HomeMy WebLinkAboutCon Con Amendment 6Kittitas County
Review Form
Grants &Contract Agreement
Today's Date PA Camas Request #:7/26/2022
Fund/Department Agenda Date:116-Public Health
Contract/Grant Information
Contract /Grant Agency:Consolidated Contract Amendment 6
Period Begin Date:1/1/2022 Period End Date:12/31/2024
Total Grant/ContractAmount:Increase of $1,018,000.00 for a new revised maximum of $4,113,724.00
Grant/Contract Number:
Contract/Grant Summary:
The Consolidated Contract Amendment 6 adds the following Statement of Work:
•Foundational Public Health Services-Effective July 1,2022
Exhibit B-6 Allocations:
Increase of $1,018,000.00 for a revised maximum consideration of $4,113,724.00
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 O Not Checked (reason)
Financial Information
Grant/Contract Review Page 1
Total Amount $1,018,000.00 State Funds $1,018,000.00 Federal Funds $
Percentage County Funds Matching Funds $CFDA#
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 Needed?Yes O attach budget form No why not
New Division Created?Already Budgeted
Revenue Code 611.336.04.25
Expense Code 611.07 611.81.6 611.81.4
612.39.17 612.96 615.40
Pass Through Information
Agency to Pass Through
Amount to Pass Through Expense Code:
Sub-Contract Approved Date:
Prosecutor Review
Has the Prosecutor reviewed this agreement?Yes No O
County Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
BOCC Approval Needed?
Yes No
Staff Member Presenting:
Assignment of Tracking Information
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer Date
Grant/Contract Review Page 2
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER:CLH31015 AMENDMENT NUMBER:6
PURPOSE OF CHANGE:To amend this contract between the DEPARTMENT OF HEALTH hereinafterreferred to as
"DOH",and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT,a Local Health Jurisdiction,hereinafterreferred
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 incorporatedby this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
https://stateofwa.sharepoint.com/sites/doh-ofsfimdingresources/sitepages/bome.aspx?=el:9a94688da2d94d3eaS0ac7fbc32e4d7e
Adds Statements of Work for the following programs:
Foundational Public Health Services (FPHS)-Effective July 1,2022
O Amends Statements of Work for the following programs:
O Deletes Statements of Work for the following programs:
2.Exhibit B-6 Allocations,attached and incorporatedby this reference,amends and replaces Exhibit B-5 Allocations as
follows:
Increase of $1,018,000 for a revised maximum considerationof $4,113,724.
Decrease of for a revised maximum considerationof
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.
STATE OF WASHINGTONKITTITASCOUNTYPUBLICHEALTHDEPARTMENTDEPARTMENTOFHEALTH
Signature:Signature:
Date:Date:
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page l of 1
EXHIBITB-6KittitasCountyPublicHealthDepartmentALLOCATIONSContractNumber:CLH31015ContractTerm:2022-2024Date:July1,2022IndirectRateJanuary1,2022throughDecember31,2022:21%PublicHealthDept&15%CountyCentralSvcsDOHUseOnlyBARSStatementofWorkChartofAccountsFundingChartofFederalAwardAssistRevenueLHJFundingPeriodFundingPeriodPeriodAccountsChartofAccountsProgramTitleIdentiilcation#Amend#List#*Code**StartDateEndDateStartDateEndDateAmountSubTotalTotalFFY22IARSNAPEdProgMgnt-Region2207WAWA5Q3903Amd410.56I333.10.5601/01/2209/30/2210/01/2I09/30/22512,090$42,908$42,908FFY22IARSNAPEdProgMgnt-Region2207WAWA5Q3903Amd110.56I333.10.5601/01/2209/30/2210/01/2I09/30/22$30,818CSFRFCTSLHJAllocationNGANotReceivedAmd521.027333.21.0201/01/2212/31/2201/01/2212/31/22$217,3135217,313$217,313FFY21PHEPBP3LHJFundingNU90TP922043Amd293.069333.93.0601/01/2206/30/2207/01/2106/30/22$29,492529,492$29,492FFY22CDCEHCEHRSupplementalNGANotReceivedAmdl93.070333.93.0701/01/2208/3L/2209/01/2008/31/22583,000$83,000$83,000FFY20EnvirHealthCapacity-C(CDC)NCENUElEH001445Amd293.070333.93.0701/01/2208/31/2209/01/2008/31/22$14,719$35,719535,719FFY20EnvirHealthCapacity-C(CDC)NCENUElEH001445Amd193.070333.93.0701/01/2208/31/2209/01/2008/31/22521,000COVIDI9VaccinesNH23IP922619Amd493.268333.93.2601/01/2206/30/2407/01/2006/30/24$225,125$225,125$225,125COVIDl9VaccinesR4NH23IP922619Amdl93.268333.93.2601/01/2206/30/2407/01/2006/30/245359,803$359,803$359,803FFY22VFCOpsNH23IP922619Amd393.268333.93.2601/01/2206/30/2207/01/2106/30/2254,98054,98054,980FFYl9COVIDCARESNU50CK0005l5Amd293.323333.93.3201/01/2204/22/2204/23/2007/31/24$l745174$174FFYl9ELCCOVÏDEdLHJAllocationNU50CKO00515Amd493.323333.93.3201/01/22[0/18/2205/19/2010/18/22(S8,897)55,69155,691FFYl9ELCCOVIDEdLHJAllocationNU50CK000515Amd293.323333.93.3201/01/2210/18/2205/19/2010/18/22514,588FFY20ELCEDELHJAllocationNU50CK000515Amd293.323333.93.3201/01/22L2/31/2201/15/2107/31/24$754,494$754,494$754,494FFY21PhysActvty&NutritionProgNU58DPOO6504Amd493.439333.93.4301/01/2209/29/2209/30/2109/29/22$19,470$53,470$53,470FFY2lPhysActvty&NutritionProgNU58DP006504AmdI93.439333.93.4301/01/2209/29/2209/30/2109/29/22534,000FFY22MCHBGLHJContractsB0445251Amd493.994333.93.9901/01/2209/30/2210/01/2109/30/2252,131535,278535,278FFY22MCHBGLHJContractsBO445251Amd193.994333.93.9901/01/2209/30/2210/01/2109/30/22$33,147GFS-GroupB(FO-E)AmdIN/A334.04.9001/01/2206/30/2207/01/2106/30/22$25,877$25,877$25,877FPHS-LHJ-Proviso(YR2)Amd6N/A336.04.2507/01/2206/30/2307/01/2106/30/23$1,018,000$1,018,000$2,228,000FPHS-LHJ-Proviso(YR2)AmdiN/A336.04.2507/01/2206/30/2307/01/2106/30/23$605,000$605,000FPHS-LHJ-Proviso(YRI)AmdIN/A336.04.2501/01/2206/30/2207/01/2106/30/23$605,000$605,000YR24SRF-LocalAsst(15%)(FO-E)SSAmd4N/A346.26.6401/01/2212/31/2207/01/2106/30/23$1,600$5,200$5,200YR24SRF-LocalAsst(15%)(FO-E)SSAmdlN/A346.26.6401/01/2212/31/2207/01/2106/30/2353,600Page1of2
EXHIBITB-6KittitasCountyPublicHealthDepartmentALLOCATIONSContractNumber:CLH31015ContractTerm:2022-2024Date:July1,2022IndirectRateJanuary1,2022throughDecember31,2022:21%PublicHealthDept&15%CountyCentralSvcsDOHUseOnlyBARSStatementofWorkChartofAccountsFundingChartofFederalAwardAssistRevenueLHJFundingPeriodFundingPeriodPeriodAccountsChartofAccountsProgramTitleIdentification#Amend#List#*Code**StartDateEndDateStartDateEndDateAmountSubTotalyoggySanitarySurveyFees(FO-E)SS-StateAmd4N/A346.26.6501/01/2212/31/2207/01/2106/30/23$1,600$5,200$5,200SanitarySurveyFees(FO-E)SS-StateAmd1N/A346.26.6501/01/2212/31/2207/01/2106/30/23$3,600YR24SRF-LocalAsst(15%)(FO-E)TAAmd4N/A346.26.6501/01/2212/31/2207/01/2106/30/2351,000$2,000$2,000YR24SRF-LocalAsst(15%)(FO-E)TAAmdlN/A346.26.6501/01/2212/31/2207/01/2106/30/23$1,000TOTAL$4,113,724$4,113,724Totalconsideration:$3,095,724GRANDTOTAL$4,113,724$1,018,000GRANDTOTAL$4,113,724TotalFed$1,847,447TotalState$2,266,277*CatalogofFederalDomesticAssistance**Federalrevenuecodesbeginwith"333".Staterevenuecodesbeginwith"334".Page2of2