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Amendment 2
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2024
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2024-08-06 10:00 AM - Commissioners' Agenda
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Amendment 2
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Last modified
10/8/2024 3:19:15 PM
Creation date
10/8/2024 3:19:09 PM
Metadata
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Template:
Meeting
Date
8/6/2024
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 2 to Agreement No. 2363-49241 between the Department of Social & Health Services and the Kittitas County Public Health Department
Order
15
Placement
Consent Agenda
Row ID
120774
Type
Agreement
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Exhibit B1 <br />Program Agreement Budget <br />Orlginal Budget X Budget Revision <br />REVENUES <br />FY24 <br />Fiscal <br />Year Fund Source Orioinal 1*iRevision 2nd Revision 3'd Revision <br />2024 State onlv 431,255 563.959 <br />Medicaid 423.884 554.483 <br />TotalRev $854.839 91.118.442 $$ <br />Fiscal <br />Year Fund Source Orioinal lstRevision 2nd Revision 3rd Revision <br />2025 State onlv 441.594 <br />Medicaid 441,759 <br />TotalRev s883.352 $$ <br />Account Title / BARS <br />Job <br />Foundation <br />Funds <br />PASRR <br />Funds r:ffi'TOTAL <br />ADMINISTRATION <br />11,12,13,14 336 95,606 <br />OTHER CONSUMER <br />SUPPORTS <br />31, 32. 41. 92.93. 94. 97 336 50,851 <br />CONSUMER SUPPORT <br />STATE-ONLY 62, 64, 65, <br />67. 69 <br />ffiffi* <br />Child Develooment 61 <br />MEDICAID CLIENTS 62, <br />64.65.67.09 95.96 4800 726,437 <br />MEDICAID PROVISO 245.548 <br />ROADS to COMMUNITY <br />LlvlNG 62.64.65.67.69 <br />TOTAL 5,472 563.774 549.1 96 1.118.442 <br />:']CItI:ii1 ltl <br />DSHS Central Contracl Services <br />1 769CP Conkact Amendment (6-1 0-24)Page 3
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