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i <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitas County <br />APublic Health <br />Nftwo Department <br />Today's Date: <br />03/30/2026 <br />Legal Request M <br />Fund/Department: <br />116- Public Health <br />Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: Washington State Healthcare Authority <br />Contract/Agreement Title: Amendment 2 between Washington State Healthcare Authority and Kittitas County Health Dept <br />Begin Date: 07/01 /2026 <br />Total $ Amount: $61,252.00 <br />End Date: 06/30/2028 <br />Contract/Agreement M K7461 amend 2 <br />Contract/Agreement Summary: <br />Contract is being extended through June 2028 allowing KCPHD to provide Access to Baby and <br />Child Dentistry services to detect and prevent early childhood dental decay. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVED TO FORM: <br />Signature f Prosec to s ffice Date <br />45� <br />L(3 2 L <br />Signatu t <br />of Auditor's Office Date <br />Riidnn+ Infnrnlmtinn <br />Revenue Code(s): <br />116 - 612.24.1.334.06.901 / 612.24.1.333.93.778 <br />Expense Code(s): <br />PH8200-101 <br />❑✓ <br />Agency is not suspended/disbarred <br />Not Checked (reason) <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />ADMIN I Version: 0 1 Supersedes: 0 Date Adopted:12/01/2024 1 Modified By: Katie Odiaga I Approval By: Chelsey Loeffers <br />