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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date <br />12/13/2018 <br />Fund/Department <br />116-Public Health <br />Contra ct/G rant Information <br />Agenda Date <br />Contract /Grant Agency: PSA between Elmview and KCPHD (DD program) <br />Period Begin Date: 01/01/2019 I I Period End Date: 08/31/2019 <br />Total Grant/Contract Amount: Not to exceed $24,523.20 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />- <br />The Professional Services Agreement is established to provide a coordinated and comprehensive local <br />program of services for persons with developmental disabilities and to fulfill the county's responsibilities <br />as outlined in attachments. <br />Recommendation for Board of Health and Board of Health Review on <br />Date:/-/~ /1 <br />Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount$ TBD State Funds $ TBD Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# <br />In-Kind$ <br />Explain <br />Grant/Contract Review Page 1