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CLINICAL OPERATIONS MOU
<br />MEMORANDUM OF UNDERSTANDING
<br />CLINICAL OPERATIONS
<br />Kittitas County / Kittitas County Jail and Contractor I August 2026
<br />1. PURPOSE AND RELATIONSHIP TO SERVICE AGREEMENT
<br />This MOU establishes the day-to-day operating model between Kittitas County, acting through Kittitas County Jail,
<br />and Apple Valley Counseling Services, LLC, a Washington limited liability company doing business as Valley Health
<br />and Counseling (Contractor), for mental health, substance use disorder (SUD), behavioral -health practitioner, and
<br />behavioral -health medication -management services at Kittitas County Jail (KCJ). It supplements the parties' service
<br />agreement and BAA. It does not expand custody duties, waive legal requirements, or override the service
<br />agreement's payment, insurance, indemnity, or termination terms.
<br />2. SERVICES
<br />• Mental health: screening, assessment, individual or group treatment when clinically appropriate, crisis evaluation
<br />and coordination, discharge or reentry referral, and clinically necessary care coordination.
<br />• SUD: screening and assessment, counseling, case management, medication -treatment referral and coordination,
<br />community referral, and warm handoff when feasible.
<br />• Behavioral -health practitioner services: behavioral -health assessment, medication evaluation and management,
<br />monitoring, prescribing, consultation, and coordination or referral within the rendering clinician's scope and
<br />credentialing. General medical, primary -care, family -medicine, urgent -care, and chronic -disease needs remain
<br />with KCJ's designated medical provider. Contractor will not alter or assume management of medical treatment
<br />already under that provider's care, except for clinically necessary coordination within the practitioner's scope to
<br />address behavioral -health medication safety.
<br />• Training, court participation, meetings, reporting, and nonclinical administrative work only when requested and
<br />priced in writing.
<br />3. REFERRAL, TRIAGE, AND SCHEDULING
<br />• KCJ will submit referrals through the approved method with accurate booking, clinical, safety, custody, language,
<br />accessibility, and insurance information available to it.
<br />• Contractor will triage referrals by clinical urgency and available scope. Emergencies remain the County's
<br />responsibility through 911, the emergency department, crisis response, or other established emergency
<br />pathways.
<br />• The parties will maintain a written staffing schedule. Reserved time cancelled by the County with less than
<br />twenty-four hours' notice may be billed under the service agreement, except for a documented emergency.
<br />• Neither the MOU nor a referral guarantees a specific treatment, prescription, diagnosis, provider, outcome, or
<br />continuous on -call coverage.
<br />4. FACILITY ACCESS AND SAFETY
<br />KCJ supplies secure workspace, reasonable privacy, connectivity, approved system access, escorts, correctional
<br />staffing, emergency response, and timely access to referred patients.
<br />Contractor personnel follow reasonable facility safety rules that do not conflict with licensure, clinical
<br />independence, confidentiality, or patient safety.
<br />Contractor personnel do not perform custody, search, transport, restraint, classification, discipline, or evidence -
<br />gathering duties.
<br />5. CLINICAL INDEPENDENCE AND CONTINUITY
<br />Clinical decisions remain with the licensed rendering professional. KCJ may provide relevant observations and safety
<br />information but may not direct diagnosis, prescribing, documentation, treatment, discharge, or disclosure contrary to
<br />law or professional standards. Contractor will coordinate clinically appropriate continuity, referral, medication
<br />reconciliation, and reentry handoffs when information and community resources permit.
<br />6. DOCUMENTATION AND RECORDS
<br />• Contractor documents services in the approved EHR or agreed record system within clinically reasonable
<br />timeframes.
<br />KITTITAS COUNTY! VALLEY HEALTH AND COUNSELING I Page 1
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