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Kittitas County <br />Review Form <br />Grants & Contract Agreement # L/bD50 <br />Today's Date Agenda Date \)\to\lB 12/10/2018 <br />Fund/Department <br />116 -Public Health <br />Cont ract /Grant Information <br />Contract /Grant Agency : Washington State Association of Local Public Health Officials and Kittitas County <br />Public Health Department <br />Period Begin Date : 01/01/2019 I I Period End Date: 12/31/2019 <br />Total Gra nt/Co ntract Amount : $ Fee for service <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The Washington State Associate of Local Public Health Officials formalizes the understanding between <br />the Washington State Association of Local Public Health Officials (WSALPHO) and Local Health <br />Jurisdiction Kittitas County Public Health regarding the operation of the Medicaid Administrative <br />Claiming in Washington State . Attached is also the Business Associate Agreement needed to satisfy the <br />Health Insurance and Accountability Act. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signatu <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />AP P. DAS TO FORM : <br />Date <br />Signature of Board of Health member Date <br />Financial Information <br />I Total Amount$ no max I State Funds$ I Federal Funds$ no max <br />Grant/Contract Review Page 1