement and a complete set of all signature and acknowledgment pages. The date upon which the last of all of the Parties have executed a counterpart of this Agreement shall be the "date of mutual execution" hereof. [Signature page follows] HUMAN SERVICES AGREEMENT - 5 - 4/2015 CITY OF '�. Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: DATE: WASHINGTON POISON CENT Printed Name: rR tcA Li E LT" m� Title: &eel)* ve , re 0. ))' DATE: 7Arch a3i a o 14- STATE OF WASHINGTON ) ) ss. COUNTY OF KING ATTEST: Ste a ie Courtney, CMC, City Clerk APPROVED AS TO FORM: J. Ryan Call, City Attorney On this day personally appeared before me Er Icc* - h'e -b-e_ 1+ , to me known to be the t.e..c.01-1 ✓e. `'b ire_ c---r o-,( of Wci 51-> > nqq1- }-10 Ls l Ce. Uhat executed the foregoing instrument, and acknowledged the said instrument'to be the free and • luntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that h:l was authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. GIVEN my hand and official seal this n" day of Notary's signature Notary's printed name (/�p eGer-► Notary Public in and for the State of Washington. My commission expires 07 1 1- l d l , 20' �• HUMAN SERVICES AGREEMENT - 6 4/2015 CITY OF '•�.... Federal Way EXHIBIT A SERVICES Project Summary CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www.cityoffederalway.com The Agency shall provide emergency treatment advice and poison prevention education in the City of Federal Way. The Agency shall ensure that services provided with funding under this Agreement are made available to Federal Way residents. Performance Measures A. Number Served The Agency agrees to serve, at minimum, the following unduplicated number of Federal Way residents with Human Services funds: B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1st Quarter JAN. — MARCH 2nd Quarter APRIL — JIJNE 2nd Quarter APRIL — JUNE 4th Quarter OCT. — DEC. 3rd Quarter JULY — SEPT. 4th Quarter OCT. — DEC. Total No. of unduplicated Federal Way persons assisted in 2017 28 28 28 28 28 112 No. of unduplicated Federal Way persons assisted in 2018 2. Outreach /Group Sessions 28 0 28 28 2 28 112 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: HUMAN SERVICES AGREEMENT 1 HSA Exh 1/2017 1St Quarter JAN.— MARCH 2nd Quarter APRIL — JIJNE 3rd Quarter JULY — SEPT. 4th Quarter OCT. — DEC. Total 2017 1. Crisis Line /Phone Calls 28 28 28 28 112 2. Outreach /Group Sessions 1 0 1 0 2 2018 1. Crisis Line /Phone Calls 28 28 28 28 112 2. Outreach/Group Sessions 1 0 1 0 2 HUMAN SERVICES AGREEMENT 1 HSA Exh 1/2017 CITY OF ... Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityo(federalway com C. Definition of Services 1. Crisis Line /Phone Calls: A service unit is a call to the Poison Center concerning a single person, which opens a new case file. 2. Outreach/Group Sessions: A service unit is either attendance at a safety /health fair or a presentation. D. Performance Measure(s) Outcomes to be reported: 1. Improved health. 2. Increased knowledge of community resources. Records A. Project Files The Agency shall maintain files for this project containing the following items: 1. Notice of Grant Award. 2. Motions, resolutions, or minutes documenting Board or Council actions. 3. A copy of this Agreement with the Scope of Services. 4. Correspondence regarding budget revision requests. 5. Copies of all invoices and reports submitted to the City for this project. 6. Bills for payment with supporting documentation. 7. Copies of approved invoices and warrants. 8. Records documenting that costs reimbursed with funding provided under this Scope are allowable. Such records include, but are not limited to: • for personnel costs, payroll for actual salary and fringe benefit costs. • for staff travel, documentation of mileage charges for private auto use must include: a) destination and starting location, and b) purpose of trip; and ■ for copy machine use, postage, telephone use, and office supplies when these costs are shared with other programs and no invoice is available, log sheets or annotated invoices. HUMAN SERVICES AGREEMENT - 2 - HSA Exh 1/2017 CITY OF '�.. Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835-7000 www.cityoffederalway.com 9. Documentation of client income. The Agency agrees to use the HUD Income Guidelines to report income of clients served under this Agreement. Income guidelines may be adjusted periodically by HUD. The Agency agrees to use updated Income Guidelines which will be provided by the City. King County FY 2016 Income Limits Summary Median Income King County FY 2016 Income Limit Category 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons $90,300 Extremely Low (30 %) Income Limits $19,000 $21,700 $24,400 $27,100 $29,300 $32,580 $36,730 $40,890 Very Low (50 %) Income Limits $31,650 $36,150 $40,650 $45,150 $48,800 $52,400 $56,000 $59,600 Low (80 %) Income Limits $48,550 $55,450 $62,400 $69,300 $74,850 $80,400 $85,950 $91,500 Reports and Reporting Schedule The Agency shall collect and report client information to the City quarterly and annually on a Service Unit Report to be provided by the City in the format requested by the City. The Agency shall submit an Annual Demographic Data Report. The agency shall collect and retain the data requested on this form from the persons served through this contract. Data should be tracked in an ongoing manner and submitted annually no later than January 15 in the format requested by the City. The Agency shall implement and track at least one measurable outcome for the program as presented in the application. Changes to the outcome presented in the application must be approved by the City prior to implementation. The Agency shall report the results of its outcome measure(s) annually on the Annual Outcome Data Report to be submitted by January 15 in the format requested by the City. Public Information In all news releases and other public notices related to projects funded under this Agreement, the Agency will include information identifying the source of funds as the City of Federal Way Human Services General Fund Program. HUMAN SERVICES AGREEMENT - 3 HSA Exh 1/2017 CITY OF Federal Way EXHIBIT B COMPENSATION Project Budget CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoftederahvay com The Agency shall apply the following funds to the project in accordance with the Line Item Budget Summary. The total amount of reimbursement pursuant to this Agreement shall not exceed Eight Thousand and 00 /100 Dollars ($8,000.00). A. City of Federal Way Funds 2017 2018 City of Federal Way General Fund: $4,000.00 $4,000.00 Total City of Federal Way Funds: $4,000.00 $4,000.00 B. Line Item Budget 2017 2018 Personnel Services (detail below) $4,000.00 $4,000.00 Office or Operating Supplies $56,752.00 $505.00 Rent & Utilities 14.345 $1,491,697.00 Communications Total: 15.345 Travel and Training $4,000.00 Other (specify): Client Travel Administration (Overhead) Total City of Federal Way Funds: $4,000.00 $4,000.00 C. Personnel Detail Position Title Position Full Time Equivalent Annual Salary and Benefits HS Funds Educator 1.0 $56,752.00 $505.00 Specialist in Poison Info 14.345 $1,491,697.00 $3,495.00 Total: 15.345 $1,548,449.00 $4,000.00 Reimbursement Requests and Service Unit Report forms shall be submitted no less frequently than quarterly and are due on the following dates: 1st Quarter: April 15 or within 10 days of notice to proceed, whichever is later; 2nd Quarter: July 15; 3rd Quarter: October 15; and 4th Quarter: Final Reimbursement Request and Service Unit Report forms due January 8; Demographic Data Report and Annual Outcome Data Report with supporting documentation due January 15. The Agency shall submit Reimbursement Requests in the format requested by the City. Reimbursement Requests Invoices shall include a copy of the Service Unit Report and any supporting documents for the billing period. HUMAN SERVICES AGREEMENT 4 HSA Exh 1/2017 CITY F O Federal Way Estimated Quarterly Payments: 2017 1st Qtr $1,000.00 2nd Qtr $1,000.00 3rd Qtr $1,000.00 4th Qtr $1,000.00 2018 I St Qtr $1,000.00 2nd Qtr $1,000.00 3rd Qtr $1,000.00 4th Qtr $1,000.00 CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835-7000 www cityoffederalway com Expenses must be incurred prior to submission of quarterly reimbursement requests. Proof of expenditures must be attached to the reimbursement request for invoice to be approved. Quarterly reimbursement requests shall not exceed the estimated payment without prior written approval from the City. Estimated quarterly payments are contingent upon meeting or exceeding the above performance measure(s) for the corresponding quarter. This requirement may be waived at the sole discretion of the City with satisfactory explanation of how the performance measure will be met by year -end on the Service Unit Report. Conditions of Funding The Agency agrees that it will meet the specific funding conditions identified for the Agency and acknowledges that payment to the Agency will not be made unless the funding conditions are met. HUMAN SERVICES AGREEMENT - 5 - HSA Exh 1/2017 Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003 -6325 (253) 835 -7000 www crtyoffederalway corn City of Federal Way Human Services Contract for 2017 -2018 General Fund Authorized Signatures for Invoices I authorize the following individuals to sign invoices and quarterly reports on behalf of: Washington Poison Center the following: Emergency Services Authorizing Signature: (must be signed by person who signs the contract, generally, Executive Director) (Contracting Agency), for (Program Title). ER 10A LI L d E % &ec -i ve ,b ivpv7 (Printed Name) (Title) Ay (Signature W_ (Date) Additional Authorized Signature: Additional Authorized Signature: r-h I ate I (Printe e• :me) •tgna ure) J Cn 14Th g_., C&JY' Q t d Name) Mea /114 tf €a-%iv PVtifraa■ (Title) deGIft /l f7 3/161/2 /7 (Date) \(21 3( {l 5 (Signature) (Title) 3.��Jac17 ate) ) rt/VI 08-Q11 Note: It is the responsibility of the contractor to inform the City of Federal Way if they wish to add a name to or delete names from this list. WASHINGTON POISON CENTER 155 NE 100th Street, #100 Seattle, WA 98125 -8007 Phone: 206.517.2350 Fax: 206.526.8490 www.wapc.org Emergency: 1.800.222.1222 March 22, 2017 Sarah Bridgeford City of Federal Way 33325 8th Ave. S. Federal Way, WA 98003 Dear Ms. Bridgeford, The Washington Poison Center's Board of Directors hired Dr. Erica Liebelt as the Executive /Medical Director on September 1, 2016. As the Executive Director of the Washington Poison Center, Dr. Liebelt is tasked by the Board with leading and performing all business and medical activities demanded of such a position, including signing contracts for the benefit of WAPC. If you have any additional questions, please do not hesitate to contact me. Sincerely, t0.44. -M.0144.1-atioost... Jane Hutcheson President, WAPC Board of Directors POISON Ile �� Equal Opportunity Employer — 501(c)(3) Nonprofit Organization 1-11011-222-1222 ' ® CERTIFICATE OF LIABILITY INSURANCE ADOo DATE (MMIDD /YYYY) 3/14/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER PLC Insurance, LLC 4211 Alderwood Mall Blvd, #210 Lynnwood WA 98036 CONTACT Select NAME: (425)275 -0564 FAX No): (425)712 -3786 PHONE N Extl: INC E-MAIL COrr] n @plcins . com INSURER(S) AFFORDING COVERAGE NAIC # INsuRERA:General Casualty of Wisconsin COMMERCIAL GENERAL LIABILITY INSURED Washington Poison Center 155 NE 100th Street Suite 100 Seattle WA 98125 INSURER B : CCI 1284459 INSURER C : 9/20/2017 INSURERD: $ 1,000,000 INSURERE: $ 100,000 INSURER F : COVERAGES CERTIFICATE NUMBER:CL1691630786 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADM_ INSD SUBR W VD POLICY NUMBER POLICY EFF IMM/DDIYYYY) POLICY EXP IMM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CCI 1284459 9/20/2016 9/20/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE X 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS CCI 1284459 9/20/2016 9/20/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A WA STOP GAP EMPLOYER' S LIABILITY CCI 1284459 9/20/2016 9/20/2017 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Federal Way is included as Additional Insured when required by written contract or agreement per form CG8155 0309. CERTIFICATE HOLDER CANCELLATION City of Federal 333325 8th Ave S Federal Way, WA Sarah. Bridgeford @cityoffed Way 98033 -6325 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Sarah Fray /TRISHA �� ACORD 25 (2014/01) I N S025 /7m 4nn © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD •2lO10462' 8)Cti 1]8445900000109014 13 2• ., CCI1284459 WMI MEE MIME Mal mom SWIM MBE Nam COMMERCIAL GENERAL UABILITY CG 81 55 03 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NONCONTRACTOR'S ADDITIONAL INSUREDS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization (called additional insured) described in Paragraphs A.1. through A.S. below whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be currently in effect or becoming effective during the term of this policy; executed prior to the "bodily injury," "property damage" or "personal injury and advertising injury," but this paragraph does not apply to any additional insured more specifically identified elsewhere in the policy. 1. ADDITIONAL INSURED — STATE OR POUTICAL SUBDIVISIONS — PERMITS A state or political subdivision subject to the following provisions: a. A state or political subdivision is an additional insured only with respect to the following hazards for which the state or political subdivision has issued a permit in connection, with premises you own, rent, or control to which this insurance applies: (1) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, drive- ways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures: or (2) The construction, erection, or removal of elevators; or CG 81 55 03 09 (3) The ownership, maintenance, or use of any elevators covered by this insurance. b. A state or political subdivision is an additional insured only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. This insurance does not apply to "bodily injury," property damage" or "personal and advertising injury" arising out of operations performed by or for you for the state or political subdivision. 2. ADDITIONAL INSURED — CONTROLLING INTEREST Any person or organizations with a controlling interest in you but only with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured. 3. ADDITIONAL INSURED — MANAGERS OR LESSORS OF PREMISES A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 3 ti a. Any "occurrence" which takes place after you can cease to be a tenant in that premises: or b. Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. 4. ADDITIONAL INSURED — MORTGAGEE, ASSIGNEE OR RECEIVER A mortgagee. assignee or receiver but only with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance, or use of a premises by you This insurance does not apply to structural alterations, new construction or demolition operations performed by or for such additional insured. 5. ADDITIONAL INSURED — OWNERS OR, OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED An owner or other interest from whom land has been leased by you but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the land leased to you and subject to the following additional exclusions. This insurance does not apply to: a. Any "occurrence" which takes place after you cease to lease that land; or b. Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. 6. ADDITIONAL INSURED — CO -OWNER OF INSURED PREMISES A co -owner of a premises co -owned by you and covered under this insurance but only with respect to the co- owners liability as co- owner of such premises. 7. ADDITIONAL INSURED — LESSOR OF LEASED •EQUIPMENT Any person or organization from whom you lease equipment. Such person or organization are insured only with respect to their liability arising out of the maintenance, operation or use by you or equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: a. To any "occurrence" which takes place after the equipment lease expires; or b. To "bodily injury" or "property damage" arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under Paragraphs A.1. through A.8• above does not apply to "bodily injury" or "property damage" included within the "products- completed operations hazard." 8. ADDITIONAL INSURED — VENDORS Any "vendor ", but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: a. The insurance afforded the vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product. (3) (5) (6) Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 3 with its permission. CG 81 55 03 09 SEW mem i Mffia MEM MESE e R1010462`67CCI I n44690000010901413∎3. C C I 1 2 8 4 4 5 9 (7) (8) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor, or "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on Its behalf. However, this exclusion does not apply to: (a) The exceptions contained in Sub- paragraphs d. or f.; or (b) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. CG 81 85 03 09 b. This insurance does not apply to any insured person or organization, from whom -you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. B. As respects the coverage provided under this endorsement, Paragraph. 4.b.(3.) SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is added: 4.b.(3.) This insurance is excess over any other insurance covering the additional insured as an insured whether primary, excess, contingent or on any other basis, unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing. Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 3 of 3 WASH 1 NGTON POISON I CENTER Arawil BF WASH 1 NGTON POISON ('ENTER 2016 Our Vision: A region where poisoning and drug exposure is no longer the leading cause of unintentional death FROM OUR PRESIDENT AND EXECUTIVE DIRECTOR to our friends, supporters, and partners 2016 was a TRANSFORMATIVE YEAR for the Washington Poison Center (WAPC), made possible by growth, opportunities, innovation, and support. Our core 24/7 telephone services and outreach made a difference, resulting in improved health outcomes while saving healthcare costs. Our Growth was significant and influential: • Addition of a full -time Medical Director • Addition of more CSPIs (Certified Specialists in Poison Center) • Addition of a full -time Health Education and Outreach specialist based in Spokane, increasing our reach in Cen- tral and Eastern Washington • Significantly increased healthcare education to various interdisciplinary trainees and hospitals • Expansion of the Yuk Box program around the state, educating more families Our Opportunities have provided more collaborations and partnerships: • Increased number of partnerships with prevention coalitions • Presented and testified at important legislative hearings • Increased number of e- Cigarette "Training of the Trainer" programs throughout the state • Invited to participate in Governor Inslee's Executive Order to combat the opioid crisis • Acquired ownership of Take Back Your Meds (TBYM) website Our Innovation to promote our mission of Harm Reduction Education: • Not For KidsTM Logo mandated by the Washington State Liquor & Cannabis Board to be on all marijuana edi- ble packaging • Six scientific abstract presentations at the North American Congress of Clinical Toxicology Our Support to Sustain and Grow: • Successful Hospital Fair Share Program • Additional /increased funding obtained from foundations and local city grants As healthcare rapidly changes, the WAPC is striving to provide outstanding quality and value -based care through our core public health services. We continue to seek opportunities for partnership, collaboration, and innovation to facilitate knowledge and data exchange, share best practices, and increase our reach to more vulnerable populations. The 2016 Annual Report highlights selected examples. Despite the 2016 Transformative Year at the WAPC, we still have more to do: Our vision of reducing the number of poisoning and drug exposures. which are the leading cause of unintentional death in Washington has not been realized. Thank you for supporting the Washington Poison Center as we continue to expand on providing transforma- tional healthcare to our state. Erica Liebelt, MD, WAPC Executive /Medical Director Mark Martzen, PhD, WAPC Board President the experts in poison treatment & .safety IWho we are: Washington Poison Center (W'APC) a 501(c)3 nonprofit El N: 94- 3214597 I -800 - 222 -1222 24 hours a day, 7 days.; a week, every day of the year Provide immediate, free and expert treatment advice and assistance on the telephone in the case of exposure to oisonous, hazardous, or drug /toxic substances Everyone in Washington State Who answers our phones: urses, pharmacists & poison specialists with clinical ex- ertise in managing poisonings and drug exposures Over 18 million dollars in avoided medical) costs by reducing unnecessary hospital visits 7 diate Expert Clinical Guidance Look for our new logo soon! I� WASHINGTON L *, POISON CENTER 180012227222 The Washington Poison Center launches its new logo in April 2017. Due to our expand- ing services and misconception of being a state agency, we are no longer using the state outline in the logo. While we still use Mr.Yuk branding on many items, it only represents a part of who we are at the core. Our new logo emphasizes the expansion of our services while incorporating an "alert- based" color and form. Our name and number are still the same. ING RELATIO As a parent, I have confidence that the Washing- 1 ton Poison Center is always available if I need their expert advice. As a legislator, I support the investment of healthcare dollars for the numerous public health services and education that they provide free of charge." - Senator David Frockt, 46th District i f "The Washington Poison Center has been a key partner and advocate for youth substance use prevention efforts through their effective public education programs on e- cigarettes, opioids and marijuana as well as offering the public a toll -free medical hotline for poisonings and drug overdos- es." - Governor jay Inslee "From their education and health initiatives to their immediate suppo for an emer- gency, the Washington Poison Center is an invaluable partner, protecting our commu- nity and making our providers better." - Kevin T. Caserta MD, Chief Medical Officer, Providence /St. Peter Hospital Tonight I called the Poison Control "hotline" in Washington State when my 85 -year old mother took her medication twice. Noemi, the pharmacist, helped me. She was friendly, professional and patient with me "'bison I was panicked. I've never called 8 ?bison center before and I'm so thankful Noemi was there to help me. - Caller i "Spokane Regional Health District is thankful for the partnership with Washington Poison Center. From having a poison center health edu- cator in Eastern Washington with emergency response capabilities, our community has greatly benefited from their expertise on emerging drug trends, e- cigarettes, poison prevention educa- tion, disaster response, and more." - Lyndia C. Wilson Division Director, Disease Preven- tion and Response, Spokane Regional Health District "The Washington Poison Center is a critical partner in public health through their education, outreach, clinical ex- pertise, and emergency response. With so many new drugs of abuse affect- ing our community, WAPC provides timely information to healthcare provid- ers and the community with their public health and seasonal health alerts. " - Carina Elsenboss MPH Preparedness Director Public Health Seattle King County 4 92% of all household cases are treated @ home at Twitter followers in- creased 32%; Facebook fincreased II% Over 115 Medical Residents, Fellows, Stu- dents, Pharmacists, & Paramedics trained by WAPC staff 62,502 calls answered by WAPC 4+4 54,000+ people were reached through education efforts at community programs & events Over 38% of poison center home callers would have visited the ER or called 91 1 49% of all calls concerned a child under 6 ire years old Over 23% of calls to WAPC are from health care professionals keeping people safely at home Translation support is available in over 240 languages, and there are also resources to help with the deaf and hearing disabled. Sources of Funding Allocation of Expenses for the WAPC State a Federal Donations /Grants Corp + Hosp. Campaign In -Kind Education /Data Sales Audited financials available upon request by the WAPC • Salaries Non- personnel Facility • Maintenance /Service ✓ Database /IT /Telephone Depreciation General Bus Expense Other The Washington State Health Care Authority is proud to provide funding for the Washington Poison Cen- ter to help ensure the safety and health of children in Washington — a critical health strategy for our state. —Dr. Dan Lessler, Chief Medical Officer, Washington State Health Care Authority Every $1 invested in a Poison Center results in a savings of $13.39 *. HOSPITAL FAIR SHARE Washington Poison Center partner in healthcare Hospitals in our state make community benefit donations to help support the costs of providing immediate access to our free consultation services. The Hospital Fair Share program had a successful first year launch, and it is now one of our organization's core programs. Please see the list of participating hospitals at the end of this report. Thank you to our partners for your ongoing support! The Washington Poison Center is a 501(c)3 Nonprofit and relies upon a combination of state contracts; federal, corpo- rate, and foundation grants, and donations from people like you to sustain our core services and expand our reach to provide public and clinical education promoting prevention, intervention, and harm reduction. In 2016, it is estimated that we saved over $18 million dollars — definitely a worthwhile investment for you and your company! *The Lewin Group, Inc., comp. http:I/www,aapcc.org /Final Report the Value of the Poison Center System Several ways to donate at www.wapcorg/about/donations/ DONATE NOW THROUGH Network r.., Good amazon - ,rn!te ou shop. Amason gives. on NOT FOR KIDS In January 2015, the Washington State Liquor and Cannabis Board (LCB) proposed rules that would have required all marijuana- infused prod- ucts on Washington's recreational market be labeled with Mr. Yuk and the National Poison Helpline. Feedback from community members, the cannabis industry, and safety educators all suggested that Mr. Yuk was not the right choice since its established use by many house- holds was to label poisonous products that no one should eat, drink, or touch. After more than 40 stakeholder interviews, the Washington Poison Center created the new Not for Kids' logo which visually warns children to stay away and gives the Nation- al Poison Helpline as a resource. In November the LCB voted to require use of the logo on all marijuana - infused products in Washington beginning in February 2017. The WAPC public ed- ucation team is working to create a comprehensive Not for Kids campaign to educate people on effectively using the logo as a safety tool in their homes. MNOT FOR KIDS EMERGENCY 18 '221222 TAKE BACK YOUR MEDS take back, YOUR MEDS In November of 2016 the Washington Poison Center assumed ownership of Takebackyour- meds.org. from King County. The WAPC updat- ed the website, adding an interactive map. Cur- rently the map includes 218 medication take - back locations throughout the state. This in- cludes law enforcement and pharmacy locations where people can dispose of their unneeded medications. This will be an invaluable tool to help combat the growing opioid epidemic that is affecting this state and the country. TBYM.org is on the list of the Best of 2016: GoodTherapy.org's Top 10 Resources for Prescription Drug Abuse" — http:/ /www.goodtherapy.org /blog /best- prescription- drug- abuse- websites- 2016 - 1227164 OPIOID CRISIS Washington State is currently experiencing an opioid abuse and over- dose crisis involving prescription opioid drugs and heroin. On Sep- tember 30, 2016, Governor Jay Inslee signed Executive Order 16 -09, Addressing the Opioid Use Public Health Crisis, formally directing activities and state agencies in accordance with the Washington State Interagency Opioid Working Plan. The Washington Poison Center was invited by the Governor as a key stakeholder at the announce- ment of his Executive Order on October 7, 2016. WAPC is already participating in 3 of the 4 Goals he delineated: Goal I: Prevent inappropriate opioid prescriptions and use • Awareness and prevention education • "Take Back Your Meds " - secure and safe opioid disposal, promoting Harm Reduction • Partner with Washington Prescription Drug Management Program (PDMP) Goal 2: Treat people with opioid use disorder and connect them to support services, including housing • Not currently in our scope of services Goal 3: Save lives by intervening in overdoses • 24/7 emergency help line for public and healthcare providers • Clinical toxicology expertise in opioid toxicity and naloxone use Goal 4: Use data to focus and improve our work • Real -time surveillance of opioid exposures, overdose, health effects, and use of naloxone Forbes July 21, 2016 Mr. Hand Beats Mr. Yuk In Contest To Repel Kids From Marijuana Jacob Sullum, Contributor Article in Forbes Magazine regard- ing the Not For KidsTM logo NOT FOR KIDS EMERGENCY 180012221222 KOMONEWS.com, July 13, 20I 6 - Washington Poison Center unveils warning label for marijuana edibles Find us on social media www.facebook.com /MrYukWA twitter.com /mryukwa Whitney on New Day show Governor Jay Inslee The WSLCB and MRYUKWA new logo will help keep cannabis products out of kids' hands wapc.org /notforkids/ Gov. Inslee tweet re: Not for KidsTM logo To see the Washington Poison Center's ad that was seen in some movie theaters, go to this link: WASHINGTON CENTER 0 https: // #_ lily iii l _ 1.80DZ2�il�2 youtu.be/ J9VPsnZW2EA Joan being interviewed on KING 5 TV regarding Not for KidsTM logo PARTNERSHIP IN PROF SIQNAL EDUCATION In January, the public education team at the Washington Poison Center launched a "Training of the Trainers" program that helped adult educa- tors, prevention specialists, healthcare providers, and other community mem- bers gain knowledge and confidence about the e- cigarette products, policy, and health research. In 2016, WAPC staff led 23 trainings in 13 counties to- taling more than 300 trainees. Through the work of these trainees, more than 5,000 youth and adults have been reached with the content from the training. Another win in 2016 included the signing of a Washington state law Gov. Inslee signing E -cig bill into law that regulates vapor products, including more specific labeling on ingredients and nicotine content. The Food and Drug Administration (FDA) also took action to regulate products on a na- tional scale. The Washington Poison Center submitted comments and testified in person about the FDA rules and Washington State's new legislation. This education and policy change has led to a decrease in calls about liquid nicotine products; however data suggests that young children are still at greatest risk of exposure and there is more work to do to prevent poisonings. Request an e- cigarette education tool kit (right) to assist with poison prevention education! To purchase send an email to: yukbox @wapc.org. For the 2nd year we partnered with the UW Professional and Continuing Education GIS Certificate Program on a project that involved analyzing and visually representing our call data. See example (right). This "heat map" provides epidemiologic data that can be used immediately and gives UW students practical experience with real -time healthcare data. 5,863 out -of- state or unknown origin calls PROFESSIONAL d CONTINUING EDI 52n 16a1 96 whereon Ska409 979 727 2016 Call Volume by County X100 cases 100 -500 501 -1000 1001 -2000 gegie 2001 -7999 _ >8000 cases Padre 125 Lewis 669 ahkiakum Cowlitz 1,443 19 Skamava 37 All Substances helan 603 pkeno,6. 324 246 343 Grant 639 Yakima 1,757 86c4Ra1 140 Benton 1 955 Franklin 592 rr, ;3 51214 60 Adams 131 St,ve 3.2 Pend 0,8119 120 Whitman 281 Walla Walla 538 2 nett/ Asotin 193 Healthcare Clinical Education The healthcare provider clinical education program grew immensely in 2016 as a result of new opportunities and fostering new relationships. Emerging drugs of abuse are constantly changing, and it's imperative that providers know how to recognize them and manage their toxicity. To that end, the Washington Poison Center gave over 20 talks on emerging drugs of abuse to local health jurisdictions, hospitals, and clinical conferences. In the summer of 2016, we embarked on a "Drugs of Abuse" road show talk focusing on critical access hospitals in Central Washington, which are affected by large outdoor electronic dance music events. The discussions focused on allocating resources for critically ill patients and drug toxicity recognition. The WAPC was to secure an education grant from BTG® focusing on snake bite envenomation. Did you know that the WAPC usually receives around 20 -30 calls a year about snake bites in Washington State? The snake bite envenomation program was launched in the summer of 2016, focusing on those high risk communities and hospitals which fre- quently treat snake bites in the state. Healthcare providers were trained in the recognition of venomous species, clinical symptoms of envenomation, and the judicious and appropriate use of antivenom. All in all, it was a great year for healthcare providers and we reached over 2,500 healthcare providers in the state! also able Public Education Eastern Washington Health Educator In April, 2016, we added our first Health Educator and Outreach Specialist on the eastern side of the state! Housed in the Spokane Regional Health Dis- trict, Jared O'Connor, MS, MPH has expanded our education and outreach, ensuring that we serve all populations in the state equally. Since starting, Jar- ed has developed and fostered many partnerships throughout the area and has attended 56 events throughout Eastern Washington. Events included par- ticipation in health fairs, and presentations on medication safety, e- cigarettes and vaping, and poison prevention at health departments, schools, and con- ferences. Locations spanned from Omak to Moses Lake to Wenatchee and Walla Walla. Because of Jared's presence, WAPC has the ability to more ef- fectively reach Eastern Washington county communities. Yuk Boxes In 2016 we added eight new locations statewide for a total of 18 sites where teachers and others can pick up a Yuk Box. These materials visually show how similar packaging is for certain food products and poisonous products such as cleaning solutions, or candy and pills. The program continues to provide alternative opportunities for engage- ment with poison prevention materials specifically in areas of the state where no WAPC staff are present. In 2016 we saw an increase of check -out requests. To request a Yuk Box go to www.wapc.org, click on Resources, order materials, and the link " Interested in checking out a Yuk Box for your class or event ? ". artners in Prev - . tion collaborating for a healthier and safer Washington Hospital Partners Capital Medical Center Cascade Valley Hosp. /Clinics Columbia Basin Hospital Columbia County Health System Confluence Health Coulee Medical Center East Adams Rural Hospital Evergreen Health Forks Community Hospital Franciscan Health System •Harrison Medical Center •Highline Medical Center •St. Anthony Hospital •St. Clare Hospital •St. Elizabeth Hospital •St. Francis Hospital •St. Joseph Hospital Garfield County Public Hospital Grays Harbor Community Hospital Group Health Cooperative Island Hospital Jefferson Healthcare Kadlec Regional Med. Center Kittitas Valley Healthcare Lake Chelan Comm. Hospital Lincoln Hospital Mid - Valley Hospital Mason General Hospital Morton General Hospital Multicare Health System •Allenmore Hospital •Auburn Medical Center •Good Samaritan Hospital •Mary Bridge Children's Hosp. •Tacoma General Hospital Newport Hospital & Health Svcs North Sound Emergency Med. North Valley Hospital Ocean Beach Hospital Odessa Memorial Olympic Medical Center Othello Community Hospital Overlake Hospital PeaceHealth Columbia Network •Southwest Medical Center •St. John Medical Center PeaceHealth Northwest Network •Island Medical Center •St. Joseph Medical Center •United General Med. Center Prosser Memorial Hospital Providence Healthcare E. WA •Holy Family Hospital •Sacred Heart Medical Center & Children's Hosp. •Mt. Carmel Hospital •St. Joseph Hospital Providence Regional Medical Center Everett Providence Healthcare SW •Centralia Hospital •St. Peter Hospital Pullman Regional Hospital Quincy Valley Medical Center Samaritan Hospital Seattle Children's Hospital Skagit Valley Hospital Skyline Hospital Snoqualmie Valley Hospital Summit Pacific Medical Center Toppenish Community Hospital Tri -State Memorial Hospital Three Rivers Hospital Trios Health UW Medicine •Harborview Med. Center •UW Medical Center •Northwest Med. Center •Valley Medical Center Virginia Mason Medical Center Walla Walla General Hospital Whidbey General Hospital Whitman Hospital Willapa Harbor Hospital Yakima Memorial Hospital Yakima Regional Medical & Cardiac Center Corporate Partners Umpqua Bank Coalition, Nonprofit, and Agency Partners 501 Commons ADAI Dept. of Health Health Care Authority Liquor & Cannabis Board Northwest Healthcare Response Network NW HIDTA Prescription Drug Monitoring Pro- gram Prevention WINS SafeKids SPE Consortium SRHD Stay Safe Seattle University Lions Club WA Assoc. of Prevention Coalitions Washington Nonprofits WA State PTA WHY Coalition WA State Hospital Association WA State Public Health Association State and Local Funding King County Human Services Grants 0 Cities of Bothell, Des Moines, Kirk- land, Renton, and Sammamish Community Health Charities of WA OARD OF DIRECTORS ties to the community President Mark Martzen, PhD, Bastyr University Vice President/President Elect Jane M Hutcheson, MSN, RN, Retired, Nurse Executive Treasurer April Henderson, CPA, Seattle Aquarium Secretary Melissa Vasiliades, MBA, UW Medical Contact Center Immediate Past Pres., Jennifer Isgrig, Strong- Bridge Consulting Director Eli Almo, Era Living Director Steve Burgon, JD, Ogden Murphy Wallace, PLLC Director Kevin Germino, MD, Providence Sacred Heart Medical Center, Spokane Director Capt. Kathryn Hobbs, USN (Ret), Washington State PTA Director Ryan Keay, MD, Providence Regional Medical Center Everett Director Laura Schiefelbein, PharmD Walgreens, District /89 Director Shabir Somani, RPh, MS, MBA, UW Medicine Director Steven D. Wanaka, RPh, Seattle Children's Hospital Terms ended: Petra Eichelsdoerfer, ND, MS, RPh, Pharmacist Joel Kaufman, MD, MPH, UW Dept. of Env. & Occ. Health Sciences POISON Hebp 1- 800 - 222 -1222 Non - Voting Ex- Official Members & WAPC Leadership Erica Liebelt, MD, Executive Director /Medical Director Alexander Garrard, Pharm D, DABAT, Clinical Managing Director Non - Voting Members Dolly Fernandes, State Director for EMS, Trauma, Washington State Department of Health Erika Henry, MSPCI, WA State - Department of Health Susan Stern, MD, Harborview Medical Center Kathy Williams, MS, WA State - DOH Office of Community Health Systems Washington Poison Center 155 NE IOOth Street Suite #100 Seattle, WA 98125 www.wapc.org Administrative Office: (206) 517 -2350 Emergencies: (800) 222 -1222 TTY users dial 711 for the Washington Relay service Sign up for the latest in poisoning trends and seasonal health alerts at Visit www.wapc.org to see annual statistics on the top I 0 most common exposures.