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Kittitas County Public Health <br />Contract/Agreement Review Form <br />Today's Date; 04/28/26 <br />Fund/Department: 116-Public Health <br />Cont <br />Information <br />Legal Request #: <br />Agenda Date: <br />Kittitas County <br />Public Health <br />Department <br />Contract/Agreement Title: Interlocal Agreement between State of Wa DOH and KCPHD <br />Begin Date: 01/01/26 i End Date: 12/31/29 <br />Total $ Amount: 0.00 Contract/Agreement #: CLH32635-0 <br />Contract/Agreement Summary: <br />The agreement is made by and between the State of Washington Department of Health and <br />Kittitas County Public Health to cover TB medications used to treat active TB disease in patients <br />who are under or uninsured or who lack prescription coverage and are not covered by Medicaid <br />or Apple Health. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVED AS T&TORM: <br />Signature of Prdsecutor's Office 14 I Date <br />Signature of Auditor's OffIcA Date <br />Budget Information <br />Revenue Code(s): <br />Expense Code(s): <br />Agency is not suspended/disbarred Not Checked (reason) <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through <br />Sub -Contract Approved Date: <br />Expense Code: <br />ADMIN Version: 0 l supersedes: 0 1 Date Adopted: 12/01/2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers <br />