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............ M
Grant Behavioral Health 6 Wellness
June 9, 2023
Board of Grant County Commissioners
PO Box 37
Ephrata, WA 98823
Re: Signature for Health Care Authority — CJTA K3958-4
Dear Board of County Commissioners:
Please see the attached amendment for review and approval.
840 E. Plum Street
Moses Lake, WA 98837
Phone: (509) 765-9239
Fax: (509) 765-1582
Contractor: Health Care Authority
Term of Contract: Agreement End Date — 6/30/23
Payment Amount: $50,,267.63 increase
Purpose: Amendment to update Renew's business name and increase of funds to cover client services.
I am requesting permission to Docu-Sign electronically with Health Care Authority.
Thank you for your consideration.
7 C.-Ook-
Dell Anderson,/.Ed,./LIMHC
Executive Director
Ext. 5472
RECCI`w
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JUN 13 7s123
GRANT COUN-1Y CV01 MIS
JUN 2 0 2023
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All 11-11L &i 14
DocuSign Envelope ID: BAF290BF-3E50-42D9-BACB-6Dl2lDFB3078
K23-149
Washington State
CONTRACT
HCA Contract No.: K3958
Amendment No.: 4
AMENDMENT
V
HeathCarefi(uuthhoorlitty,
For Treatment and
Recovery Services
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
CONTRACTOR doing business as (DBA)
Grant County
Renew
CONTRACTOR ADDRESS
CONTRACTOR CONTRACT MANAGER
35 C Street NW, PO Box 37
Name: Linze Greenwalt
Ephrata, WA 98823-0037
Email: Igreenwalt(&.grantcountv.wa.gov
AMENDMENT START DATE
CONTRACT END DATE
Date of Execution
June 30, 2023
Prior Maximum Contract Amount
Amount of Increase
Total Maximum Compensation
$569)193.00
$507267.63
$6191460.63
WHEREAS, HCA and Contractor previously entered into a Contract for Criminal Justice Treatment Act (CJTA)
Funded Treatment and Recovery Support Services, and;
WHEREAS, HCA determined that some SFY2023 CJTA funds allocated to HCA were underspent, and;
WHEREAS, HCA and Contractor determined that additional work could be added to this Contract, and;
WHEREAS, Contractor registered a DBA' in 2021 that was not previously referenced in this Contract;
WHEREAS, HCA and Contractor wish to amend the Contract pursuant to Section 4.3 to increase Total ,
Maximum Compensation, and to amend Subsection 3.3.2 — Deliverables Table and Attachment 1 — Statement of
Work to add a summary report to gather information on activities from SFY2023, and recognize the new DBA
name;
NOW THEREFORE, the parties agree the Contract is amended as follows:
1. Business Name. Contractor's business name is hereby recognized as Grant County DBA Renew.
2. Section 3.3, Compensation, is amended to increase the Total Maximum Compensation by $50,267.63 from
$569,193.00 to $619,460.63.
3. Section 3.3, Compensation, subsection 3.3.1, is amended to read as follows:
3.3.1 Schedule A-1, Statement of Work (SFY 2022 — SFY 2023) is increased by $50,267.63 from
$331,956.00 to $382,223.63. Total Maximum Compensation for SFY 2022 — SFY 2023 includes
$2307321.63 CJTA funding; $151,902.00 Supplemental CJTA funding; and $0 State Drug Court
funding.
4. Section 3.3 Compensation, subsection 3.3.2, Deliverable Tables for July 1, 2022 through June 30, 2023 is
amended to read as follows:
HCA Contract No. K3958-4 Page 1 of 2
DocuSign Envelope ID: BAF290BF-3E50-42D9-BACB-6D121 DFB3078
Deliverables Table
July 1, 2022 through June 30, 2023
#
Deliverable
Due Date
Amount
1
Submit an updated county Criminal Justice Treatment
Account (CJTA) Plan that was approved by the local CJTA
panel and signed by County Legislative Authority that
indicates how the CJTA Supplemental will be utilized.
October 1, 2022
$417494.50
2
Submit quarterly progress reports
January 1, 2023
$417494.50
3
Submit quarterly CJTA Revenue and Expenditure Reports.
April 1, 2023
$417494.50
4
Submit monthly and/or quarterly Programmatic Treatment
Reports through Secure File Transfer (SFT) process.
July 1, 2023
$417494.50
5
Submit final report
July 1, 2023
$507267.63
Total Maximum Compensation for deliverables completed through 6-30-2023
$216,245.63
5. Attachment 1, Statement of Work, is amended to add a new section, as follows:
8. Final Report. Contractor will provide HCA Contract Manager a summary report for approval, to include,
but not limited to, the following:
8.1 Increase in clients being served in the past fiscal year;
8.2 Challenges and/or unique circumstances in managing the increasing capacity;
8.3 Increase in costs of providing services;
8.4 Self -reflection of program strengths and future needs.
6. This Amendment will be effective the date of last signature ("Effective Date").
7. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Contract.
8. 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
linze Greenwalt
HCA SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
DocuSignedby:
LAVA&& �
n nette Schuffenhauer
h i of Legal Officer
6/9/2023
HCA Contract No. K3958-4 Page 2 of 2