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C-86-20-034-G-02 )'3 6XEDZDUG Amendment $PHQGPHQW 1R 2 6XEDZDUG 1R 547365 3DVV 7hrough Entity (PTE) Subrecipient Arizona Board of Regents on behalf of the University of Arizona (QWLW\ 1DPH Maricopa County Public Health Department SPS-Subawards@email.arizona.edu &RQWDFW (PDLO k.mason@maricopa.gov Scott C Carvajal 3ULQFLSDO ,QYHVWLJDWRU Mark Gallegos Project Title Health Promotion and Disease Prevention Research Centers - 2019 37( 3ULPH $ZDUG 1R 6 U48DP006413-01-03 Awarding Agency National Institutes of Health (NIH) &XPXODWLYH %XGJHW 3HULRG V $PRXQW )XQGHG 7KLV $FWLRQ Total Amount of Funds Obligated to 'ate $JUHHPHQW 6WDUW 'DWH (QG 'DWH RI /DWHVW %XGJHW 3HULRG Start Date: 09/30/2019 End Date: 09/29/2021 $ 24,000.00 $ 39,992.87 6XEUHFLSLHQW &RVW 6KDUH 6XEMHFW WR ))$7$ ■ 6XEUHFLSLHQW 8(, EODQN 8QLTXH LI XQFKDQJHG (QWLW\ ,GHQWLILHU IURP SULRU 0D\ $JUHHPHQW OHDYH Amendment(s) to Original Terms and Conditions This Amendment revises the above-referenced Subaward $JUHHPHQW as follows: Supplemental funding in the amount of $24,000 is hereby authorized for the period of May 1, 2021 to September 29, 2021. The supplemental budget and budget justification are hereby incorporated by attachment to this Amendment. The scope of work remains unchanged. &DUU\RYHU LV Not Automatic Carryover across budget periods requires prior approval. If carryover is not automatic, the "Total Amount of Funds Obligated to Date" stated above may not reflect the actual balance available. The Subrecipient is responsible for tracking unobligated balances and subsequent carryover approvals from prior budget periods. In the event that funding was not fully expended by the Subrecipient during the prior period, the Subrecipient is not authorized to use funds from any prior periods, unless approval is granted by the PTE. )RU FODULW\ DOO DPRXQWV VWDWHG LQ WKLV DPHQGPHQW DUH LQ 8QLWHG 6WDWHV 'ROODUV All other terms and conditions of this Subaward Agreement remain in full force and effect. By an Authorized Official of P7(: By an Authorized Official of Subrecipient: Date 'ate Name Radha Radhakrishnan Ph.D Name Jack Sellers Title Director – Contracting Services & Subawards Title Chairman, Board of Supervisors APPROVED AS TO FORM:____________________________ Anne Longo, Attorny for County, Date ATTEST:_______________________________________ 5HYLVHG Office of the Clerk of the Board Date Health Promotion and Disease Prevention Research Centers RFA/Subaward No. 547365 Project Begin Date 05/01/21 Project End Date 09/29/21 Number of Years 4 mos Personnel Key in purple Name Title % Effort Months Base Salary Rqsted Salary Fringe Rate Fringe Year 1 0.00 $ - $ - $ - 0.00 $ - $ - $ - 0.00 $ - $ - $ - 0.00 $ - $ - $ - 0.00 $ - $ - $ - 0.00 $ - $ - $ - Total $ - EREs AZ State Retirement $ - Social Security $ - Medicare Cont $ - Worker's Comp $ - Health Insurance (C.Esp) $ - Health Insurance (G.Cor) $ - Life Insurance $ - Employee Assistance $ - Total $ - Contractual - Reserach Project ACRO- Temp Agency contract for Cummunity Health Worker $ 20,202 Total $ 20,202 Equipment Total $ - Travel Total $ - Materials and Supplies Total $ - Other Expenses $ - Total $ - Totals Total Direct Costs $ 20,202 18.8% Total Indirect Costs $ 3,798 Total cost requested $ 24,000 Total cost for all years Maricopa County Ͳ Justification PO# 547365 From 5/01/21 - 9/29/21 the Contractual Research funding of $20.202.00 , will be utilized by Maricopa County Department of Public Health to prepare for the UNIDOS clinical linkage CHW grant by hiring a full-time CHW to: 1. Identify and engage key stakeholders from community and clinical sectors. 2. Create a CHW workflow that services community members within a clinical linkage model. 3. Develop strategies for CHW and community participation recruitment within the health care continuum. 4. Enroll in and complete the core competencies (CHW) as developed by the CHD team within assigned work hours. 5. Identify and engage senior housing providers throughout Maricopa County to establish rapport and create interest in better health outcomes for their residents.