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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date .----, Agenda Date <br />February 22, 2018 March 6, 2018 <br />Fund/Department <br />30/ Sheriff <br />Contract/Grant Information <br />Contract /Grant Agency: Family Healthcare of Ellensburg #SH17-040 <br />Period Begin Date: 1/1/2018 r I] Period End Date: 12/31/2018 <br />Total Grant/Contract Amount: $46,870 annual fee, to be billed monthly in the amount of $3,905.41. This <br />is a 3% increase over 2017. There was no increase between 2016 and 2017. <br />Grant/Contract Number: SH17-040 <br />Contract/Grant Summary: Professional services agreement for inmate medical care with Family Healthcare <br />of Ellensburg. Kittitas County is currently contracted with this local healthcare provider for inmate <br />medical services. <br />Financial Information <br />Total Amount $46,870 State Funds $0 Federal Funds $0 <br />Percentage County Funds 100% Matching Funds $0 CFDA# na <br />In-Kind $ <br />Explain <br />Is Equipment being purchased? NO Who owns equipment? na <br />New Personnel being hired? NO Contact HR hiring -reporting requirements -na <br />Future impacts or liability to Kittitas County: <br />Contractor must present proof of medical malpractice insurance of at least $1,000,000. <br />Budget Information <br />Budget Amendment Needed? Yes D attach budget form NoO Why not -In 2017 budget. <br />New Division Created? NO <br />Revenue Code NA <br />Expense Code 001-300954113 <br />Pass Through Information <br />Agency to Pass Through NA <br />Amount to Pass Through $0 <br />Sub-Contract Approved Date: <br />Grant/Contract Review Page 1