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Docusign Envelope lD: CCD86BBF-645D-4579-9C75-FB0399'l 1CF89 <br />THIS AGREEMENT is made by and between Washington State Health Care Authority (HCA) and Kittitas <br />County Sheriffs Office (Contractor), pursuant to the authority granted by Chapter 39.34 RCW. <br />The parties signing below warrant that they have read and understand this Contract, have authority to execute this <br />Contract. This Contract will only be binding upon signature by both parties. The parties may execute this contract in <br />multiple counterparts, each of which is deemed an original and all of which constitute only one agreement. E-mail <br />(electronic mail) transmission of a signed copy of this contract shall be the same as delivery of an original. <br />Washington State 1 .-'l <br />Health Care /\fthority <br />INTERAGENCY AGREEMENT <br />for <br />Reentry Demonstration <br />lnitiative Project <br />HCA Contract Number: K7843 <br />Contractor Contract Number: <br />CONTRACTOR NAME <br />Kittitas County Sheriff's Office - Jail <br />GoNTRACTOR DOING BUSTNESS AS (DBA) <br />CONTRACTOR ADDRESS I Street <br />307 Umptanum Rd. <br />Facility: 205 W 5tt'; Suite 1, Ellensburg 98926 <br />Citv <br />Ellensburg <br />State <br />WA <br />Zip Code <br />98926 <br />CONTRACTOR CONTRACT MANAG ER <br />Sheriff Clay Myers <br />CONTRACTOR TELEPHONE <br />509-962-7525 <br />CONTRACTOR E-MAIL ADDRESS <br />clay.myers@co.kittitas.wa. us <br />HCA PROGRAM <br />Medicaid Reentry Demonstration lnitiative Project <br />HCA DIVISION/SECTION <br />1070/0MT <br />HCA CONTRACT MANAGER NAME AND TITLE <br />Emma Oppenheim, Medicaid Transformation Project Director <br />HCA CONTRACT MANAGER ADDRESS <br />Health Care Authority <br />626 8th Avenue SE <br />Olympia, WA 98504 <br />HCA CONTRACT MANAGER TELEPHONE <br />(360) 725-0868 <br />HCA CONTRACT MANAGER E.MAIL ADDRESS <br />emma.oppenheim@hca.wa.gov <br />CONTRACT START DATE <br />July 1,2024 <br />CONTRACT END DATE <br />July 31 ,2028 <br />TOTAL MMIMUM CONTRACT AMOUNT <br />$2,2s0,000.00 <br />PURPOSE OF CONTRACT: <br />To provide essential services for individuals while in or leaving a carceral facility (i.e., state prison, county/city jail, or <br />youth correctional facility). <br />CONTRACTOR SIGNATURE <br />gA? .?w?.L-1 <br />PRINTED NAME AND TITLE <br />cL..+ Y ln YE R:t *;tdrfufr <br />DATE <br />7 t z-a.l <br />HCA SIGNATURE <br />f-Slgned by; <br />ilv,:,rulL Sdmtr1^l'^rtr <br />PRINTED NAME AND TITLE <br />\nnette Schuffenhauer <br />Chief Legal Officer <br />DATE <br />8t1412024 <br />Washington State <br />Health Care Authority <br />Page 1 of 24 HCA IAA K7843