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Docusign Envelope lD: CCD36BBF-645D-4579-9C75-F803991 1CF89 <br />Participating in the Evaluatlon <br />Contractor will support the Evaluation of the lnitiative. HCA contracted with an independent <br />evaluator to evaluate the Waiver. The evaluator will use claims data from pre-release services <br />to assess the effectiveness of this lnitiative. The evaluator stores and analyzes the data in a <br />secure environrnent. Facilities that participate are consenting to the use of this claims data for <br />evaluation. Facility staff may also be asked to participate in qualitative interviews performed by <br />the independent evaluator regarding their experience participating in the lnitiative, to inform the <br />evaluation. <br />Washington State <br />Health Care Authority <br />2) Capacity Building <br />Application <br />Submission <br />Up to 40% of total RPP <br />funding upon approval: <br />Tier 2; Up to $500,000 <br />Up to <br />$500,000 <br />upon <br />approval of <br />the <br />Application <br />Due Date: October 1, <br />2024 <br />Funding Paid: December <br />1,2024 <br />3) Readiness <br />Assessment <br />$ubmission and <br />Approval <br />Up to 40% of total RPP <br />funding upon approval: <br />Tier2: Up to $500,000 <br />Up to <br />$500,000 <br />upon <br />approval of <br />the <br />Readiness <br />Assessment <br />Due Date: March 1,2025 <br />Funding Paid: July 1, <br />2025 <br />lmnlementation Milestones After Go-Live with Pre-Release Services <br />4) lnterlm Progress <br />Report Submission <br />Up to 5% of total RPP funding <br />upon submission: <br />Tier 2; Up to $62,500 <br />N/A Due Date: May 1,2026 <br />Funding Paid: July 1, <br />2026 <br />5) Final Progress <br />Report Submission <br />Up to 5% of total RPP funding <br />upon submission: <br />Tier 2: Up to $62,500 <br />N/A Due Date: November 1, <br />2026 <br />Funding Paid: January 1, <br />2027 <br />14 HCA Contract #R7843