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Home My WebLink AboutSHJ26-008 VALLEY HEALTH MOU - PARTIALLY EXECUTEDCLINICAL OPERATIONS MOU MEMORANDUM OF UNDERSTANDING CLINICAL OPERATIONS Kittitas County / Kittitas County Jail and Contractor I August 2026 1. PURPOSE AND RELATIONSHIP TO SERVICE AGREEMENT This MOU establishes the day-to-day operating model between Kittitas County, acting through Kittitas County Jail, and Apple Valley Counseling Services, LLC, a Washington limited liability company doing business as Valley Health and Counseling (Contractor), for mental health, substance use disorder (SUD), behavioral -health practitioner, and behavioral -health medication -management services at Kittitas County Jail (KCJ). It supplements the parties' service agreement and BAA. It does not expand custody duties, waive legal requirements, or override the service agreement's payment, insurance, indemnity, or termination terms. 2. SERVICES • Mental health: screening, assessment, individual or group treatment when clinically appropriate, crisis evaluation and coordination, discharge or reentry referral, and clinically necessary care coordination. • SUD: screening and assessment, counseling, case management, medication -treatment referral and coordination, community referral, and warm handoff when feasible. • Behavioral -health practitioner services: behavioral -health assessment, medication evaluation and management, monitoring, prescribing, consultation, and coordination or referral within the rendering clinician's scope and credentialing. General medical, primary -care, family -medicine, urgent -care, and chronic -disease needs remain with KCJ's designated medical provider. Contractor will not alter or assume management of medical treatment already under that provider's care, except for clinically necessary coordination within the practitioner's scope to address behavioral -health medication safety. • Training, court participation, meetings, reporting, and nonclinical administrative work only when requested and priced in writing. 3. REFERRAL, TRIAGE, AND SCHEDULING • KCJ will submit referrals through the approved method with accurate booking, clinical, safety, custody, language, accessibility, and insurance information available to it. • Contractor will triage referrals by clinical urgency and available scope. Emergencies remain the County's responsibility through 911, the emergency department, crisis response, or other established emergency pathways. • The parties will maintain a written staffing schedule. Reserved time cancelled by the County with less than twenty-four hours' notice may be billed under the service agreement, except for a documented emergency. • Neither the MOU nor a referral guarantees a specific treatment, prescription, diagnosis, provider, outcome, or continuous on -call coverage. 4. FACILITY ACCESS AND SAFETY KCJ supplies secure workspace, reasonable privacy, connectivity, approved system access, escorts, correctional staffing, emergency response, and timely access to referred patients. Contractor personnel follow reasonable facility safety rules that do not conflict with licensure, clinical independence, confidentiality, or patient safety. Contractor personnel do not perform custody, search, transport, restraint, classification, discipline, or evidence - gathering duties. 5. CLINICAL INDEPENDENCE AND CONTINUITY Clinical decisions remain with the licensed rendering professional. KCJ may provide relevant observations and safety information but may not direct diagnosis, prescribing, documentation, treatment, discharge, or disclosure contrary to law or professional standards. Contractor will coordinate clinically appropriate continuity, referral, medication reconciliation, and reentry handoffs when information and community resources permit. 6. DOCUMENTATION AND RECORDS • Contractor documents services in the approved EHR or agreed record system within clinically reasonable timeframes. KITTITAS COUNTY! VALLEY HEALTH AND COUNSELING I Page 1 CLINICAL OPERATIONS MOU • Corrections to clinical records follow professional and legal standards; neither party will require alteration of an accurate clinical record. • KCJ receives operational and de -identified aggregate reports. Where reasonably available from existing systems, aggregate measures may include service timeliness, telehealth utilization, referral status or closure, discharge or reentry referrals, and behavioral -health medication -management continuity. Neither party must create a new reporting system or perform material custom analytics without a separately approved scope and price. Access to identifiable records requires a lawful purpose and minimum -necessary basis under the BAA, Part 2, chapter 70.02 RCW, privilege, and other applicable law. 7. PRIVACY AND COMMUNICATION The parties will execute the BAA and applicable Part 2 terms before exchanging PHI or SUD records. Clinical information will be communicated through approved secure channels. Communications with courts, prosecutors, defense counsel, family, or outside providers require the authorization, court order, treatment exception, or other legal basis applicable to the information. 8. INSURANCE VERIFICATION AND BILLING • KCJ provides available coverage information at referral and promptly supplies updates. Contractor performs reasonable verification but does not guarantee payer eligibility or payment. • Contractor bills an active third -party payer first only when the client, service, setting, provider, and claim are lawfully payable and Contractor is authorized to bill. • If insurance is inactive or cannot be verified at the visit, incarceration or payer policy prevents payment, or a claim is denied for a reason other than Contractor billing error, KCJ reimburses Contractor at the Medicaid -equivalent rate. Contractor need not await a denial when eligibility records establish that no payer is available. • Contractor will not bill or balance -bill the incarcerated client. No service may be billed to both a payer and KCJ beyond any lawful residual amount; later payer recovery will be credited or refunded to KCJ. • Invoices will identify service date, category, code, modifier, units, provider type, HCA schedule/effective date, insurance status or payer disposition, and amount. KCJ will pay undisputed amounts within thirty days and identify disputes within fifteen days. Undisputed amounts not paid when due accrue interest as provided by chapter 39.76 RCW, consistent with the service agreement. 9. MEDICAID -EQUIVALENT RATE METHOD Mental health uses the HCA Mental Health and Psychology Services Fee Schedule. SUD uses the HCA Substance Use Disorder Fee Schedule and applicable SERI requirements. Behavioral -health practitioner and medication - management services use the HCA Physician -Related Services/Health Care Professional Services Fee Schedule. The schedule effective on the service date controls for the correctly documented code, modifier, unit, provider type, age, place of service, and facility designation. Where no HCA rate exists, the parties must approve a written rate before service. Preapproved business mileage is reimbursed at the Washington Office of Financial Management privately owned vehicle rate effective on the travel date ($0.725 per mile effective January 1, 2026). Travel time and other expenses are not separately payable unless approved in writing before travel. 10. TECHNOLOGY AND FUNDING COOPERATION Subject to available funding, applicable approvals, and a mutually approved written implementation plan, the parties may use secure telehealth, electronic referral, behavioral -health medication follow-up, and transition - support technology to improve access to the contracted services. Before deployment, the implementation plan will address ownership, approved location, space, power, connectivity, system access, privacy, security, accessibility, clinical safety, support, custody, incident reporting, and removal. Grant funds will not duplicate technology the County already provides under the service agreement. Upon reasonable request, the County may provide factual confirmation of the service relationship, identified operational need, intended location, and approved workflows for a funding application. This does not require the County to sponsor or endorse an application, provide matching funds, guarantee an award, purchase equipment, administer a grant, accept grant -compliance duties, or incur costs not separately approved in writing. 11. INCIDENTS, COMPLAINTS, AND ESCALATION • Immediate clinical or safety threats follow KCJ emergency procedures first, followed by prompt notice to Contractor leadership. KITTITAS COUNTY / VALLEY HEALTH AND COUNSELING I Page 2 CLINICAL OPERATIONS MOU • Privacy or security events follow the BAA. Clinical -quality complaints are routed to Contractor; custody or facility complaints are routed to KCJ. • Operational disputes escalate from designated liaisons to executive representatives. Patient care will not be delayed for an administrative dispute when safe lawful care can proceed. 12. CONTACTS AND REVIEW Function KCJ Contractor Steve Panattoni, Superintendent Tanner Rapp Clinical operations p steve.panattoni@co.kittitas.wa.us T.Ra .Rapp@ValleyHC.org 509-962-7527 509-961-6336 (proposed; County to confirm) Steve Panattoni, Superintendent Tanner Rapp Scheduling referrals steve.panattoni@co.kittitas.wa.us T.Rapp@ValleyHC.org 509-962-7527 509-961-6336 (proposed; County to confirm) Steve Panattoni, Superintendent Tanner Rapp Billing steve.panattoni@co.kittitas.wa.us T.Rapp@ValleyHC.org 509-962-7527 509-961-6336 (proposed; County to confirm) Steve Panattoni, Superintendent Tanner Rapp Privacy /security steve. panattoni@co.kittitas.wa. us T.Rapp@ValleyHC.org 509-962-7527 509-961-6336 (proposed; County to confirm) Steve Panattoni, Superintendent Tanner Rapp Executive escalation steve.panattoni@co.kittitas.wa.us 509-962-7527 T.Rapp@ValleyHC.org (proposed; County to confirm) 509-961-6336 The parties will review operations at least quarterly during the first year and update contacts, workflows, and written rate exceptions as needed. Material scope or compensation changes require a signed service -agreement amendment. KITTITAS COUNTY / VALLEY HEALTH AND COUNSELING I Page 3 CLINICAL OPERATIONS MOU EXHIBIT 1- MEDICAID -EQUIVALENT RATE REFERENCE The controlling amount is the Washington HCA fee -for -service maximum allowable amount effective on the service date for the correct code, modifier, unit, provider type, age, place of service, and facility designation. The examples below verify the July 1, 2026 schedules; they are not a frozen rate card. Category Code Modifier NFS FS Description/note Mental health 90791 None $127.46 $99.23 Psychiatric diagnostic evaluation Mental health 90834 None $83.48 $66.31 Psychotherapy, 45 minutes Mental health 90837 None $122.51 $97.82 Psychotherapy, 60 minutes SUD H0001 HF $161.59 Same SUD assessment Individual SUD SUD H0004 HF $31.07 Same therapy, per 15 minutes (HCPCS unit) SUD T1017 HF $14.20 Same Case management, each 15 minutes Established patient Behavioral -health 99213 None $42.65 $25.08 E/M; behavioral - practitioner E/M health medication management only Established patient Behavioral -health g9214 None $6065 $36.70 E/M; behavioral - practitioner E/M . health medication management only NFS = non -facility setting; FS = facility setting. HCA billing guides determine which amount applies. Enhanced, age - specific, telehealth, or other HCA rules may change the payable amount. KITTITAS COUNTY / VALLEY HEALTH AND COUNSELING I Page 4 CLINICAL OPERATIONS MOU EXHIBIT 2 - CURRENT SOURCE REFERENCES • Washington HCA provider billing guides and fee schedules: https://www.hca.wa.gov/billers-providers- partners/prior-authorization-claims-and-billinglprovider-billing-guides-and-fee-schedules • Mental health fee schedule effective July 1, 2026: mental-health-services-20260701.xlsx • Substance use disorder fee schedule effective July 1, 2026: substance-use-disorder-20260701.xlsx • Physician -related services fee schedule effective July 1, 2026: physician-20260701.xlsx • Washington OFM travel rates: https://ofm.wa.gov/accounting/travel/per-diem-rate-tables/ SIGNATURES KITTITAS COUNTY By: Name/Title: � Date: S -if _,cG CONTRACTOR Apple Valley Counseling Services, LLC dlbla Valley Health and Counseling By; Name/Title: Date: KlTTITAS COUNTY 1 VALLEY HEALTH AND COUNSELING I Page 5