HomeMy WebLinkAboutCon Con 15Kittitas County
Review Form
Grants & Contract Agreement
Today's Date
08.31.2023 PBK# 10097
Fund/Department
116-Public Health Agenda Date:
Contract/Grant Information
Contract /Grant Agency: Consolidated Contract Amendment 15
Period Begin Date: 01.01.2022
Period End Date: 12.31.2024
I Total Grant/Contract Amount: Increase of $906,343 for a new revised maximum of $5,687,387 1
Grant/Contract Number: CLH31015
Contract/Grant Summary:
The Consolidated Contract Amendment 15 amends the following:
Adds Statements of Work for the following programs:
• COVID-19 LHJ Gap Funding - Effective July 1, 2023
• Executive Office of Resiliency & Health Security-PHEP - Effective July 1, 2023
• Executive Office of Resiliency & Health Security-WFD LHJ - Effective July 1, 2023
Amends Statements of Work for the following programs:
• Foundational Public Health Services (FPHS) - Effective July 1, 2023
• Maternal and Child Health Block Grant - Effective January 1, 2022
• Office of Immunization -Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2023
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 D to
Signature of Auditor's Office
I
Verification the Contracting Agency is not Suspended/Disbarred:
❑x Agency is not suspended/disbarred
❑ Not Checked (reason)
Grant/Contract Review Page 1
Financial Information
Total Amount $906,343
State Funds $
Federal Funds $
Percentage County Funds
Matching Funds $
CFDA#
In -Kind $
Explain
Is 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 ❑ attach budget form No ® why not
New Division Created? Budgeted, & not using some funds till 2024,
will be in budget
612.39.29.333.21.02' z•3 2°►• 3 33 • zi • o i1
612.88.3.333.93.069 - PH EeR �H s
Revenue Code 612.32.13.333.93.268%,- (o I2. 32• 13.333, a3. �•�
611.336.04.25 , r(octVY)Ri IQn�+L IOU AQr t-tE-A-Ln-I -5VC
612.22.10.333.93.994 - rrnA, ,t r X?-C. -e14«v wCYTE r,+ st P_1 s
Expense Code 51001/51002/50098/54199 for all
Pass Through Information
Agency to Pass Through
Amount to Pass Through
Sub -Contract Approved Date:
Expense Code:
Prosecutor Review
Has the Prosecutor reviewed this agreement? Yes ❑ No ❑
County Departments Impacted
Auditor
Information Services
Prosecutor
Facilities Maintenance
Human Resource
Treasurer
BOCC Approval Needed?
[Yes
Staff Member Presenting:
Assignment of Tracking Inform_ ation
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
No ❑
Reviewer Date
Grant/Contract Review Page 2
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31015
AMENDMENT NUMBER: 15
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:
htt s://stacQfwa.sharepoint.cam/sitesfdoh-efsc
® Adds Statements of Work for the following programs:
COVID-19 LHJ Gap Funding - Effective July 1, 2023
Executive Office of Resiliency & Health Security-PHEP - Effective July 1, 2023
Executive Office of Resiliency & Health Security-WFD LHJ - Effective July 1, 2023
® Amends Statements of Work for the following programs:
Foundational Public Health Services (FPHS) - Effective July 1, 2023
Maternal and Child Health Block Grant - Effective January 1, 2022
Office of Immunization -Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2023
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-15 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-14 Allocations
as follows:
® Increase of $906,343 for a revised maximum consideration of $5,687,387.
❑ 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
Signature:
Date:
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature:
Date:
APPROVED AS TO FORM ONLY
Assistant Attorney General
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