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12. December
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2020-12-01 10:00 AM - Commissioners' Agenda
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Last modified
1/11/2021 2:26:16 PM
Creation date
1/11/2021 2:25:58 PM
Metadata
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Meeting
Date
12/1/2020
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
s
Item
Request to Approve a Professional Services Agreement between Kittitas County Public Health Department and Community Health of Central Washington for Children and Youth with Special Health Care Needs.
Order
19
Placement
Consent Agenda
Row ID
69627
Type
Contract
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EXHIBIT ''A'' <br />SCOPE OF WORK <br />ln addition to providing all material and labor, the Contractor shall perform the following <br />services as detailed below: <br />Employ a registered nurse, fully licensed within the State of Washington to perform the work <br />described below within the Children with Special Health Care Needs Program, hereinafter,.CYSHCN". <br />This work shall include quarterly reporting (Exhibit E) and the following: <br />Professional Services Agreement <br />Page 13 of20 <br />Task/Activity/Descriptio n Del iverables/Outcomes Due Dateffime <br />Frame <br />Complete Child Health lntake Form <br />(CHIF) using the CHIF Automated <br />System on all infants and children <br />served by the CYSHCN Program as <br />referenced in CYSHCN Program <br />Manual. Ensure client data is <br />collected on all children served by <br />CYSHCN contractors, including <br />neu rodevelopmental centers, <br />regional maxillofacial coord inators, <br />and the DOH Newborn Screening <br />Program. <br />Submit CHIF data into Secure <br />File Transpo rt (S FT)website : <br />https://sft.wa.gov <br />1115121 <br />4115t21 <br />7115121 <br />10115t21 <br />Administer requested DOH <br />Diagnostic and Treatment funds for <br />infants and children per CYSHCN <br />Program Manualwhen funds are <br />used. <br />Submit completed Health <br />Services Authorization forms <br />and Central Treatment Fund <br />requests directly to the <br />CYSHCN Program as needed <br />30 days after <br />forms are <br />completed.
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