Laserfiche WebLink
uuuu5lgl I El lvcluPg lu' v I yuvunv' uJLnLVv-^- <br />Washington State <br />Health Care 0 r ty <br />for <br />Med icaid Ad min istrative <br />Claiming <br />INTERAGENCY AGREEMENT <br />Contractor Contract Number: <br />HCA Contract Number: K8630 <br />THIS AGREEMENT is made bY and between Washington State Health Care AuthoritY (HCA) and Kittitas <br />Chapter 39.34 RCW <br />County, (Contractor), Pursuant to the authoritY granted bY <br />CONTRACT START DATE <br />January 1,2026 <br />CONTRACT END DATE <br />December 31,2029 No Maximum <br />TOTAL MAXIMUM CONTRACT <br />AMOUNT <br />h <br />P <br />tn <br />Ju <br />U <br />n <br />The <br />th <br />time <br />provi <br />ave <br />e <br />sd <br />d <br />its <br />no <br />ES a <br />Med <br />or <br />RPOSE <br />staff <br />ictions <br />purpose <br />( <br />OF <br />L <br />icaid <br />of <br />c <br />spen <br />th <br />HJ <br />nadeq <br />d <br />process <br />u <br />is <br />appl <br />to <br />for <br />ate <br />ication <br />med <br />Wash <br />a <br />Contract <br />ONTRACT: <br />in <br />performing <br />partially <br />IS <br />ical <br />nd <br />to <br />gton <br />retm <br />cove <br />Medica <br />bu <br />renewal <br />rag <br />State <br />id <br />rsr <br />support <br />ng <br />Ad <br />M <br />mi <br />and <br />ed <br />n <br />the <br />tn <br />residents <br />cl <br />processes <br />caid <br />an <br />who <br />istrative <br />udes <br />d <br />live <br />Contractor <br />in <br />related <br />expl <br />Claim <br />for <br />king <br />ln <br />with <br />ing <br />all <br />ln <br />tng <br />the <br />its <br />outreach <br />m <br />the <br />u <br />(MAC <br />to <br />owable <br />and <br />a <br />a <br />in <br />nd <br />benefits <br />ctiviti <br />risdiction <br />Medicai <br />kage <br />d <br />of <br />es. <br />Th <br />he <br />reasonab <br />cove <br />ese <br />le <br />red <br />Med <br />activities pe <br />icaid <br />expen <br />activities <br />SES <br />servtces. <br />rformed <br />Th <br />assist <br />program <br />ts <br />by <br />Ag <br />associated <br />Local <br />assisti <br />residents <br />ng <br />with <br />reement <br />th <br />who <br />Health <br />e <br />them <br />CONTRACTOR CO NTRACT MANAGER <br />Candi Blackford <br />507 N Nanum Street, STE 102 <br />StreetADDRESScoNTRACTOR <br />CONTRACTOR NAM E <br />Kittitas CountY <br />CONTRACTOR T ELEPHONE <br />(509) 962-7515 <br />Citv <br />Ellensburg WA <br />State <br />STNESS AS (DBA)CONTRACTOR DOI NG BU <br />CONTRACTOR <br />cand i. bl ackford@co. kittitas.wa' us <br />L ADDRESSE-MAI <br />Zip Code <br />98926 <br />Medicaid Administrative Claiming <br />HCA PROG RAM <br />ER TELEPHONEHCA CONTRACT MANAG <br />(360) 725-1647 <br />Jon Brogger, Health Care Program Manager <br />ER NAME AND TITLTHCA CONTRACT MANAG <br />ms Division/CommunitY ServicesMedicaid Progra <br />HCA DIVISIO N/SECTION <br />wa <br />MAIL ADDRESSHCA CONTMCT MANAGER E- <br />Health Care AuthoritY <br />626 8th Avenue SE <br />Olympia, WA 98504 <br />ER ADDRESSHCA CONTRACT MANAG <br />The parties signing below warrant that they have read and understand this <br />contract. This contract will only be binding upon signature by both parties' <br />multiplecounterparts,eachofwhichisdeemedanoriginalandallofwhich <br />(electronicmail)transmissionofasignedcopyofthiscontractshallbethe <br />Contract, and have authority to execute this <br />The parties may execute this contract in <br />constitute only one agreement' E-mail <br />same as delivery of an original' <br />-["5^';- 1""t"^1"^" <br />IGNATUREH <br />by: <br />SIGNATURE PRI <br />L.U r rl <br />NTED NAME\Arr <br />fb&r-(/ <br />Andria Howerton <br />Deputy Contracts Ad ministrator <br />PRINTED NAME AND TITLE <br />tzlrv lLs <br />DATE <br />DATE <br />1112412025 <br />Washington State <br />Health Care AuthoritY <br />HCA IAA K8630 <br />Revised 0712023Page 1 of 35