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DSHS Contract Amend 2
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2018-07-17 10:00 AM - Commissioners' Agenda
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DSHS Contract Amend 2
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Last modified
8/29/2018 12:15:02 PM
Creation date
8/29/2018 12:14:56 PM
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Meeting
Date
7/17/2018
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Alpha Order
e
Item
Request to Approve Amendment 2 to Contract #1763-98187 with the Department of Social & Health Services, Developmental Disabilities Administration
Order
5
Placement
Consent Agenda
Row ID
46299
Type
Agreement
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This Contract between the State of Washington Department of Social and Health Services (DSHS) and the <br />Contractor is hereby amended as follows: <br />1. The Total Maximum Contract Amount is hereby decreased in the amount of ($8,442) for a new <br />Contract Amount of $826,847. The decreased amount is reflected in the attached amended Spend <br />Plan. <br />All other terms and conditions of this Contract remain in full force and effect. <br />EXHIBIT B <br />Program Agreement Budget <br />D Original Budget X Budget Revision <br />REVENUES <br />Fiscal <br />Year Fund Source Original 1st Revision 2nd Revision 3rd Revision <br />2018 State Only 413,416 421,051 <br />Waiver <br />Local <br />Medicaid Match to <br />Local <br />Total Rev . $820,341 $835,289 $826 ,847 <br />Fiscal <br />Year Fund Source Original 1st Revision 2nd Revision 3rd Revision <br />2019 State Only <br />Waiver <br />Local <br />Medicaid Match to <br />Local <br />Total Rev . <br />COUNTY FY 2018 SPENDING PLAN <br />I <br />- <br />Planned Expenditures <br />Local PASRR Medicaid <br />Funds Funds State Funds Funds TOTAL <br />ADMINISTRATION 98 <br />(CMIS/AWA BARS 11) 29697 24298 54093 <br />OTHER CONSUMER <br />SUPPORTS I <br />(CMIS/AWA Code 31, 32, 41, <br />92, 93,94) 27754 22708 50462 <br />CONSUMER SUPPORT . II <br />I <br />STATE-ONLY 464 6312 6776 <br />Child Development <br />DSHS Central Contract Services Page 2 <br />6024PF Contract Amendment (1-26-2018)
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