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DSHS Contract Amend 3
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2018-07-17 10:00 AM - Commissioners' Agenda
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DSHS Contract Amend 3
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Last modified
8/29/2018 12:15:21 PM
Creation date
8/29/2018 12:15:15 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
f
Item
Request to Approve Amendment 3 to Contract #1763-98187 with the Department of Social & Health Services, Developmental Disabilities Administration
Order
6
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 increased in the amount of $801,577 for a new <br />Contract Amount of $1,628,424. <br />2. The Program Agreement end date is extended to June 30, 2019 . <br />3. Special Terms and Conditions, Section 8, Billing and Payment is amended as follows: <br />a . Program Agreement Budget: DSHS shall pay the County all allowable costs, which are defined by <br />DOA as costs incurred by the program for: <br />f. Program Administration : The County will provide program administration and may bill for <br />administrative costs up to the identified amount in Exhibit B. Administrative costs reimbursement <br />will not exceed 7% of the total combined allocation for Consumer Support and Other Consumer <br />Support services unless millage has been declared or the Assistant Secretary of ODA approves a <br />request for an exception under Chapter 388-850 WAC. Monthly claims for administrative costs will <br />be for allowable expenditures incurred or 1/12 of the maximum Administration amount identified in <br />Exhibit B, or the lessor of the two. <br />4. Exhibit B. Program Agreement Budget is hereby replaced with the following Budget Revision : <br />All other terms and conditions of this Contract remain in full force and effect. <br />EXHIBITB <br />Program Agreement Budget <br />D Original Budget X Budget Revision <br />REVENUES <br />Fiscal <br />Year Fund Source Original 1st Revision 2nd 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 <br />2019 State Only 408A62 <br />Waiver <br />Local <br />Medicaid Match to <br />Local <br />Total Rev . $801,577 <br />DSHS Central Contract Services <br />6024PF Contract Amendment (1-26-2018) <br />3rd Revision <br />3rd Revision <br />Page 2
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