Laserfiche WebLink
DOH Program Name or Title: Foundational Public Health Services (FPHS) -" <br />Elfective Julv iJ023 <br />Exhibit A <br />Statement of Work <br />Con tract Term : 2022-2024 <br />Local Health Jurisdiction Name: Kittitas County Public Health Department <br />Contract Number: CLH3l0l5 <br />SOW Type: Revision Revision # (for this SOW) 2 Funding Source <br />Federal <Select One> <br />State <br />Other <br />nXn <br />Federal Compliance <br />(check if applicable) <br />nn FFATA (Transparency Act) <br />Research & Development <br />Type of Payment <br />! Reimbursement <br />I Periodic Distribution <br />Period ofPerformance: July 1.2023 through June 30.2024 <br />StatementofWorkPurpose: PerRCW43.70.512,Foundational PublicHealthServices(FPHS)lundsareforthegovernmental publichealthsystem: local healthjurisdictions, <br />FPHS services statewide. <br />Revision Purpose: Conecting BARS expenditure code typo and updating Master Index Code Chart of Accounts Title to match the title in the new 2025 biennium chart of <br />accounts. <br />Exhibit A, Statenent of Work Page I of 5 Contract Number CLH3 l0l 5-Amendment l7 <br />DOH Chart of Accounts Master lndex Title <br />Master <br />Index <br />Code <br />Assistance <br />Listing <br />Number <br />BARS <br />Revenue <br />Code <br />LHJ Funding Period <br />start Date End Date <br />Current <br />Allocation <br />Allocation <br />Change <br />None <br />Total <br />Allocation <br />SFY24 FPHS-LHJ FLINDS.GFS 99210840 N/A 336.04.25 07/01/23 06t30/24 I.783,000 0 1.783 000 <br />0 0 0 <br />0 0 0 <br />0 0 0 <br />0 0 0 <br />0 0 0 <br />TOTALS 1.783.000 0 1.783.000 <br />Task <br />#Activity Deliverables/Outcomes Due Date/Time Frame <br />Payment <br />Information and/or <br />Amount <br />FPHS funds to each LHJ See below in Program Specific <br />Reauirements - Activity Special Instructions for details <br />See below in Prograrn Snecific <br />Requirements - Deliverables <br />See below in Progrart <br />Soecific Recuirements - <br />Deliverables <br />$s7s,000 <br />2 Assessment Reinforcing Capacity - See below in Prosram Specific <br />Reouirements Activitv Soecial Instructions for details <br />See below in Proqram Specific <br />Requirements - Deliverables <br />See below in Pro[ratn <br />Soecific Requirements - <br />Deliverables <br />$60,000 <br />3 <br />Assessment - CHA/CHIP See below in Prograrn Specific <br />Requirements - Activity Snecial Instructions for details <br />See below in Program Specific <br />Recuirements - Deliverables <br />See below in Program <br />Specific Requirernents - <br />Deliverahles <br />s30,000