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Home My WebLink AboutCon Con Amendment 4Kittitas County Review Form /r KIJTIT1%fi‡I M1 Grants &Contract Agreement Today's Date PA Camas Request #:04/28/2022 Fund/Department Agenda Date:116-Public Health Contract/Grant Information Contract /Grant Agency:Consolidated Contract Amendment 4 Period Begin Date:1/1/2022 Period End Date:12/31/2024 Total Grant/Contract Amount:Increase of $254,119 for a revised maximum consideration of $2,878,411 Grant/Contract Number:CLH31015 Contract/Grant Summary: •Amends Statements of Work for the following programs: o COVID-19 Mass Vaccination-FEMA -Effective January 1,2022 o DCHS-ELC COVID-19 Response -Effective January 1,2022 o LSPAN-Local Strategies for Physical Activity &Nutrition -Effective January 1,2022 o Maternal &Child Health Block Grant -Effective January 1,2022 o Office of Drinking Water Group A Program -Effective January 1,2022 o Office of Immunization COVID-19 Vaccine -Effective January 1,2022 o Supplemental Nutrition Assistance Program-Education -Effective January 1,2022 Recommendation for Board of Health Review on Department Head Signature:,Director Date: Kittitas County Prosecutor,Auditor,and Board of Health Review and Comment: APPROVED AS TO FORM: Signature of Prosecutor's Office Date Signature of Auditor's Office Date Verification the contracting Agency is not Suspended/Disbarred: Agency is not suspended/disbarred Not Checked (reason) Grant/Contract Review Page 1 Financial Information Total Amount $254,119 State Funds $Federal Funds NTE $254,119 Percentage County Funds Matching Funds $CFDA#93.421 In-Kind $ Explain ls Equipment being purchased?Who owns equipment? New Personnel being hired?Contact HR hiring -reporting requirements Future impacts or liability to Kittitas County: Budget Information Budget Amendment Yes attach budget form No why not Needed?Budgeted for New Division Created? Revenue Code 116.612.31.333.93.439 $19,470 116.615.02.2.346.26.64 $1,600 116.612.94.333.10.56 $12,090 116.615.02.2.346.26.65 $1,600 116.612.39.24.333.93.26 $225,125 116.615.02.2.346.26.66 $1,000 116.612.22.10.333.93.994 $2,131 Pass Through Information Agency to Pass Through Amount to Pass Through Sub-Contract Approved Date: Prosecutor Review Has the Prosecutor reviewed this agreement?Yes O No County Departments Impacted Auditor Facilities Maintenance Information Services Human Resource Prosecutor Treasurer BOCC Approval Needed? Yes [X)No Staff Member Presenting:Tristen Lamb Assignment of Tracking Information Auditor's Office Human Resource Prosecutor's Office Grant/Contract Review Page 2 Who Signed the grant application Reviewer Date Grant/Contract Review Page 3 KITTITAS COUNTY PUBLIC HEALTHDEPARTMENT 2022-2024 CONSOLIDATED CONTRACT CONTRACT NUMBER:CLH31015 AMENDMENT NUMBER:4 PURPOSE OF CHANGE:To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH",and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT,a Local Health Jurisdiction,hereinafter referred to as "LHJ",pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED:That the contract is hereby amended as follows: 1.Exhibit A Statements of Work,includes the following statements of work,which are incorporated by this reference and located on the DOH Finance SharePoint site in the Upload Center at the following URL: https://stateofwa.sharepoint.com/sites/doh-ofsfundingresources/sitepaaes/home.aspx?=el:9a94688da2d94d3ea80ac7fbc32e4d7c [¯] Adds Statements of Work for the following programs: Amends Statements of Work for the following programs: COVID-19 Mass Vaccination-FEMA -Effective January 1,2022 DCHS-ELC COVID-19 Response -Effective January 1,2022 LSPAN-Local Strategies for Physical Activity &Nutrition -Effective January 1,2022 Maternal &Child Health Block Grant -Effective January 1,2022 Office of Drinking Water Group A Program -Effective January 1,2022 Office of Immunization COVID-19 Vaccine -Effective January 1,2022 Supplemental Nutrition Assistance Program-Education -Effective January 1,2022 O Deletes Statements of Work for the following programs: 2.Exhibit B-4 Allocations,attached and incorporated by this reference,amends and replaces Exhibit B-3 Allocations as follows: Increase of $254,119 for a revised maximum consideration of $2,878,411. Decrease of for a revised maximum consideration of No change in the maximum consideration of Exhibit B Allocations are attached only for informational purposes. Unless designated otherwise herein,the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof. KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT STATE OF WASHINGTON DEPARTMENT OF HEALTH Signature:Signature: Date:Date: APPROVED AS TO FORM ONLY Assistant Attorney General Page 1 of 1 EXHIBITB-4KittitasCountyPublicHealthDepartmentALLOCATIONSContractNumber:CLH31015ContractTerm:2022-2024Date:April1,2022IndirectRateasofJanuary1,2022:25.25%PublicHealthDept&12.75%CountyCentralSvcsDOHUseOnlyBARSStatementofWorkChartofAccountsFundingChartofFederalAwardAssistRevenueLHJFundingPeriodFundingPeriodPeriodAccountsChartofAccountsProgramTitleIdentification#Amend#List#*Code**StartDateEndDateStartDateEndDateAmountSubTotalTotalFFY22IARSNAPEdProgMgnt-Region2207WAWA5Q3903Amd410.561333.10.5601/01/2209/30/2210/01/2109/30/22512,090$42,908542,908FFY22IARSNAPEdProgMgnt-Region2207WAWA5Q3903Amd110.561333.10.5601/01/2209/30/2210/01/2109/30/22530,818FFY21PHEPBP3LHJFundingNU90TP922043Amd293.069333.93.0601/01/2206/30/2207/01/2106/30/22$29,492$29,492$29,492FFY22CDCEHCEHRSupplementalNGANotReceivedAmd193.070333.93.0701/01/2208/31/2209/01/2008/31/22$83,000$83,000$83,000FFY20EnvirHealthCapacity-C(CDC)NCENUE1EH001445Amd293.070333.93.0701/01/2208/31/2209/01/2008/31/22$14,719$35,719$35,719FFY20EnvirHealthCapacity-C(CDC)NCENUElEHO01445Amd193.070333.93.0701/01/2208/31/2209/01/2008/31/22$21,000COVIDI9VaccinesNH23IP922619Amd493.268333.93.2601/01/2206/30/2407/01/2006/30/245225,125$225,125$225,125COVID19VaccinesR4NH23IP922619Amd193.268333.93.2601/01/2206/30/2407/01/2006/30/245359,803$359,803$359,803FFY22VFCOpsNH23IP922619Amd393.268333.93.2601/01/2206/30/2207/01/2106/30/22$4,980$4,980$4,980FFYl9COVIDCARESNU50CKOOO515Amd293.323333.93.3201/01/2204/22/2204/23/2007/31/24$174$1745174FFYl9ELCCOVIDEdLHJAllocationNU50CKOOO515Amd493.323333.93.3201/01/2210/18/2205/19/2010/18/22(58,897)$5,691$5,691FFYl9ELCCOVIDEdLHJAllocationNU50CK000515Amd293.323333.93.3201/01/2210/18/2205/19/2010/18/22$14,588FFY20ELCEDELHJAllocationNU50CKOOO515Amd293.323333.93.3201/01/2212/31/2201/15/2107/31/24$754,494$754,494$754,494FFY21PhysActvty&NutritionProgNIJ58DPOO6504Amd493.439333.93.4301/01/2209/29/2209/30/2109/29/22519,470$53,470553,470FFY21PhysActvty&NutritionProgNU58DPOO6504Amd193.439333.93.4301/01/2209/29/2209/30/2109/29/22$34,000FFY22MCHBGLHJContractsB0445251Amd493.994333.93.9901/01/2209/30/2210/01/2109/30/22$2,131$35,278$35,278FFY22MCHBGLHJContractsB0445251Amd193.994333.93.9901/01/2209/30/2210/01/2109/30/22$33,147GFS-GroupB(FO-E)AmdlN/A334.04.9001/01/2206/30/2207/01/2106/30/22$25,877525,877$25,877FPHS-LHJ-Proviso(YR2)Amd1N/A336.04.2507/01/2206/30/2307/01/2106/30/235605,000$605,000$1,210,000FPHS-LHJ-Proviso(YR1)Amd1N/A336.04.2501/01/2206/30/2207/01/2106/30/23$605,0005605,000YR24SRF-LocalAsst(15%)(FO-E)SSAmd4N/A346.26.6401/01/2212/31/2207/01/2106/30/2351,60055,20055,200YR24SRF-LocalAsst(15%)(FO-E)SSAmd1N/A346.26.6401/01/2212/31/2207/01/2106/30/23$3,600SanitarySurveyFees(FO-E)SS-StateAmd4N/A346.26.6501/01/2212/31/2207/01/2106/30/2351,600$5,20055,200SanitarySurveyFees(FO-E)SS-StateAmd1N/A346.26.6501/01/2212/31/2207/01/2106/30/23$3,600YR24SRF-LocalAsst(15%)(FO-E)TAAmd4N/A346.26.6501/01/2212/31/2207/01/2106/30/23$1,000$2,00052,000YR24SRF-LocalAsst(15%)(FO-E)TAAmd1N/A346.26.6501/01/2212/31/2207/01/2106/30/23$1,000Page1of2 EXHIBITB-4KittitasCountyPublicHealthDepartmentALLOCATIONSContractNumber:CLH31015ContractTerm:2022-2024Date:April1,2022IndirectRateasofJanuary1,2022:25.25%PublicHealthDept&12.75%CountyCentralSvesDOHUseOnlyBARSStatementofWorkChartofAccountsFundingChartofFederalAwardAssistRevenueLHJFundingPeriodFundingPeriodPeriodAccountsChartofAccountsProgramTitleIdentification#Amend#List#*Code**StartDateEndDateStartDateEndDateAmountSubTotalTotalTOTAL$2,878,411$2,878,411Totalconsideration:$2,624,292GRANDTOTAL$2,878,4115254,119GRANDTOTAL$2,878,411TotalFed51,630,134TotalState$1,248,277*CatalogofFederalDomesticAssistance**Federalrevenuecodesbeginwith"333".Staterevenuecodesbeginwith"334".Page2of2