HomeMy WebLinkAboutGrants and Contract PH 7-1-23 PSAKittitas County
Review Form
Grants & Contract Agreement
Contract/G ra nt I nformation
Recommendation for Board of Health Review on
Department Head Signature:Director
verification the contracting Agency is not suspended/Disbarred:
Today's Date
06/07/2023 PA Camas Request #:YT
Fund/Department
116-Public Health Agenda Date:
Period Begin Date: July L,2023
Contract /Grant Agency: PSA between Kittitas County and Kittitas County Health Network
Period End Date: lune 30,2O24
Total Grant/Contract Amount: Not:o exceed S100,000.00
G ra nt/Contract N umber:
The Contractor (Kittitas County) shall employ one or more Community Health Workers/ Promotoras de
Salud, who will work to decrease ba.riers to accessing COVID-19 vaccination for Kittitas County's Latinx
and Spanish-speaking households. The position requires courteous and cooperative interaction with all
department staff, County, State, and Federal agencies, and the general public, and will be expected to
in other areas of Public Health as needed. All employees work under the guidance ofprovide assistance
local/state/federa I lations.
Contract/G rant Sum mary:
Kittitas Cou nty Prosecutor, Auditor, and Board of Health Review and Comment:
APPROVED TO FORM
t 'r.r.6 ?}
Signature of P tor's Office Dat
/
Signature of Auditor's Da
Agency is not suspended/disbarred f Not Checked (reason)
Grant/Contract Review Page 1
Financial lnformation
Bu lnformation
Pass Throu lnformation
Prosecutor Review
Total Amount NTE $t00,000 State Funds S Federal Funds $too,oOO
Percentage County Funds Matching Funds S CFDA# 93.268
ln-l(ind S
txpbin
ls Equipment being purchased?Who owns equipment?
New Personnel being hired?Contact HR hiring - reporting requirements
Future impacts or liability to Kittitas County:
Budget Amendment Needed?
New Division Created?
Yes ! attach budget form No E Why not
Funds already budgeted
Revenue Code L1,6.6L239243339332 q, Sl^^\, corn L t4tS a!!.0.e-f'or-
Expense Code tL5.6t2392454101 _\t a --i.. ^g a-frraa-il-
Agencyto Pass Through
Amount to Pass Through Expense Code:
Sub-Contract Approved Date:
Has the Prosecutor reviewed this agreement?Yes No
County Departments lm acted
BOCCApproval Needed?
Yes I NoI
Staff Member Presenting: Chelsey Loe'fers
Assi ment of Tracki lnformation
Who Signed the grant application
Auditor Facilities Maintenance
lnformation Services Human Resource
Prosecutor Treasurer
Auditor's Office
Human Resource
Prosecutor's Office A*1,?rt
Grant/Contract Review Page 2
Reviewer Date
Grant/Contract Review Page 3