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DSHS County Program Amendment
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2023
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05. May
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2023-05-16 10:00 AM - Commissioners' Agenda
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DSHS County Program Amendment
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Last modified
1/17/2024 10:05:47 AM
Creation date
1/17/2024 10:05:28 AM
Metadata
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Template:
Meeting
Date
5/16/2023
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
Item
Request to Approve Amendment No. 2 between the Department of Social & Health Services, Division of Developmental Disabilities and Kittitas County
Order
11
Placement
Consent Agenda
Row ID
103113
Type
Contract
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l- tscal <br />Year <br />r Fund S ource <br />2022 lstRe visionState o nl 2nd Revision <br />ion2rdRevisMedicaid <br />313,916 <br />Total Rev <br />$630 <br />Exhibit B1 <br />Program Agreement Budget <br />Originat Budget <br />REVENUES X Budget Revision <br />FY22 <br />toco LIVING <br />I Fiscal-_ <br />Year <br />I Fund Source <br />2023 lstRevis ionState o lon2ndRevis316,726 3rd R evisionMedicaid <br />Total Rev <br />$ <br />Job Fo unoation <br />Funds PASRR <br />Funds State Funds <br />Medicaid <br />Funds <br />S/A <br />AD MI NI STRA TION <br />cMl WA BARS 1 1 <br />22494 18405 <br />CONS UM ER <br />PSU PORTS <br />IS/ACM WA Code J 13214929394 <br />21 023 1720a <br />co NSU MER <br />LYSTATE.ON <br />SUPPORT <br />chitd nt <br />c LIENTS <br />48A0 <br />5,472 <br />[3 f ilfi?l.?il,iiJ,i.Tffi fi 2. 1 o.2 1 ) <br />Page 1g
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