WASHINGTON BEHAVIORIAL HEALTH SERVICES WRAPAROUND CONTRACT HCA Contract Number: Resulting from Solicitation Number (If applicable):Wraparound Contract • January 30th, 2020
THIS AGREEMENT is made by and between Washington State Health Care Authority, hereinafter referred to as "HCA," and the party whose name appears below, hereinafter referred to as the "Contractor."
THIS DOCUMENT IS A RESTATED CONTRACT WITH AN EFFECTIVE DATE OF JULY 1, 2020.Wraparound Contract • June 25th, 2020
WASHINGTON BEHAVIORIAL HEALTH SERVICES INTEGRATED FOSTER CARE WRAPAROUND CONTRACT HCA Contract Number: K4612 Resulting from Solicitation Number (If applicable): 15-002 THIS CONTRACT is made by and between the Washington State Health Care Authority ("HCA") and the party whose name appears below ("Contractor”). CONTRACTOR NAME CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAM HCA DIVISION/SECTION HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESS HCA CONTACT TELEPHONE HCA CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUBRECIPIENT FORPURPOSES OF THIS CONTRACT?YES NO CFDA NUMBER(S)N/A FFATA Form RequiredYES NO CONTRACT START DATE July 1, 2020 CONTRACT END DATE December 31, 2020 TOTAL MAXIMUM CONTRACT AMOUNT $ PURPOSE OF CONTRACT:Contract for Foster Care BH Wrap Around Services ATTACHMENTS/EXHIBITS. When the box below is marked with an X, the following Exhibits/Attachments are attached and are incorpora
RFP 2020HCA5, Attachment 2: Draft Sample BH Wraparound ContractWraparound Contract • December 11th, 2019
WASHINGTON BEHAVIORIAL HEALTH SERVICES WRAPAROUND CONTRACT HCA Contract Number: Resulting from Solicitation Number (If applicable): THIS AGREEMENT is made by and between Washington State Health Care Authority, hereinafter referred to as "HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME«Organization_Name» CONTRACTOR ADDRESS«City», «State» «Zip_Code» WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)«UBI» CONTRACTOR CONTACT«Contact_Fname» «Contact_LName» CONTRACTOR TELEPHONE«PhoneNo» CONTRACTOR E-MAIL ADDRESS«EmailAddress» HCA PROGRAMManaged Care Program HCA DIVISION/SECTIONMedicaid Program Operations and Integrity HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESSPost Office Box 45502 Olympia, WA 98504-5502 HCA CONTACT TELEPHONE HCA CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT?YES NO CFDA NUMBER(S) FFATA Form RequiredYES NO CONTRACT START DATEJanuary 1, 2020 CONTRACT END DATEDecember 31, 2020 TO
