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Today's Date <br />03/23/2018 <br />Fund/Department <br />116 -Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Agenda Date <br />r` <br />r r� ray s•��r- i r <br />Contract/Grant Information <br />Contract /Grant Agency: Health Care Authority (Admatch) <br />Period Begin Date: 01/01/2019 Period End Date: 12/31/2020 <br />Total Grant/Contract Amount: Fee for Service <br />Grant/Contract Number: K1407 <br />Contract/Grant Summary: <br />The Healthcare Authority Professional Services Contract is established to support Medicaid related <br />outreach and linkage activities performed by Local Health Jurisdictions to Washington State residents <br />who live within its jurisdiction. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature: Administrator Date: <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $ NO MAX <br />State Funds $ Federal Funds $ NO MAX <br />Percentage County Funds <br />Matching Funds $ CFDA# 93.778 <br />In -Kind $ <br />Explain <br />Grant/Contract Review Page 1 <br />