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DSHS DDA Amendment 3
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2025-07-01 10:00 AM - Commissioners' Agenda
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DSHS DDA Amendment 3
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Last modified
6/26/2025 12:13:32 PM
Creation date
6/26/2025 12:12:33 PM
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Meeting
Date
7/1/2025
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve Amendment No. 3 to Agreement 2363-49241 between the Department of Social & Health Services and Kittitas County for Developmental Disabilities Admin. Services
Order
6
Placement
Consent Agenda
Row ID
132637
Type
Contract
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Exhibit 131 <br />Program Agreement Budget <br />Original Budget X Budget Revision <br />REVENUES <br />Fiscal Y <br />Year Fund Source Original 15' Revision 2"d Revision 3d Revision <br />2024 State only 431,255 563,959 <br />Medicaid 423,584 554,483 <br />Total Rev. $854.839 $1,118,442 $ $ <br />Fiscal <br />Year <br />Fund Source <br />Original <br />1 s' Revision <br />2"d Revision <br />3rd Revision <br />2025 <br />State only <br />441,594 <br />552,182 <br />Medicaid <br />441,759 <br />548,868 <br />Total Rev. <br />$883,352 <br />$1,101,050 <br />$ <br />$ <br />I <br />Account Title / BARS <br />ADMINISTRATION <br />11,12,13,14 <br />OTHER CONSUMER <br />SUPPORTS <br />31, 32, 41, 92, 93, 94, 97 <br />CONSUMER SUPPORT <br />STATE -ONLY 62, 64, 65, <br />67,69 <br />Child Development 61 <br />MEDICAID CLIENTS 62, <br />64, 65, 67, 69 95. 96 <br />MEDICAID PROVISO <br />ROADS to COMMUNITY <br />LIVING 62, 64, 65, 67, 69 <br />TOTAL <br />DSHS Central Contract Services <br />1769CP Contract Amendment (6-10-24) <br />FY24 <br />Job <br />Foundation PASRR <br />Funds Funds <br />336 1 <br />4800 <br />5,472 <br />State <br />Medicaid <br />Funds <br />Funds <br />TOTAL <br />52398 <br />42872 <br />95,606 <br />27783 22732 50,851 <br />360819 <br />360818 <br />726.437 <br />122774 <br />122774 <br />245,548 <br />563,774 <br />549,196 <br />1,118,442 <br />Page 3 <br />
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