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State of Ohio - Controlling Board Request
STATE OF OHIO
CONTROLLING BOARD
30 East Broad Street, 34th Floor
Columbus, Ohio 43215-3457
(614) 466-5721 FAX:(614) 466-3813
OPERATING REQUEST Controlling Board No.
DMR0100455
Status:  Approved
Meeting Date:  2/26/2018

GENERAL INFORMATION
Agency
Department of Developmental Disabilities


Division/Institution
Department of Developmental Disabilities
Waiver of Competitive Selection  (Revised Code Section 127.16B)
      No Competitive Opportunity
      Agency Released Competitive Opportunity
Agency Released Competitive Opportunity (Revised Code Section 127.162)
Other Statutory Authority/Bill Section:
Operating Transfer Request  (Revised Code Section 127.14)
      Appropriation
      Cash
      Other Statutory Authority/Bill Section:
Fiscal Year(s)
2018
Bill No.
HB49
Eligible for OBM
Director Approval?
No

VENDOR INFORMATION
For FYAmountNameAddressCityStateCountyZip Code
DMR01 2018 $73,125.00 Dr. John A. Johnson 4913 Vaux Link New Albany OH Franklin 43054

FUNDING INFORMATION
Fund GroupFund CodeAppropriation Line ItemAppropriation Line Item NameFYAmountFYAmount
3A40 653654 Medicaid Services 2018 $73,125.00 $.00

SIGNATURES
     
John L. Martin 02/26/2018
   
Agency Director or Authorized Agent On The Date Of
   
01/26/2018 Christine Morrison
   
Date Controlling Board President/OBM Director
   
AGENCY CONTACT
Name:  Jerimiah S Wagner Title:  Legislative Liaison
Phone:  (614) 728 - 5311 Fax:  E-Mail:  Jeremiah.Wagner@dodd.ohio.gov
REQUIRED EXPLANATION OF REQUEST
  The Department of Developmental Disabilities respectfully requests Controlling Board approval to waive competitive selection in the amount of $73,125.00 for FY18 from fund 3A40, ALI 653654 (Medicaid Services), to amend the contract with Dr. John Johnson to continue providing psychiatric services to residents of the Columbus Developmental Center.  
  The Department of Developmental Disabilities is working to onboard Dr. Johnson with InGenesis, which is the managed service provider under contract thru DAS for all non-IT staff augmentation. In the interim, to ensure a continuity of service for the residents the Department is amending its personal service contract to allow the doctor to continue providing psychiatric services.  
   
Attachments Controlling Board Request No.: DMR0100455
Attachment TypeAttachment Description
Contract amendment Contract Addendum
 
Release and Permit Information
NameFYAmountR & P #R & P DateIssued ByComments
Dr. John A. Johnson 2018 $73,125.00 25K04913

Operating Request Required Information
Contract Amendment - Dr. John A. Johnson
Controlling Board Request No.: DMR0100455
1. Identify the contractor and provide the contractor's address of their principal place of business.
Dr. John A. Johnson
4913 Vaux Link
New Albany,  OH  43054
County: Franklin
   
2. Explain why the contract is being amended and the effect on the project or program.
To ensure a continuity of service for the residents the Department is amending its personal service contract to allow the doctor to continue providing psychiatric services.
   
3. Specify the deliverables of this contract or describe the scope of service(s) to be performed by this contractor.
The Contractor will be paid a rate of $195.00 per hour for the term of this contract to provide psychiatric service to residents of the Columbus Developmental Center.
   
4.
Cite the account category of expense being used for this purchase of service(s).
Account CategorySubobjectAmountNon-Exempt Amount
510051 $73,125.00 $73,125.00
Total Amounts $73,125.00 $73,125.00
   
5.
Provide the dates of previous Controlling Board approvals for this contract. Indicate whether the approvals were for the initial contract, amendments to this contract, or previous renewals for this contract. In addition to the
date(s) of Controlling Board approval, provide the following information depending upon the type of contract previously approved by the Controlling Board.
Initial Contract - Total amount of the initial contract or number of hours and the rate per hour.
Amendment - Total amount of the amended contract (initial + amendment) or total number of hours (initial + amendment) and the total rate per hour (initial contract + contract amendment + contract renewals within the biennium).
Renewal - Total amount of the renewed contract or the total number of hours and the total rate per hour.
CB Approval DateType of ContractAmount per FY# of HoursRate per Hour per FY
   
6. If this contract amendment affects the total amount of the contract or the total number of hours and total rate
per hour, provide the new rate information.
Total Contract Amount Total Number of Hours Total Rate per Hour FY

  $97,500.00

  500

  $195.00

18

7. Duration of this contract (beginning and ending dates) within the fiscal biennium, including amendment.
Beginning Date Ending Date  
07/01/2017 01/31/2018
8. Provide all subsequent renewal schedules (beginning and ending dates) and amounts associated with this contract.
Beginning DateEnding DateTotal Lease AmountFY2
  Explain contract provisions. 
9.
Provide the following employee information: Nationwide Ohio
Total Number of Employees 1    1   
Percentage of Women 0% 0%
Percentage of Minorities 0% 0%