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Home My WebLink AboutConsolidated Contract PHKittitas County Review Form Grants & Contract Agreement Contract/G ra nt I nformation Recommendation for Board of Health Review on Department Head Signature Director Date: verification the contracting Agency is not suspended/Disbarred: Today's Date 08.31.2023 PBK# 10097 Fund/Department 116-Public Health AgendaDate: lO t Contract /Grant Agency: Consolidated Contract Amendment 15 Period Begin Date: OL.OL.2A22 Period End Date: I2.3L.2024 Total Grant/Contract Amount: lncrease of 5906,343 for a new revised maximum of $5 ,687,397 G rant/Contract Number: CLH3 1015 Contract/G rant Summa ry: The Consolidated Contract Amendment 15 amends the following Adds Statements of Work for the following programs: COVID-19 LHJ Gap Funding - Effective July J.,2023 Executive office of Resiliency & Health security-pHEp - Effectiv e July t, zo23 Executive office of Resiliency & Health security-wFD LHJ - Effective July r,2023 Foundational Public Health Services (FPHS) - Effective July 1.,2023 Maternal and Child Health Block Grant - Effective January 1",2022 2023Office of lmmunization-Promotion of lmmunizations to lm rove Vaccination Rates - Effective Ju a a a Amends Statements of Work for the following programs a a a Kittitas county Prosecutor, Auditor, and Board of Health Review and comment: APPROVED TO FORM Signature of P utor's Office D e Signature of Auditor's Office Da E Agency is not suspended/disbarred ! Not Checked (reason) Grant/Contract Review Page 1 Financial lnformation Budget lnformation Pass Throu lnformation Prosecutor Review TotalAmount S906,343 State Funds $Federal Funds S Percentage County Funds Matching Funds S CFDA# ln-Kind S la in ls Equipment being purchased?Who owns equipment? New Personnel bei hired?Contact HR hirin orting requirements-re Future i acts or liability to Kittitas Cou Budget Amendment Needed?Yes I attach budget form No E why not Budgeted, & not using some funds til|2024, will be in b New Division Created? Revenue Code 612.39.29.333,21.02F. . Vtz:a?Dvq. r se. >r . 0 >J 612.99.3.333.93.069 _ PH EPR LH j' 612.32.13.333, 93. 2688, - b 12.. 3-2. li. 313.',t 3. zLt 611.336.04.25 612.22.L0.333,93.994 - FAU,/\D t+Tto n rtlL ?7-AL/"C l+EALr/4 'Va ' /'rtAlEt>t14-L. *(rt(LD *{41n-l Sal?.vi ( t'.S Expense Code 5 100L/5 10 02/ 5OO98/ 54199 for a I I Agency to Pass Through Amount to Pass Through Expense Code Sub-Contract Approved Date Has the Prosecutor reviewed this agreement?Yes No County De artments lmpacted BOCC roval Needed? Ass nment of Tracki lnformation Auditor Facilities Maintenance lnformation Services Human Resource Prosecutor Treasurer Yes I NoI Staff Mem ber Presenting Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer Date Grant/Contract Review Page 2 KITTITAS COUNTY PUBLIC HBALTH DEPARTMENT 2022.202 4 CONSOLIDATED CONTRACT CONTRACT NUMBER: CLH310I5 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 tlrereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 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/sitepages/home.aspx?:e l:9a94688da2d94d3ea80ac7fbca2e4d7c X Adds Staternents of Work for the following programs: COVID-l9 LHJ Gap Funding - Effective luly 1,2023 Executive Office of Resiliency & Health Security-PHEP - Effective July 1,2023 Executive Office of Resiliency & Health security-WFD LHJ - Effective |uJy 1,2023 X Amends Statements of Work for the following progralns: 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: X lncrease of $906.343 for a revised maximum consideration of $5,687.387. Decrease of _ for a revised maximum consideration of _. No change in the rnaximum consideration of _. Exhibit B Allocations are attached only for informational purposes. Unless designated otherwise lrerein, 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, APPROVED AS TO FORM ONLY Assistant Attorney General KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT STATE OF WASHINGTON DEPARTMENT OF HEALTH Signature: Chelreu bellen .hdryrodka tMr r.4nir or pDrl Signature: Rren2oHw&w B.ordr Heniksotr lod 5, r023 13r6 pDrl Date: Oct 3, 2023 Date: Oct 5, 2023 Page I of I EXHIBIT B-I5 Kittitas County Public Health Department ALLOCATIONS Contract T er m: 2022-2024 Indirect Rate January 1,2022 through December 31, 20222 2lo/o Public Health Dept & l5% County Central Svcs Indirect Rate January 1,2023 through December 31, 2023:34.30%o Federal Award Identification # NGA Not Received 207WAWA5Q3903 207WAWA5Q3903 207WAWA5Q3903 SLFRPOO02 SLFRPOOO2 SLFRPOOO2 NU90TP922043 NU9OTP922043 NU90TP922043 NUElEHOOI445 NUEIEHOOI445 NUEIEHOOI445 NH23rP9226l9 NH23IP9226l9 NH23tP9226t9 NH231P922619 NH23IP9226t9 NUs0cK000s rs NU50CK0005 l 5 NU50CK0005 15 NU50CK0005 I 5 NU50CK0005 I 5 NU50CK0005 15 NGA Not Received NU50CK0005 I 5 Amend # Amd 9 Arnd 7 Amd 4 Amd I Amd l5 Amd 7 Amd 2 And 2 Amd I Amd 15 Amd 14 Amd 7 Amd 4 Amd 2 Amd 7, 9, 13 4md,2,9,13 Amd 13 Amd 13 333.10 56 10/01t22 333.10.56 0t/01/22 333.10.56 0l/0|22 333.10.56 0r/01/22 Contract Number: Date: Funding Period SubTotal $29,934 $37,008 $2t7,313 s47.151 $32,977 $49,133 $49, r33 (?q l1o) $83,000 $35,7 I 9 $6,r 60 $225,125 $3s9,803 $4,980 $ 174 $7,238 $720,249 $3,200 s4,800 cLH3l0l5 August l,2023 Chart of Accounts Total s66,942 52t7,313 s47,454 s32,977 $ I 27,758 $83,000 $35,7 l 9 s6, l 60 $225,125 $359,803 $4,980 $ 174 $7,238 s'120,249 Assist List #* DOH tlse Only BARS Statement of Work Chart of Accounts Revenue LHJ Funding Period Funding Period Code** Start Date End Date Start Date End DateChart ofAccounts Program Title FFY23 IAR SNAP Ed Prog MgntRegion 2 FFY22 IAR SNAP Ed Prog Mgnt-Region 2 FFY22 IAR SNAP Ed Prog Mgnt-Region 2 FFY22 IAR SNAP Ed Prog Mgnt-Region 2 CSFRF CTS LHJ Allocation FY24 LHJ COVID-I9 ARPA LHJ Vaccination ARPA FFY23 PHEP BP5 LHJ Funding FFY22 PHEP BP4 LHJ Funding FFY2I PHEP BP3 LHJ Funding FFY21 CDC EHC EHR Supplemental FFY20 Envir Health Capacity-C (CDC) NCE FFY20 Envir Health Capacity-C (CDC) NCE FFY24 CDC VFC Ops FFY24 CDC VFC Ops COVIDI9 Vaccines COVID19 Vaccines R4 FFY22 VFC Ops FFYl9 COVID CARES FFYI9 ELC COVID Ed LHJ Allocation FFYl9 ELC COVID Ed LHJ Allocation FFY19 ELC COVID Ed LHJ Allocation FFY20 ELC EDE LHJ Allocahon FFY20 ELC EDE LHJ Allocation FFY23 Vector-bomeT2&3 Epi ELC FPH FFY22 Vector-bome T2&3 Epi ELC FPH 10.561 10.56 I 10.561 10 56I 09t30t23 09/30/22 09130/22 09/30/22 t0l0v22 t0t0U2t l0/0U21 t0t0t/21 01/0u23 07101t22 07l0It2t 09130t23 09/30t22 09t30t22 09t30t22 06t30t24 06130123 06/30/22 Amount $29,934 ($5,e00) $ r2,090 $30,8 l 8 Amd5. ll 21.027 333.2t.02 0U0U22 06/30123 0t/0v22 06t30123 $217.313 Amd l5 21.027 333-21.02 07t01/23 06/30/24 07t01/23 06t30t25 s47,454 Amd l0 2t.02t 333.2t.02 t1/01122 06/30/23 |t0U22 06t30123 $32,977 93.069 93 069 93.069 333.93.06 3 33.93.06 333.93 06 07t0U23 07101/22 0U0lt22 06t30t24 06/30/23 06130t22 0813U22 08/31/22 s49,133 $49, l 33 $29,492 $ 14,719 $2 1,000 $s60 $s,600 $225,t25 $359,803 $4,980 $ 174 $ 1,547 ($8,8e7) $ 14,588 ($34,24s) $754,494 $3,200 $4,800 Amd l- 7 93 070 333 93.07 0U0I/22 12t31t22 0910v20 t2/31/22 $S3.000 93.070 93.070 333.93 07 0t/01/22 333 93.07 0U0U22 08/31t22 09t0U20 08t31122 09t0v20 93.268 93.268 333.93.26 333.93.26 07t0il23 07/0U23 06/30t24 07t0v23 06130t24 07t0U23 06/30t24 06/30t24 Amd 4 93.268 333.93 26 01101/22 06130t24 07t0U20 06t30t24 Amd I 93.268 333.93.26 01/01t22 06t30/24 07t0U20 06t30/24 Amd 3 93.268 333.93.26 0U0U22 06/30/22 07/0v2t 06t30/22 Amd 2 93.323 333 93.32 0v01t22 04t22t22 04t23t20 01t3U24 93.323 93.323 93.323 333.93.32 333.93.32 333.93.32 01/0t/22 0U0ll22 0U0ll22 I0/t8/22 t0/18/22 l0/18/22 t0/18/22 05il9120 t0/18/22 05n9t20 t0/18122 05/r9/20 93.323 93.323 333.93.32 0I/0U22 333.93.32 01101t22 l2/3t/23 t2/3U23 01/15/2r 0vt5t2I 07/31/24 0'713U21 93.323 93.323 333.93.32 08t01t23 333.93.32 06/01/23 09130/23 08/0123 07/31/23 08t0U22 09/30/23 07/31/23 Page I of2 $8,000 Kittitas County Public Heatth Department Indirect Rate January 1,2022 through December3l, 2022:2lo/o Public Health Dept & l5% County Central Svcs Indirect Rate January 1, 2023 through December 31, 2023:34.30o/o EXHIBIT B.I5 ALLOCATIONS Con tract T er m: 2022-2024 Contract Number: Date: Funding Period SubTotal cLH3l0ls August l,2023 Chart of Accounts Total Federal Award Identification # Assist List #* BARS Revenue Code** DOH ttse Only Statement of Work Chart of Accounts LHJ Funding Period Funding period Start Date End Date Start Date End DateChart ofAccounts Title FFY22 Phys Achty & Nutrition Prog FFY22 Phys Achty & Nutrition Prog FFY2I Phys Ach4y & Nutrition Prog FFY2I Phys Acfvty & Nutrition Prog FFY24 HRSA MCHBG LHJ Contracts FFY23 HRSA MCHBG LIJJ Contracts FFY22 MCHBG LHJ Contracts FFY22 MCHBG LHJ Contracts GFS-Group B (FO-E) GFS-Group B (FO-E) FPHS-LHJ-Proviso (YR2) FPHS-LHJ-Proviso (YR2) FPHS-LHJ-Proviso (YR2) FPHS-LHJ-Proviso (YRl ) FPHS-Local Health Jurisdiction FPHS-Local Health Jurisdiction YR 25 SRr' - Local Asst (15%) (FO-E) SS YR 25 SRF - Local Asst (15%) (FO-E) SS YR24 SRF - Local Asst (15%) (FO-E) SS YR24 SRF - Local Asst (15%) (FO-E) SS Sanitary Survey Fees (FO-E) SS-State Sanitary Survey Fees (FO-E) SS-State Sanitary Survey Fees (FO-E) SS-State Sanitary Survey Fees (FO-E) SS-State YR 25 SRF - Local Asst (157o) (FO-E) TA YR24 SRF - Local Asst (15%) (FO-E) TA YR24 SRF - Local Asst (15%) (FO-E) TA TOTAL Total consideration: GRAND TOTAL *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333" NU58DP006504 NU58DP006504 NU58DPo06504 NU58DP006504 NGA Not Received 804MC47453 B04MC45251 B04MC4525 i $4,781,044 s906,343 $5,687,387 Amd 4 Amd I 93.994 93.994 Amend # Amd 12 Amd 7 Amd 4 Amd 1 93.439 93.439 93.439 93.439 93.994 93.994 333.93.43 333.93.43 333.93.43 333.93.43 09/30/22 09t30t22 0t/0t/22 0|01/22 09129/23 09129/23 09/29/22 09129/22 09130/22 09/30t22 09t30/2t 09t30t21 09/29t23 09t29/23 09/29t22 09129/22 Amount $ 1 0,000 $80,000 $19,470 $34,000 $44,196 $44" 196 $90,000 $53,470 s44,196 $44,196 $3s,278 $25,878 $25,877 $ 1,018,000 $0 $605,000 $1,783,000 $2,600 $s,200 $2,600 $5,200 $2,000 $2,000 s143,470 $88J92 $35,278 $s 1,755 $ 1,623,000 $ l,783,000 $7,800 $7,800 $4,000 $5,687,387 $2,210,032 s3,477,355 Amd 15 Amd 7 tund ll Amd I Amd 6 Amd 7 Amd 1 Amd I Amd 15 Amd 14 Amd 13 Amd 12 Arnd 4, 12 Amd l, 12 Amd 13 Amd 12 Amd 4, 12 Arnd 1, 12 Amd 12 Arnd,4,12 Amd 1, 12 333.93.99 333.93.99 l0l0l/23 09/30/24 t0/0r/22 09/30/23 l0/01t23 w01n2 09t30t24 09/30/23 333.93.99 333.93.99 t0/01/2r t0t0U2l 09/30/22 09130/22 06t30/23 06130t22 $2,13 l $33"147 01/0U22 09t30/22 01/01/22 09/30/22 N/A N/A 334 04.90 0t/0U23 06/30/23 334.04.90 0r/01/22 06/30t22 0710v22 07l0lt2t $25"878 $2s,877 $ 1,018,000 ($605,000) $60s,000 $605,000 $765,000 $ r,0 18,000 ($ 1,000) $3,600 $ 1,600 $3,600 ($ 1,000) $3,600 $ r,600 $3,600 $2,000 $ 1,000 $ 1,000 N/A N/A N/A N/A N/A N/A 336.04.25 336.04.25 336.04.25 336.04.25 07/0r/22 06/30/23 07t01/21 07/01D2 06t30t23 0'il0u21 07/01/22 06/30/23 07/01/2t 0ll0U22 06t30t22 07t0U2t 06130/23 06/30t23 06t30t23 06/30t23 336.04.2s 07t0u23 06/30t24 336.04.25 07/0|23 06/30t24 07/0U23 07/0U23 06/30t25 06/30/2s N/A N/A N/A N/A N/A N/A N/A N/A 0110U23 0r/0v23 01101t22 0l/0!22 12/3U23 t2/31/23 12131/22 12/3t/22 12/31t23 l2/31/23 I2/3U23 t2/31/23 0t/0v23 0v0U23 07/01/2t 07 t0t t2t 12/3t/23 t2/3U23 a6/30/23 06t30123 346.26.64 346.26.64 346.26.64 346.26.64 346.26.65 0U01t22 346.26.65 0t/01/22 346.26.6s 01/01/22 346.26.65 0t/01/22 07t0t/21 07/01/21 07/01/2t 07t0t/21 t2t3t/23 t2/31/23 l2/3U23 t2/31/23 t2/3t/23 06/30t23 06130/23 N/A N/A N/A 346.26.66 0t/01/23 346.26.65 01t0r/22 346.26.65 0I/01/22 l2/3r/23 0t/oU23 t2/3t/22 07l0u2l 12/31/22 0?/0t/21 $5,687,387 $5,697,387 GRAND TOTAT Total Fed Total State State revenue codes begin with "334" Page2 of2 Created: By: Status: Transaclion lD 2023-08-31 Brenda Henrikson (Brenda. Henrikson@DOH.WA. GOV) Signed CBJ C H BCAABAARFmnYgfgq-T-4zTitr0L6DCymvhzgVyu C1H31015 Kittitas Amend #15 FinalAudit Report 2023-'10-06 "CLH31015 Kittitas Amend #15" History S Document created by Brenda Henrikson (Brenda.Henrikson@DoH.wA,cov) 2023-08-31 - 1:49:07 AM cMT- tp address: 98.97.38.235 [?* Document emailed to Candi Blackford (candi.blacKord@co.kittitas.wa.us) for signature 2023-08-31 - 1:49:45 AM GMT fi Email viewed by candi Blackford (candi.blackford@co.kittitas.wa.us) 2023-10-03 - 7:48:36 PM GMT- tP address: 66.243.254.19 El New document URL requested by Candi Blackford (candi.blackford@co.kittitas.wa.us) 2023-10-03 - 9:36:05 PM GMT- tp address: 66.249.254.1A de Signer Candi Blackford (candi.blackford@co.kittitas.wa.us) entered name at signing as Chelsey Loeffers 2023-10-03 - 10:05:39 PM GMT- tp address: 66.249.254.19 ds Document e-signed by chelsey Loeffers (candi.blackford@co.kittitas.wa.us) Signature Date: 2023-10-03 - 10:05:41 PM GMT - Time Source: server- lp address: 66.243.254.1g tr] Document emailed to Brenda Henrikson (Brenda.Henrikson@DOH.WA.cOV) for signature 2023-10-03 - 10:05.42 PM GMT /6 Document e-signed by Brenda Henrikson (Brenda.Henrikson@DoH.wA.Gov) SignatureDate: 2023-10-06-'l;16:38AMGMT-TimeSource: server-lPaddress: g8.g7.84.114 O Agreement completed. 2023-10-06 - 1:16:38 AM GMT Powered by Adobe Acrobat Slgnrtnwn I