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DSHS County Program Agreement
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2019
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08. August
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2019-08-20 10:00 AM - Commissioners' Agenda
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DSHS County Program Agreement
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Last modified
8/15/2019 12:45:43 PM
Creation date
8/15/2019 12:44:45 PM
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Meeting
Date
8/20/2019
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
g
Item
Request to Approve an Agreement between the Department of Social and Health Services and the Kittitas County Public Health Department
Order
7
Placement
Consent Agenda
Row ID
55882
Type
Contract
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Exhibit B <br />Program Agreement Budget <br />X Original Budget Budget Revision <br />REVENUES <br />Fiscal <br />Year Fund Source Ori inal 1St Revision 2"d Revision <br />2020 State only f 368,623 <br />Waiver <br />Total Rev. <br />Fiscal <br />Year Fund Source <br />2021 State only <br />Waiver <br />Total Rev - <br />3 d Revision <br />8,032 1 $ $ $ <br />riginal 1St Revision 2nd Revision 3rd Revision <br />$ $ $ $ <br />I <br />PASRR Funds <br />State Funds <br />Medicaid <br />Funds <br />TOTAL <br />ADMINISTRATION (CMIS/AWA <br />_BARS 11) <br />OTHER CONSUMER SUPPORTS <br />(CMIS/AWA Code 31, 32, 41, 92, <br />93,94) <br />26195 <br />21433 <br />47628 <br />24482 <br />20030 <br />44512 <br />CONSUMER SUPPORT <br />STATE -ONLY <br />Child Development <br />317946 <br />317946 <br />635892 <br />MEDICAID CLIENTS <br />ROADS to COMMUNITY LIVING <br />TOTAL <br />368,623 <br />359,4091 728,032 <br />DSHS Central Contract Services Page 24 <br />1769CS County Agreement 5-1-2019 <br />
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