BOARD OF COUNTY COMMISSIONERS REVISED AGENDA THURSDAY, JULY 18, 2019, 9:00 AM COMMISSION CHAMBERS, ROOM B-11 I. PROCLAMATIONS/PRESENTATIONS
1. Introduction of the Shawnee County Fair Queen (Molly Biggs) and the Shawnee County Fair King (Ian Schulz)—Candis Meerpohl, 4H Youth Development Agent.
II. UNFINISHED BUSINESS
III. CONSENT AGENDA
1. Acknowledge receipt of report indicating that the Ambulance Compliance Officer has found that American Medical Response is in compliance with the response parameters and requirements set forth in Contract C207-2016 for January 2019 but will be penalized in the amount of $2,420.00 for long responses in four different zones.
2. Acknowledge receipt of the July 10, 2019 Stormont Vail Events Center Advisory Board meeting agenda and minutes of the May 8, 2019 Kansas Expocentre Advisory Board meeting.
3. Acknowledge receipt of an out-of-state travel report from one staff member regarding the Nurse- Family Partnership DANCE training in Denver, Colorado—Health Department.
4. Acknowledge receipt of correspondence from Sheriff Hill to send four officers to Dallas, Texas to attend the 2019 Crimes Against Children conference at a cost of no more than $4,600.00 with funding from the Offender Registration Fund.
5. Consider acceptance of the June 2019 bank reconciliation report—Treasurer.
6. Consider approval of request to pay invoices from the Diversion Fund account in a total amount of $1,415.86—District Attorney.
7. Consider acceptance of two easements for the culvert replacement project on SW Morrill Road over un-named tributary to Colby Creek and authorization to pay the agreed settlement amount of $4,500.00.
8. Acknowledge receipt of Summons in Case No. 2019CV000464 Branch Banking and Trust Company vs. Board of Commissioners of Shawnee County, Kansas, et. al and Case No. 2019CV000478 Wells Fargo Bank NA vs. Board of Commissioners of Shawnee County, Kansas et. al —County Clerk.
9. Consider approval of request to update the Centers for Medicare and Medicaid Services 855B Provider Enrollment—Health Department.
IV. NEW BUSINESS
A. COUNTY CLERK – Cynthia Beck
1. Consider all voucher payments.
2. Consider correction orders.
B. PUBLIC WORKS / SOLID WASTE – Curt Niehaus
1. Consider approval of request to hire William Sutton as the Solid Waste Director at an annual salary of $95,000.00 with funding from the Solid Waste Budget.
C. ADMINISTRATIVE SERVICES – Betty Greiner
1. Acknowledge that the Notice of Budget Hearing will appear in the Topeka Capital-Journal on Monday, July 22, 2019 showing the total of all departmental budget requests and what the resulting tax rate would be if all budget requests were granted (this is not the actual 2020 budget or tax rate).
V. ADMINISTRATIVE COMMUNICATIONS
VI. EXECUTIVE SESSIONS SHAWNEE COUNTY Department of 1]I.. Emergency Management /. 200 SE i~ Street Emergency Operations Center Topeka, KS 66603 (785) 251-4150 Dusty Nichols. Director July 3, 2019
MEMO: Contract C207-2016 Compliance Certmcation & Invoicing Jan-19
TO: Ambulance Advisory Board Members Board of County Commissioners Shawnee County Kansas
FROM: Nelson E Casteel -Ambulance Compliance Officer Shawnee County Emergency Management
This report signifies and certifies that the Shawnee County Ambulance Compliance Officer has found that American Medical Response (AMR) is in compliance with the response parameters and requirements as set forth in Contract C207-2016 for January 2019 and AMR will be penalized in the amount of $2420 for long responses in the four different zones as outlined in the contract.
AMR was approved for 29 exemptions during the month of January 2019that was requested due to hazardous road conditions during the inclement winter weather.
Zone 1 1773 1632 141 92.05% 9:00 Zone 2 89 59 30 66.29% 11:00 Zone 3 35 20 15 57.14% 12:00 Zone4 25 19 6 76.00% KTA 3 2 33.33% TOTALS 1925 1731 194 89.92%
LATES FINE $10 PER FINED AMOUNT MIN OVER Zone 1 55 $2,110.00 15:00 .Zone 2 5 $200.00 18:00 Zone 3 2 $100.00 20:00 Zone4 1 $10.00 22:00 TOTALS 63 $2,420.00 ~.
Please place on the Consent Agenda for review.
Should you have any questions please feel free to contact: Compliance Officer Nelson E Casteel at [email protected] or 785-251-4558 111#1
Mitigation Preparedness Response Recovery COMPARISON 1/11 1 On Time 1349 )> 1 ~~ n JANUARY MONTHLY TOTALS 1 Number Fined 33 2017 DISPATCHED CANCELLATION ARRIVED TRANSPORTED REFUSED 3 CT 1 !Amount Fined I $2,110.00 $2;11G:OO; $1,590.00 I $640.00 Jan-17 1580 52 1528 1165 I 363 c 1 On lime percentage 92.05% dt2;0S%t_.., 92.84% 94.87% I YTD -I» ZONE TOTAL 1773 . ··1m . ,: 1914 1422 I TOTALS 1580 52 1528 1165 ·-- 363 :I "" ...... _ .,., __ ...... ----, ..,..... 50 n ID 2 Late 30 · . -~30-· ·· · 32 13 2 Number Fined 5 ·-_,...;.s· .., : 10 4 n
2 Amount Fined _ L-$200.00 <$200:00-i.: $230.00 $30.00 JANUARY MONTHLY TOTALS 0 2 On timepercentage 79.37% 2018 DISPATCHED I CANCELLATION I ARRIVED I TRANSPORTED I REFUSED ,3 ZONETOTAL ______§1_ Jan-18 2238 I 159 I 2079 I 1495 I 584 3 IOnTime I 10 I .20•. I 11 I 20 YTD -I»-· 3 Lare 15 .15 ·. · 20 11 TOTALS 2238 I 159 I 2079 I 1495 I 584 :I 3 NumberFined 2 ·.. 2-:'--. 3 2 n 3 AmountFined $100.00 :$100:00.·' $150.00 $30.00 ID 3 On timepercentage 64.52% 0 ZONETOTAL 31 3i IOnTime I 19 I 29 .I 11 I 7 n Late 6 6 9 3 JANUARY MONTHLY TOTALS ID .. Number Fined 1 1 3 0 2019 DISPATCHED I CANCELLATION I ARRIVED I TRANSPORTED I REFUSED • 4 Amoun!Fined 510.00 $10.00 $80.00 $0.00 Jan-19 2114 I 189 I 1925 I 1403 I 522 c.. I» 4 On lime percentage 82.86% 82.86% 55.00% 70.00% YTD :I ZONE TOTAL 35 . •• "' TOTALS 2114 I 189 1 1925 1403 I 522 c KTA !On Time I» KTA late ~ KTA Ontime! 33.33% '33;33% 71.43% N ZONE TOTAL _1.. '.1. ~ __l_ 0 ALL jonTime 1731 1141'' 1879 1426 .... ALL Late 194 -194'' 100 100 CD ALL Number Rned 63 63' 85 39 n ALL AmountFined $1,410.0( 0 ALL On·" 89.92% . 90.38% 1 9346% 3 _----~~1935. , I TOTAL 2079 1528 ~ .. •29. ALL I 19 18 I B I»--· :I n ID J> 3 cr Total c D)- :I ~ KTA n :J113 c ~ 113 ...... llJ u n c Zone4 113 2019 0
E.__ .g • 2018 3 llJ -a 0.. Zone 3 • 2017 llJ - E D)-· t= c :I 0 Zone 2 n ~ 0 Zone 1 ::t n-· 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.0()0,.{, 90.00% 100.00% ~ I f.. D) Total REFUSED :I c AI ~ Zone4 ro TRANSPORTED c~ ~ ro 2019 ...... ~ 2019 1\) ~ Zone3 113 :J c •2018 c ARRIVED 0 u.. ro •2018 ~ V'l .. • 2017 ro Zone 2 • 2017 CD u CANCELLATION n Zone 1 0 DISPATCHED 3 0 20 40 60 80 100 -a 0 500 1000 1500 2000 2500 D)--· :In ~ ~-
"Stormont Vai I EVENTS CENTER
STORMONT VAIL EVENTS CENTER ADVISORY BOARD MEETING Manor Conference Centre Homestead Room Wednesday, July 10,2019 Luuch at 11:30 I2,oo- I,oo
AGENDA Roll Call
Approve Minutes
Capital Expenditures- General Manager & Operations Director
STAFF REPORTS General Manager- Kellen Seitz Financial- Donna Casebier Operations -Justin Gregory Livestock-Justin Gregory Events-Martin De Jesus Marketing - Allie Manning Sales/Partnerships - Kyler Tarwater
REPORTS Expo Remodel and Expansion - SNCO Counselor, Jim Crowl Capital Plaz.e. Hotel - Dan Clarizio Heart of America -Bob Lohmeyer Kansas State Extension- Cindy Evans
COMMITTEE REPORTS Capital Committee- Gregory, Seitz, Block, Eckert Expo Remodel and Expansion- Block. Crowl, Seitz., Eckert Marketing Committee- Block, Beach, Walstrom, Manning
ADJOURN
NEXT BOARD MEETING
Manor Conference Centre Wheat Room August 14, 2019 I 2:00pm KANSAS EXPOCENTRE ADVISORY BOARD MEETING Wednesday, May 8, 2019 Maner Conference Centre Wheat Room 12:00 P.M.
The following members were present for the board meeting: Chairwoman Brenda Block, Commissioner Bob Archer; Spencer Duncan; Pam Walstrom; Councilman Jeff Coen; Sandra Griffith; Bill Beach
Also. present were: Kellen Seitz, General Manager; Justin Gregory, Director of Operations; Kyler Tarwater, Director of Partnerships; Allie Manning, Director of Marketing; Martin De Jesus, Director of Events; Brie Berggren, Convention Sales Manager; Josh Cordero, Events Manager; Wayne Wazlikak, AGM, F&B Director, Capital Plaza Hotel; Barbara Coultis, SNCO Fair Board; Jim Crowl, SNCO Counselor; Betty Greiner, SNCO AuditiFinance
Block called the meeting to order at 12:00 P.M. Roll call was taken.
Commissioner Archer made a motion to approve April Minutes. Walstrom seconded the motion. Motion passed.
Capital Expenditures: Gregory's operations report is attached hereto and made a part of the minutes. There were no capital expenditures to approve.
General Manager's report: Seitz's report is attached hereto and made a part of the minutes.
Financial report: Seitz stated that we are cnnently behind budget by about $52,000.00 but also stated that we are waiting on some last-minute numbers to fully see where we are currently at. Next report will show updated numbers. Walstrom made a motion to approve the financial report. Councilman Coen seconded the motion. Motion passed.
Operations report: Gregory's report is attached hereto and made a part of the minutes.
Livestock report: Gregory's report is attached hereto and made a part of the minutes.
Event report: De Jesus's report is attached hereto and made a part of the minutes.
Marketing report: Marming's report is attached hereto and made a part of the minutes.
Corporate Partnership report: Truwater's report is attached hereto and made a part of the minutes.
I Expocentre Expansion and Remodel: Crowl stated that the next step of phasing is actual groundbreaking. There is a meeting next week to go over final bndgets and to get things underway on complex for renovations.
Capitol Plaza Hotel report: Wazlikak stated all the gnest room floor carpet will be done by end of the summer. The hotel is currently working on updating their internet services for their clients and guests and a few internet updates in Manor are happening too.
Heart of America report: Lohmeyer was not pres~nt at the meeting.
Kansas State Extension report: Evans was not present at the meeting.
THERE BEING NO OTiffiR BUSINESS to come before the board, the Kansas Expo centre Advisory Board adjourned at I :00 P.M.
Brenda Block, Chairwoman Prepared by Brianna Berggren
2 SPECTRA -ElY COMCAST SPECTACOR
Memorandum
To: Kansas Expocentre Advisory Board
From: Kellen Seitz, Genernl Manager
Date: May 8, 2019
Re: April 2019 Advisory Board Report
April 2019 was certainly a month for the record books. We hosted back to back weekends of Cirque du Soleil Corteo and Disney on lee Frozen. These two events combined brought in over $618,000 in gross ticket sales revenue. These two events spanned 11 performances in only 8 event days, to say our crews and staff were working around the clock would be an understatement. All of our department teams did an amazing job preparing, executing and operating these two highlight events of the year in back to back weekends and a collective job well done is owed to each and every one of our team members. We are not able to produce this type of content without a significant amount of dedication and commitment from our internal department teams.
In addition to Cirque and Disney, we also hosted the FBLA State Conference, Barrel Bash, Seaman High School Prom, Farm to You with the Shawnee County Extension Office, Go for Broke Barrel Race, the AQHA Horse Show, Evening as a Child Banquet, 3 wedding receptions and a number of smaller events on property.
We continue to play a bit of catch up after quarter one, as we currently sit about $52,000 behind budget through March fmancials. Some of this variance will be made up from the healthy revenue streams of Cirque du Soleil and Disney this month. We have also bee able to realize a cost savings to the indirect expenses side. most notably from utilities savings. We are continuing to put a strong focus on plugging in some additional event content for Q3 and Q4 to drive the revenues side up even further. We have confidence on a few offers we have out in the market for these late year events and will continue to drive an emphasis on indirect cost controls to balance us back out through the coming months. SPECTRA -BY COMCAST SPECTACOR
Memorandtnn
To: Kansas Expocentre Advisory Board
From: Justin Gregory, Director of Operations
Date: May 2, 2019
Re: April Advisory Board Report
Operations Update:
The boiler replacement project began on June 25th and is on schedule to be completed on September 29th. Since installation we have been challenged with many small issues that have kept the system from working at 100% efficiency, including computer progranuning issues. The manufacture has sent technicians to work with McElroys Electrical to find a solution. We have recently faced a serious challenge with our old pwnps and piping that are tied to the boiler system. Matt Rockers and Bill Kroll have been working on a solution for these issues. Expected savings is 40% energy usage efficiency once system is 100% operational. Lockenvar sent a representative last week and discovered the natural gas lines going to each boiler are not the correct size and causing failure to start when each boiler attempts to ftre. We have figured out bow to ensure 2 of the 4 boilers are working for the remainder of the winter season. Bill Basset and McElroys will re-pipe the gas supply and we hope this alleviates the issues.
On July 18th, one of the two air conditioning units at Ag Hall was vandalized to the point it was no longer operational. The new outside condenser and interior coil have been installed by PC! and project was completed the last week of January, It will be sununer before we can test the unit under full work load.
The 6-ton AC unit that services the kitchen of Ag Hall failed last fall and is not repaimble, Cost of replacement for this unit is $5.253.00. We collected three bids from area contractors and would like to go with PC!, which was the low bid. Work is to begin on this project on May IS, 2019, The heating and chilled water lines on Air Handler I 0 are in need of replacement. Age has deteriorated the pipes and shut off valves on the unit to the point where the valves are non operable. Repair of the individual valves is not an option due to the deterioration of the pipes the valves attach to. Three bids were collected, with Samco coming in the least cost at $5,400.00. Start date for this project has not been established at this time, still waiting on parts.
Areas of Coocern: Irrigation system for the Kansas Expocentre is in declining operational shape and will need fixed before the summer of 2019. We are working with HTK, McCown Gordan and Schendel Lawo and Landscape to identifY the parts of the system that needs repaired or replaced.
Capital Expenditure Items:
Capital Expenditure account has a balance of no-less-than $10,575.04
This concludes my report and I will be happy to answer any questions.
Justin Gregory Director of Operations SPECTRA -BY COM CAST SPECTACOR
Memorandmn
To: Kansas Expocentre Advisory Board
From: Justin Gregory, Director of Operations
Date: May 2, 2019
Re: April Advisory Board Report
3 4-H Horse Clinic
5-7 Barrel Bash
10 KS09 Barrel Race
16 4-H Farm to you
19-21 Go For Broke Barrel Race
24-28 Let It Ride AQHA Horse Show
The 4-H Horse Clinic on April 3rd was well attended and everyone is enjoying that fact that winter is finally over.
Renea Bolling and Double B Productions held the first of three Barrel Bashes here at Domer arena in 2019. The entries for this event exceeded her expectations. welcoming 300+ barrel racers each day for three days. Between Renea Bolling's Barrel Bash and Lynde Johnson's Go For Broke Barrel Race, Domer Arena will host over 1900 barrel racing runs over six different days.
Lynde Johoson and the Big J Barrel Blast returns for the third time to Domer Arena April 19-21. This event has changed dates from 2018 to avoid competing directly with the Better Barrel Race National Finals in Oklahoma City. Attendance was up 12% for this event over last year. The Kansas Quarter Horse Youth Association and the Kansas Quarter Horse Association hosted a joint show on April 25-28 at Domer Areoa. This show looked to host approximately 300 horses from Kansas aod surrounding states, but the turnout was considerably smaller than expected.
Domer Areoa hosted events on 15 of the 30 days in April.
This concludes my report and I will be happy to answer your questions.
Justin Gregory Director of Operations SPECTRA -BY COMCAST SPECTACOR
Memorandum
To: Kansas Expocentre Advisory Board
From: Martin De Jesus, Director of Events
Date: April2019
Re: April Advisory Board Report
I hope the Advisory Board had as wonderful an April as the Kansas Expocentre had!
In the month of April, the Expocentre campus hosted 21 events across all five venues including: seven social gatherings, five equestrian events, three clinics, one state conference and two live performance events in Cirque Du Soleil's Corteo and Disney On tee's Frozen.
Cirque Du Soleil hosted five performances drawing about 5900 visitors to Landon Arena. The Corteo presentation was absolutely incredible and everyone I talked to raved about the show. I had one couple state they would be returning with family to watch a second one that weekend. I believe that our entire staff did an incredible job from our box office staff to the operations department to ensure that the client had all their needs fulfilled and that the show ran seamlessiy. In particular, my event manager, Joshua Cordero did an outstanding job assisting me with the client during this run. I believe he is blossoming into a proficient event manager with an ability of producing a great experience for our promoters and visitors alike.
immediately after the Cirque Du Soleil week, Landon Arena became home to the 3srt' tour leg of Disney On Ice: Frozen. This show was another complex event with the added element of an ice floor and a smaller space to work· Exhibition Hall hosted Evening as a Child that same weekend (Cirque was able to expand their footprint into Ex Hall during their stay). Regardless, the week was a great success drawing nearly 11,000 guests across seven performances. I'm particularly proud of this event and the month of April because of all the remarkable work our team put together to serve our community.
This concludes my monthly report.
Respectfully,
Martin De Jesus SPECTRA -BY COMCAST SPECTACOR
Memorandtnn
To: Kansas Expocentre Advisory Board
From: Allie Manning, Director of Marketing
Date: May 5, 2019
Re: April Advisory Board Report
April was a busy month. We garnered some of our highest ticket revenues of the year between Disney on Ice Frozen, and Cirque Du Soleil Corteo. The promoter for Disney on Ice was very pleased with where tickets sales ended up in comparison to previous years. We were able to assist setting up a great public relations push that helped drive through the weekend.
The Cirque du Soleil team was very happy with how the show went here in Topeka. However, we were a little bit behind the national average in ticket sales for Corteo. The marketing budget that we were given was about 50% less than what was given for Cirque du Solei! Crystal. After discussing this point with Cirque du Solei!, the marketing budget is something that will likely increase when the show comes back to Topeka.
In an effort to boost ticket sales for Corteo in the final two weeks, our team participated in First Friday in NOTO. We worked with Norsemen, who allowed us to set up a promotional table in front of their establishment for April's First Friday. We followed that up by hosting an event at Norsemen that next Friday called Disk Drop for Corteo. We co-promoted this event with KSNT, who assisted with :10 TV spots. We also involved Majic 107 .7, who hosted a live remote on-site. We had a good, consistent crowd participating in the Disk Drop for Corteo during the 3 hours, and gave out approx. 30 tickets for Opening Night, plus a lot of KSNT, Majic, Go Modern, and KS Expo swag. The largest value of this event came from the full week's worth of free promotion for Corteo on both radio and 1'V.
Since Feld does all of the media buying for Disney on Ice, we focused our attention on the unpaid assets that we have available to us. We hosted a ticket giveaway on our Facebook using our Woobox program. It was a poll contest, asking patrons to vote for their favorite song from the movie Frozen. It's no surprise, that "Let It Go" won. More importantly, we were able to drive 411 votes, and add 281 emails to our database. On the Public Relations side of things, Kellen and I participated in an Interview with the editor of Business View Magazine. They were looking to highlight a few facilities, and their operational efficiencies, and thousht we would be a great venue to feature. The magazine didn't have an exact issue that the feature would run, but they estimated this summer.
An update on sponsorship marketins, the Sky Zone ticket backs came in in April, so you will now see a Sky Zone coupon for $25 off a Birthday Party on both our Print·at·Home tickets and on physical tickets from the Box Office. We were also able to start highlighting our newest sponsor, Johnsonville, as presenting sponsor of PIS 'N Pour.
We announced Pig 'N Pour, our new in-house event at the end of April! We have partnered up with KSNT and V100 for lV and Radio promotion. We are utilizing a more social-focused marketing plan for this event. Much of our social content promoting this event will center around our restaurant participants, and our mascot, Peggy the Pig. We will use our stuffed animal pig to host scavenger hunts, be in photos for social posts at sponsor locations and participating restaurants, and to create a playful buzz around the event.
Feel free to ask me questions!
Thank you,
Allie Manning SPECTRA I~ -BY COMCAST SPECTACOR
Memorandmn
To: Kansas Expocentre Advisory Board
From: Kyler Tarwater, Director of Partnerships- Spectra
Date: May 8, 2019
Re: April Advisory Board Report
April was a very active month for Spectra Partnerships with the pursuit of a naming rights partner being a key area of attention. And while we have no definitive updates on this as of today, I can share with you that we have three significant candidates that are showing interest and have the means to fund a partnership program of this size. 1anticipate some definitive answers to be returned between now and the end of August.
Our National Partnership team signed an agreement with Ticket Galaxy to sell them a guaranteed number of tickets for every event. The tickets they purchase from us will be discounted and then resold on the Ticket Galaxy website. This new agreement is beneficial because it will help us bring in additional patrons for what once was most likely going to be an empty seat. If you're not familiar with Ticket Galaxy, you should take a look at their website. The website is professional and professionally managed and will lend even more credibility to the events we have here in Topeka at the Expocentre.
Once again, we partnered with Go Modern on a new project aimed at improving the patron/partner experience. This time, the goal was to provide free parking as an add-on benefit to the complimentary event tickets our key sponsors receive. The secondary goal was to have them professionally and securely printed without adding an additional expense to the budget. Both goals were achieved as Go Modern agreed to trade out the print work and materials In exchange for their logo on the passes. (See "hand-out" sample of passes.)
City Hall Meetins- Michael Hall- In working with partner Schendel lawn & landscape we discovered that there were some zoning issues to address in regard to placing signage on certain parts of the campus. The meeting was productive and we found some starting directions, but there is certainly room for some subjective challenges on what is and is not allowed. We have not reached final resolution but feel the board should be aware of this challenge.
Sincerely,
Kyler Tarwater Director of Partnerships -J]L Shawnee County Health Deparb'nent 3 .. linda K. Ochs, Director 2600 SW East Circle Dr., Topeka, KS 66606 Public Health Pc~vont_ Prom~l<- Protoct. Ph. 785.251.5600 I Fax 785.251.5696 www.shawneehealth.org
July 2, 2019
TO: Board of County Commissioners of the County of Shawnee, Kansas
FROM: Linda K. Ochs, Director r)fro
RE: CONSENT AGENDA- Acknowledge Receipt of the Report on Out-of-State Travel to DANCE Training for Nurse-Family Partnership in Denver, Colorado
Action Requested: Acknowledge receipt of the report on out-of-state travel for a Shawnee County Health Department staff member who attended Nurse-Family Partnership (NFP) DANCE Training in Denver, Colorado on June 4-6, 2019.
The NFP Program is an evidence-based, home visitation program which serves first time, at-risk mothers and their children and families. Registered nurses (RN s) work Mth women from pregnancy and throughout their child's first two years. During the home visits, mothers are engaged around preventative health and developing healthier habits. The RNs model proper and responsible infant care and help mothers connect to other comnnmity support services.
The NFP research has consistently documented the long-term effect of improved school readiness for children who participated. The program is designed to provide a long-tenn, intensive level of support required for positive outcomes in children of at-risk families.
The NFP training is required and trains the RNs to perform the duties of the NFP Program.
LKO/ Attachment C: Teresa Fisher, Family Health Division Manager
Healthy People- Healthy Environment- Healthy Shawnee County Shawnee County Health Department linda K. Ochs, Director 2.600 sw East Circle Dr., Topeka, KS 66606 Public Health Ph. 785.251.5600 I Fax 785.251.5696 Pr~vont. Promolo. Prot•o'- www.shawneehealth.org Shawnee County Health Depart:ment
July 2, 2019
MEMO, Report on Out-ofState Training
TO: Board of County Commissioners of the County of Shawnee, Kansas
FROM: Felicia Turk Nurse-Family Partnership Registered Nurse
During the February 18, 2019 Board of County Commission meeting, the following agenda item was approved:
Action requested: Approval of out-of-state travel for one Shawnee County Health Department (SCHD) Nurse-Family Partnership (NFP) Registered Nurse to attend NFP DANCE training June 4-6, 2019 in Denver, Colorado at a total cost of $2,575.00.
Nurse-Family Partnership (NFP) is a highly respected, evidence-based model of home visitation that is proven to result in positive outcomes for the at-risk women and children who receive the service. To maintain fidelity to the program, Nurse Family partnership requires nurses be trained and demonstrate competency in assessing interactions between the mother and child. Research shows maternal sensitivity plays a subsequent role in social and academic competence throughout childhood, adolescence, and early adulthood. The research-based assessment, unique to NFP, is called Dyadic Assessment of Naturalistic Caregiving-child Experiences (DANCE). The purpose of this assessment is to have a feasible, clinically useful, and valid tool to assess the interactions between mothers and children, and to target areas in which more intervention is needed to support the child's development. Training and testing for competence in use of the DANCE assessment requires a three-day course in Denver, Colorado. This course provides an intense examination of 18 critical assessment behaviors, provides the skill-building information necessary for the nurse to score the assessment based on specific criteria, and the knowledge needed to provide interventions with mothers that will enhance the strength of their interactions with their children.
I attended DANCE training at the NFP National Education Center in Denver, Colorado on June 4-6, 2019.
Day 1
Day one of the training began with a brief review of the DANCE history and development, followed by an in-depth review of assessment of the Emotional Quality of the caregiver's interaction with her child, which focuses on 5 caregiver behaviors: • Expressed positive affect • Caregiver affect complements child's affect • Verbal Quality • Response to Distress
Healthy People- Healthy Environment- Healthy Shawnee County • Negative Comments
Day 2
Day two of training focused on the assessment of the Sensitivity and Responsivity of the mother's interaction with her child, as well as the quality of Regulation the mother displays when interacting with her child. This training focused on 8 caregiver behaviors, including: • Positioning • Visual Engagement • Pacing • Negative touch • Responsiveness • Non -Intrusiveness • Limit Setting • Interaction Completion
Day3
The final day of the training began with examination of the Promotion of Developmental Growth exhibited by the mother as she interacts with her child. This content focused on 5 caregiver behaviors: • Support of Exploration • Scaffolding • Verbal Connectedness • Praise • Negative verbal content
The second part of the day focused on looking at the entire group of caregiver behaviors, and assessing aIllS behaviors during a brief observation of a mother-child interaction, with practice utilizing the DANCE assessment. Emphasis was also placed on interpreting the results of the assessment, and providing interventions with the mother that strengthen the quality of her interactions with her child. Finally, the last part of the day involved testing to demonstrate nurse-proficiency in use of the assessment tool.
I returned from the training equipped with knowledge and skills necessary to perform the DANCE assessment, and was notified on 6/14/19 that I was determined to be proficient in use of the tool. Shawnee County Sheriff's Office Sheriff Brian C. Hill Law Enforcement Center
320 S. KANSAS, SUITE 200 TOPEKA, KANSAS 66603-3641 785-251-2200
MEMORANDUM
July 5, 2019
To: Board of Shawnee County Commissioners
From: Sheriff Brian C. Hill
Re: Out of State Travel to Dallas, Texas
I am sending four officers to Dallas, Texas to attend the 2019 Crimes Against Children conference. The conference will focus on Offender Management, Managing Homeless Offenders, Verifications and Registration, and other important topics. The conference is August 12 through 15, 2019. Travel, lodging, and seminar will cost no more than $4600.00 and will be paid from the Offender Registration Fund.
Please place this on your July 18, 2019 consent agenda.
If you have any questions please let me know.
Sincerely,
Brian C Hill, Shawnee County Sheriff Shawnee County 1lJ--s. Office of County Treasurer
Room 101, Courthouse, Topeka, Kansas 66603 Phone 785-251-6493 (MV) 785-251.Q483 (Tax) htlp:lf..~Hm.snoo.us LARRYMAH COUNTY TREASURER
MEMORANDUM
DATE: July 10, 2019
TO: Shawnee County Board of Commissioners
FROM: Larry Mah, Shawnee County Treasurer LJ.i)t.j#
RE: June 2019 Bank Reconciliation
Please place this request on the Thursday, July 18, 2019 Board of County Commission Consent agenda for final approval of the June 2019 bank reconciliation report. This bank reconciliation report has been reviewed and approved by Audit Finance Department.
Thank you for your time and consideration.
CC: Audit Finance Dept. June 2019 Bank Reconciliation
Ending balance Per OneSolution $ 149,859,494.11 $ 149,859,494.11
Reconciling Items Less: Credit cards (posted to bank July 1, 2019) $ 65,622.61 Deposit in Transit {posted to bar1k July 1 & 2, 20191 s 59,299.06 Kanpay Return {ROD) (posted to OneSolutior~ July 2, 2019) s 55.00
$ 124,976.67
Add: Outstanding checks as of 6/30/2019 s 1,288,103.99 Credit card payments (posted to OneSolutlon July 2 & 3, 2019) $ 569.86 Deposit (P & R) (postt"d to Ont"Solutlon July 1, 2019) $ 10,336.75 ACH Credit-Remote deposit (P & R) (posted to OneSolution July 1, 2019) s 427.33 ACH Crt"dlt-Lake Shawnee Golf COurse (P & R) (posted to OneSolution July 1, 2019) $ 34,635.50 ACH Credit-Efunds-Shawr~ee North Day Camp (P & R) (posted to OneSolution July 1, 2019) $ 350.00 ACH Credit-UMB Bank interest adjustment (posted to OneSolution July 1, 2019) s 694.04 ACH Credit-Aetr~a payment (SCHA) (posted to OneSolution July 3, 2019) s 617.21 ACH Credlt-UHC of the Midwest payment (SCHA) (posted to OneSolution July 3, 2019) $ 25.00 ACH Credit-IRS payment (ROD) (posted to OneSolution July 2, 2019} $ 128.00 ACH Credit- MHC Kenworth payment (Solid Waste) (posted to OneSolutlon July 2, 2019) s 202.00 ACH File Upload to UMB Bank for Aocour~ts Payable payments (posted to bar~k July 1 & 2, 2019) s 92,006.11 Payment to JEDO (posted to bank July 1, 2019) s 640,205.46 Payment to Wells Fargo (posted to bank July 1, 2019) $ 34,328.70 ACH Cred1t-Treas 31D- Mise Pay payment (not posted to OneSolutlCJn} s 611.91 ACH Credit-Ks Claims payment (SCHA) (not posted to OneSolution) $ 366.47 ACH Credit-BCBS payment (SCHA) (posted to OneSolution July 10, 1019) $ 7,906.50 Pending AP test transaction not posted tCJ bank (Audit) $ 0.01 $ 3,111,514.84
Adjusted ending balance $ 152,846,032.28
Vault cash $ 4,000.00 Ending balance per UMB Bank 152,841,032.18 152,846,002.28
Difference $
Prepared by: tjt Shawnee County Treasurer's Office July 10, 2019 OFFICE OF THE DISTRICT ATTORNEY THIRD JUDICIAL DISTRICT OF KANSAS Michael F. Kagay, District Attorney
MEMORANDUM
TO: Board of County Commissioners
FROM: Michael F. Kagay, District Attorney nt:.-
DATE: July 10,2019
Request for Diversion Fund Payments
The District Attorney's Office wishes to pay the following invoices from their Diversion Fund account: l) Independent Stationers for office supplies a) Invoice No. 345277 dated May 1, 2019 in the amount of $227.43 b) Invoice No. 347880 dated May 15, 2019 in the amount of$371.55
2) Olsen, Jennifer for transcript fees a) Invoice No. 2019-13 dated July 8, 2019 in the amountof$68.00 b) Invoice No. 2019-14 dated July 8, 2019 in the amount of$44.00
3) The Topeka Metro News for legal publications a) Invoice No. L80019 dated May 13,2019 in the amount of$87.12 b) Invoice No. L80021 dated May 13,2019 in the amount of$88.56 c) Invoice No. L80022 dated :May 13,2019 in the amount of$89.28 _ d) Invoice No. L80023 dated May 13, 2019 in the amount of $90.72 e) Invoice No. L80024 dated May 13, 2019 in the amount of$90.00 f) Invoice No. L80028 dated May 13, 2019 in the amount of$84.96 g) Invoice No. L80031 dated :May 13, 2019 in the amount of $86.40 h) Invoice No. L80034 dated May 13, 2019 in the amount of $87.84
The District Attorney's Office hereby requests placement on the consent agenda for consideration of the above itemized invoices, in the total amount of $1,415.86, to be paid from the Diversion Fund account.
Shawnee County Courthouse 200 SE 7th Street, Suite 214 • Topeka, Kansas 66603 • (785) 251-4330 Local Delwery Provided By: SALES INVOICE Oindepemlent OFFICE PLUS OF KANSAS $bi~Orter.l Sales Invoice Number: 5100345277
Remit Independent Stationers, Inc. Sales Invoice Date: 05/01119 To: 5600 N River Road, Suite 700 Invoice Questions: 847·261-0052 Page: 1 Rosemont, IL 60018 Contract No.: R141701 Ordered By: Kathy Beach 800-231-9848
Sold SHA'NNEE COUNTY Ship DISTRICT ATTORNEY To: 200 SE 7TH ST To: Kalhy Beach TOPEKA, KS 56603 20il SE 7TH RM 214 DISTRICT ATTORNEY TOPEKA, KS 66603
ACCT. NO. Sales Order No. CUSTOMER PO DEPARTMENT DUE DATE I ' PNW265562 0000000 05131/19
PNWitem Description Ord Q1y Ship Qty Unit Price Total Price Customer ID:
SMD34276 FLDR,FILE,ENDTAB,LTR,MLA 2 BX 2 BX 64.22 128.44
PerTCPN Co11trac1 # R141701 UNV15262 POCKET,FILE,LTR,STR,5.25" 2 BX 2 BX 9.38 18.76
Core Contract Item DXEPSM21 SPOON,SOUP,PLS,MDWT,1MC 1 CT 1 CT 20.54 20.54
PerTCPN Contract# R141701 RAC84251 WIPES,DISINF,LL,80CT-3PK 2 PK 2 PK 18.52 37.04
Per TCPN Contract# R141701 CL003191 CLEANER,KIT,TOILET,WAND 1 KT 1KT 17.74 17.74
CL014882 REFILL,FffOILET WAND,B/PK 1 PK 1 PK 4.91 4.91
Per TCPN Contract# R141701 Local Delivery Provided By: SALES INVOICE OFFICE PLUS OF KANSAS 8inde~nt- .slatiDI'ICII'll Sales Invoice Number: 5100345277
Remit Independent Stationers, Inc. Sales Invoice Date: 05/01119 To: 5600 N River Road, Suite 700 Invoice Questions: 847-261.(]052 Page: 2 Rosemont. IL 60018 Contract No.: R141701 Ordered By: Kathy Beadl B00-231..S848
Sold SHAWNEE COUNTY Ship DISTRICT ATIORNEY To: 200 SE 7TH ST To: Kathy Beech TOPEKA, KS 66603 200SE7THRM214 DISTRICT ATTORNEY TOPEKA, KS 56603
ACCT. NO. Sales Order No. CUSTOMER PO DEPARTMENT DUE DATE
PN'vV265562 0000000 05131/19 : ··-
Amount Subject to Amount Exempt Subtotal: 227.43 Sales Tax from Sales Tax 0.00 227.43 Total Sales Tax: 0.00
Total: 227.43 (End ci Report)
Payments: 0.00 Remaining Amount: 227.43 Local Delivery Provided By: SALES INVOICE Oimlepe'!f!!! OFFICE PLUS OF KANSAS Sales Invoice Number: 5100347880
Remit Independent Statioriers, Inc. Sales Invoice Date: 05/15119 To: 5600 N River Road, Suite 700 Invoice Questions: 847-261..0052 Page: 1 Rosemont, IL 60018 Contract No.: R1417D1 Ordered By; KalhV Beach 800-231-9848
Sold SHA\o\PNEE COUN1Y Ship DISTRICT ATTORNEY To: 200 SE 7TH ST To: Kathy Beach TOPEKA, KS 66603 200 SE 7TH RM 214 DISTRICT ATTORNEY TOPEKA, KS 66603
ACCT. NO. Sales Order No. CUSTOMER PO DEPARTMENT DUE DATE PNW2ti8101 0000000 06/14/19
PNWitem Description Ord Qty Ship Qty Unit Price Total Price Customer ID: 4.89 AVE11025 TAG,KEY,50PK, 125"DIA,WE 1 PK 1 PK 4.89
Per TCPN Corltracl # R141701 29.22 DCCF6BW FORK,PlASTIC,M-WGT,WHT 1 CT 1 CT 29.22
Per TCPN Ct.:lrrtracl # R141701 337.44 UNV21200 PAPER,XERO/DUP,WELlR,20# 8 CT 8 CT 42.18
Core Cor~tract Item
371.55 Amount Subject to Amount Exempt Subtotal: Sates Tax from Sales Tax 0.00 0.00 371.55 Total Sales Tax:
Total: 371.55
Payments: 0.00 Remaining Amount: 371.55 The Topeka Metro News THANK YOU! You can depend on P.O. Box 1794 The TopekaMetroNewsfor Topeka, KS 66601-1794 Service,Accuracy and Economy. Phone: "(785) 232-8600
INVOICE ATTN: KEVIN KEATLEY SHAWNEE COUNTY - ASSISTANT DIST ATTY 200 SE 7TH ST STE 214 Invoice #: L80019 TOPEKA KS 66603-3933 Payment Due: 6/11/19
DATE· 5113119
CASE DESCRIPTION, CASE NO. AND PUBUCATION DATES Amount
$87.12 State Of Kansas v. $2020 us Currency, et al. 19CV180 5/13/19
Subtotal $87.12
Amount Paid $0.00
Balance D.Je $87.12 Lewis Legal News, Inc., Fed. Tax I.D. No. 48·1031751
The Topella Metro News is your Destvaluefor publishll:ff yo~.~r l~al notioos. Total amount shoWn Is the sum of all lees lor publicatiOI"l, Including a ~lng and proal ol pu calion. UBUCATION TERMS: ThEt Topeka Metro News r~lres, and se!VIces are render strlctiJ: upon the oonclition, lhilt lhe alt~S) submitting the public notice for fr lcallon Is r~lelor payment or ese charges. l"al/ITleol Te1111s: Nel d~. Past due amoonts are sOOj&ct o a FINANCE C GEOF 1.% per monltl on the unpaid balanClB. ANNUA!. PER ENTAGE FIAT£: 18".4..
1 c P/Nu r«um !1M portion b!rlow with your payment to ensure proper credit.
Invoice #:LS0019 5/13t19 19CV1B0-5/13/19 $ Payment Enclosed ATTN: KEVIN KEATLEY (Make Check. Payable to THE TOI"EKA METRO NEWS) SHAWNEE COUNTY - ASSISTANT DIST ATTY -or- Charge my cred"rt card: 200 SE 7TH ST STE 214 Card# TOPEKA KS 66603-3933 Name on card ______
Signaturo______
smi11g Address------CW#___ _ Zip Code THE TOPEKA METRO NEWS L80019 P.O. BOX 1794 Yes, plea:Je send me The: Topeka. Metro News TOPEKA, KS 66601-1794 X every week for a year. (Retail value: $44) The Topeka Metro News THANK YOU! P.O. Box 1794 You can depend on Topeka, KS 66601·1794 The Topeka Metro News for Service, Accuracy and Economy. Phone: (785) 2:32-8600
A'I"''N: KEVIN KEATLEY INVOICE SHAWNEE COUNTY - ASSISTANT DIST ATTY 200 SE 7TH ST STE 214 Invoice#: LB0021 TOPEKA KS 66603-3933 Payment Due: 6/11/19
-~ DATE· 5113119
CASE DESCRIPTION, CASE NO. AND PUBLICATION DATES Amount
State Of Kansas v. 2001 Chevy Tahoe, et al. $88.58 19CV178 5/13/19
Subtotal $88.56
Amount Paid $0.00
$88.56 Le~is Legal News, lne., Fed. Tax J.D. No. 48-1031751 Balance Due
The Topeka Maim News Is your best value lor publlshi~ your l~al nCJlices. Total amount shown is the sum of al lll&tfcr putlllcaUon, inciLldlrlg a~~ 911d proof of pu catiorJ. UBLICATlONTERMS: The Topeka Metro News r:;:ires, and serviOOS are Iende mllf)OO the condition, thatth!l atlomey(s) stbnttliO!J the public OC!Iice for pu lcalloo Is resp011Sibla !Cll" pa~l'll o1 ese charges. PaymentTem1s: Net 30 da[i. Past due amounts are sut:lject to a FJNANCE CHARGE OF i. %par mor1th on thel111paid Mlance. ANNUAL. PEA ENTAGE RATE: 18%.
1 c Please rettlm the porlfon be/uw with your payment tD snsunJ propN crOOtt.
Invoice #:L80021 5/13/19
$ P;Jyment Enclosed 19CV178-5/l3/19 ATTN: KEVIN KEATLEY (Make Check PayaOie to THE TOPEKA METRO NEWS) SHAWNEE COUNTY - ASSISTANT DIST ATTY -or- Charge mY aedit card: 200 SE 7TH ST STE 214 aml# TOPEKA KS 66603-3933 Name oo card ______
Signat\Jr~------
BmirogAddMSS ------
Zip Code ------CW#'----cc:: THE TOPEKA METRO NEWS P.O. BOX 1794 Yes, please send me The Topeka Metro News""'" TOPEKA, KS 66601-1794 X every week for a year. (R~tail value: $44) The Topeka Metro News THANK YOU! You can depend on P.O. Box 1794 The Topeka Metro News for Topeka, KS 66601-"1794 Service, Accuracy and Ecorwmy. Phone: {785) 232-8600
INVOICE ATTN: KEVIN KEATLEY SHAwm:E COUNTY - ASSISTANT DIST ATTY 200 SE 7TH 5'1' STE 214 Invoice #: L80022 TOPEKA KS 66603-3933 Payment Due: 6/11/19
DATE· 5113119
CASE DESCRIPTION, CASE NO. AND PUBLICATION DATES Amoun1
$89.28 State Of Kansas v. $814.00 US Currency, et al. 19CV163 5/13/19
Sub1otal $89.28
Amount Paid $0.00
Balance Due $89.28 Lewis Legal Naws, lrx:., Fed. Tax I.D. No. 48-1031751
The TopeKa MlllrO News Is your best value. for r.-.rblishl~ yol.lr l~al nollces. Total amount shown Is "the sum of all fees _for pt~~ica~"'!.lnc:h.rctlrlg a d~lng and proof o'f PI*' cation. UBLICATION TEAMS: The Topeka Mlllro News requ1res. am:lserv~ces are render stnc:tl~on the condttlon, that the aHome~sJ submitting the pubnc: no~cetor ,...bllootkln Is r~cn&ible for f~ent of charges. Payment Terms: Ne! ~s. Past due amounts are subject to a FINANCE ARGEOF . %per month on the ~paid l:lalance. ANNUAL PER ENTAGE RATE: 16%.
1 c Please relum the porfian belaw with your payment t.o ensura praper r;redlt
Invoice #:L80022 5/131"19 19CV163-5/13/19 $ Payment Eridosed (Make Check Payable to THE TOPEKA METRO NEWS) ATTN~ KEVIN KEATLEY SHAWNEE COUNTY - ASSISTANT DIST ATTY -or- Charge my O"edit Ciln:t 200 SE 7TB ST STE 214 Card# TOPEKA KS 66603-3933 ------~'··----
Name o~ card------
Signature•------
BlingAddress ------
lip Cod!!'------ON# THE TOPEKA METRO NEWS P.O. BOX 1794 Yes, please ~end me The Topeka Metro News"""" TOPEKA. KS 66601·1794 X every weekfor a year. (Retail value: $44) The Topeka Metro News THANK YOU! You can depend on P.O. Box 1794 Topeka, KS 66601-1794 The TopekaMetroNewsfor ServiceJ Accuracy and Economy. Phone: (785) 232-8600
ATTN: KEVIN KEATLEY INVOICE SHAWNEE COUNTY - ASSISTANT DIST ATTY 200 SE 7TH ST STE 214 Invoice#: L80023 TOPEKA KS 66603-3933 Payment Due: 6/11119
DATE· 5/13/19
CASE DESCRIPTION, CASE NO. AND PUBUCATION DATES Amount
State Of Kansas v. .$6,092. 65 us Currency, et al. $90.72 19CV164 5/13/19
Subtotal $90.72
Amount Paid $0.00
$90.72 Lewis Legal News, Inc., Fed. Tax I.D. No. 48-1031751 Balance Due
The Topeka Metro News Is Y"urbestvalve lor publislllb!/ your l~al notices. Total amount shown is the sum of aD fees lor publication, irlCIOOmg a ~lf!Q am! proof o1 pub cation. USL.ICATlON TERMS: The Topeka MBII'o News r:J,ulres, and iervlces are rande Blri~pon the oomllion, lh!t1 tfla alt~sJ &Ubmltllng th& public nolic(lfor pu lic:ation Is responsible lor ~erJI o1 se charges. Paymenl TSITTIS: Nel ~- Past due amounts are subjec:l to a FINANCE CHARGE OF 1 %per month on ttle unpalclbalance. ANNUAL PER ENTAGE RATE: 18'%.
1 c Plea£.e 11!nmt the ponlon below with your Jnyml!ld to rmsun~ prop~ GnJdft..
Invoice #:L80023 5/13119
$ Payment Enclosed 19CV164-5/13/l9 AT'l'N: KEVIN KEATLEY (Make Check Payable to THE TOPEKA METRO NEWS) SHAWNEE COUNTY - ASSISTANT DIST ATTY ·or- Cl\arge my aed"Jt card: 200 SE 7TH ST STE 214 TOPEKA KS 66603-3933 """'------"''·--- Name on card ______
Signature______
BIHing Add"ess ------
Zip Code------r:w••----• THE TOPEKA METRO NEWS CS0023 P.O. BOX 1794 Yes, please !lelldme The Topeka Metro News TOPEKA, KS 66601-1794 X every week for a year. (Retail value: $44) The Topeka Metro News THANK YOU! You can depend on P.O. Box 1794 Topeka, KS 65601-1794 The Topeka Metro News for Service) Accuracy and Economy. Phone: (7B5) 232-8600
ATTN: KEVIN KEATLEY INVOICE SHAWNEE COUNTY - ASSISTANT DIST ATTY 200 SE 7TH ST STE 214 Invoice #: L80024 TOPEKA KS 66603-3933 Payment Due: 6/11/19
CASE DESCRIPTION, CASE NO. AND PUBLICATION DATES Amount
State Of Kansas v. $21,605.00 us Currency, et al. $90.00 19CV159 5/13/19
Subtotal $90.00
f\Jnount Paid $0.00
$90.00 Lewis Legal News, lllC., Fed. Tax I.D. No. 48-1031751 Balance Due
The Topeka Metro News Is your OOsl value lor pubilshln!J your l~al rroflces. TD!al amount shown Is the sum ot aD fees for publicatloo, lncludlrog ad~~ and proof c1 publication. UBLICATION TERMS: The T"Pt'ka Metro News r~lnes, and services are render ctly upon the condilloo.lhl!l the etlom~{s) sllbmltlin!J the public notiCE for p k:ation Is msponsii:Jie lor ~ent ofthesedlaryes. Payment Terms: Net o daSl. Past due amounts are subject to a FINANCE CHARGE OF 1 %per montl"l on ll'le unpaid balance. ANNUAL PEA ENTAGE RATE: 18%.
1 c Pleass rewm the portlrm below with your payment to l!lfiS/1/'fJ proper credil.
Invoice #:L80024 5113!19
$ Payment Enclosed 19CV159-5/13/l9 ATTN: KEVIN KEATLEY (Make Check P'a)l !>lam! on card------ Signatur'------Billing Ad!tess ______ Zip Code ______<:W#!___ _ THE TOPEKA METRO NEWS LB0024 P.O. BOX 1794 Yes, please send me The Topeka Metro News TOPEKA, KS 66601-1794 X every week for a year. (Retail value; $44) The Topeka Metro News THANK YOU! P.O. Box 1794 You can depend on Topeka, KS 66601-1794 The Topeka Metro Newr for Service_,Accuracy and Economy. Phone: (785) 232-8600 ATTN: KEVIN KEATLEY INVOICE SHAWNEE COUNTY - ASSISTANT DIST ATTY 200 SE 7TB ST STE 214 Invoice #: LS0028 TOPEKA KS 66603-3933 Payment Due: 6111119 DATE: 5113/19 CASE DESCRIPTION, CASE NO. AND PUBLICATION DATES Amount State Of Kansas v. 2015 Chevy Impala $84.98 19CV185 5/13/19 Subtotal $84.96 Amount Paid $0.00 $84.96 L.e~i:o Legal News, Inc., Fed Tax J.D. No. 48--1031751 Balance Due The Topeka Metro New!! Is yo~ best value for putlflshln~ your ~EI] rwticea. Total arnCJUnt shown is lhe sum of aU fee:s lor publication, Including a clipping and pmol ol pubhcatlon. UBLICATlON TEAMS: The Topeka Metro News requlrM, and services ara rendered strictiJ;' upon the condition, tl\at lhe attomeg'J'l submitting tile~ notice lor foutlllcation Is r='ble for ~yrnmt of ese charges. P!1Yf11erll Ten'llS: Net d~. Past due amoonts are subjed (I FINANCE G GEOF .5% Ptll month oothe.unpaitl OaJanc:e. ANNUAL PE ENTAGE RAlE: 18%. 1 c Invoice #:LB0028 5/13/19 $ Payment Endosed l9CV185-5/13/19 ATTN: KEVIN KEATLEY (Make Check Payab~ to THE TOPEKA METRO NEWS) SHAWNEE COUNTY - ASSISTANT DIST ATTY -or- Ch~rge my credit care!: 200 SE 7TH ST STE 214 TOPEKA KS 66603-3933 ------'"1'--'""" N~me en 01rd ------Signature•------Billing Address ______ ZipCode ______CN#<___ _ THE TOPEKA METRO NEWS P.O. BOX 1794 Yes, please send me The Tor.eka Metro News"'""" TOPEKA, KS 66601-1794 X every week for a year. (Retrul value; $44) The Topeka Metro News THANK YOU! P.O. Box 1794 You can depend on Topeka, KS 66601-1794 The Topeka Metro News for Service) Accuracy and Economy. Phone: (785) 232-8600 ATTN: KEVIN KEATLEY INVOICE SHAWNEE COUNTY - ASSISTANT DIST ATTY 200 SE 7TH ST STE 214 Invoice#: L80031 TOPEKA KS 66603-3933 Payment Due: 6/11/19 DATE· 5113/19 CASE DESCRIPTION, CASE NO. AND PUBLICATION DATES Amount State Of Kansas v. 2010 Mercedes $86.40 19CV186 5/13/19 Subtotal $86.40 Amount Paid $0.00 Lewis legal News, Jno .. Fed. Two: I.D. No. 413-1031751 BaJanoo Due $86.40 The Topeka Metro News is your best value lor publish~ your ~al no~ees. Total amounl shoWn Is the sum of all lees IOJ publication, including a ~ing artd proill o1 p icafion_ UBUCATION TERMS; The Topeka Metro News rOCjulres. and sel'lices are rende stri~ upon the candition, that the artorney(s) suhmitting the po.~blio nutioo lor ~ublicatlon Is responsible I [If pa~e11t of e.se c:harges. Peymen!T&rms: Net 30 dabl. Pas1 due amounts are subject a FINANCE CHARGE OF 1. %per month on the unpatd balance. ANNUAL PER ENTAGE RATE: 18%. 1 Plea$6 retwn the porlir:m b Invoice #:LB0031 5/13/19 $ Payment Endo~ed HCV186-5/13/19 ATTN: KEVIN KEATLEY (Make Ctled< P Signature'------ Billing Address ------ Zip Code ------r:vY#I______THE TOPEKA METRO NEWS P.O. BOX 1794 TOPEKA, KS 66601-1794 Yes, please send me The Topeka Metro News X every week for a year. {Retail value: $44) The Topeka Metro News .THANK YOU! P.O. Box1794 You can depend on Topeka, KS 66601-1794 The Topeka Metro News for Service} Accuracy and Economy. Phone: _(785) 232-8600 ATTN: KEVIN KEATLEY INVOICE SHAWNEE COUNTY - ASSISTANT DIST ATTY 200 SE 7TB ST STE 214 Invoice#: L80034 TOPEKA KS 66603-3933 Payment Due: 6/11119 DATE: 5113/19 CASE DESCRIPTION, CASE NO. AND PUBLICATION DATES Amount State Of Kansas v. 2007 Mercedez-Benz $87.84 19CV182 5/13/19 Subtotal $87.84 Amount Paid $0.00 Lewis Legal News, Inc., Fed. Tax I.D. No. 48-1031751 Balance Due $87.84 The Topeka Metro News ill yrn. bsst value I~ publishl~l~ not1oos. Tolal amount shown is the Sl.n of aU fees for publiwtion, lndu:flng a d~Mcl proof of pu . . BLICATION TERMS: The Topah Melro News requires, and services areremier ~poo ltle condtlion. that the attomey(s} sLJbmittlng the public nolicefor fu~lcatjon Is restr.inslble for f'5:ant ol se charges. Pa)'lllef1!Tenns. Net 30dal'$. Past due amounts are subjeOI o a FINANCE C AAGE OF . %per monlll on lh! unpaid balanoe. ANNUAL PERCENTAGE RATE: 18%. 1 c PJ&ass fl!lum the pOrtion below with your paymwrt to !lll$ure proper- crndit. Invoice #:L80034 5/13/i9 $ Payment Endos-ed 19CV182-5/l3/19 ATTN; KEVIN KEATLEY (Make Check Payable to THE TOPEKA METRO NEWS) SHAWNEE COUNTY - ASSISTANT DIST ATTY -<:~r- Ch~rge rny cr~dit r:an:l: Card# 200 SE 7TH ST STE 214 ______IB Name on e<~rd ______ Signatur'------ Billing Ad:lress ------Zip Code ______CW#•---- THE TOPEKA METRO NEWS UIOOM P.O. BOX 1794 Yes, please send me The Topeka Metro News TOPEKA, KS 66601-1794 X every week for a year. (Retail value: $44) Shawnee County Department of Public Works 1515 N.W. SALINE STREET· SUITE 200 ·TOPEKA, KANSAS 66618-2867 785-251-61 01 FAX 785-251-4920 CURT F. NIEHAUS, P.E. DIRECTOR OF PUBLIC WORKS COUNTY ENGINEER MEMORANDUM DATEo July9,20!9 TO: Board of County Commissioners (Consent Agenda) FR0\1: Michael M_ Welch, P.E. ')-t1;;7/t{.,_t Civil Engineer 11 RE: Acceptance of Right of Way Project No. S-121 042.00, Culvert Replacement, WI-009 SW Morrill Road over Un-named Tributary to Colby Creek 0.76 mi S ofSW 69th St The Public Works Department ha~ reached agreement with the following list of landowners to acquire permanent and temporary easements for construction of the referenced project. We request your acceptance of the attached easements and authorization for payment Owner Item Value The Holthaus Revocable Living Trust Permanent Easement 0.20 acres $4,500 Allan L. & Vickie A. Holthaus Trustees Permanenl Easement 0.06 acres Encl. cc: Curt F. Nieha~1s file PERMANENT PUBLIC RIGHT-OF-WAY EASEMENT +/, THIS INDENTURE, made this J...S day of 3J0n-c.. , 2019 by and between Alia~ L Holthaus and Vickie A Holthaus, Trust~es of "Tne HDithaus Revocable llviflQ Trust", hereinafter reFerred \!J as the LandoiMler; and THE BOARD 0~=' COUNTY COMMISSIONERS OF THE COUNTY OF SHAWNEE, KANSAS, hereinafter referred to as the Col!nty. WITNESSETH, that itle Lanr.1<.nv11er 1n consideratiorJ of ontJ dollar and no/1 00 (~1.00) and other valuable considerations, the reco.!ipl of which is hereby acknowledged, does for itself, 1ts heifl; and mo~igns, hereby grant. bargain, sell, and convey unto the County, a perrmmenl public right-of-way easement for vehicular and pedestrian traffic together with t~e attendant customary uses, including dratnage and utilities over. under, through, across, and along all the following descrlbeQ real estate in tha Cou~ty of Shawnee, anC State of K (Signiiflira, diile and seal of a Registered Land SV!'V&YIX r.:wtif~es that the following realpropatty legal description is an origtnel description and has bet~n prepared by or under t/1<1 dirvct supervision of wbscribed Registered Lend &uveyor. KS.A. 74-7003) Part of Lot !, Dloek A, Holthaus S\lbd,vision loca:ed in the Southwest Quarter of Section 1~, Township 13 SoUih, R!lllg'O 15 East of the 61h P.M., in Shawne¢ Co!lnty, Kansas cl=ribed as fullows: Beginning at the Norlhwest comer of sald Lot !, Block A; tile~ North 88 de!:fl"'" 28 miilutcs 50 se<.:onds East a distance of24_54 f~et, •hence So!lth 19 degrees 56 rninu~' 17 seconds Wen a distanr.e nf 25.69 fcc~ thence Smllh 01 degrees 51 minutes 49 sewndl! East a diStance uf 151.99 fl:llt ro the South liru: of said Lot l; !hence Sot.~tb 87 degrees 49 nunutes 50 =:on Said trnct oflarui comama 1,753 square fi:et, or 0.06 anrcs ofl.a.'l'i, Ol{)re or !ells. The County is purchasing ltlis permanent public right-of-IWy easement for the purpose of erecctng or 1m proving a public roadWil)' for the passage of vehicular and pedestrian traffic, and the County reserves the nght to maka improvements on that property according to ::;uch ploms and specifications. ss will. in 1ts opinion, best serve :he publiC purjXIse The payment of !he purcilase price for the public rjght of-W The Landowner, its f1eirs. or assigns shall retain Should Orle or more ol Uoe Landowners be natural persons not JOined by their respective spouses, ot is ooncluslvaly presur:1ed Umt the land conveyed is not the residence or business ~1omestead of such Landowner(s). Should one or more. of the grantOJs be a legal entity other than a natural pe-rson, it shell be condusively presumed that the pe~on signong o.1 behalf of that party has been duly and legally autllori.wd to so sign and 11ere shall be no r1ecessity for a sea! or attestal•an This Permanent Public Righ;-of-Way Easement shall run w1th the land and be binding upon the grantees, lessees, succ&ssors, and 01s~•gns of ltle parties hereto, unless terminated by ltle Easement No. 3 Project No. S-121042.00 IN WITNESS WHEREOF, Said partes of the flrst part have llereunto sal their hands the day and year first ahD\Ie written. ~;;J~ ~~A·~------ STATE OF KANSAS, COUNTY OF SHAWNEE, ss. ~ BE IT REMEMBERED, !flat on this J.ft.. day of :)";j.t~-<. , 2019, before me, the undersigned, a ootary public in and for the County and State aforesaid, came Allan L Holthau3 and V~ekie A. Holthaus, T11.1stees of "The Holthaus Revocable Lfvlng Trust", persoMOy known to me to be the same persons who exec:uted tr,e within instrument of wr!tlng, and such per.~ons duly acKrio'Medged the execution of the same. IN WITNESS WHEREOF, I ~.ave hereunto :;et my hand and affiXed my notarial seW, the day and )"38r last above wrttten. My commission explres:-::)Qi-1\JGV'-, J1. ).02,.? / 7 PERMANENT PUBLIC RIGHT-OF-WAY EASEMENT {0 THIS INDENTURE, m WfTNE!:iSETH. that the : .andowner in carJ~iceration of 01'\e dollar omd no/100 ($1.00) and other valuable consideratio11s, the rer:eipt of which is hereby acknowledged, does for itself. its heirs and assigns, hereby grunt, bargain, sell, and conv"y unto the County, a p(lrrnanent p~;bllc right-of-way easement for veh•cular and pedestriom traffir:: together with the attendant ClJstomary uses, :nduding drEi.1age and utilities over, urlder, througll, across, and along all the following described real ~tate in the Co:.Jnt~ of Shawnee, ar1d Stale of K:omsas. to-wit: (Signotc..lfe, date and seal of a R?gwtarod Land Survr>yor cwtil A lJact of land in th~ Southwest Quane:.- of:>oction 12, TownshH:> 13 Suulh, Range 15 East ofth~ 5'" P_M, Shawnee Cm:uly Kamas described as follow;· . Comrnenclflg a! the Nortbwcat oomer of satd Sollthwest Qua:'ler: then.ue Salllh Ql degre<:s 51 lllJJ\utes 49 seconds Fa't an the West line ofsaid Southwest Quarter a distance of955_4U fE Said tra": oflamlwntaim; 8,720 square fee~ or 0.2(1 aL'T~ of land more or l""~· e~duding the e:-:.istir.g right of way ,,··~·:"'A"'"····· ,•''''c" x-.r ,..... : 1'•.() '•, ~)i~4;t? : l LS-1126 i ~ \ (~·-.:(~~~~/~ / -.,,-1-,:,'·-.., •••• ··~o~.· '•,,,,,.. SUR'~\,,••' ., ...... The Cmmty is purcha,ing this permanent public rignt-of-way easement for the pl.irpase of erecting or irrprovlns a public rO The Landowner, its heirs, or assigns sl1 S·muid one or more of the Larldown"rs be natural person~ not JOined by their respecti~e spouses, 1! •s conclusively presumed that the land conve~d is not the res•dence or business homestead of such Landowner(s). Should one or r10re of the grantors be a legal onl1ty other lhan a r~atural person, ~shall be condt;sively presumed that the person signing on behalf of that party has been duly a.1d legally authoriLed to so sign and there shal1 be no r~ecessity for" ,cal or at!estaHan. This Permammt Publ•c Right-of-Way Easement shali run 'Nlth the lamJ and iJe binding upon ths grantees, tess~s, sucwssors, and 8!;l;igns of the p01rf1es ;Jf:lreto, unless terminated by the abandonmer1t of the Public Rigllt-of-W<~y Easement by the Courty. Easement No. 4 ProJeCt No. S-121042.00 IN WITNESS WHEREOF, Said JXlrties of lhe first part haV'l;l hereunlo sel their hallds the day and ye<:lr fil"6t ab0'11< written. ~z:.~ cJ,_pjW.i,iJd~,_~---- STATE OF KANSAS, COUNlYOF SHAWNEE, ss. BE IT REMEMBERED, that or; this J.S~ay of Jon~ 2019, before me, the UllCersignad, a notary public in end for the County and State aforesaid, came Alan L. HQIIhaU'il and Vickie A. Holthaus, Trustees of"T!rt~ Hollhaus Revocable Uvlng Trusr', personally known W me to be the same persons wflo executed the wrthin rnstrument of writing, and soo11 persons duly ack.rlowleo;lged ltle execution of the same. IN WITNESS WHEREOF, I have hereunto set my hand and affiXed my: ootsrial seal, the day anC ''" '"' ''"' ""'" ..,() ji .tlt? ~· ~__j I My commission expires: JatJr.J~ J.l .ADl.-3 I Shawnee County Office of County Clerk CYNTHIA A. BECK 785-251-4155 Fax 785-251-4912 200 SE 7"' Street Room 107 www.snco.us. Topeka, Kansas 66603-3963 MEMORANDUM TO: Board of Cou~ Commissioners FROM: CynthiC~eck, County Clerk RE: Litigation DATE: July 10, 2019 Please acknowledge receipt of Summons for the following cases in the District Court of Shawnee County, Kansas: CASE NO: 2019CV000464 Branch Banking and Trust Company vs. Board of Commissioners of Shawnee County, Kansas et. al. CASE NO: 2019CV00047B Wells Fargo Bank NA vs. Board of Commissioners of Shawnee County, Kansas et. al. which were received in the office of the Shawnee County Clerk and forwarded to the County Counselor on this date. Attachment ELECTRONICALLY FILED 2019 Jun 25 AM 10:06 Branch Banking and Trust Company CLERK OF THE SHAWNEE COUNTY DISTRICT COURT' VS, CASE NUMBER 2019-CVfiOD$6L'l\ t,-_cni~-J;:c;E,-f:-f"'w'""""'~-@-0- Travis Lightle- Deceased et. al. 1' 1,------; r-'" I SUMMONS 1:, 1[l I I :u U JUL a 2019 Chapter 60 - Service by the Sheriff I I ~~A-~v-;;,-,!,-E-C-_Gu-r-~iTY ci~RK / To the above-named DefendanURespondent: Board of County Commissioners for Shawnee County 200 SE 7th St Topeka,KS 66603 You are hereby notified that an action has been commenced against you in this court. You are required to file your answer or motion under K.S.A. 60-212, and amendments thereto, to the petition with the court and to serve a copy upon: Shawn Michael Scl1arenborg 4210 Shawnee Mission Pkwy Ste 203A Fairway, KS 66205 within 21 days after service of summons on you. Clerk of the District Court Electronically signed on 06/26/2019 02:45:32 PM Documents to be served with the Summons: PLE: Petition Petition for Foreclosure of Mortgage ELECTRONICALLY FILED 2019 Jun 25 AM 10:06 CLERK OF THE SHAWNEE COUNTY DISTRICT COURT CASE NUMBER: 2019-CV..000464 Shawn Scharenborg, KS # 24542 Sara Pelikan, KS # 23624 Dustin Stiles, KS # 25152 Kozeny & McCubbin, L.C. (St Louis Office) 12400 Olive Blvd., Suite 555 Sl Louis, MO 63141 Phone: {314) 991..0255 Fax: (314) 567.a006 K&M Ale Code:UGTRB6T IN THE DISTRICT COURT OF SHAWNEE COUNTY, KANSAS Branch Banking and Trust Company, Case No. Plaintiff, Div. No. ___ vs. Travis L. Lightle (Deceased} Serve at: No Summons to Issue Topeka, KS 66606 Unknown Heirs, Devisees and Legatees of Travis L. Lightle Serve at No Summons to Issue Topeka, KS 66606 John Doe Unknown Occupant Serve at: 1829 SW 2nd Street Topeka, KS 66606 Jane Doe Unknown Spouse of Travis L. Lightle Serve at: 1829 SW 2nd Street Topeka, KS 66606 Patricia Lightle Serve at 1900 SW Lincoln Street Topeka, KS 66604 1 ------· ------·------~------John Doe Unknown Spouse of Patricia Lightle Serve at 1900 SW Lincoln Street Topeka, KS 66604 Terry Lightle Serve at 41 0 NW 43rd Street Topeka, KS 66617 Jane Doe Unknown Spouse of Terry UghHe Serve at: 410 NW 43rd Street Topeka, KS 66617 The Board of County Commissioners, Shawnee County Serve at 200 SE 7th Street Topeka, KS 66603 Defendants. Pet~ion Pursuant to K.SA Chapter 60 PETITION FOR FORECLOSURE OF MORTGAGE COMES NOW, Plaintiff, Branch Banking and Trust Company, and for its cause of act.ion against the Defendants states as follows: 1. Plaintiff is a corporation dllly organized and existing by virtue of Jaw. 2. Venue is proper In this District by way of the subject matter, i.e., the foreclosure of a mortgage on certain real estate located In the County of Shawnee, State of Kansas. 3. On or about December 29, 2011, Travis L Ligh11e (Deceased) {hereinafter "Borrower(s)1 borrowed money from, execLrted and deliVered to Cspttol Federal Savings Bank, a Note, payable in monthly installments, in the original principal sum of $76,509.00, together with interest as stated. A true and correct copy of the Note is attached and incorporated by reference as if fully set forth as Exhibit 1. 2 ·---·------~- ---~-~------~------. ELECTRONICALLY FILED 2019 Jul 01 AM 10:31 CLERK OF THE SHAWNEE COUNTY DISTRICT COURT' CASE NUMBER: 2019-CV-000478 Shawn Scharenborg, KS # 24542 Sara Pelikan, KS # 23624 Dus1in Stiles, KS # 25152 Kozeny & McCubbin, L.C. (St. Louis Office) 12400 Olive Blvd., Suite 555 St. Louis, MO 63141 Phone: (314) 991-0255 Fax: (314) 567-8006 K&M File Code:RICOEN04 Wells Fargo Bank, National Association, Case No. not in its individual or banking capacity, but · N0 solely as Indenture Trustee for Mortgage Dill. · -- Lenders Network Home Equity Loan Trust, Series 1999-1, Plaintiff, vs. Denise L. Richards Serve at: 2005 SW McAllister Ave Topeka, KS 66604 RichardT. Richards Serve at: 2005 SW Mcalister Ave Topeka, KS 66604 John Doe Unknown Occupant Serve at: 2005 SW McAlister Avenue Topeka, KS 66604 The Board of County Commissioners, Shawnee County Serve at 200 SE 7th Street Topeka, KS 66603 Defendants. Petition Pursuant to K.S.A. Chapter 60 1 PETITION FOR FORECLOSURE OF MORTGAGE COMES NOW, Plaintiff, Wells Fargo Bank, National Association, not in its individual or banking capacity, but solely as Indenture Trustee for Mortgage Lenders Network Home Equity Loan Trust, Series 1999-1, and for its cause of action against the Defendants states as follows: 1. Plaintiff is a corporation duty organ!zed and existing by virtue of law. 2. Venue is proper in til is District by way of the subject matter, i.e., the foreclosure of a mortgage on certain real estate located in the County of Shawnee, State of Kansas. 3. On or about January 29, 1999, Denise L. Rlchards, RichardT. Richards [hereinafter "Borrower(s)1 borrowed money from, executed and delivered to Mortgage Lende~ Network USA, Inc., a Note, payable in monthly installments, in the original principal sum of $48,000.00, together with interest as state,d. A true and correct copy of the Note is attached and incorporated by reference as If fully set forth as Exhibit 1. 4. As a part of the loan 1ransaction and in order to secure payment of the Note, Borrower(s} executed and delivered to Mortgage Lenders Network USA, Inc., a Mortgage of the same date upon the following described real estate: LOT 53, BANCROFT ADDITION TO THE CITY OF TOPEKA, SHAWNEE COUNTY, KANSAS. known and numbered as 2005 SW McAlister Avenue, Topeka, KS 66604. The Mortgage was duly recorded on February 5, 1999, in the Offrce of the Register of Deeds of Shawnee County, Kansas, in Book 3298 Page 109. The Mortgage tax was paid. A true and correct copy of the Mortgage is attached and incorporated by reference as if fully set forth as Exhibit 2. 5. Wells Fargo Bank, National Association, not in Its Individual or banking capacity, but solely as Indenture Trustee for Mortgage Lenders Network Home Equity Loan Trust, Series 1999-1 i.s the current legal holder of the debt, and possesses an rights, including the right af enforcemen1 2 of the Note and Mortgage. A true and correct copy of the Assignment of Mortgage is attached and incorporated by reference as if fully set forth as Exhibit 3. 6. Borrower(s) have failed and refused to make the payments as provided for in the Note and Mortgage, and said contracts are delinquent and the last payment received was the paymerrt due June 3, 2018 and Borrower(s) remains due for all payments and interest from that date fornard. For this reason, the Note and Mortgage are in default and Plaintiff has elected to accelerate tMe maturity date of the contracts pursuant to their terms and declare the entire indebtedness due and payable as follows; a. the unpaid principal balance due on the Note in the sum of $34, 153.14; b. the unpaid interest accruing at 10.75000 percent per annum from June 3 2018; 1 c. any accrued late charges; d. any amount paid by Plaintiff for property inspections, BPOs, maintenance expenses, insufficient funds charges, or other escrow advances, if applicable; e. all sums paid by Plaintiff for bankruptcy attomey fees and court costs, if applicable; f. all sums advanced or to be advanced by Plaintiff prior to sale for real estate taxes and hazard insurance premiums; g. all sums advanced by Plaintiff for service fees, title expenses, plus the costs of this action, including reasonable attorney fees, if allowable. 7. Due to the defauH in payment of the Note and Mortgage, Plaintiff is entitled to foreclosure of its real estate Mortgage and the amount found to be due and owing declared a first and prior lien on the real estate, that the Court find that less than one-third (1/3) of the original indebtedness secured by the Mortgage has been paid, and that the redemption period should not exceed three (3) months from the date of the Sheriff's Sale, pursuant to K.S.A. 60-2414(m}. 3 1[L. Shawnee County Health Department 1~ linda K. Ochs, Director 2600 SW East Circle Dr., Topeka, KS 66606 Public Health Prevent. Promote. f'roteot. Ph. 785.251.5600 I Fax 785.251.5696 www.shawneehealth.org Shawaee Count]' Health Dep... tment July 10,2019 TO: Board of County Commissioners of the County of Shawnee, Kansas FROM: Linda K. Ochs, Director CX!?o RE: CONSENT AGENDA - Update of the Centers for Medicare and Medicaid Services 855B Provider Emollment Action Requested: Approval of the Centers for Medicare and Medicaid Services (CMS) 8SSB Medicare EnroUment Application to update the authorized official for the Shawnee County HeaJtb Department (SCHD) with WPS Government HeaJth Administrators to provide Medicare Part B seiTices. The CMS mandates that each enrolled provider or supplier must update its application for change of ownership or control, including changes in authorized officials or delegated officials in order to bill and receive reimbursement for services provided. This application is specific to Part B services billed by SCHD. Note to Commissioners: The Social Security numbers and Dates of Birth will be added to the application prior to mailing it to CMS. LKO/kjo Attachment C: Betty Greiner, Director of Administrative Services Edith Gaines, SCHD Finance Officer Healthy People- Healthy Environment- Healthy Shawnee County SECTION 17: SUPPORTING DOCUMENTS Thi.s section lists the documents that, if applicable, must be submitted witl1 this enrollment application. If you are newly enrolling, or are reactiv<~ting or revalidating your enmllment, you mll~t provide all applicable. documents. For changes, only submit documents t!"lM are applic<~ble to that change. The fee-for-set·vice contrnctor may request, at any time during the enrollment process, documentation to suppo1·t m· validate information reported on the application. The Medicare fee-for .'iervice contrador may also l'equest documents from you, other than those identified in this Section 17, as a1·e necessary to bill Medicare, MANDATORY FOR ALL PROVIDER/SUPPLIER TYPES 0" Written confirmation from the IRS confirming your Tax Identification Number with the Legal Business Name (e.g., IRS form CP 575) provided in Section 2. (NOTE: This information is needed if the applicant is enrol!ing their· pmfessional corporation, pwfe!monal associmion, or limited liability corporation with this application or enrolling as a sole p10prietm using an Employer Identification Number.)" 0 Completed Form CMS-588, fot· Electronic Funds Transfer Authorization AgLeement. (NOTE: If a supplier already receives payments elt:.ctronically and is not making a change to its banking information, the CMS-588 is not required.) MANDATORY FOR SELECTED PROVIDER/SUPPLIER TYPES 0 Copy(s) of all documentation verifying IDTF Supervisory Physician(s) proficiency and/or State licenses or certification for IDTF non-physician personnel. 0 Copy(s) of all documentation verifying the State licenses or certiftcattons of the labmutory Director or non-phy£ician pmctitioner personnel of an Lndependent dinicHI1~:~boratory. MANDATORY, IF APPLICABLE 0 Copy of IRS Determination Letter, if suppli~r is registered with the IRS as non-pwfit. 0 Written confirmation fmm the IRS confirming your Limited Liability Company (LLC) is automatically classlfiect as a Disregarded Entity. (e.g., FOt"m 8832). (NOTE: A disregarded entity is ao eligible entity that is tr~ated as an entity not separate from its single owner for income tax pmposes. 0 St(t!emen! in wr·iting from the bank. If Medic~re payment due R Sllpplier of sen, ices is being sent to a b~nk (or similar financial institution) with whom the supplier has a lending relationship (that is, any type of loan), the[] the supplier must provide a statement in writing from the bank (which must be in the Joan agreement) that the bank has agreed to waive its right of offset for Medicare receivables. 0 Copy{s) of all final adverse action documentatio[] (e.g., notifications, resolutions, and rei11statement letters). D Completed Form(s) CMS 855R, Rea~signment of Medicare Benefit.~. 0 Completed Form CMS-460, Medicare Participating Physician m· S1rpplier Agreement. D Copy of an attestation for government ent1tie~ and tribttl organizations. D Cupy of FAA 135 certificate (air ambulance suppliers). 0 Copy(s) of comprehensive linbility insurance policy (lDTFs only). A<:~ording to the Paperwork Reduction A~t of 1;195, no pn>on~ are required to respond to a col!~ctlon of informatlo11 u11less it displays~ ~~~lid OMB control m•mber. The ~alid OMB control number for this information collection i• Cl93B- 0685. The time required to complete thi~ inform~tion collection is estimated to 5 hours per respon~e. in~ludirlg the time to review irmructions, search e~isting data re~ources, gather the data needed, and comp:ete and review the Information collection. If you have any comments conceming t.~~ accuracy of th~ t.-m~ estimate(s) or sugge:otion:o for improving this form, ple CMS·8SS~ ((17111) MEDICARE ENROLLMENT APPLICATION Clinics/Group Practices and Certain Other Suppliers CMS-8558 SEE PAGE 1 TO DETERMINE IF YOU ARE COMPLETING THE CORRECT APPLICATION. SEE PAGE 2 FOR INFORMATION ON WHERE TO MAIL THIS APPLICATION. SEE PAGE 35 TO FIND A LIST OF THE SUPPORTING DOCUMENTATION THAT MUST BE SUBMITTED WITH THIS APPLJCATION. CAdS UflrERJ lu M£r/K411t I M#IKAIIJ f!/iVKlf f)lffl Apprcvod OMEI 1\10_ ogJS-0665 DEPARTMENT OF HEALTH AND HUMAN ~~RVICEI EXJllros: ~IIJ19 CENTERS fOR MEDICARE & MEDICAID nRVICJ:I WHO SHOULD SUBMIT THIS APPLICATION Clinics and groLlp practices can apply for enrollment in the Medicare program or make a change in their enrollment information using either: • The Internet-based Provider Enrollment, Chah1 and Owner~hip System (PECOS), or • The paper enrollment application process (e.g., CMS 85.5B). For additional information regarding the Medicare enrollment process, including Internet-based PECOS, go to http :I /www .c ms .g ov/ Medica reProvf d erS>tp Enroll. Clinics and gmup practices who are enrolled in the Medicare program, but have not submitted the CMS 855B since 2003, are required to submit a MedicaJe enrollment application (i.e., Internet-based PECOS or the CMS 855B) as an initial application when reporting a change for the first ~ime. The following supplier:, mu5t complete this application to initiate the enrollment process: Ambulance Service Supplier Mammography Center Ambulatory Surgical Center Mass Immunization (Ro~ter Biller Only) Clinic/Group Practice P~rt B Drug Vendor Independent Clinical Laboratory Portable X-ray Supplit:J Independent Diagnostic Testing Facility (IDTF} • Radiation Thernpy Center lnte.nsive Cardiac Rehabilitatton Supplier If your supplier type is not listed above, contact your designated fee-for-service contractm before you submit this application. Complete and submit this application if you are an organization/group that plans to bill Medicare nnd you are: A medical practice or clink that will bill for Medira1·e Part B services (e.g., gmup practices, clinics, independent laboratones, portable x·ray supplier~}. A hospital or other medical practice or clinic that may bill for Medicare Part A services but will also bill for Medicare Part B practitioner services or provide pw-chased laboratory tests to other entities that bill Medicare Part 8. Currently enrolled with a Medicare fee-for-service contractor but need to enroll In another fee-for-service conb·actor's jurisdiction (e.g., you have opened a practice location in a geographic territory serviced by another Medicare fee-for-serv1ce contnJCtor). Currently enrolled in Medicare and need to malte changes to your enrollment dotn (e.g., you h~we added or changed a practice location), Changes must be reported in accordance with the timeframes established in 42 C.F.l\. § 424.516(d). (IDTF changes of mfonnation mu~t be reported in accordance with 42 C.P.R.§ 41033) BILLING NUMBER INFORMATION The National Provider Identifier (NPI) is the standa1d unique health identifier for health care providers and IS assigned by the National Plan and Provider Enumeration System (NPPES). As a Medicare health supplier, you must obtain an NPI prior to emo11ing in Medicare or bef(lre submitting a change for yom· existing Medicare enro11ment information. Applying for an NPI is a process separate from Medicare enrollment. As a supplier, it is your responsibility to determine if you have "subpam ," A subpru lis a component of an organization (supplier) that furnishes healthcare and is not itself a legal entity.lf you do have subpH.rls, you mu~t determine if they should obtain their own unique NPis. Before you complete this enrollm~nt application, you need to make those determinations anrl obtain NPI(s) ~ccordingly. CMI-S5~B 1~'111) Important; For NPI pm·poses, sole proprietors and sole propridorships are considered to be "Type 1" providers. Organizati()m (e.g., corpllt'atious, pa1·tnerships) are treated as •~Type 2" entities. When reporting the NPI of a sole proprietor on thls appHcntlon, therefore, the indlviclnaFs Type 1 NPI should be reported; for organizations, the Type 2 NPI should be furnished. To obtain an NPI, you may apply online at https:/iNPPES.cms.hhs.f!.OV. For more infmmation about subparts, visit www.cms.gov/Nationa/ProvldemStand to view the "Medicru·e El'pectations Subparts Paper." The Medicare Identification Number, often referred to as a Provider Tnmsaction Access Number (PT AN) or Medicare "legacy" number, is a generic term for any number other than the NPI that i.~ used to identify a Medicare suppiler. INSTRUCTIONS FOR COMPLETING AND SUBMITTING THIS APPLICATION Type or print all information so that it is legible. Do nol use pencil. Report additional informatton within a section by copying and completing that section for each addit1011al entry. Attach all required supporting documentatio;l. Keep a copy of your completed Medicare enrollment package fm your L-ecords. Send the completed application with original signatures and all required documentation to your de~ignated Medic11re fee-for-service contractor. AVOID DELAYS IN YOUR ENROLLMENT To avoid delays in the enrollment process, you should· Complete all required sections. Ensure thnt the legal bu~iness name shown in Sectlan 2 matches tbe name on the tax documents. Ensure that the correspondence address shown in Section 2 is the supplier's address. Enter your NPI in the applicable sections. Enter all applicable dates. Ensure that the con·ect person signs the application. Send your application and all supporting documentation to the designated fee-for-service contmctor. ADDITIONAL INFORMATION For additional information t·egarding the Medicare enrollment process, vi~il www.cms.gov/ Medicare?roviderSupEnmll. The fee-for-service contractor may request, at any time during the enrollment process, documentation to suppO!t and validate information reported on the application. You are responsible for providing this documentation in a timely manner. Certain infmmation you provide on this application is con~idered to be protected under 5 U.S .C. Section 552(b)(4) ;md/or (b)(6). respecllvely. For mote infmmation, see the last p<"-ge of this application for the Privacy Act Statement. MAIL YOUR APPLICATION The Medicare fee-for-service contractor (also referred to as a ctu-rier or a Medicare administrative contractor) th NEW ENROLLEES AND THOSE WITH A NEW TAX ID NUMBER If you are: Enrolling in the Medic ENROLLED MEDICARE SUPPLIERS Reactivation To react1vate your Medicare billing privlleges, submit this emollment application. In addition, prior to belng t·eactivated, you mu~t be able to submJt a valid claim and meet all current requirements for your supplier type before reactivation m~y occm. Voluntary Termination A supplier should voluntarily terminate ;t~ Medicare enrollment when it: Will no longer be rendering services to Medicare patients, or Is planning to cease (nr has ceased) operations. Change of Ownership If a hospital, ambulatory surgical center, or portable X -ray supplier is undergoing a change of ownersbip (CHOW) in accordance with the principles outlined in 42 C.F.R. 489.\8, the entity must submit a new application for the new ownership. Change of Information A change of information should be submitted if you are changing, adding or deleting information under your cmTent tax identification numbel'. Changes in yo11r existing enrollment data must be reported to the fee-for-service contractor in accordance w1th 42 C.F.R. § 424.516 (Physician ;md Non Physician Practitioner Organizations). (IDTF changes of information must comply with the provisions found at 42 C.F.R. § 410.33.) If you are already enrolled in Medicare and <'l:·e not receiving Medicare payments via EFT, any change to your enrollment information will .require you to submit a CMS-588 form. All futme payments will then be made via EFT. Revalidation CMS may reqmre you to submit or upd<~te your enrollment information, The fee-for-service contractor will notify you w~en it is time for you to revalidate your enrollment information. Do not submit 3 revalidation application until yo11 have been contacted by the fee-for-service contractor. CM5-85"SS (07111\ SECTION 1: BASIC INFORMATION ALL APPLICANTS MUST COMPLETE THIS SECTION (See instructions for detaifs.) A. Check one box and complete the required sections. - REQUIRED SECTIONS REASON FOR APPLICATION BILLING NUMBER INFORMATION - 0 You are a new enrollee in Enter your Medicare Identtfication Complete all applicable Medicare Number (if issued) and the NPI you sP.ctiom would like to !ink to this nltmber in Ambulance suppliers must Section 4. complete Attachment 1 IDTF suppliers must complete Attachment 2 -- Complete all applicable 0 You are enrolling in Enter your Medicare Identification another fee-for-service Number (iflum:d) and the NPT you sections contractor's jurisd idion would like to link to this number in Ambulance suppliers must Section 4. complete Attachment 1 IDTF suppliers must complete Attachment 2 0 You are reactivating your Enter your Medicare Identification Complete all applicable Medicare enrollment Number (lji.T.m~d) and the NPI you sections would !ike tu link to this number in Ambulance suppliers must Section 4. complete Attachment 1 Medicare identificalior; Number(s) IDTF suppliers mu~l complete (if i~su~d): Attachment 2 National Provider Identifier (if rssued): Effective Date of Termin~tion: Sections 1, 2Bl, 13, and either 0 You are voluntarily terminating your 15 or 16 Medicare enrollment. (Th1s Medicare Identification Number(s) to If you are terminatir.g an (if issued): is not the ~arne os ''opting Term111<1te employmenl arrangement out" of the program) with a physician a~sistant, National Providet Identifier (if Issued): complete Sections 1A 1 2G, 13, and either 15 or 16 ~ CMS-ll55B (01111) SECTIO N 1: BASIC INFORMATION rcontlnued) ALL A PPLICANTS MUST COMPLETE THIS SECTION (See instructions for details.) A. Chec k one box and compl!!t!! the required sections. REQUIRED SECTIONS REAS ON FOR APPLICATION BILLING NUMBER INFORMATION Medicare ldentifi ' !' ! ' ' ' ' :' i ! ' i' i ' i ! i i CM\·8550 (0 7111) ' !' i ' SECTION 1: BASIC INFORMATION (Continued) B. Check illl that apply and complete the required sections· REQUIRED SECTIONS 1, 2 (complete only those sections that are chunging), 3,13 1 at1d either 15 (if you are an authorized official) (E] Identifying Information or 16 (if you are a delegated official), and 6 for the signer tf that authorized or delegated official has not been established for this supplier - 1, 2Bl,3, 13, and either 15 (if you are an authorized officlal) or 16 (if you are a delegated offidal), and 0 Final Adverse Actions/Convictions 6 for the signer if that authorized or delegated official has not ·C)een established fm this supplieJ 1, 2B1, 3,4 (complete only those sections that are D Practice Location lnformation, Payment changing), 13, and either 15 (if you are an authorized Address & Medical Record Storage official) aL· 16 (if you are a delegated offici<~ I), and Information 6 for the signer if that authorized or delegated official has not been est~blished for this suppliet' D Change of Ownersllip (Hn~pitah, Pot table Complete all sections and X-Ray Suppliers & Ambulatory Surgical provide a copy of the sales agreement Centers Only) 1, 2Bl, J, 5,13, and eithet- 15 (if you are an authorized 0 Owner.~ hip fnterest and/or Managing official) ot·16 (if you are u delegated official), and 6 Control Information (Organi:.:atians) far the signer if that authorized or delegated official has not been established for this supplier - 1,2B1,J, 6, 13, and either 15 (if you are ~m atlthorized [!)Ownership Interest and/or Managing Control official) or 16 (if you art> a delegated offici 1, 2Bl, 3, 13, 15, 16, nnd 6 for the signet· if that D Delegated Official(s) (Optional) delegated official has not been established for this Stlpplier. - CMS-S~5~ (07111) SECTION 1: BASIC INFORMATION (Continued) ATTACHMENT 1: AMBULANCE SERVICE SUPPLIERS (ONLY) REQUIRED SECTIONS 1, 2Bl, 3,131 and 15 if you are the authorized official or 16 if you are the 0 Geographic Area delegated official Attachment l(A) I, 2Bl, 3, 13, ond 15lfyou an~ the authorized official Ol' 16 if you nre the 0 State License Information delegated official Attachment l(B) 1, 2Bl, 3, 13, and 15 if you a:·e the authorized official or 16 if you are the 0 Paramedic Intercept Services Information delegated official Atlachment l(C) -- 1, 2Bl, 3, 13, and 15 if you are the authorized official or 16 if you are the D Vehicle Information delegated official Attachment l(D) -~ ATTACHMENT 2: INDEPENDENT DIAGNOSTIC TESTING REQUIRED SECTIONS FACILlTIES (ONLY) 1, 2Bl, 3, 13, and 15 if you are the authorized offtcial or 16 if you are the D CPT-4 and HCPCS Codes delegated official Attachment 2(B) 1, 2Bl, 3, 13, and 15 if you are the authorized official or 16 lf you are the 0 lntet]Jreting Physic1an Information delegated official Attachment 2(C) - 1~ 2Bl, 3, 13, and 15 if you are the authorized official or 16 if you are the D Personnel (Technicians) Who Perform Tests delegated official Attachment 2(D) 1, 2Bl, 3, 13, and 15 if you are the authorized official or 16 if you are the D Supervising Physician(s) delegated official Attachment 2(E) - 1, 2B1, 3, 13, and 15 if you are the authorized official or 16 if you are the D Li A. Type of Supplier Check lhe appropriate box to identify the type of supplier you are enrolling as WJth Medicare. If you are more than one type of SllpiJlier, st1bmit a separate ~pplication for each type. ff you change the type of servrce tf'.at you p:·ovide (i.e., become a dJffe1ent supplier ~ype), submit a new application. Your organization must meet all Federal ~.nd State requirements for the type of supplier checked below. TYPE OF SUPPLIER: (Check one only) D Ambulance Servtce Supplier D Mass Immunization (Roster Biller Only) D Ambulatory Su:·gical Center D Pharmacy li:l Clinic/Group Practice C P~ysical/Occupational Therapy Group in 0 Hospital Departrnent(s) Private Practice 0 Independent Clinical Laboratory 0 PoH<~ble X·ray Supplie1' 0 Illdependent Diagnostic Testing Facility 0 Radiation Thenpy Center D Intensive Cardiac Rehabilit:1tion D Other (Specify): 0 Mammography Cen'.er B. Supplier Identification Information 1. BUSINESS INFORMATION Legal Busine~s Name (not the "Doing B~slness As" na~e) as reported to the lntemal Re11enue Servi(e Shawnee County Tax ldentlti,ation Number 48602B759 Other Name Type of Oti"'er Ncme Shawnee County Heal~h Department D Former Lege~ Business Name 0 Doing Business As Ncme D Other (Specify): Identify how your business is regi~tered with the IRS, (NOTE: 1f your business is a Federcl and/or State governme:1t provider or supplier, lndiccte "Non-Profit" below.) 0 Proprietary jg] Non-Profit NOTE: If a c:heckbox indic<~ting Proprietary or non-profit status is not completed, the providerfsupplier will be detaulted to "PrQprietary." Identify the type of organi2ational structure of this provider/supplier (CI1eck one) 0 Corporation 0 L1mited Liability Company 0 Partnership 0 Sole Proprietor ~Other (Specify): Government Org. lncorpora tion Da.te (mmfdd!yyyy) (if applicilb/c) State Wl1en~ Incorporated (if appllcilble) 0813011855 Kansas Is this supplier an Indian Health facility enrolling with the designated Indian Health Service {IHS) Medi(are Administrative Contractor (MAC)? DYes ~No CMS·GSSBI07111) • SECTION 2: IDENTIFYING INFORMATION (Contliwed) 2. STATE LICENSE INFORMATION/CERTIFICATION INFORMATION Provide Jhe following information if the supplier has a Stnte license/cel'tification to operate as the supplier type for which you are enrolling. [ill State License Not Applicable Ucr:nse Number ------~11c,c1 ,~vv"hc,o,,cc1 ,,c,c,cd------ Effective ~ate (mmfddlyyyy) , Explration/Rr:new.a I Date (mm!ddtyyyy) Certification Information !ID Certification Not Applicable Certificatron Number State Where Issued Effective Date (mmlddlyyyy) Expiration/Renewal Date (mm!ddlyyyy) 3. CORRESPONDENCE ADDRESS Provide contact infonnation fm the entity or person li~tcd in Question 1 of this section. Once enrolled, the informat10n provided below will be used hy the fee-for-service contractor if it needs to COlllact you directly. This address cflnnot be a billing agency's address. Malii11g Addre!S Une 1 (Street Name <~nd Number) 2600 SW East Circle Drive S Mailing Address Line 2 (Suite, Room, etc.) CityfTown Stat~: Zlf' Code+ 4 Topeka Kansas 66606-2447 T~lcphone Number F~~ Number (if app/i{ab/e) E·mall Addre.11 (if app/ic~ble) (765) 251-5600 (785) 251-5697 haadmin@snc:o.us C. Hospitals Only 'This section should only be completed by hospi1als that are currently enrolled or en:nlling with a fee-for service contractor (the Part A Medicare contractor), and will be billing a fee-for-service contractor for Medicare Part B services, as follows: Hospitals f1at need depanmental billing nJJmbers to oill for Pan B practitioner services. Hospitals requiring a Part B billing number to pi'Ovirlc pathology services. Hospitals requiring a Medicare Part B billing number to provide purchased tests to other Medicare Part B bilkrs. If the hospitfll requires more than one departmental P~trt 8 billing number, list each department needing a number. lf yolll' organization is r10t a hospital, flnd believes it will need a Part B billing numbeJ·, contact the designated fee-for-service contractor to determine if this form should be submitLed. ' SECTION 3: FINAL ADVERSE LEGAL ACTIONS/CONVICTIONS This section captures information on final adverse legal actions, such as convictions, exclu~ions, revocations, and suspen~ious. All applicable final adverse legal actions must be repo:ted, regardles£ of whether nny recmd5 were expunged or any appeals are pending. Convictions I. The provider, supplier, or any owner of the provider or .-.upplier was, within the lEIS! IO years p1·cceding emollment or revalidation of enrollment, convicted of a Fedeatl or State felony offense that CMS has determined to be detrimental to the best interests of the program and its bcneficia!ies. Offenses include: Felony crimes against persons and other sim1lar crimes for which the individual was convicted, including guilty pleas and ~djudicated pre-tri~l diversions: financial crimes, such as extortion, embezzlement, income tax evasion, msunmce fnl.Lld and other similm crimes for which the individul:ll was convicted, including guilty pleas and adjudicated pre-!.rial diversions: any felony that placed the Medicare program or its beneficiaries at immediate ri.sk (such as a malpractice suit thai result:'> in a conviction of criminal neglect or misconduct); nnd any felonies that would result in a mandatory exclusion under Section ll2.8(a) of the Act. 2. Any misdemeanor conviction, under Feder~] or State law, related to: (a) the delivery of an item or service under Medicare or a State health care program. or (b) the abuse or neglect of a patient in connecti011 with the delivery of a health care !terr. or ~~rvice. 3. Any misdemeanor conviction, under Federal or State law, related to theft, fraud, embezzlement, breach of fiduciary duty, or other financial misconduct in connection with the delivery of a health care item or service. 4. Any felony or misdemeanor conviction, under Federal or State law, relating to the interference with or obstruction of any investigation into any criminal offense described in 42 C.P.R. Section 1001.101 OJ' 1001.201. 5. Any felony or misdemeanm conviction, under Federal o1 State law, relating to the unlawful manufacture, dtstriblltion, prescription, or dispensing of a controlled substnnce. Exclusions, Revocations, or Suspensions I. Any revocation m suspension of a license Lo provide health care by any State licensing f!Uthority. This includes the surrender of such a license while a fmmal disciplinary proceeding w~s pending before a State licensing authority. 2. Any revocation or suspension of accreditation. 3. Any suspemion or exclusion from participation in, or any sanction impo,~ed by, a Federal or State health car~ program, or any debarment from participation in any Federal Executive Branch procurement or non-procurement progntm. 4. Any current Medicare payment suspension under any MeCicare billing number. 5. Any Medicare revocation of any Medicare btlling number. CMS·655B 10711 I) SECTION 3: FINAL ADVERSE ACTIONS/CONVICTIONS (Continued) FINAL ADVERSE HISTORY 1, HRs your organization, under ~ny curr~nt m former name or business identity, ever had any of the final adverse actions listed on page 13 of this application imposed against it? 0 YES~Continuc Below !El NO-Sklp to SectJUn U 2. If yes, report each final adverse action, when it occuned, the f RESOLUTION FINAL ADVERSE ACTION DATE TAKEN BY ,_ CMS-ai5B (C7111) SECTION 6: OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (INDIVIDUALS) (Continued) A. Individuals with Ownership Interest and/or Managing Control-Identification Information If you are changing, adtiing, or deleting information, check the applicable box, furnish the effective date, and complete the appmpriille fields in this section . .. CHECK ONE 8l CHANGE DADO 0 DELETE . I DATE (mmlddlyyyy) 0111412019 I . . The name, date of birth, and social security number of each person listed in this Section must coincide with the individual's information as listed with the Social Security Administration. t'irst N<~tne Middle Initial Last Name JL, Sr., etc ITitle Rober1 E. Archer BCC Chairperson Date of Birth (mmtdd!yyYYT- Place of Birth (State) COlint -,,-,~f~B"irth Social Security Number (Required) Medio;are Identification Number (!"f issued) NPI- (if issued) - - What IS the above md1111dual's relat1onsh1p with the supplier 1n Sect1on 281? (Check all that apply.) D 5 Percent or Greater Direct/lnd1rect Owner D Director/Officer [gl Authorized Official D Contracted Managing Employee 0 Delegated Official 0 Managing Employee (W-2) D Partner What is the effective date this owner acquired ownership of the provider identified in Section 2B 1 Qf this applicrttion? (r•ollldd(YY.>)'J ~ N A __ What i:; the effective date this individual acquired managing control of the provider identified in Scclion 2B I of this appl!cation? (r 11111 1dd!yyyy)<".01~1~14~1~2~0~19-______ NOTE: Furnish both dates if applicable. CM5·855~ J07f1"] SECTION 6: OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (INDIVIDUALS) (Continued) B. Final Adverse Legal Action History Complete this section for the individual repmied in Sec\ion 6A above. If Jeporting a change to extsting infonmHion, check "change," ptovide the effective date of the change and complete the ~tppmpri 2. If YES, repoft each final adverse legal action, when it occuned, the Federal or State agency or the cour!/adrninistrative body thflt imposed the Hction, and the resolution, if any. Attach a copy of the final adve!'se legal action documentation and L-esolution . . RESOLUTION FINAL ADVERSE LEGAL ACTION DATE TAKEN BY -----·--- . . SECTION 5: OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (INDIVIDUALS} (Continued) A. Individuals with Ownership Interest and/or Mansging Control-Identification Information If you ~1·c changing, adding, or dele!ing i:-tfmmation, check the applicable box, furni:.h tl1c effective date, ~ncl complete tlw appropriate fielcis i11 tbi~ Hectiun CHECI< ONE 0 CHANGE 0 ADD IX! DELETE --+------1------1-----~----j 01!14/2019 DATE (mmldC/yyyy)______l ______j __ The name, date of bi1·th, rmd social secUI'ity number of each person listed in this Section m\\st coincide with the individ\lHI's information as listed with the Social Secmity Atiministu1tion. Jr .. Sr., etc. Title First Name jMiddle \nJtial Lo~t Name Buhler BCC Chairperson Michele ; A. Country of llirth ·)a':e ot 9irth (mmtddlyyyy) I~l~ce of Birth (Staii") NPI (if issued) -5~d;,l Secur<1y Number rReqi.Jired) Medicare Identifies lion Number (if im,;erJ) ---~--- --~What 1s the above md1v1dual s relat1onsh1p w1th the $Uppiler 1n Sect1on 2B17 (Check a!l that apply.) 0 5 Percent or Greater Dil"ettllndirect Owner 0 Director/Officer L§ Autho~ized Offici.:.] 0 Contracted Managing Empioyee 0 Managing {W-2) D D~legated Official Employee 0 Partner What is the effectiv~ dale tl1is owner acquired ownership of the provider identified in Section 2B 1 of this <~ppl i-.:ali011? (mmiddly)yy) ____J!f J.J:'!----~-----~ Whnt i~ the effcc:ive date this individual ncquired managing cor'drol of the provide1· identified in Section 2B l or !]·,is ~pplic!ltion? (mm!dd!yyyy) 0"./0912_0"1"2'------~ NOTE: Fumi~h both dotes if ~1pplicoble. CMS·OSJB [01111) SECTION 6: OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (INDIVIDUALS) (Continued) B. Final Adverse Legal Action History Complete this secli:m for tbe individual reported in Section 6A above. If reporting a change to existing information, check "clumge," provide the effective date of the change and complete the appropri~te fields in this section. 0 Change Effedive Date: ______I. Has this individml in Section 6/\ nbove, under any current or former name or business identity, ever had a final adverse legal action listed on page 13 of this application imposed against him/her? I 0 YES-Con~inue Below 1};1 NO-Skip to Section s] 2. If YES, teport each final advene legal action, when it occurred, the Federal or State agency or the co,Jrt/administrative body that impo~ed che ~ction, ~nd the resolution, if any. Attnch a copy of the final aC:verse legal action documentation and resolution. ~ RESOLUTION FINAL ADVERSE LEGAL ACTION DATE TAI ~ CMS.8~SO 10711\) SECTION 6: OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (INDIVIDUALS) (Continued) A. Individuals with Ownership Interest and/or Managing Control-Identification Information If you are changing, adding, or deleting information, check the applic~ble box, furnish the effective date, (lnd complete the appropriate fit:lds in this section. ,------~------, [iiJ DELETE CHECI< ONE 0 CHANGE OADD 06/3012016 DATE (rr:mlddlyyyy! The name, date of birth, and social security number of each person listed in this Section must coincide Wlth the individual's information as listed with the Social Security Administration. Jr., Sr., et~. Title Flrlt N8me Middle Initial La~t Name Aile!! V. Weingar1ner Country of Birth Date of Birth (mmlddlyyyy) Place of Birth (StilteJ Social Sewrit\1 Number (Reqwlred) Medicare !dentific~tion Number (d i~rued) NPI (,'f issued) Wh/11 is the above individual's relationship with the supplier in Section 2817 (Check all that apply.) 0 5 Percent or Gre~ter Direct/Indirect Owner 0 Director/Officer D Autho"iz.ed Offiw;l D Contracted Managing Employee D Delegated Official lEI Managing Employee (W"2) 0 Partner What is the effective date this [}Wner acquired ownership of the provider identified in Section 2B 1 of this applic~tion? (m111itfd!yyyy} ------What i£ the effective date th1s individual acquired managing control of the provider identified in Section 2R 1 of this application? (mm!ddJyyyy) c'o'""~o,t,20,1c"c,------ NOTE: Fmnish bolh dates if applicable. CMS-855E (0711\) SECTION 6: OWNERSHIP INTEREST AND/OR MANAGING CONTROL INFORMATION (INDIVIDUALS) (Continued) B. Final Adverse Legal Action History Complete this senion for the indi~·idual reported in Section 6A above. If reporting R change to existing information, check "change," provide the effective date of the change and complete the appropriate fields it\ this section. 0 Change Etfective Date:: ______ 1. Has this individu~l in Section 6A above, under any current or former name or business identity, ever had a fin21l adverse legal action listed on page 13 of this application imposed ag<~inst him/her? 0 YES-Cor1tinue Below [81 NO-Skip to Section 3 2. If YES, rcpmt each final adver~e legal action, when it occurred, the Federal or State agency or the court/administrative body that imposed the action, and the resolution, if any. Attach a copy of the final adverse legal action documentation and re~olution. RESOLUTION FINAL ADVERSE LEGAL ACTI~J DATE TAKEN BY I ,I ! I l CMI·SSIH [07/1 I) SECTION 13: CONTACT PERSON If question~ arise during the processing of this application, the fee-for-service contractm will contact the individual shown bdow. If the contact person is either an authorized or delegated official, check the appropriate box below. D Contact an Authorized Official listed in Section 15. 0 Contact a Delegated Official listed in Section 16. Jr., Sr., etc. First Name Middle lniti~i Last Name Kathy Or~ ega -~-- E-mail Add res; (if appiioble) To:lephone Number Fax Number (if app.ficable) kathy. ortega@s r~co. us (785) 251-5662 (785) 251-5697 " Address L1ne 1 (Street Name and Number) 2600 SW Eas\ Circle DriveS Address Line 2 (SUire, Room, et,.) ZIP Code+ 4 City!Town IStale I Kansas 66606-24<17 Topeka SECTION 14: PENALTIES FOR FALSIFYING INFORMATION This section explains the penalties for deliberately hlsiiying information in this application to gain or maintain enrollment in the Medicare program. I. 18 U.S.C. § 1001 authorizes criminal penalties against an individual who, in any matter within the jurisdtction of any department or agency of the United States, knowingly and willfully falsifies, conceals or covec·s up by any trick, scheme or device a material fact, or makes any false, fictitious or fraudulent statements or representations, or makes any false writing or document k:wwing the same to contain <1ny false, fictitious or fr<~udulent statement or entry. Individual offenders are subject to fines Gf up to $250,000 and imprisonment for up to five years. Offenders that are organizations are subjec:t to fines of up to $500,000 (18 U,S.C. § 3571). Section 357l(d) also authorizes fines of up to twice the gross gain derived by the offender if it is greater tban the amount specifically authorized by the sentencing statute. 2. Section J 12RB(a)( 1) of the Social Security Act authorizes criminal penalties against any individual who, "knowingly and willfully," makes or causes to be made any false statement 01 representation of a material fact in any appllcation for ~ny benefit or payment under a Federal health caie progn1m. The offender is subject to fines of up to $25,000 and/or imprisonment for up to five years. 3. The Civil False Claims Act, 31 U.S.C. § 3729, impogcs civil liability, in p<1rt, on any person who: a) knowingly present~. or causes to be presented, to an officer or .any employee of the United States Govemment a fahe or fraudulent clalm for payment or approval; b) knowingly make~. uses, or causes to be made or used, a false record 01' statement to get a false or fraudulent claim paid or approved by tile Govemment; or c) conspires to defraud the Government by getting a false ar fnmdulent claim nllowed or paid. The Act imposes a civil penalty of $5,000 to$ lO ,000 per violation, plus three times the amount of damages sustained by the Govemment. SECTION 14: PENALTIES FOR FALSIFYING INFORMATION (Continued) 4. Section 1128A(a)(l) of the Social Security Act imposes civil liability, in part, on any perwn (includ ing an organization, agency or othe1 entity) that knowingly presents or causes to be presented to an officer, employee, or agent of the Untied States, or of <~ny depaJtment or agency thereof, or of any State agency, .. a claim, , .that the Secretary detcrmines is for a medical or other item or service that the person knows or should know: a) wu~ not prov-ided as claimed: and/or b) the clc.im is false or fnmdulent. This provision authorizes a civil monetary penalty of up to $\0,000 for each item or service, an asse~sment of up to three times the amount chimed, and exclusion from participation in the Medicare program and State he•1llh care programs. S. 18 U.S.C. 1035 fluthorizes criminal pen<1lties <~gainst tndividuals in any matter involving fl health care benefit program who knowingly and willfully falsifies, conceals or covers up by any trick, scheme, or device a material fact; or makes any m~terially false, tlctitious, or fraudulent statements or representations, or makes or uses any materially false fictitious, or fraudulent statement or entry, Ln connection with the delivery of or payment for health care benefits, items or services. The indi vidual shall be fined or imprisooed up lo S years or both. 6. 18 U.S.C. 1347 authoriz;es criminal penalties agamst individur~ls who knowing and willfully execute, or attempt. to executive a scheme or artifice to defraud any health care benefit program, or to obtain, by meam of false or fraudulent pretenses, representations, or promi3es, any of the money or pmperty nwned by Ol' under Lhe control of any, hca~th care benefit program in connection with the delivery of or pllyment for health care benefits, items, or services. Individuals shall be fined· or imprisoned up to 10 years m both. If the violation results in serious bodily injury, an individual will be fmed or imprisoned up to 20 years, or hoth. If the violation results in death, tbe individual shall be fined or imprisoned for any term of ye:1rs or for life, or both, 7. The government may assert common law claims such as "common lllW fraud," "money paid by mistake," and ·•unjust enrichment." Remedies include compensatory and punitive damages, testitution. ::~nd recovery of the amount of the unjust profit. CM~·85Sii (07/ll) 29 SECTION 15: CERTIFICATION STATEMENT An AUTHORIZED OFFICIAL means an appoinced official (for example, chief executive officer, chief finc.ncial officer, general p~rtner, chairman of the board, or direct owner} to whom the organization has granted the legal authority to enroll it in the Medicare program, to make changes or updates to the organization's status in the Medicare program, and to commit the organization to fully abide by the statutes, regulations, and program in~tructions of the Medicare program. A DELEGATED OFFICIAL means an individual who is delegated by an authorized official the o.uthority to report changes and updates to the supplier's enrollcnent record. A delegated official must be <1n individual with an "ownership or control interest" in (as that term is defined in Section li24(a)(3) of the Social Security Act), or be a W-2 managing employee of, the supplier. Delegated offictals may not de~egate their authority to any other individual. Only an authorized official 1T.ay delegate the authority to make changes and/or updates to the supplier's Medicare stntus. Even when delegated official~ are reported in this application, an authmized officittl retains tile authority to make any such changes and/or updates by providing his or her printed name, stgnature, and date of signature as required in Section \SE. NOTE: Authorized off1ciah and deleg<\led officials must be :·eported in Section 6, either on this application or on a previous applicc.tion to this same Medicare fee-for-service contractor. If this is the first time an authorized and/or delegated official has been reported on the CMS-85SB, you must complete Section 6 for that individual. By his/her signature(s), an authorized official binds the supplier to all of the requirements listed in the Ce1·tification Stutemer.t and acknowledges that the wpplier may be denied entry to or revol £ACH AUTHORIZED AND DELEGATED OFFICIAL MUST HAVE AND DISCLOSE HIS/HER SOCIAL SECURITY NUMBER. CMS·BSSB {07/11] SECTION 1 S: CERTIFICATION STATEMENT (continued) A. Additional Requirements for Medicare Enrollment These at·e additional requirements that the supplier must meet and maintain in order to bill the Medicare program. Read these tequirements carefully. By signing, the supplier is attesting to having read the requirements and undel·standing them. By his/her signature(s), the authori7.ed official(s) named below ~nd the delegated official(s) named in Section 16 agree to adhere to the following reqeirements stated in this Certttlcation Statement: 1. I authorize the Medicare contractor to verify the information contained herein. I agree to notify the Medicare contnctor of uny future changes to the information contained in this application in accordance with the timeframes established ~n 42 CF.R. § 424.516. I understand that any change in the business structure of this ~upplier may require the S'Jbl1'.1ssion of a new applit:ation. 2. l have read and understand the Penalties for Falsifying Information, as printed in this application. l understand that any deliberate omission, misrepresentation, or falsification of any inf01mation contained in this application m contained in any communication supplying infotmfltion to Medicare, or any delibe1·ate alteration of any text on this application fo1m, may be punished by criminal, civil, or administrative pen~.lties including, but not limited to, the denial or revocation of Medicare billing pt'ivilcges. Md/or the imposition of fines, civil damages, and/m imprisonment. 3. I agree to abide by the MedicaL·e laws, regulations and program instructions that apply to thi~ supplier. The Medicare law.~, regulations, and program instructions are available through the MedicHre contractor. I understand that payment of a claim by Medicare is conditioned upon the claim and the underlying transaction complying with ~uch laws, regulations, and progt·am instructions (including, but not limited to, the Feder~.\ anti-kickback statute and the Stark law), and on the supplier's compliance with all applicable conditiom of participation in Medicare. 4. Neither this ~upplier, nor any five percent or greater owner, partner, officer, directm, managing employee, authorlzed official, or delegated offki 5. l agree that any e:r.tsting or future overpayment m<1dc to the supplier by the Medicare program 1nfly be recouped by Medicare through the •vithholding of future payments, 6. I will not knowingly present or cause to be presented a false or fraudulent claim for payment by Medic<~re, and I will not submit claims with deliberate ignorance 01 reckless di.negard of their truth or hlsity. 7. I authorize any muional accrediting body whose standards are recognized by the Secretaiy as meeting the Medicare program participation requiremer.ts, to release to any authorized representative, employee, or agent or the Centers for Medicare & Medicaid Services (CMS) a copy of my most rece'11 !lccreditation survey, together with nny information related to the survey that CMS may require (including corrective action plat1s). CMS-S5SS (07fll) " Apprc'lled as to Legality a Form: Date7-'7-/j SELDA SECTION 1S: CERTIFICATION STATEMENT (Continued) B. 151 Authorized Dffidal Signature I have read the content£ of thi~ application. My signRture legally a[]d financially binds this .supplier to the lliws, regulations, and program instruc~ions of the Medicam program. By my signature, I certify that !he information contained herein is true, conect, and complete and I authorize the MeCicare fee~ for-service contractor to verify this ill formation. If I become aware that my information in this application is no! lr:ue, cnrrect, or complete, I agree to notify the Medicare fee-for-~ervice contractor of this fact in accordance with the time frames establisl1ed in 42 CFR § 424.516. If you are changing, adding, or deleting information, check the applicable box, furnish the effective date, and complete the appropriate fields in this sec~ion. ,------,------,------,------~ ,l__ c_H_E_c_K_o __ N_E __r- __ --~__ c_H_A_N_G __ E _____I_, _. _____o__ A_o_o ______~ ______o__ oE_l_E_TE ______~ I__ DATE (mmldc!/yyyyJ --~-0_1_11_41~01_9 _____L_~ ______[ ______j =~~------'A0u,t"h"o~r"iz,e"d~O~ft i cia I' s In formation and 5i g nature Fir1t Name Mlddl~ ~ast Name Initial Robet1 E. Archer .----~~------£- Telepf'lone Number Title/Position - --- (785) 251-4471 Board of County Commission Chairperson Authori~ed Official 5i9nature (Fir5t; MiddlE, Last NamE, Jr .. Sr.. M.D., 0.0, etc_) Date Signed (mmlddlyyyy) I ' (blue ink pretP.rred) C. 2~ 0 Authorized Official Signature I have read the contents of this application. My signt~ture legally and financially binC:E this supplier to the laws, regulations, and pmgram inEtructions of the Medicare program. By my signature, I certify that the information contained herein is true, correct, and compJere :;nd I authorize the Medicare fee" for-service contractor to verify this infOimation. If 1 become aware that any information in this application is not true, correct, or complete, I agree to notify the Medicare fee-for-service contractor of this fact in accordance w:th the time frames established in 42 CFR § 424.5!6. If you are changing, adding, or deleting information, check the applicable box, furnish the effective date, and comple:e the appropriate fields in this set:tian. ,------,------r--.------r------CHECK ONE 0 CHANGE i OADD 0 DELETE f------4--- --·-- - - -. --·------+------DATE (mmlcici!yyy;J Authorized Offidal's Information and Signature Flr~t Nsme Suffi~ (e.g., .lr., 5r.) Telephor1e Number Title/Position Authorized Otfkial S'gnature (first, MJdd/e, L~st N<~mc, Jr.. Sr., M.D., D 0., ~tc) D All s'gnatLJres must be orlg,nal ar~d ~'gned In l~k (blue Ink pr<>ferred). Application~ with ~ignatures deemed not onglnal will not be pmcused. Stamped, faxed or copi!!d signatures will not be accepted. " ',, )'n I'!>PlW l'a·far- to 1 o21157H'IIill N~v. 29; ZOO<> LT-R : sHA\ \~o re.ce.~v~Q ybur 1"~<\uesi: d ·\~h~noYer )loll Wl'iio 1 ~l!}!I.S!l J.~p].wde ti\:lS lottat'.!iltldi ~n tho .s;J!IC:6S "below, Q"l.l'tl l/$ :;Ot1r telellllone numPnl' ·with ~he hPUrs w~ c.<~h r.nach you, ',A_ls-oJ y~u IIIIIY want to keetl !1 oopy c·P Ui.ls laHar foJ' :vour l'~oords, Hnurs__.,.... ~--'--- .·.' ... . SHAWNEE COUNTY SOLID WASTE DEPARTMENT 1515 N.W. SALINE STREET., SUITE 225 • TOPEKA, KANSAS 66618-2868 785-233-4774 FAX 785-251-4929 Curt F. Niehaus, P.E. Director of Solid Waste MEMORANDUM Date: July 9, 2019 To: Board of County Commissioners From: Curt F. Niehaus, P.E. § ~/d<..c...l Director of Public W~ s~~ W;;: Re: Approval of Request to hire a Director of Solid Waste at an annual base pay of $95,000. Board of County Commissioners (BCC) <:~pproval to advertise & fill: AprilS, 2019 via Exhibit A of Resolution 2019-17. Since obtaining approval from the BCC to advertise and fill the position of Solid Waste Director, the County received sixteen applications of which fifteen applicants were interviewed. Of these first round interviews, four applicants were selected for a second interview with Solid Waste management. After this lengthy interview process, an applicant has recently been selected and a conditional offer has been extended. The preferred applicant (William "Bill" Sutton) has over 30 years ofleadership and management experience in both the militazy and the civilian private sectors, including six years in the landfill industry. Considering Mr. Sutton's past experiences and responsibilities, an annual salary of$95,000 (not including benefits) is requested. Funding for this expense will come from the Solid Waste Budget. With the addition of a dedicated Solid Waste director, that portion of the present director's salary paid by Solid Waste can, at some point, be transferred back to Public Works. The net result of the roughly cancelling effect of the two salaries will be no unacceptable impact to Public Works' budget. Although the most basic function of the Shawnee County Solid Waste Department (SCSWD) is curbside refuse collection and recycling, there are a number of complex issues "behind the scenes" that need to be solved before collection takes place, When considering the uncertainty in the future of recycling, the latest trends and developments in the methods of efficient refuse collection, and ever more stringent environmental requirements, it's imperative that the SCSWD have a dedicated director who can provide effective leadership going forward. I believe Mr. Sutton will provide that leadership. Thank you for your consideration uf this request. BILLStmON 34:1 NE 60111 Terrace Topeka, KS 66617 Cell: 281 745-5396 [email protected] QHJEQ"IVE Seeking a position as Director of Solid Waste in Shawnee County SUMMARY OF QUALIFICATIONS A dynamic leader that is mission focused with over 31 years of leadership and management experience culminating at the executive level in both the military and civilian sector. Proven to succeed in fast paced, complex environments with exceptional results Supervised and evaluated up to 500 personnel of different cultural and national backgrounds Documented fast learner both academically and occupationally Proficient in all Microsoft Office Suite EXPERIENCE September 2015- Current District Manager Waste Management Topeka, KS • Manage day-to dily operations; wmply with all star~dards enforted by the Federal, State, and Local authorities. • Review monthly f'&L reports to ensure accuracy and budgetary compliar~ce. • Assist in capital planning and project mar~agementto ensure all projects are completed under budget. • Increase financial performance by optimizing operations and fleet operations to achi~e a higher EBIT over prior year. • Establish good working rapport with all customers to ensure good communications and lr~creased safety awareness. • Establish safety program to prevent accider1t and injuries through training and employee buy in. April 2013-September 2015 District Manager Waste Management Russellville, KY • Managed day-to day operations in a ~hallenglng end-of-site life facility. Managed the site into closure and two final capping projects. • Formulated both short-term and lorlg-term goals and action plans In corljunctlon with the Director of Operations. • Maintained performance and prodL.~ctlvity me tries and cost management processes. Reviewed safety, service, and other operational problems with the sales, service and maintenance functions to maintain a high level of customer satisfaction and profitability. • Developed, Implemented, and maintained processes, procedures, and programs to Improve safety and productivity. • Assisted in the prevention of accidents and injuries by conductirlg regularly scheduled safety meetings, alerts, and tailgate meEltings. • Investigated all Injuries and Incidents, fallowing-up with coMistent disdplinec and retralnlr~g. • Complied with all standards enforced by the Federal, Stilte, and Local authorities, as well as the Department of Environmental Quality (DEQ)_ March 2012- April2013 Disposal- Operations Management Trainee Waste Manageml'nt Okeechobee, Fl • El June 2011- February 2012 Asymmetric Warfare/Counter-lED Sergeant Major US Army Fort Riley Kansas • Developed scope of work, secure the bid for construction and provided QAjQC for a training site e~epansion project • ln5tituted a comprehensive training progrilm for 10000 personnel • Coordinated training across multiple agencies ranging from local to niltionallevel June 2009- May 2011 Protection Sergeant Major US Army Fort Riley Kansas /Iraq • Managed and directed daily operations of 100 personnel while deployed in a combat environment • Managed the development and execution of il complex certification project to help the Port of Umm Qasr achieve international port certification standard. • Developed project timelines to bring the Basnh International Airport to ICAO standards • Saved over $300k by desi!!ning and re-utilizing existing facilities to construct a multi-use facility January 2008- May 2008 Administrative and Loglstks Operations Center NCOIC US Army Afghanistan • Developed Innovative methods of logistical shipments across Af!!hanistan • Reor!!anized fleet vehicle maintenance facility that yielded an increased maintenance efficiency • Synchronized information flow and communications across nine satellite locations January 2007- December 2007 First Sergeant US Army Fort Riley Kan~as I Afghanistan • Planned and managed daily operations of 150 personnel in a challenging environment • Trained and implemented a logistical delivery element which greatly aided in mission accomplishment • Revamped the organization's 85 vehicle maintenance program that reduced the maintenance down time of vehicle fleet significantly August 2006 - December 2006 Command Sergeant Major US Army Fort Riley Kansas • Was the senior advisor for over 420 personnel and responsible for the development of 140 mid-level managers • Established a comprehensive safety program that resulted in zero reportable accidents • Ensured the organization was trained to succeed in the mission May 2006-August 2006 First Sergeant US Army Fort Riley Kansas • Focused on team development of a 90 personnel organization • Displayed outstanding judgment in assisting the reorganlz<~tlon of the organization EDUCATION Southwestern Colle!!€, Winfield l United States Army Sergeants Major Academy, Fort Bliss, Texas, 2009 Executive Management, Public Speaking, and Strategic-level Decision Making Academic Honors Semar Leadership Course, Fort leonard Wood, Missouri, 1999 Management, leadership, and Administrative Procedures Honor GradLJate Drill Sergeant School, Fort leonard Wood, Missouri, 1996 Personal counseling, Instructional techniques, and interpersonal communication Academic Honors Sapper Leadership Course, Fort leonard Wood, Missouri, 1993 Small Unit leadership Training and Specialized Military Trainin!! Honor Graduate Advanced leadership Course, Fort Leonard Wood, Missouri, 1991 leadership Training and Speciallze