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Docusign Envelope lD: C1 90C649-709E-4E00-A409-4A1 6CEDBC800 THIS AGREEMENT is made by and between Washington County, (Contractor), pursuant to the authority granted by State Health Care Authority (HCA) and Kittitas Chapter 39.34 RCW. Washington State Health Care hority INTERAGENCY AGREEMENT for Med icaid Adm inistrative Claiming HCA Contract Number: K8630 Contractor Contract Number: CONTRACTOR CONTRACT MANAGER CandiBlackford CONTRACTOR ADDRESS 507 N Nanum Street, STE 102 Street CONTRACTOR NAME Kiftitas County CONTRACTOR TELEPHONE (509) 962-7515 Citv Ellensburg CONTRACTOR DOING BUSINESS AS (DBA) CONTRACTOR E-MAIL ADDRESS candi. blackford@co. kittitas.wa. us State WA Zip Code 98926 HCA CONTMCT MANAGER TELEPHONE (360) 725-1647 HCA CONTRACT MANAGER NAME AND TITLE Jon Brogger, Health Care Program Manager HCA PROGRAM Medicaid Administrative Claiming HCA CONTRACT MANAGER E-MAIL ADDRESS ion. broooer@hca.wa.qov HCA CONTRACT MANAGER ADDRESS Health Care AuthoritY 626 8th Avenue SE Olympia, WA 98504 HCA DIVISION/SECTION Medicaid Programs Division/Community Services PURPOSE OF CONTRACT: The purpose of this Contract is to support Medicaid related outreach and linkage activities performed by Local Health Jurisdiciions (LHJ) to Washington Staie residents who live within its jurisdiction. These aclivities assist residents who have no or inadequate medicil coverage, and includes explaining the benefits of the Medicaid program, assisting them in the Medicaid application and renewal processes, and linking them to Medicaid covered services. This Agreement provides a process for partially reimbursing the Contractor for allowable and reasonable expenses associated with the iime its staff spend performing Medicaid Administrative Claiming (MAC) activities. CONTRACT START DATE January 1,2026 CONTRACT END DATE December 31,2029 TOTAL MAXIMUM CONTRACT AMOUNT No Maximum The parties signing below warrant that they have read and understand this Contract, and have authority to execute this Contract. This Contract will only be binding upon signature by both parties. The parties may execute this contract in multiple counterparts, each of which is deemed an original and all of which constitute only one agreement. E-mail (electronic mail) transmission of a signed copy of this contract shall be the same as delivery of an original. HCA SIGNATURE /-D@usigned by: I -d"S^,a ll"*tr.^Z'-r't ____- _ t_ CONTRACTOR SIGNATURE Signed by: b,tr'n PRINTED NAME AND TITLE Andria Howerton Deputy Contracts Ad ministrator PRINTED NAME AND TITLE Chelsey Loeffers Public Health Director DATE 11t24t2025 DATE 12t16t2025 Washington State Health Care Authority HCA IAA K8630 Revised 07l2O23 Page 1 of 35