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Washington State s t <br />INTERAGENCY AGREEMENT <br />HCA Contract Number: K7843 <br />Health Care ' utharity <br />for <br />Reentry Demonstration <br />Contractor Contract Number: <br />Initiative Project <br />THIS AGREEMENT is made by and between Washington State Health Care Authority (HCA) and Kittitas <br />County Sheriff's Office (Contractor), pursuant to the authority granted by Chapter 39.34 RCW, <br />CONTRACTOR NAME <br />Kittitas County Sheriff's Office - Jail <br />CONTRACTOR DOING BUSINESS AS (DBA) <br />CONTRACTOR ADDRESS Street Citv State Zip Code <br />307 Umptanum Rd. <br />Ellensburg WA 98926 <br />Facility: 205 W 51'; Suite 1, Ellensburg 98926 <br />CONTRACTOR CONTRACT MANAGER CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS <br />Sheriff Clay Myers 509-962-7525 clay.myers@co.kittitas.wa.us <br />HCA PROGRAM <br />Medicaid Reentry Demonstration Initiative Project <br />HCA DIVISION/SECTION <br />10701OMT <br />HCA CONTRACT MANAGER NAME AND TITLE <br />HCA CONTRACT MANAGER ADDRESS <br />Health Care Authority <br />Emma Oppenheim, Medicaid Transformation Project Director <br />626 8th Avenue SE <br />Olympia, WA 98504 <br />HCA CONTRACT MANAGER TELEPHONE <br />HCA CONTRACT MANAGER E-MAIL ADDRESS <br />(360) 725-0868 <br />emma.oppenheim@hca.wa.gov <br />CONTRACT START DATE <br />July 1, 2024 <br />PURPOSE OF CONTRACT: <br />CONTRACT END DATE <br />July 31, 2028 <br />TOTAL MAXIMUM CONTRACT AMOUNT <br />$2,250,000.00 <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 />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 />CONTRACTOR SIGNATURE <br />84,r - ,-,�, �.� <br />PRINTED NAME AND TITLE <br />0 4 y �r Yt I� 5 S° f �'F- <br />DATE <br />fi -1 7 -a <br />HCA SIGNATURE <br />PRINTED NAME AND TITLE <br />DATE <br />Washington State Page 1 of 24 HCA IAA K7843 <br />Health Care Authority <br />