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Docusign Envelope lD: CCD36BBF-645D-4579-9C75-F803991 ICFBg <br />d. An ability to support communication with community providers and Medicaid <br />billing. <br />4. Milestones <br />The Contractor will develop and implement the following deliverables that execute the <br />Project Objectives. The Contractor will provide services and deliverables to perform all <br />activities necessary for or incidental to the performance of work as set forth under this <br />SOW and described in the Waiver to achieve progress on the following milestones. <br />Milestone 1 - Letter of lntent <br />Following the receipt of a Letter of lntent documentation and approval by HCA, Contractor <br />must meet the specifications outlined in the template provided to the Contractor as <br />determined by HCA for each of the following four milestones in order to receive funding and <br />participate in the next milestone. <br />Milestone 2 - Gomplete a Gapacity Building Application <br />The Capacity Building Application includes an lmplementation Plan and a detailed budget. <br />The lmplementation plan must describe how the facility will support pre-release services. <br />The detailed budget will represent a facility's formal application for capacity building funds <br />and will specify how capacity building funds will be spent by facilities on lT and non-lT <br />needs. Facilities in Cohorts 1 and 2 that identify the need for additional time to complete a <br />Capacity Building Application may implement after the go live date of that cohort or join a <br />subsequent cohort and complete milestones in-line with the deadlines for these cohorts. <br />Milestone 3 - Complete a Readiness Assessment <br />The Readiness Assessment report must include a framework for assessing facility <br />readiness to go-live as part of the lnitiative and will include an attestation that the facility is <br />ready to go-live. HCA will provide a template for the assessment and will review submitted <br />assessments and determine facility readiness prior to the go-live date for each facility. <br />Milestone 4 - Submit lnterim Progress Report <br />The Contractor will be required to submit an lnterim Progress Report to HCA with <br />information on the initial implementation of the lnitiative. HCA will provide a template for the <br />lnterim Progress Report and will review and approve submitted progress reports. <br />Milestone 5 - Submit Final Progress Report <br />The Contractor will be required to submit a Final Progress Report to HCA with information <br />on the overall implementation progress of the lnitiative and outcomes for clients. HCA will <br />provide a template for the Final Progress Report and will review and approve submitted <br />progress reports. <br />Milestones deadlines will be based upon the cohort a Facility participates in. Milestone <br />deadlines for Cohort 1 are as follows: <br />5. HGA Responsibilities <br />Washington State <br />Health Care Authority <br />Oct 1 2026Cohort I June 1 2024 Oc|1,2024 Mar 1, <br />2l <br />lmplement. <br />Plan <br />3)Readiness <br />Assessment <br />Go-live with <br />pre-release <br />soryices <br />4)lnterim <br />Progress <br />5) Final <br />Progress1)LOr <br />Re rt <br />12 HCA Contract #K7843