SIGNED FINAL Public Health Outreach Services for ForwardHealth Program Services $51,511 6-1-2026

DHS Grant Agreement No.: 435400-G27-56-30 Agreement Amount: $51,511
Agreement Term Period: July 1, 2026 to June 30, 2027 GEARS Pre-Packet No: 4053
DHS Division: Division of Medicaid Services DHS Grant Administrator: Sabrina Zahn DHS Email: 
sabrina.zahn@dhs.wisconsin.gov
Grantee Grant Administrator: Jody Bruni Grantee Email: Jody.Bruni@saukcountywi.gov
Grantee Unique Entity Identifier (UEI) Name: County of
Grantee Unique Entity Identifier (UEI) Number: MBBB
DHS and the Grantee acknowledge that they have read the Agreement and the attached documents, 
understand them and agree to be bound by their terms and conditions. Further, DHS and the Grantee 
agree that the Agreement and the exhibits and documents incorporated herein by reference are the 
complete and exclusive statement of agreement between the parties relating to the subject matter of 
the Agreement and supersede all proposals, letters of intent or prior agreements, oral or written 
and all other communications and representations between the parties relating to the subject matter 
of the Agreement. DHS reserves the rights to reject or cancel Agreements based on documents that 
have been altered. This Agreement becomes null and void if the time between the earlier dated 
signature and the later dated signature exceeds sixty (60) days, unless waived by DHS.
State of Wisconsin
   Department  of  Health  Services      

Grantee
Entity Name
Authorized Representative                   Authorized Representative
Name                             Name

Amanda Dreyer                   Lisa Wilson

Title                              Title

Medicaid Director

COUNTY ADMINIST

Signature                           Signature

Date

6D/1at/e2026
Docusign Envelope ID: 81C125C4-A851-8967-811E-C4CC369A2620

RATOR
 County of Sauk   

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Sauk