HomeMy WebLinkAboutWEEKEND NURSE AMENDMENT- Grant and Contract Review Form�E CR LUES_ to N
Kittitas County
Review Form
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Grants & Contract Agreement
Today's Date Agenda Date
January 30, 2023 February 7, 2023
Fund/Department
30 / Sheriff
Contract/Grant Information
Contract /Grant Agency: Ellensburg Family Medicine d/b/a CompassDirect Healthcare
Period Begin Date: upon signature
Federal Funds $0
Period End Date: until funding is no longer
Matching Funds $0
CFDA# na
available, or until term'd by either party
Total Grant/Contract Amount: The total cost to the Contractor will increase from no greater than
$235,000 annually to no greater than $310,000 annually, reflecting a cost increase of up to $75,000.
Grant/Contract Number: #SH21-044 (2nd Modification)
Contract/Grant Summary: The purpose of this modification is to expand the current scope of work to
include responsibility for Suboxone distribution, and to allow for a nurse to provide services to the jail on
the weekends. The total cost to Kittitas County will increase from no greater than $235,000 to no greater
than $310,000, reflecting a cost increase of up to $75,000. This increase will be funded by existing grant
awards and its continuation is contingent upon those awards being renewed.
Financial Information
Total Amount: Total compensation
to increase by up to $75,000
State Funds $0
Federal Funds $0
Percentage County Funds
Matching Funds $0
CFDA# na
Expense Codes:
In -Kind $
Explain
Is Equipment bein urchased? No
Who owns equipment? na
New Personnel being hired? No I
Contact HR hiring — na
Future impacts or liability to Kittitas County: Program is contingent upon the continuing availability of
grant funds.
Budget Information
Budget Amendment Needed?
Yes❑ attach budget form
No ❑x Why not - Already budgeted
New Division Created? No
Revenue Code N/A
Expense Codes:
001-3012365xxxx
001-3012355xxxx
Grant/Contract Review Page 1
Pass i nrou n information
Agency to Pass Through NA
Amount to Pass Through $0
Sub -Contract Approved Date:
Prosecutor Review
Has the Prosecutor reviewed this agreement? YesEk No❑ CAMAS# 55291
Coun Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Submitted
Signature:
Date:
Department: Sh iff
Assignment of Tracking Information
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer I Date
Grant/Contract Review Page 2