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HomeMy WebLinkAboutAmend 2 between Wa State Healthcare Auth and KCPHDi Kittitas County Public Health Contract/Agreement Review Form Kittitas County APublic Health Nftwo Department Today's Date: 03/30/2026 Legal Request M Fund/Department: 116- Public Health Agenda Date: Contract/Agreement Information Contract/Agreement Agency: Washington State Healthcare Authority Contract/Agreement Title: Amendment 2 between Washington State Healthcare Authority and Kittitas County Health Dept Begin Date: 07/01 /2026 Total $ Amount: $61,252.00 End Date: 06/30/2028 Contract/Agreement M K7461 amend 2 Contract/Agreement Summary: Contract is being extended through June 2028 allowing KCPHD to provide Access to Baby and Child Dentistry services to detect and prevent early childhood dental decay. Kittitas County Prosecutor and Auditor Review and Comment: APPROVED TO FORM: Signature f Prosec to s ffice Date 45� L(3 2 L Signatu t of Auditor's Office Date Riidnn+ Infnrnlmtinn Revenue Code(s): 116 - 612.24.1.334.06.901 / 612.24.1.333.93.778 Expense Code(s): PH8200-101 ❑✓ Agency is not suspended/disbarred Not Checked (reason) Pass Through Information Agency to Pass Through Amount to Pass Through Expense Code: Sub -Contract Approved Date: ADMIN I Version: 0 1 Supersedes: 0 Date Adopted:12/01/2024 1 Modified By: Katie Odiaga I Approval By: Chelsey Loeffers 3/31 /26, 10:04 AM SAM.gov HEALTH CARE AUTHORITY Unique Entity ID CAGE/NCAGE LNHZYKMNB9T5 5NJP5 Physical Address 626 8TH AVE SE Olympia, Washington 98501, United States Purpose of Registration Federal Assistance Awards Only Version Current Record BUSINESS INFORMATION Doing Business As URL (blank) (blank) Division Name Division Number (blank) (blank) Congressional State/Country of District Incorporation Washington 10 (blank), (blank) Owner CAGE Legal Business Name Immediate (blank)(blank) Owner Entity Information Active Registration Mailing Address 626 8TH Avenue PO Box 45502 Olympia, Washington 98504-5502, United States Registration Dates Activation Date Sep 22, 2025 Submission Date Sep 18, 2025 Initial Registration Date Sep 16, 2009 Expiration Date Sep 18, 2026 https://sam.gov/entities/view/LN HZYKMNB9T5/coreData?status=Active&emrKeyValue=l 047576-1757949179865689&reg Id=16417065 1 /3 3/31 /26, 10:04 AM SAM.gov Highest Level (blank)(blank) Owner Executive Compensation Entity Dates Entity Start Date Jun 1, 1988 Fiscal Year End Close Date Jun 30 Registrants in the System for Award Management (SAM) respond to the Executive Compensation questions in accordance with Section 6202 of P.L. 110-252, amending the Federal Funding Accountability and Transparency Act (P.L. 109-282). This information is not displayed in SAM. It is sent to USAspending.gov for display in association with an eligible award. Maintaining an active registration in SAM demonstrates the registrant responded to the questions. SAM SEARCH AUTHORIZATION I authorize my entity's non -sensitive information to be displayed in SAM public search results: Yes ENTITY TYPES Business Types Entity Structure U.S. Government Entity Entity Type US State Government Profit Structure (blank) Organization (blank) Factors Socio-Economic Types Check the registrant's Reps & Certs, if present, under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA -certified HUBZone small business concern. Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the SBA supplemental pages during registration. https://sam.gov/entities/view/LNHZYKMNB9T5/coreData?status=Active&emrKeyValue=l047576-1757949179865689&regld=16417066 2/3 3/31 /26, 10:04 AM SAM.gov Government Types U.S. State Government FINANCIAL INFORMATION https://sam.gov/entities/viewILNHZYKMNB9T51coreData?status=Active&emrKeyValue=l 047576-1757949179865669&regld=16417065 3/3 ✓UUUJIIy. I I CI IVCIUF t: I✓. I ✓ / C I ✓/'1/-Y.7/ V-4�0 V-.7Cr V-�C✓r�r CJO'4CO HCA Contract No.: K7461 Washington State CONTRACT Amendment No.: 02 Health CareVut-hority AMENDMENT THIS AMENDMENT TO THE CONTRACT is between the Washington State Health Care Authority and the party whose name appears below, and is effective as of the date set forth below. CONTRACTOR NAME Kittitas County Health Department CONTRACTOR ADDRESS 507 N Nanum St., Suite 102 Ellensburg, WA 98926 AMENDMENT START DATE July 1, 2026 Prior Maximum Contract Amount $35,876.00 CONTRACTOR doing business as (DBA) CONTRACTOR CONTRACT MANAGER Name: Nea Alfaro Email: nea.alfaro aaco.kittitas.wa.us AMENDMENT END DATE I CONTRACT END DATE June 30, 2028 June 30, 2028 Amount of Increase Total Maximum Compensation $25,376.00 $61,252.00 WHEREAS, HCA and Contractor previously entered into a Contract for providing "Access to Baby and Child Dentistry" services to detect and prevent early childhood dental decay, and; WHEREAS, HCA and Contractor wish to amend the Contract pursuant to Section 4.4 - Amendments to extend the Contract Term and increase Maximum Compensation; NOW THEREFORE, the parties agree the Contract is amended as follows: 1. Section 3.2 — Term, subsection 3.2.1 is amended to extend the term for two years and shall now read as follows: 3.2.1 The initial term of the Contract will commence on July 1, 2024, and continue through June 30, 2028, unless terminated sooner as provided herein. 2. Section 3.3 — Compensation, subsection 3.3.1 is amended to increase the maximum compensation and shall now read as follows: 3.3.1 The parties have determined the cost of accomplishing the work herein will not exceed $61,252.00, inclusive of all fees, taxes, and expenses. Compensation for satisfactory performance of the work will not exceed this amount unless the parties agree to a higher amount through an amendment. 3. In Attachment 1: Statement of Work, is hereby amended and replaced in its entirety with a new Attachment 1 B, Statement of Work, and is attached hereto and incorporated herein. 4. A new Attachment 5: ABCD Action Plan, is hereby incorporated and attached hereto. 5. Attachment 5: Data Sharing Agreement, is hereby renumbered to be Attachment 6, and any reference throughout the Contract to the Data Sharing Agreement shall be updated to reference the new attachment number. HCA Contract No. K7461-2 Page 1 of 14 LIUUUwYlI GIIVCIUF/C IL/. ILJI C ILim !-'T.`7/ V-4DoLY.7CrU-DCUr.7r C:Jo'iC0 6. Any reference on the Contract for HCA Clinical Dental Program Manager Pixie Needham and email address Pixie.needham hca.wa. ov, shall now be replaced with Jayson Diaz and the email address 'ayson.diaz(@hca.wa.gov. 7. This Amendment will be effective as of July 1, 2026 ("Effective Date"). 8. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Contract. 9. All other terms and conditions of the Contract remain unchanged and in full force and effect. The parties signing below warrant that they have read and understand this Amendment and have authority to execute the Amendment. This Amendment will be binding on HCA only upon signature by both parties. CONTRACTOR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED Audelia Martinez HCA SIGNATURE PRINTED NAME AND TITLE DATE SIGNED e—DocuSigned by: Andria Howerton 3/27/2026 A-,,� ..-,-C.. HCA Deputy Contracts Administrator F?EF77E93F©C.ID: HCA Contract No. K7461-2 Page 2 of 14 VUUUA1ly.II GIIVC1LJpV IV. 1 V/ C I VM/ W7/U-Y�O V-�Cr U-DCVr.7r CJOYCO ATTACHMENT 1B: STATEMENT OF WORK The Contractor shall provide the services and staff, and otherwise do all things necessary for or incidental to the performance of work, as set forth below: 1. Contractor Responsibilities In accordance with deadlines in Attachment 2, ABCD Quarterly Community and Provider Outreach and Case Management Report, develop and implement an ABCD action plan in accordance with the ABCD program principles and submit corresponding budget, using Attachment 4, ABCD Yearly Budget Tool. The ABCD program principles are outlined below. A. Provide Outreach and linkage of Apple Health/Medicaid-eligible Clients, ages birth to six (6), and ages six (6) to thirteen (13) who are clients of the Developmental Disabilities Community Services (DDCS) with an emphasis on groups with low utilization and high risk of dental disease such as children residing in rural communities, children of color, children aged zero (0) to two (2) and other eligible but underserved children in the service area, through collaboration with other organizations, including, but not limited to: Attending Outreach and marketing events and activities such as health fairs, use of social media (i.e., Facebook, Instagram, Constant Contact, etc.) to perform targeted Outreach activities that effectively connect with families of eligible children; SmileMobile (sponsored by the Arcora Foundation) locations (a mobile dental clinic providing dental services to children, pregnant women, and others); iii. Women, Infants, and Children (WIC) offices (a federal assistance program of the Food and Nutrition Services of the United States Department of Agriculture); iv. Head Start and Early Head Start facilities (a federal program that promotes the school readiness of children under five from low-income families); v. Early Learning Regional Coalitions that are a not -for -profit alliance of employers and community subsidized before- and after -school child care; vi. Day Care facilities throughout the state of Washington; vii. Community health workers or regional networks to gain resources, community connections on Outreach efforts for eligible children of color and children ages 0-2; and viii. Local Children with Special Health Care Needs (CSHCN) program, local Developmental Disabilities Community Services (DDCS) office and/or other organizations who work with children with disabilities to find methods and resources on how to identify eligible children for Outreach work. B. Provide care coordination, including but not limited to: Family Orientation such as sharing information about the value of an infant, toddler, or young child going to the dentist, what activities to expect at the dentist's office, and the importance of oral health care at home and the importance of keeping an appointment; HCA Contract No. K7461-2 Page 3 of 14 ✓UUUblyl I CI IVCIUFIC I✓. I Lit G I ✓P1l -4.7 / U-'*OO✓-Vr-r U-DC✓r-,r CJO'FGO Connecting families with an ABCD certified dental providers who accepts Apple Health/Medicaid, and providing information including, but not limited to, names and referrals to dentists, sharing information about interpreters and transportation benefits, and assist in scheduling appointments for eligible children and following up after an appointment, if appropriate; and iii. Maintain an up-to-date website with the correct ABCD logo, program eligibility information, and directions and a URL link to DentistLink.org. C. Collaborate with the DentistLink team to align the DentistLink tool with local program's referral processes to ensure ABCD clients have a variety of complementary avenues for referral and linkage to ABCD providers. D. Coordinate provider relationship management and program communication with DentistLink to support participating dental practices and maintain accurate program information. E. Contact each practice initially and periodically to update participating-ABCD dentist roster and collect the following information: Capacity and frequency for accepting ABCD clients; Availability of language and translation services; iii. Changes in participation status (e.g., temporarily not accepting new ABCD clients, increased availability); iv. Practice capability of serving children with disabilities and special health care needs, such as providing accessibility accommodation and equipment being available (e.g. wheelchair accessible operatories, sensory friendly rooms, sedation services, adaptive dental chairs, behavioral supports); V. Availability of General Anesthesia (GA); and vi. Ensure timely communication of any changes to participating practices to abcd p rog ramga rcora foundatio n . orcl. F. Identify and address family barriers to accessing oral health care. G. Bi-annually convene or participate in a county -wide or regional oral Health Coalition, ABCD Steering Committee, or other groups with focuses on health care, access or early learning in order to build awareness of the ABCD program and solicit input on process improvements. H. Invite Champion(s) to participate in the meeting with the ABCD state managing director, the Arcora Foundation, and the Health Care Authority dental program administrator. Continuously coordinate with the local ABCD Dental Champion(s) to: Identify and recruit dental providers to accept and provide care to Apple Health/Medicaid clients zero (0) to six (6) years through the ABCD Program; ii. Maintain a public facing list of active ABCD dental who accept Apple Health/Medicaid Clients zero (0) to six (6) years, ages six (6) to thirteen (13) who are clients of the Developmental Disabilities Community Services (DDCS) and monitor provider availability to HCA Contract No. K7461-2 Page 4 of 14 UUUUblyI I CI IVCIUpC IU. I UI C I Lim 1-+UI U-'T DO U-J Gr U-O CUrSr CUOYCO accept new Client's zero (0) to six (6) years into their practice; iii. Support current ABCD providers by communicating program changes and policy updates through in -person meetings and written communication; iv. Plan and implement, in coordination with the UW School of Dentistry, timely ABCD provider trainings (Phase I, II, III and refresher training) leading to certification of providers and onboarding of their staff; V. Ensure provider ABCD certification process is completed; vi. Provide or arrange for, timely Apple Health/Medicaid billing training assistance to ABCD office staff and providers, as needed; vii. At minimum, annually update dental society (or local dentists/study clubs in counties without a society) on the ABCD Program and support their continued participation in the program and encourage recruitment of new Apple Health/Medicaid providers; viii. Support the Dental Champion(s) participation in meetings and activities necessary to effectively conduct Apple Health/Medicaid provider Outreach, recruitment and training, including financial support of attendance (travel, lodging, etc.) in ABCD Champion Development Day; ix. Participate in the annual statewide ABCD Champion Development Day to remain current with new clinical practices and opportunities. Meet, network, and share knowledge with other champions regarding program roadblocks and successes; and X. Extend invitation(s) to ABCD Dental Champion(s) to attend the annual ABCD Champion Development Day. Provide ABCD Champion(s) travel reimbursement, if any, to attend ABCD Champion Development Day, is included in the total compensation. K. Partner with the MouthMatters program to expand primary care medical providers' participation in Apple Health/Medicaid as ABCD-certified providers and support integrated referral pathways to ensure Apple Health/Medicaid-eligible children are connected early and consistently to the ABCD Program. L. Participate in all three (3) statewide ABCD Coordinators group meetings to remain current with ABCD policies, practices, and opportunities. Programs which do not meet this annual Contract requirement will be subject to Contract review by HCA and potentially, to loss of this Contract. M. Identify an ABCD Coordinator within the contracting organization who shall develop and maintain a desk manual that outlines the expected ABCD contractual deliverables and how the Contractor meets each deliverable. The Coordinator shall utilize this manual to fulfill the contractual requirements and to orient new lead staff within the organization to the ABCD program. N. If the Contractor's Coordinator vacates the position, the Contractor must: Notify the Health Care Authority within two (2) weeks of the coordinator's departure; HCA Contract No. K7461-2 Page 5 of 14 UUI:UZ,1 1I CI IVCIUmt- IL/. I LJI [--I Lim f - tuI U'YDoL!-JGrU-o CL)r.7r C:)04CO Share the Contractor's developed work plan that outlines how the expected Contract deliverables will be met; iii. Include the HCA and the State Managing Partner, Arcora Foundation, in the hiring process to find a new coordinator; iv. Share with HCA the contact information of the newly hired or appointed Coordinator; V. Coordinate with HCA to assure a smooth transition of the expected contracted work deliverables, including participation in program orientation with HCA and other state partners, and; vi. ABCD Coordinator new hire must reasonably meet the expectations as identified in Exhibit D ABCD Coordinator Performance Expectations and Abilities of the ABCD Toolkit for coordinators, as provided by Arcora Foundation (https://abcd- dental.org/resources/abcd-toolkit/). O. If the Contractor determines that it can no longer serve as the ABCD Contractor, Contractor must: Give reasonable notice of at least ninety (90) days to HCA in order to assure uninterrupted service to clients and work with providers; and Work with HCA and other state partners to identify potential new ABCD-lead agencies. 2. Reporting Requirements A. Quarterly, the Contractor must complete and submit the following via email: Community and Provider Outreach and Coordination Care summary which shall include; a. Attachment 2, ABCD Quarterly Community and Provider Outreach and Case Management Report for the specific quarter; and b. Attachment 3, ABCD Quarterly Outreach and Coordination of Care Report. B. Annually, the Contractor must complete and submit via email the Attachment 4, ABCD Yearly Budget Tool, as applicable to the requirements contained in Attachment 2. The Contractor must allocate a defined percentage of staff time to the ABCD Coordinator role, as documented in the Annual Budget Tool. This allocation must reflect actual, dedicated hours spent on ABCD program activities and may not be reassigned to unrelated organizational duties. The assigned full-time employee (FTE) must be sufficiently available to meet all requirements of the SOW and align with the approved Action Plan. Contractor shall document and report how staff time supports ABCD Action Plan (Attachment 5) activities and deliverables as part of required in Attachment 3: ABCD Quarterly Outreach and Coordination of Care Report. C. Annually, the Contractor must complete and submit via email, Attachment 5, ABCD Action Plan due no later than October 31 st, each year. D. The Contractor must meet with the State Managing Partner, Arcora Foundation, on a yearly basis to HCA Contract No. K7461-2 Page 6 of 14 LJUUUJIy, I GI IV CIVFJc ILJ. I L!! G I LjMr-.+uI u-•4DOL/-d7Gr V-DMLiFUr CJO.4CD review local needs, utilization, and review the desk manual that outlines the ABCD contractual deliverables and how the Contractor has met or plans to meet those deliverables. E. Quarterly, the Contractor must submit a fully completed invoice that correlates with dollar values for completed deliverables outlined in Attachment 2 that includes the following: Exhibit templates, which are available on the ABCD website http://abcd-dental.org/for- coordinaeors/; ii. Each report must document the status of the SMART goals from the ABCD Action Plan (Attachment 5), detailing specific achievements or ongoing effort; and iii. Reports and billing must be submitted no later than one (1) month after each quarter end date, unless otherwise mutually agreed by both parties. 3. Acceptance Criteria Contractor may invoice for the deliverables listed below on completion of each deliverable. HCA has the right to withhold payment if the Contractor fails to meet deliverables standards. a. HCA will consider the ABCD Yearly Budget Tool (Attachment 4) complete once HCA confirms receipt of the report containing all required and relevant information. b. HCA will consider the quarterly Community and Provider Outreach and Coordination Care summary to be complete once HCA confirms receipt of the report containing the ABCD Quarterly Community and Provider Outreach and Case Management Report (Attachment 2) for the specific quarter; and the ABCD Quarterly Outreach and Coordination of Care Report (Attachment 3). c. HCA will consider the yearly ABCD Action Plan (Attachment 5) complete once HCA has confirmed receipt of the report containing all required and relevant information completed to HCA reasonable satisfaction. 4. Invoicing Schedule The Invoicing Pricing Table below is for FY27 and FY28, and prior fiscal year invoicing schedules are referenced in the prior Contract #K7461. Contractor shall invoice HCA once a quarter at the end of each quarter for the amounts listed in the table below: Deliverable Date Due to HCA Invoice Amount SFY27 I Invoice Amount SFY28 July — September +Coordinator Meeting Attendance 31-Oct $1,000.00 $1,000.00 Community Outreach Report $1,298.00 $1,298.00 Coordinate Care for Patients $324.00 $324.00 Coalition/Steering Committee Tasks $500.00 $500.00 July — September Total $3,122.00 $3,122.00 October— December HCA Contract No. K7461-2 Page 7 of 14 L/UUUJIIJ.II CIIVCIUpG IL/. IL!/ C ILim /-4.7/ V-YOOL/-.7CrU-CCUr�r C:/O4GC Dentistlink Roster 31-Jan $100.00 $100.00 Community Outreach Report $1,298.00 $1,298.00 Coordinate Care for Patients $324.00 $324.00 Development Care $2,000.00 $2,000.00 October — December Total $3,722.00 $3,722.00 January — March Coordinator Meeting Attendance 30-Apr $1,000.00 $1,000.00 Community Outreach Report $1,298.00 $1,298.00 Coordinate Care for Patients $324.00 $324.00 Coalition/Steering Committee Tasks $500.00 $500.00 January — March Total $3,122.00 $3,122.00 April — June Dentistlink Roster 31-Jul $100.00 $100.00 Community Outreach Report $1,298.00 $1,298.00 Coordinate Care for Patients $324.00 $324.00 Coordinators Meeting Attendance $1,000.00 $1,000.00 April — June Total $2,722.00 $2,722.00 SFY Total Amount $12,688.00 $12,688.00 Total Budget $25,376.00 HCA Contract No. K7461-2 Page 8 of 14 Co r aai .a m o a �C)o moo L Yo0121 M v C c y� z CO a O 0)� U Z�Zm co � z�incn�•�aY i U a c� p Ucn p O C� cn m a cB i to N a N a U p a O o o o = ti o a a� s •- - `n m N cB t- cn -o a� c�_ o o co a o i U L O N mz s0 maw c Q.� ocoi,) CO as 3co ° ma° Q. 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