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Home My WebLink AboutGrant Related - BOCC (004)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: BOCC REQUEST SUBMITTED BY: K Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Kal'I'I@ Stockton CONFIDENTIAL INFORMATION: ❑YES ® NO SATE: 7/23/2026 PHONE:2937 []Agreement / Contract ❑AP Vouchers ❑Appointment / Reappointment ®ARPA Related ❑ Bids / RFPs / Quotes Award []Bid Opening Scheduled ❑ Boards / Committees ❑ Budget El Computer Related ❑County Code El Emergency Purchase El Employee Rel, ❑ Facilities Related ❑ Financial ❑ Funds ❑ Hearing ❑ Invoices / Purchase Orders ® Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑ Minutes ❑ Ordinances []Out of State Travel ❑ Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution ❑ Recommendation ❑ Professional Serv/Consultant ❑ Support Letter ❑ Surplus Rego ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB M T WE !-T If, 1 -,-U-Vf 0 UP W A Et Reimbursement request from Renew on the American Rescue Plan Act (ARPA) in the amount of $4,226 for the uninsured category. If necessary, was this document reviewed by accounting? ❑ YES ❑ NO R N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO Fm-1 N/A N. N-m-.60--s- - - Memo I J., i DATE OF ACTION: 7 11b Z APPROVE: DENIED ABSTAIN K D 1: ,r(. D2: D3: v�- DEFERRED OR CONTINUED TO- WITHDRAWN - 4/23/24 reuu Grant Behavioral Health 6 Wellness PO Box 1057 Moses Lake, WA 98837 Phone (509) 765-9239 BILL TO: Grant County Attention: Karrie Stockton PO Box 37 Ephrata, WA 98823 DATE: July 23rd9 2026 DESCRIPTION lientc.. Serv. AMOUNT AMOUNT ARPA FUNDS Un-Insured Dollars SUD clients Service Dates from 05/13/2025 - 05/19/2026 5 27 45226.00 $ 4,226.00 $ - $ SUBTOTAL TOTAL $ 43226.00 $ 49226.00 THANK YOU FOR YOUR BUSINESS! Service ID Service Date Client ID Service Type CPT Code CPT Modifie r Progra m Location Recipient Employee Name Status Service Amount ARPA 867342 5/13/2025 12548671 Intake 90791 MH I EP Office Client Miller, Judy RESUBMIT $ 250.00 $ 1.00 871942 5/30/2025 12548671 Individual 90837 MH EP Office Client Drapeau, Patrick RESUBMIT $ 240.00 $ 10.00 873349 6/3/2025 12548671 Individual 90837 MH EP Office Client Drapeau, Patrick RESUBMIT $ 240.00 $ 10.00 874560 6/5/2025 12540828 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 876531 6/11/2025 12548671 Individual 90837 MH EP Office Client Drapeau, Patrick RESUBMIT $ 240.00 $ 10.00 883349 7/1/2025 12540828 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 883960 7/3/2025 12548671 Individual 90834 MH EP Office Client Drapeau, Patrick RESUBMIT $ 180.00 $ 10.00 885778 7/9/2025 12548671 Individual 90837 MH EP Office Client Drapeau, Patrick RESUBMIT $ 240.00 $ 10.00 888685 7/15/2025 12540828 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 888690 7/16/2025 12548671 Individual 90837 MH EP Office Client Drapeau, Patrick RESUBMIT $ 240.00 $ 10.00 894257 7/30/2025 12540828 Individual 90837 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 240.00 $ 240.00 899702 8/15/2025 12540828 Individual 90837 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 240.00 $ 240.00 904161 8/27/2025 12540828 Individual 90832 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 120.00 $ 120.00 909205 9/10/2025 12540828 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 913752 9/24/2025 12548671 Individual 90834 MH GC Office Client Drapeau, Patrick RESUBMIT $ 180.00 $ 10.00 925188 10/23/2025 12540828 Individual 90837 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 240.00 $ 240.00 934593 11/17/2025 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 940061 12/2/2025 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 945664 12/16/2025 12540828 EBP Kids 90837 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 240.00 $ 240.00 952210 1/7/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 957585 1/22/2026 12540828 Med Man 99215 MH ML Telehealth Fam+Client Dick, Michelle RESUBMIT $ 335.00 $ 30.00 958536 1/23/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 964560 2/10/2026 12551917 BH Care Cr H0023 Crisis Phone Other Other Mitchell, Thomas (Gene) RESUBMIT $ 37.50 $ 37.50 964785 2/10/2026 12550856 BH Care Cr H0023 Crisis Phone Other Phone Mitchell, Thomas (Gene) RESUBMIT $ 37.50 $ 37.50 971192 2/25/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 11810.00 974160 3/4/2026 12547206 CM H2O15 FQ MH I Phone Clients Phone Heen, Michelle COMPLETED $ 120.00 $ 12110.00 976901 3/11/2026 12547206 CM H2O15 MH GC Office Client Heen, Michelle COMPLETED $ 120.00 $ 120.00 977307 3/12/2026 12540828 Med Man 99215 MH ML Telehealth Fam+Client Dick, Michelle RESUBMIT $ 335.00 $ 30.00 978142 3/12/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 984122 3/26/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 988731 4/7/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 993855 4/21/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 1000452 5/6/2026 12540828 EBP Kids 90834 MH ML Office Client Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 180.00 1006201 5/19/2026 12540828 EBP Kids 90834 MH I ML Office lClient Serrano Castrellon, Alejandra RESUBMIT $ 180.00 $ 1810.0'0 $ 6,575.00 $ 4,226.0'0 7/15/2026 ARPA TOTAL CLIENTS SERVED 5 1 nta ke 1 Case Management 2 BH Care Cr 2 EBP Kids 14 Individual 8 TOTAL SERVICES PROVIDED 27 TOTAL INVOICE $ 4,226.00 Contract #_ARPA Uninsured Dollars Submitted to GC by: Reyna Gonzales Request for Reimbursement No. $4,226.00 Grant County's Subrecipient Checklist: State Auditor's Office Audit Procedures for Testing Activities Allowed And Not Allowed, As Published In 2007 Questions to ask before submitting a payment request Was the expenditure or cost: _X_ Made for an allowable activity under the grant guidelines? _X_ Authorized (or not prohibited) under state or local laws or regulations? X_ Approved by the federal awarding agency, if required? _X Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43? For payroll transactions _X_ Does the employee's time and effort documentation meet the requirements of Circular A-1 22? _X_ Allocable to the program? (i.e., was the dollar amount charged to the program relative to the benefits received by the program? Is the federal grantor being charged its fair share of the cost?) _X_ Based on actual costs, not budgeted or projected amounts? _X_ Applied uniformly to federal and non-federal activities (i.e., is the federal government being charged the same amount as if non-federal funds were being used to pay the cost)? _X_ Given consistent accounting treatment within and between accounting periods? (Consistency in accounting requires that costs incurred for the same purpose, in like circumstances, be treated as either direct costs only or indirect costs only with respect to final cost objectives). _X_ Calculated in conformity with generally accepted accounting principles, or another comprehensive basis of accounting, when required under the applicable cost principles? _X_ Not included as a cost (or used to meet cost sharing requirements) of other federally -supported activities of the current or a prior period? _X_ Net of all applicable credits? (e.g., volume or cash discounts, insurance recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and scrap sales). _X_ Not included as both a direct billing and as a component of indirect costs? _X_ Properly classified (e.g.,, some costs may be incorrectly claimed as a direct cost instead of being incorporated as part of the indirect cost rate). _X_ Supported by appropriate documentation? (e.g., approved purchase orders, receiving reports, vendor invoices, canceled checks, and time and attendance records.) Documentation may be in an electronic form. _X_ Correctly charged to the proper account code and grant period? Page 1