CTR055429 (FORMERLY IGA 2020-013) MARICOPA COUNTY A1.PDF

C-86-21-010-X-01
ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
Karla Varela
(formerly: IGA 2020-013)
Healthy People Healthy Communities
1. Effective upon signature by all parties and pursuant to the Terms and Conditions, Provision Six (6), Contract Changes,
Section 6.1, Amendments, Purchases Orders and Change Orders it is mutually agreed that the Intergovernmental
Agreement referenced is amended as follows under this Amendment One (1):
1.1 The Contract No. IGA2020-013 is revised to CTR055429 due to the Contracts being placed back into the Arizona
Procurement Portal;
1.2 The Terms and Conditions Provision Twenty (20) has been updated;
1.3 The Terms and Conditions Provision Twenty-Four (24) has been added;
(CONTINUED ON NEXT PAGE)
Contractor Name: Authorized Signature
MARICOPA COUNTY
Address: Sign
4041 N CENTRAL AVE Jack Sellers
City State Zip Title
Chairman, Board of Supervisors
PHOENIX ARIZONA 85012
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has determined This Intergovernmental Agreement Amendment shall be effective
that this Intergovernmental Agreement is in proper form and is within the powers and the date indicated. The Public Agency is hereby cautioned not to
authority granted under the laws of Arizona commence any billable work or provide any material, service or
construction under this IGA until the IGA has been executed by an
authorized ADHS signatory.
State of Arizona
Signature Date
Signed this day of 2021.
Anne Longo, Attorney for County
Print Name
Procurement Officer
Contract No.: CTR055429, which is an Agreement between public agencies, has been
reviewed pursuant to A.R.S. § 11-952 by the undersigned Assistant Attorney, who has
determined that it is in proper form and is within the powers and authority granted
under the laws of the State of Arizona.
Signature Date
Assistant Attorney General
Print Name
1

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
1.4 The Scope of Work has been revised and replaced;
1.5 The Price Sheet has been revised and replaced;
1.6 Exhibit D has been revised and replaced;
1.7 Exhibit E is revised and replaced;
1.8 Exhibit F is revised and replaced; and
1.9 Exhibit G is revised and replaced.
All other provisions of this Agreement remain unchanged.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
TERMS AND CONDITIONS
1. Definition of Terms. As used in this Contract, the terms listed below are defined as follows:
1.1 “Attachment” means any document attached to the Contract and incorporated into the Contract.
1.2 “ADHS” means Arizona Department of Health Services.
1.3 “Budget Term” means the period of time for which the contract budget has been created and during which
funds should be expended.
1.4 “Change Order” means a written order that is signed by a Procurement Officer and that directs the Contractor
to make changes authorized by the Uniform Terms and Conditions of the Contract.
1.5 “Contract” means the combination of the Uniform and Special Terms and Conditions, the Specifications and
Statement or Scope of Work, Attachments, Referenced Documents, any Contract Amendments and any
terms applied by law.
1.6 “Contract Amendment” means a written document signed by the Procurement Officer and the Contractor that
is issued for the purpose of making changes in the Contract.
1.7 “Contractor” means any person who has a Contract with the Arizona Department of Health Services.
1.8 “Cost Reimbursement” means a contract under which a contractor is reimbursed for costs, which are
reasonable, allowable and allocable in accordance with the contract terms and approved by ADHS.
1.9 “Days” means calendar days unless otherwise specified.
1.10 “Emerging Issues” means a potential new threat, or problem to a local health system that can impact local
resources, the environment, or populations.
1.11 “Evidence-Based Strategies” are strategies that explicitly link public health or clinical practice
recommendation to scientific evidence of the effectiveness and/or other characteristics of such practices.
(Reference: Community Guide: http://www.thecommunityguide.org/) Evidence based public health practice
is the careful, intentional and sensible use of current best scientific evidence in making decisions about the
choice and application of public health interventions. (Reference: Community Commons
http://www.communitycommons.org/)
1.12 “Fixed Price” establishes a set price per unit of service. The set price shall be based on costs, which are
reasonable, allowable and allocable.
1.13 “Gratuity” means a payment, loan, subscription, advance, deposit of money, services, or anything of more
than nominal value, present or promised, unless consideration of substantially equal or greater value is
received.
1.14 “HPHC IGA” means Healthy People Healthy Communities Intergovernmental Agreement. This IGA was
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
developed to facilitate collaboration, coordination, and communication between the Contractors/Local Health
Departments and ADHS to improve the health and well-being of Arizona residents.
1.15 “Materials” unless otherwise stated herein, means all property, including but not limited to equipment,
supplies, printing, insurance and leases of property.
1.16 “May” means the Contractor is encouraged to utilize recommended policy in order to fulfill the intent of the
contract.
1.17 “Must” means a mandatory Program policy considered essential to the provision of high-quality services. A
Contractor who does not follow a required Program policy will be cited for this failure.
1.18 “Procurement Officer” means the person duly authorized by the State to enter into, administer Contracts, and
make written determinations with respect to the Contract.
1.19 “Program Manager” means the ADHS employee who is responsible for the implementation and oversight of
the specific programs within the HPHC IGA. The Program Manager coordinates activities among
Contractors and among ADHS staff, receives and reconciles invoices, handles budget issues, and provides
technical support. The Program Manager is responsible for negotiating contracts, requesting contract
amendments to be processed by the Procurement Office, conducting site visits, and monitoring Contractor
compliance with the provisions of the contract.
1.20 “Purchase Order” means a written document that is signed by a Procurement Officer, that requests a vendor
to deliver described goods or services at a specific price and that, on delivery and acceptance of the goods
or services by ADHS, becomes an obligation of the State.
1.21 “Scope of Work” means the area in an agreement where the work to be performed is described. The SOW
should contain any milestones, reports, deliverables, and end products that are expected to be provided by
the performing party/Contractor.
1.22 “Services” means the furnishing of labor, time or effort by a Contractor or Subcontractor.
1.23 “Site Visit” means any visit to the Contractor’s or Sub-contractor’s business location by ADHS HPHC IGA
Program staff or a designee, once per year.
1.24 “Subcontract” means any contract, express or implied, between the Contractor and another party or between
a subcontractor and another party delegating or assigning, in whole or in part, the making or furnishing of any
material or any service required for the performance of this Contract.
1.25 “State” means the State of Arizona, or ADHS. For purposes of this Contract, the term “State” shall not include
the Contractor.
2. Contract Type.
This Contract shall be:
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
X Fixed Price
3. Contract Interpretation.
3.1. Arizona Law. The law of Arizona applies to this Contract including, where applicable, the Uniform Commercial
Code as adopted by the State of Arizona.
3.2. Implied Contract Terms. Each provision of law and any terms required by law to be in this Contract are a part
of this Contract as if fully stated in it.
3.3. Contract Order of Precedence. In the event of a conflict in the provisions of the Contract, as accepted by the
State and as they may be amended, the following shall prevail in the order set forth below:
3.3.1. Terms and Conditions;
3.3.2. Statement or Scope of Work;
3.3.3. Attachments; and
3.3.4. Referenced Documents.
3.4. Relationship of Parties. The Contractor under this Contract is an independent Contractor. Neither party to
this Contract shall be deemed to be the employee or agent of the other party to the Contract.
3.5. Severability. The provisions of this Contract are severable. Any term or condition deemed illegal or invalid
shall not affect any other term or condition of the Contract.
3.6. No Parole Evidence. This Contract is intended by the parties as a final and complete expression of their
agreement. No course of prior dealings between the parties and no usage of the trade shall supplement or
explain any terms used in this document.
3.7. No Waiver. Either party’s failure to insist on strict performance of any term or condition of the Contract shall
not be deemed a waiver of that term or condition even if the party accepting or acquiescing in the
nonconforming performance knows of the nature of the performance and fails to object to it.
3.8. Headings. Headings are for organizational purposes only and shall not be interpreted as having legal
significance or meaning.
4. Contract Administration and Operation.
4.1. Term. As indicated on the signature page of the Contract, the Contract shall be effective as of the Begin Date
and shall remain effective until the Termination Date.
4.2. Contract Renewal. This Contract shall not bind, nor purport to bind, the State for any contractual commitment
in excess of the original Contract period. The term of the Contract shall not exceed five years. However, if
the original Contract period is for less than five years, the State shall have the right, at its sole option, to renew
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
the Contract, so long as the original Contract period together with the renewal periods does not exceed five
years. If the State exercises such rights, all terms, conditions and provisions of the original Contract shall
remain the same and apply during the renewal period with the exception of price and Scope of Work, which
may be renegotiated.
4.3. New Budget Term. If a budget term has been completed in a multi-term Contract, the parties may agree to
change the amount and type of funding to accommodate new circumstances in the next budget term. Any
increase or decrease in funding at the time of the new budget term shall coincide with a change in the Scope
of Work or change in cost of services as approved by the Arizona Department of Health Services.
4.4. Non-Discrimination. The Contractor shall comply with State Executive Order No. 2009-09 and all other
applicable Federal and State laws, rules and regulations, including the Americans with Disabilities Act.
4.5. Records and Audit. Under A.R.S. § 35-214 and A.R.S. § 35-215, the Contractor shall retain and shall
contractually require each subcontractor to retain all data and other records (“records”) relating to the
acquisition and performance of the Contract for a period of five years after the completion of the Contract. All
records shall be subject to inspection and audit by the State and where applicable the Federal Government
at reasonable times. Upon request, the Contractor shall produce a legible copy of any or all such records.
4.6. Financial Management. For all contracts, the practices, procedures, and standards specified in and required
by the Accounting and Auditing Procedures Manual for the ADHS funded programs shall be used by the
Contractor in the management of Contract funds and by the State when performing a Contract audit. Funds
collected by the Contractor in the form of fees, donations and/or charges for the delivery of these Contract
services shall be accounted for in a separate fund.
4.6.1. Federal Funding. Contractors receiving federal funds under this Contract shall comply with the
certified finance and compliance audit provision of the Office of Management and Budget (OMB)
Circular A-133, if applicable. The federal financial assistance information shall be stated in a Change
Order or Purchase Order.
4.6.2. State Funding. Contractors receiving state funds under this Contract shall comply with the certified
compliance provisions of A.R.S. § 35-181.03.
4.7. Inspection and Testing. The Contractor agrees to permit access, at reasonable times, to its facilities.
4.8. Notices. Notices to the Contractor required by this Contract shall be made by the State to the person indicated
on the signature page by the Contractor, unless otherwise stated in the Contract. Notices to the State required
by the Contract shall be made by the Contractor to an ADHS Procurement Officer, unless otherwise stated
in the Contract. An authorized ADHS Procurement Officer and an authorized Contractor representative may
change their respective person to whom notice shall be given by written notice, and an amendment to the
Contract shall not be necessary.
4.9. Advertising and Promotion of Contract. The Contractor shall not advertise or publish information for
commercial benefit concerning this Contract without the prior written approval of an ADHS Procurement
Officer.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
4.10. Property of the State.
4.10.1. Equipment. Except as provided below or otherwise agreed to by the parties, the title to any and all
equipment acquired through the expenditure of funds received from the State shall remain the
property of the State by and through the ADHS and, as such, shall remain under the sole direction,
management and control of the ADHS. When this Contract is terminated, the disposition of all such
property shall be determined by the ADHS. For Fixed Price contracts, when the Contractor provides
the services/materials required by the Contract, any and all equipment purchased by the Contractor
remains the property of the Contractor. All purchases of equipment need to be reported to the ADHS
Office of Inventory Control.
4.10.2. Title and Rights to Materials. As used in this section, the term “Materials” means all products created
or produced by the Contractor under this Contract, including, but not limited to: written and electronic
information, recordings, reports, research, research findings, conclusions, abstracts, results,
software, data and any other intellectual property or deliverables created, prepared, or received by
the Contractor in performance of this Contract. Contractor acknowledges that all Materials are the
property of the State by and through the ADHS and, as such, shall remain under the sole direction,
management and control of the ADHS. The Contractor is not entitled to a patent or copyright on
these Materials and may not transfer a patent or copyright on them to any other person or entity. To
the extent any copyright in any Materials may originally vest in the Contractor, the Contractor hereby
irrevocably transfers to the ADHS, for and on behalf of the State, all copyright ownership. The ADHS
shall have full, complete and exclusive rights to reproduce, duplicate, adapt, distribute, display,
disclose, publish, release and otherwise use all Materials. The Contractor shall not use or release
these Materials without the prior written consent of the ADHS. When this Contract is terminated, the
disposition of all such Materials shall be determined by the ADHS. Further, the Contractor agrees to
give recognition to the ADHS for its support of any program when releasing or publishing program
Materials.
4.10.3. Notwithstanding the above, if the Contractor is a State agency, the following shall apply instead: It is
the intention of ADHS and Contractor that all material and intellectual property developed under this
Agreement be used and controlled in ways to produce the greatest benefit to the parties to this
Contract and the citizens of the State of Arizona. As used in this paragraph, “Material” means all
written and electronic information, recordings, reports, findings, research information, abstracts,
results, software, data, discoveries, inventions, procedures and processes of services developed by
the Contractor and any other materials created, prepared or received by the Contractor and
subcontractors in performance of this Agreement. “Material” as used herein shall not include any
pre-existing data, information, materials, discoveries, inventions or any form of intellectual property
invented, created, developed or devised by Contractor (or its employees, subcontractors or agents)
prior to the commencement of the services funded by this Agreement or that may result from
Contractor’s involvement in other service activities that are not funded by the Agreement.
4.10.4. Title and exclusive copyright to all Material shall vest in the State of Arizona, subject to any rights
reserved on behalf of the federal government. As State agencies and instrumentalities, both ADHS
and Contractor shall have full, complete, perpetual, irrevocable and non-transferable rights to
reproduce, duplicate, adapt, make derivative works, distribute, display, disclose, publish and
otherwise use any and all Material. The Contractor’s right to use Material shall include the following
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
rights: the right to use the Material in connection with its internal, non-profit research and educational
activities, the right to present at academic or professional meetings or symposia and the right to
publish in journals, theses, dissertations or otherwise of Contractor’s own choosing. Contractor
agrees to provide ADHS with a right of review prior to any publication or public presentation of the
Material, and ADHS shall be entitled to request the removal of its confidential information or any other
content the disclosure of which would be contrary to the best interest of the State of Arizona. Neither
party shall release confidential information to the public without the prior expressly written permission
of the other, unless required by the State public records statutes or other law, including a court order.
Each party agrees to give recognition to the other party in all public presentations or publications of
any Material, when releasing or publishing them.
4.10.5. In addition, ADHS and Contractor agree that any and all Material shall be made freely available to
the public to the extent it is in the best interest of the State. However, if either party wants to license
or assign an intellectual property interest in the material to a third-party for monetary compensation,
ADHS and Contractor agree to convene to determine the relevant issues of title, copyright, patent
and distribution of revenue. In the event of a controversy as to whether the Material is being used
for monetary compensation or in a way that interferes with the best interest of the state or ADHS,
then the Arizona Department of Administration shall make the final decision. Notwithstanding the
above, “monetary compensation’ does not include compensation paid to an individual creator for
traditional publications in academia (the copyrights to which are Employee-Excluded Works under
ABOR Intellectual Property Policy Section 6-908C.4.), an honorarium or other reimbursement of
expenses for an academic or professional presentation, or an unprofitable distribution of Material.
4.11. E-Verify Requirements In accordance with A.R.S. § 41-4401, Contractor warrants compliance with all
Federal immigration laws and regulations relating to employees and warrants its compliance with Section
A.R.S. § 23-214, Subsection A.
4.12. Federal Immigration and Nationality Act The Contractor shall comply with all federal, state and local
immigration laws and regulations relating to the immigration status of their employees during the term of the
Contract. Further, the Contractor shall flow down this requirement to all subcontractors utilized during the
term of the Contract. The State shall retain the right to perform random audits of Contractor and subcontractor
records or to inspect papers of any employee thereof to ensure compliance. Should the State determine that
the Contractor and/or any subcontractors be found noncompliant, the State may pursue all remedies allowed
by law, including, but not limited to; suspension of work, termination of the Contract for default and suspension
and/or debarment of the Contractor.
5. Costs and Payments
5.1. Payments. Payments shall comply with the requirements of A.R.S. Titles 35 and 41, net 30 days. Upon
receipt and acceptance of goods or services, the Contractor shall submit a complete and accurate
Contractor’s Expenditure Report for payment from the State within thirty (30) days, as provided in the
Accounting and Auditing Procedures Manual for the ADHS.
5.2. Recoupment of Contract Payments.
5.2.1. Unearned Advanced Funds. Any unearned State funds that have been advanced to the Contractor
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
and remain in its possession at the end of each budget term, or at the time of termination of the
Contract, shall be refunded to the ADHS within forty-five (45) days of the end of a budget term or of
the time of termination.
5.2.2. Contracted Services. In a fixed price contract, if the number of services provided is less than the
number of services for which the Contractor received compensation, funds to be returned to the
ADHS shall be determined by the Contract price. Where the price is determined by cost per unit of
service or material, the funds to be returned shall be determined by multiplying the unit of service
cost by the number of services the Contractor did not provide during the Contract term. Where the
price for a deliverable is fixed, but the deliverable has not been completed, the Contractor shall be
paid a pro rata portion of the completed deliverable. In a cost reimbursement contract, the ADHS
shall pay for any costs that the Contractor can document as having been paid by the Contractor and
approved by ADHS. In addition, the Contractor will be paid its reasonable actual costs for work in
progress as determined by Generally Accepted Accounting Procedures up to the date of contract
termination.
5.2.3. Refunds. Within forty-five (45) days after the end of each budget term or of the time of termination
of the Contract, the Contractor shall refund the greater of: i) the amount refundable in accordance
with paragraph 4.2.1, Unearned Advanced Funds; or ii) the amount refundable in accordance with
paragraph 5.2.2, Contracted Services.
5.2.4. Unacceptable Expenditures. The Contractor agrees to reimburse the ADHS for all Contract funds
expended, which are determined by the ADHS not to have been disbursed by the Contractor in
accordance with the terms of this Contract. The Contractor shall reimburse ADHS within 45 days of
the determination of unacceptability.
5.3. Unit Costs/Rates or Fees. Unit costs/rates or fees shall be based on costs, which are determined by ADHS
to be reasonable, allowable and allocable as outlined in the Accounting and Auditing Procedures Manual for
the ADHS.
5.4. Applicable Taxes.
5.4.1. State and Local Transaction Privilege Taxes. The State of Arizona is subject to all applicable state
and local transaction privilege taxes. Transaction privilege taxes apply to the sale and are the
responsibility of the seller to remit. Failure to collect taxes from the buyer does not relieve the seller
from its obligation to remit taxes.
5.4.2. Tax Indemnification. The Contractor and all subcontractors shall pay all federal, state and local taxes
applicable to its operation and any persons employed by the Contractor. Contractor shall require all
subcontractors to hold the State harmless from any responsibility for taxes, damages and interest, if
applicable, contributions required under Federal, and/or state and local laws and regulations and any
other costs, including transaction privilege taxes, unemployment compensation insurance, Social
Security and Worker’s Compensation.
5.4.3. I.R.S. W9 Form. In order to receive payment under any resulting Contract, the Contractor shall have
a current I.R.S. W9 Form on file with the State of Arizona.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
5.5. Availability of Funds for the Next Fiscal Year. Funds may not be presently available for performance under
this Contract beyond the first year of the budget term or Contract term. The State may reduce payments or
terminate this Contract without further recourse, obligation or penalty in the event that insufficient funds are
appropriated in the subsequent budget term. The State shall not be liable for any purchases or Subcontracts
entered into by the Contractor in anticipation of such funding. The Procurement Officer shall have the
discretion in determining the availability of funds.
5.6. Availability of Funds for the Current Contract Term. Should the State Legislature enter back into session and
decrease the appropriations through line item or general fund reductions, or for any other reason these goods
or services are not funded as determined by ADHS, the following actions may be taken by ADHS:
5.6.1. Accept a decrease in price offered by the Contractor;
5.6.2. Reduce the number of goods or units of service and reduce the payments accordingly;
5.6.3. Offer reductions in funding as an alternative to Contract termination; or
5.6.4. Cancel the Contract.
6. Contract Changes
6.1. Amendments, Purchase Orders and Change Orders. This Contract is issued under the authority of the
Procurement Officer who signed this Contract. The Contract may be modified only through a Contract
Amendment, Purchase Order and/or Change Order within the scope of the Contract, unless the change is
administrative or otherwise permitted by the Special Terms and Conditions. Changes to the Contract,
including the addition of work or materials, the revision of payment terms, or the substitution of work or
materials, directed by an unauthorized State employee or made unilaterally by the Contractor are violations
of the Contract and of applicable law. Such changes, including unauthorized Contract Amendments,
Purchase Orders and/or Change Orders, shall be void and without effect, and the Contractor shall not be
entitled to any claim under this Contract based on those changes.
6.2. Subcontracts. The Contractor shall not enter into any subcontract under this Contract without the advance
written approval of the Procurement Officer. The subcontract shall incorporate by reference all material and
applicable terms and conditions of this Contract.
6.3. Assignments and Delegation. The Contractor shall not assign any right nor delegate any duty under this
Contract without the prior written approval of the Procurement Officer. The State shall not unreasonably
withhold approval.
7. Risk and Liability
7.1. Risk of Loss. The Contractor shall bear all loss of conforming material covered under this Contract until
received and accepted by authorized personnel at the location designated in the Purchase Order, Change
Order or Contract. Mere receipt does not constitute final acceptance. The risk of loss for nonconforming
materials shall remain with the Contractor regardless of receipt.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
7.2. Mutual Indemnification. Each party (as “indemnitor”) agrees to indemnify, defend and hold harmless the other
party (as “indemnitee”) from and against any and all claims, losses, liability, costs or expenses (including
reasonable attorney’s fees) (hereinafter collectively referred to as “claims”) arising out of bodily injury of any
person (including death) or property damage, but only to the extent that such claims, which result in
vicarious/derivative liability to the indemnitee, are caused by the act, omission, negligence, misconduct, or
other fault of the indemnitor, its officers, officials, agents, employees or volunteers.
7.3. Force Majeure.
7.3.1. Liability and Definition. Except for payment of sums due, neither party shall be liable to the other nor
deemed in default under this Contract if and to the extent that such party’s performance of this
Contract is prevented by reason of force majeure. The term “force majeure” means an occurrence
that is beyond the control of the party affected and occurs without its fault or negligence. Without
limiting the foregoing, force majeure includes acts of God; acts of the public enemy; acts of terrorism;
war; riots; strikes; mobilization; labor disputes; civil disorders; fire; flood; lockouts; injunctions-
interventions not caused by or resulting from the act or failure to act of the parties; failures or refusals
to act by government authority not caused by or resulting from the act or failure to act of the parties;
and other similar occurrences beyond the control of the party declaring force majeure, which such
party is unable to prevent by exercising reasonable diligence.
7.3.2. Exclusions. Force Majeure shall not include the following occurrences:
7.3.2.1. Late delivery of Materials caused by congestion at a manufacturer’s plant or elsewhere, or
an oversold condition of the market;
7.3.2.2. Late performance by a subcontractor unless the delay arises out of a force majeure
occurrence in accordance with this force majeure term and condition; or
7.3.2.3. Inability of either the Contractor or any subcontractor to acquire or maintain any required
insurance, bonds, licenses or permits.
7.3.3. Notice. If either party is delayed at any time in the progress of the work by force majeure, the delayed
party shall notify the other party in writing of such delay, as soon as is practicable and no later than
the following working day of the commencement thereof, and shall specify the causes of such delay
in such notice. Such notice shall be delivered or mailed certified-return receipt and shall make a
specific reference to this article, thereby invoking its provisions. The delayed party shall cause such
delay to cease as soon as practicable and shall notify the other party in writing when it has done so.
The time of completion shall be extended by Contract Amendment for a period of time equal to the
time that the results or effects of such delay prevent the delayed party from performing in accordance
with this Contract.
7.3.4. Default. Any delay or failure in performance by either party hereto shall not constitute default
hereunder or give rise to any claim for damages or loss of anticipated profits if, and to the extent that,
such delay or failure is caused by force majeure.
7.4. Third Party Antitrust Violations. The Contractor assigns to the State any claim for overcharges resulting from
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
antitrust violations to the extent that those violations concern materials or services supplied by third parties
to the Contractor for or toward the fulfillment of this Contract.
8. Description of Materials The following provisions shall apply to Materials only:
8.1. Liens. The Contractor agrees that the Materials supplied under this Contract are free of liens. In the event
the Materials are not free of liens, Contractor shall pay to remove the lien and any associated damages or
replace the Materials with Materials free of liens.
8.2. Quality. Unless otherwise modified elsewhere in these terms and conditions, the Contractor agrees that, for
one year after acceptance by the State of the Materials, they shall be:
8.2.1. Of a quality to pass without objection in the Contract description;
8.2.2. Fit for the intended purposes for which the Materials are used;
8.2.3. Within the variations permitted by the Contract and are of even kind, quantity, and quality within each
unit and among all units;
8.2.4. Adequately contained, packaged and marked as the Contract may require; and
8.2.5. Conform to the written promises or affirmations of fact made by the Contractor.
8.3. Inspection/Testing. Subparagraphs 8.1 through 8.2 of this paragraph are not affected by inspection or testing
of or payment for the Materials by the State.
8.4. Compliance with Applicable Laws. The Materials and services supplied under this Contract shall comply with
all applicable federal, state and local laws, and the Contractor shall maintain all applicable license and permit
requirements.
8.5. Survival of Rights and Obligations After Contract Expiration and Termination.
8.5.1. Contractor’s Representations. All representations and warranties made by the Contractor under this
Contract in paragraphs 7 and 8 shall survive the expiration or termination hereof. In addition, the
parties hereto acknowledge that pursuant to A.R.S. § 12.510, except as provided in A.R.S. § 12-529,
the State is not subject to or barred by any limitations of actions prescribed in A.R.S. Title 12, Chapter
5.
8.5.2. Purchase Orders and Change Orders. Unless otherwise directed in writing by the Procurement
Officer, the Contractor shall fully perform and shall be obligated to comply with all Purchase Orders
and Change Orders received by the Contractor prior to the expiration or termination hereof, including,
without limitation, all Purchase Orders and Change Orders received prior to but not fully performed
and satisfied at the expiration or termination of this Contract.
9. State’s Contractual Remedies
12

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
9.1. Right to Assurance. If the State, in good faith, has reason to believe that the Contractor does not intend to,
or is unable to, perform or continue performing under this Contract, the Procurement Officer may demand in
writing that the Contractor give a written assurance of intent to perform. Failure by the Contractor to provide
written assurance within the number of Days specified in the demand may, at the State’s option, be the basis
for terminating the Contract.
9.2. Stop Work Order.
9.2.1. Terms. The State may, at any time, by written order to the Contractor, require the Contractor to stop
all or any part of the work called for by this Contract for a period up to ninety (90) Days after the order
is delivered to the Contractor, and for any further period to which the parties may agree. The order
shall be specifically identified as a stop work order issued under this clause. Upon receipt of the
order, the Contractor shall immediately comply with its terms and take all reasonable steps to
minimize the incurrence of costs allocable to the work covered by the order during the period of work
stoppage.
9.2.2. Cancellation or Expiration. If a stop work order issued under this clause is canceled or the period of
the order or any extension expires, the Contractor shall resume work. The Procurement Officer shall
make an equitable adjustment in the delivery schedule or Contract price, or both, and the Contract
shall be amended in writing accordingly.
9.3. Non-exclusive Remédies. The rights and remedies of ADHS under this Contract are not exclusive, and ADHS
is entitled to all rights and remedies available to it, including those under the Arizona Uniform Commercial
Code and Arizona common law.
9.4. Right of Offset. The State shall be entitled to offset against any sums due the Contractor in any Contract
with the State or damages assessed by the State because of the Contractor’s non-conforming performance
or failure to perform this Contract. The right to offset may include, but is not limited to, a deduction from an
unpaid balance and a collection against the bid and/or performance bonds. Any offset taken for damages
assessed by the State shall represent a fair and reasonable amount for the actual damages and shall not be
a penalty for non-performance.
10. Contract Termination
10.1. Cancellation for Conflict of Interest. Pursuant to A.R.S. § 38-511, the State may cancel this Contract within
three (3) years after Contract execution without penalty or further obligation if any person significantly
involved in initiating, negotiating, securing, drafting or creating the Contract on behalf of the State is, or
becomes at any time while the Contract or an extension of the Contract is in effect, an employee of or a
consultant to any other party to this Contract with respect to the subject matter of the Contract. The
cancellation shall be effective when the Contractor receives written notice of the cancellation, unless the
notice specifies a later time. If the Contractor is a political subdivision of the State, it may also cancel this
Contract as provided in A.R.S. § 38-511.
10.2. Gratuities. The State may, by written notice, terminate this Contract, in whole or in part, if the State
determines that employment or a Gratuity was offered or made by the Contractor or a representative of the
Contractor to any officer or employee of the State for the purpose of influencing the outcome of the
13

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
procurement, securing the Contract or an Amendment to the Contract, or receiving favorable treatment
concerning the Contract, including the making of any determination or decision about Contract performance.
The State, in addition to any other rights or remedies, shall be entitled to recover exemplary damages in the
amount of three times the value of the Gratuity offered by the Contractor.
10.3. Suspension or Debarment. The State may, by written notice to the Contractor, immediately terminate this
Contract if the State determines that the Contractor or its subcontractor has been debarred, suspended or
otherwise lawfully prohibited from participating in any public procurement activity, including but not limited to,
being disapproved as a subcontractor of any public procurement unit or other governmental body.
10.4. Termination Without Cause.
10.4.1. Both the State and the Contractor may terminate this Contract at any time with thirty (30) days’ notice
in writing specifying the termination date. Such notices shall be given by personal delivery or by
certified mail, return receipt requested.
10.4.2. If the Contractor terminates this Contract, any monies prepaid by the State, for which no service or
benefit was received by the State, shall be refunded to the State within 5 days of the termination
notice. In addition, if the Contractor terminates the Contract, the Contractor shall indemnify the State
for any sanctions imposed by the funding source as a result of the Contractor’s failure to complete
the Contract.
10.4.3. If the State terminates this Contact pursuant to this Section, the State shall pay the Contractor the
Contract price for all Services and Materials completed up to the date of termination. In a fixed price
contract, the State shall pay the amount owed for the Services or Materials by multiplying the unit of
service or item cost by the number of unpaid service units or items. In a cost reimbursement contract,
the ADHS shall pay for any costs that the Contractor can document as having been paid by the
Contractor and approved by ADHS. In addition, the Contractor will be paid its reasonable actual
costs for work in progress as determined by GAAP up to the date of termination. Upon such
termination, the Contractor shall deliver to the ADHS all deliverables completed. ADHS may require
Contractor to negotiate the terms of any remaining deliverables still due.
10.5. Mutual Termination. This Contract may be terminated by mutual written agreement of the parties specifying
the termination date and the terms for disposition of property and, as necessary, submission of required
deliverables and payment therein.
10.6. Termination for Default. The State reserves the right to terminate the Contract in whole or in part due to the
failure of the Contractor to comply with any material obligation, term or condition of the Contract, to acquire
and maintain all required insurance policies, bonds, licenses and permits, or to make satisfactory progress
in performing the Contract. In the event the ADHS terminates the Contract in whole or in part as provided in
this paragraph, the ADHS may procure, upon such terms and in such manner as deemed appropriate,
Services or Materials, similar to those terminated, and Contractor shall be liable to the ADHS for any excess
costs incurred by the ADHS in obtaining such similar Services or Materials.
10.7. Continuation of Performance Through Termination. Upon receipt of the notice of termination and until the
effective date of the notice of termination, the Contractor shall perform work consistent with the requirements
14

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
of the Contract and, if applicable, in accordance with a written transition plan approved by the ADHS. If the
Contract is terminated in part, the Contractor shall continue to perform the Contract to the extent not
terminated. After receiving the notice of termination, the Contractor shall immediately notify all
subcontractors, in writing, to stop work on the effective date of termination, and on the effective date of
termination, the Contractor and subcontractors shall stop all work.
10.8. Disposition of Property. Upon termination of this Contract, all property of the State, as defined herein, shall
be delivered to the ADHS upon demand.
11. Arbitration
Pursuant to A.R.S. § 12-1518, disputes under this Contract shall be resolved through the use of arbitration when
the case or lawsuit is subject to mandatory arbitration pursuant to rules adopted under A.R.S. § 12 -133.
12. Communication
12.1. Program Report. When reports are required by the Contract, the Contractor shall provide them in the format
approved by ADHS.
12.2. Information and Coordination. The State will provide information to the Contractor pertaining to activities that
affect the Contractor’s delivery of services, and the Contractor shall be responsible for coordinating their
activities with the State’s in such a manner as not to conflict or unnecessarily duplicate the State’s activities.
As the work of the Contractor progresses, advice and information on matters covered by the Contract shall
be made available by the Contractor to the State throughout the effective period of the Contract.
13. Client Grievances
If applicable, the Contractor and its subcontractors shall use a procedure through which clients may present
grievances about the operation of the program that result in the denial, suspension or reduction of services provided
pursuant to this Contract and which is acceptable to and approved by the State.
14. Sovereign Immunity
Pursuant to A.R.S. § 41-621(O), the obtaining of insurance by the State shall not be a waiver of any sovereign
immunity defense in the event of suit.
15. Administrative Changes
The Procurement Officer, or authorized designee, reserves the right to correct any obvious clerical, typographical
or grammatical errors, as well as errors in party contact information (collectively, “Administrative Changes”), prior
to or after the final execution of a Contract or Contract Amendment. Administrative Changes subject to permissible
corrections include: misspellings, grammar errors, incorrect addresses, incorrect Contract Amendment numbers,
pagination and citation errors, mistakes in the labeling of the rate as either extended or unit, and calendar date
errors that are illogical due to typographical error. The Procurement Office shall subsequently send to the
Contractor notice of corrections to administrative errors in a written confirmation letter with a copy of the corrected
Administrative Change attached.
15

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
16. Survival of Terms After Termination or Cancellation of Contract
All applicable Contract terms shall survive and apply after Contract termination or cancellation to the extent
necessary for Contractor to complete and for the ADHS to receive and accept any final deliverables that are due
after the date of the termination or cancellation.
17. Health Insurance Portability and Accountability Act of 1996 (HIPAA)
17.1. The Contractor warrants that it is familiar with the requirements of HIPAA, as amended by the Health
Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009, and accompanying
regulations and will comply with all applicable HIPAA requirements in the course of this Contract. Contractor
warrants that it will cooperate with the Arizona Department of Health Services (ADHS) in the course of
performance of the Contract so that both ADHS and Contractor will be in compliance with HIPAA, including
cooperation and coordination with the Arizona Department of Administration-Arizona Strategic Enterprise
Technology (ADOA-ASET) Office, the ADOA-ASET Arizona State Chief Information Security Officer and
HIPAA Coordinator and other compliance officials required by HIPAA and its regulations. Contractor will sign
any documents that are reasonably necessary to keep ADHS and Contractor in compliance with HIPAA,
including, but not limited to, business associate agreements.
17.2. If requested by the ADHS Procurement Office, Contractor agrees to sign a “Pledge To Protect Confidential
Information” and to abide by the statements addressing the creation, use and disclosure of confidential
information, including information designated as protected health information and all other confidential or
sensitive information as defined in policy. In addition, if requested, Contractor agrees to attend or participate
in HIPAA training offered by ADHS or to provide written verification that the Contractor has attended or
participated in job related HIPAA training that is: (1) intended to make the Contractor proficient in HIPAA for
purposes of performing the services required and (2) presented by a HIPAA Privacy Officer or other person
or program knowledgeable and experienced in HIPAA and who has been approved by the ADOA-ASET
Arizona State Chief Information Security Officer and HIPAA Coordinator.
18. Comments Welcome
The ADHS Procurement Office periodically reviews the Uniform Terms and Conditions and welcomes any
comments you may have. Please submit your comments to: ADHS Procurement Administrator, Arizona Department
of Health Services, 150 North 18th Avenue, Suite 280, Phoenix, Arizona 85007.
19. Data Universal Numbering System (DUNS) Requirement
For federal funding, pursuant to 2 CFR 25.100 et seq., no entity (defined as a Governmental organization, which is
a State, local government, or Indian tribe; foreign public entity; domestic or foreign nonprofit organization; domestic
or foreign for-profit organization; or Federal agency, but only as a subrecipient under an award or subaward to a
non-Federal entity) may receive a subaward from ADHS unless the entity provides its Data Universal Numbering
System (DUNS) Number to ADHS.
20. The Federal Funding Accountability and Transparency Act (FFATA or Transparency Act - P.L.109-282, as
amended by section 6202(a) of P.L. 110-252), found at https://www.fsrs.gov/
16

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
If applicable, the subrecipient or sub-awardee is required to abide by the Federal Funding Accountability and
Transparency Act (FFATA or Transparency Act – P.L. 109-282, as amended by section 6202(a) of P.L. 110-252),
found at https://www.fsrs.gov/. The associated Grant Reporting Certification Form and completion instructions will
be sent to the subrecipient from ADHS Program(s) responsible for the specific contract. The subrecipient or sub-
awardee must return the completed form to ADHS Program(s) by the 15th of the month following that in which the
award was received. Failure to complete a required Grant Reporting Certification Form may result in loss of funding.
21. Contracting; Procurement; Investment; Prohibitions
21.1. A public entity may not enter into a contract with a company to acquire or dispose of services, supplies,
information technology or construction unless the contract includes a written certification that the company is
not currently engaged in, and agrees for the duration of the contract to not engage in, a boycott of Israel.
21.2. A public entity may not adopt a procurement, investment or other policy that has the effect of inducing or
requiring a person or company to boycott Israel.
21.3. Contractor hereby certifies that it is not currently engaged in, and will not for the duration of this Contract
engage in, a boycott of Israel as defined by A.R.S. § 35-393.01. Violation of this certification by Contractor
may result in action by the State up to and including termination of this Contract.
22. Technology Replacement
In any event where product is discontinued, no longer available or technically inferior to newly developed product,
the Contractor shall provide an equivalent replacement model at no additional cost and shall honor the original
contract terms
23. Authorization for Provision of Services
Authorization for purchase of services under this Agreement shall be made only upon ADHS issuance of a Purchase
Order that is signed by an authorized agent. The Purchase Order will indicate the Agreement number and the dollar
amount of the funds authorized. The Contractor shall only be authorized to perform services up to the amount of
the Purchase Order. ADHS shall not have any legal obligation to pay for services in excess of the amount indicated
on the Purchase Order. No further obligation for payment shall exist on behalf of ADHS unless 2) the Purchase
Order is changed or modified with an official ADHS Procurement Change Order, and/or an additional Purchase
Order is issued for purchase of services under this Agreement.
24. Public Health Emergencies
24.1 In the event of a public health emergency, ADHS under the guidance of the federal funder may authorize a
Contractor to temporarily reassign staff to address the emergency. Contractors shall adhere to the following
reassignment conditions:
24.1.1. Approval from ADHS shall be requested prior to reassignment of staff.
24.1.2. Reassignment must be voluntary;
17

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
24.1.3. Locations for reassignment must be covered under the public health emergency; and
24.1.4. Any reassignment over 30 days must be reauthorized.
24.2. ADHS shall continue to coordinate with program staff regarding the extent and duration of
the planned assignment(s) and other potential impacts to the program.
18

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
SCOPE OF WORK
1. Background
1.1. The vision of the Arizona Department of Health Services (ADHS) is “Health and Wellness for all Arizonans.”
In December of 2013, ADHS completed a State Health Assessment (SHA). The SHA utilized Community
Health Assessments conducted by local county health departments to assess the needs and capacity of
public health in Arizona. This work resulted in the identification of fifteen (15) leading public health issues
affecting the health of our communities. With stakeholder input, the Arizona State Health Improvement Plan
(AzHIP) created a roadmap to improve the health of Arizonans over the next five (5) years through the
development of partnerships and resources to work collectively on shared health improvement goals and
strategies. This is how the original Healthy People Healthy Communities Intergovernmental Agreement
(HPHC IGA) was born.
1.2. These goals and strategies were accomplished through a collaborative approach that engages local, state
and national partners to improve the health and well-being of Arizonans. Collectively, evidence based
preventative health strategies were implemented, designed to impact health through health policy, system
and environmental change initiatives, health promotion and education for individuals and communities, and
enhancement of the public health infrastructure.
1.3. Implementation of the original IGA was completed in three (3) phases that occurred in the first year of the
IGA to accommodate funding cycles. Phase I included Tobacco, Chronic Disease, and the Health in Arizona
Policy Initiative (HAPI), and began in July 2015. Phase II included the Public Health and Health Services
Block Grant/Accreditation and began in October 2015. Phase III included Teen Pregnancy Prevention, Family
Planning, and Maternal and Child Health, and began in January 2016. All three (3) phases were operational
and fully implemented in years two (2) through five (5) with annual start dates of July 1st.
1.4. Beginning in July 2020, the original HPHC IGA was split apart and two (2) separate IGAs were formed; a
fixed price contract and a cost-based reimbursement contract. The programs to be included in this fixed price
contract are: Tobacco Cessation and Prevention, Teen Pregnancy Prevention and its Youth Mental Health
First Aid Initiative, Health in Arizona Policy Initiative (HAPI), Public Health Improvement, Healthy Arizona
Worksite, and the Suicide Mortality Review Programs.
1.5. The Suicide Mortality Review Program is administered by ADHS, who will develop a suicide mortalities data
collection system, encourage and assist in the development of local suicide mortality review teams, and
provide training and technical assistance to those teams.
2. Purpose
The purpose of this IGA is to leverage multiple public health funding sources to support implementation of health
priorities identified in the AzHIP (2021- 2026) and the County Health Improvement Plans (CHIP). This IGA is
intended to provide flexibility to the County Health Departments to best meet the needs of their local communities
through high impact strategies that realize the agreed upon outcomes. The IGA provides a pathway to improved
coordination of multiple prevention programs and the Suicide Mortality Review Program, while streamlining the
administrative functions for the programs that were previously administered separately.
19

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
3. Objective
The County Contractor will implement evidence-based strategies at the local community level that:
3.1 Promote and implement healthy communities’ interventions that target policy, system and environmental
approaches that will shape the communities in which we live, learn, work, and play; and
3.2 Promote and implement healthy people interventions that target individual behavior and support making
healthy choices.
The County Contractor shall implement evidence-based strategies and conduct Suicide Mortality Review
at the local community level that:
3.3 Promote and implement healthy communities' interventions that target policy, system and environmental
approaches that will shape the communities in which we live, learn, work, and play;
3.4 Attend ADHS training and technical assistance sessions on standards and protocols for local suicide
mortality review teams;
3.5 Bring together local community agencies in a formal process to systematically share information on suicide
events for persons over the age of eighteen (18) years old, identify risk factors in those deaths, and provide
prevention recommendations.
4. Scope of Service
This IGA offers a variety of evidence-based strategies designed to impact policy, system, and environmental
change at the community, organizational, individual, and policy levels in order to promote county-wide health
changes so that public health impact will be maximized. Contingent upon available funding, Counties are expected
to implement at multiple levels, in accordance with local community needs, and should emphasize complementary
policy, environmental, programmatic, and infrastructure activities that integrate and build on each other to optimize
the health improvements of the community.
In Arizona, both the number and rate of suicides continues to rise. Arizona’s rate of suicide per 100,000 people
was 24% higher than that of the United States in 2017. In 2018, suicide ranked 8th among the leading causes of
death but contributed substantially to premature mortality. Yet, suicide is preventable. Pursuant to A.R.S. § 36-
199 and § 36-199.01, ADHS is establishing a Suicide Mortality Review Team in the Department of Health
Services. The program will conduct an annual analysis on the incidences and causes of suicides in the state
during the preceding fiscal year. This analysis will help to inform what changes are needed to decrease the
incidence of preventable suicides, and as appropriate, take steps to implement these changes. ADHS will
fund, encourage and assist in the development of local county health department Suicide Mortality Review
Teams in their local jurisdiction and to develop suicide prevention recommendations for their communities.
Counties must select from a menu of evidence-based strategies, found in Exhibits A-F that influence individual
behaviors, policy, organizational practices, systems, and environments though the following specific program
areas:
20

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
4.1 Exhibit A – Tobacco;
4.2 Exhibit B – Health in Arizona Policy Initiative (HAPI);
4.3 Exhibit C – Public Health Improvement;
4.4 Exhibit D – Teen Pregnancy Prevention and Youth Mental Health First Aid Initiative;
4.5 Exhibit E – Healthy Arizona Worksite;
4.6 Exhibit F – Suicide Mortality Review; and
4.7 Exhibit G – Supporting Documentation.
5. Evaluation:
Performance measures and evaluations allow the counties and ADHS to collaboratively track progress, process
indicators, outcomes measures, and impacts. As part of the local evaluation plan, the counties will be responsible
for measuring the short term, and intermediate outcomes. Monitoring progress on short-term outcomes provides an
opportunity for the Local Health Departments to adjust strategies to ensure increased long-term impact. ADHS in
coordination with the Counties will be responsible for measuring the long-term and impact outcomes. Process
indicators, outcomes measures, and impacts must clearly relate to the selected strategies and activities identified
within each County’s Annual Action Plan.
6. Approvals:
6.1. The quarterly reports, yearly action plans, yearly budget templates, and supporting documentation shall be
approved by ADHS;
6.2. Local county Suicide Mortality Review proposed team rosters will be submitted to ADHS for review;
6.3. Once the Action Plan has been approved, any changes to the approved activities, or strategies must be
approved again, by ADHS prior to implementation;
6.4. Capital Equipment (Single item purchase of $5,000 or more) purchased for the program: A written request
shall be submitted to ADHS for review and approval prior to any purchase on a case-by-case basis. The
written request shall include details of how the proposed purchase supports current approved scope of work
and annual action plan. Ownership will be retained by the Contractor for continued use in the objectives of
the Action Plan;
6.5. All marketing materials (the use of ADHS logo, brochures, posters, public service announcements, paid
media, videos, etc.) which have been developed, written, published, or recorded by the Counties and paid for
with funds from this award must be first approved by ADHS prior to the dissemination of such materials or
airing or use of such announcements;
21

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
6.6. All County local emerging issues and related supporting documentation must be approved by ADHS prior to
implementation. The approval process document will be provided to all Counties and must be followed in
order for the proposed local emerging issue to be worked on;
6.7. Contractors will be required to attend ADHS Suicide Mortality Review quarterly training and technical
sessions, submit quarterly Suicide data using the ADHS Data Collection Tool and the ADHS report template
to the Suicide Mortality Review Program Manager prior to payment;
6.8. The quarterly Contractor’s Expenditure Report (CER/Invoice) and any supporting documentation, when
submitted, shall be approved by ADHS prior to payment; and
6.9. All evaluation components that involve human subjects.
7. Tasks
The County Contractor shall for the overall IGA:
7.1 Develop and implement a 3-year Action Plan and a Budget Plan within the first forty-five (45) days of each
budget period;
7.2 Participate in all calls (monthly, bi-monthly, quarterly), technical assistance calls and/or webinars, meetings
and trainings;
7.3 Implement the approved strategies;
7.4 Participate in the development of a shared comprehensive evaluation plan and report out on any performance
measures related to the implementation of their activities (process and/or intermediate), or as defined by the
funding sources; and
7.5 Provide supporting documentation that supports the completion of the defined deliverables within the
approved annual action plan to the ADHS IGA Program Manager. Examples of acceptable supporting
documentation can be found in Exhibit G. Further guidance will be provided by ADHS Program Managers, as
needed.
ADHS Shall for the overall IGA:
7.6 Review, provide feedback, and approve the Annual Action Plan(s), Annual Budgets, and Supporting
Documentation within thirty (30) days of submission;
7.7 Provide evidence-based strategies and supporting resources;
7.8 Provide a Quarterly Reporting Template;
7.9 Provide the Annual Action Plan Template;
7.10 Provide a Budget Plan and CER Template;
22

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
7.11 Collaborate and work with the County to develop a comprehensive Logic Model Template;
7.12 Host TPP Youth Mental Health First Aid Certification Training annually, if needed;
7.13 Provide Outcome Measures and examples of process, or intermediate performance measures, as needed;
7.14 Provide a Financial Guidance Document (if applicable);
7.15 Provide feedback, technical assistance, and training to support the approved Annual Action Plan(s), Annual
Budget, Quarterly Reporting, and Supporting Documentation;
7.16 Provide access to virtual technical assistance and guidance from ADHS staff, local Health Department
peers/mentors, and subject matter experts related to the strategy for which the County has received funding;
and
7.17 Coordinate and conduct Contractor site visits. Note: If not yearly, at least every two (2) years a site visit will
be conducted.
The County Contractor shall for the Suicide Mortality Review Program:
7.18 Attend quarterly training sessions with ADHS on Suicide Mortality Review Policies and Procedures Manual
including instructions on case narrative and timeline forms; confidentiality rules; establishing a team roster;
quarterly reporting forms and use of ADHS data collection tool for quarterly and annual reporting;
7.19 With guidance from ADHS Suicide Mortality Program Manager, establish a local Suicide Mortality Review
team roster;
7.20 Provide orientation to all members and consultants which include, at a minimum, the following topics:
7.20.1 Instruction regarding confidentiality,
7.20.2 Use of the data forms,
7.20.3 Public access to team information,
7.20.4 Responsibilities and limitations of team membership; Process and goals of
fatality review,
7.20.5 The promotion of culturally diverse and competent approaches in case
reviews, using Suicide Mortality Review materials provided by the State Team,
7.20.6 The promotion of culturally diverse and competent approaches in case
reviews, and
7.20.7 Review materials provided by the State Team.
23

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
7.21 Establish procedures for access to the following records related to the circumstances surrounding
suicide:
7.21.1 Death Certificates,
7.21.2 Birth Certificates,
7.21.3 Law enforcement Reports,
7.21.4 Medical Examiner's Reports,
7.21.5 Medical Records,
7.21.6 Child Protective Services' Reports, and
7.21.7 Other Records as Needed.
7.22 Establish procedures to track fatalities requiring review by the Local Team and completion of
Reviews;
7.23 Prepare quarterly reports and data for the ADHS Suicide Mortality Review Program, cases reviewed,
and obstacles to completion of reviews;
7.24 Convene team meetings, at a frequency sufficient to review all fatalities within the identified scope of
work;
7.25 Enter data for each case reviewed using ADHS Suicide Mortality Review Data Collection Tool to include
demographic and prevention recommendation data. Data should be entered for cases following
completion of each case review meeting; and
7.26 Conduct an annual analysis on the incidences and causes of suicides in the local community during the
preceding fiscal year.
ADHS will for the Suicide Mortality Review Program:
7.27 Establish a State Suicide Mortality Review Team;
7.28 Provide a Policies and Procedure Manual;
7.29 Develop standards and protocols for local suicide mortality review teams and provide training and
technical assistance to these teams;
7.30 Provide a Quarterly Reporting Template;
7.31 Provide a Suicide Mortality Data Collection Tool;
24

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
7.32 Provide CER Template, and documentation requirements for quarterly payment;
7.33 Provide Quarterly Meeting for contractors to:
7.33.1 Provide training and technical assistance on suicide review process;
7.33.2 Provide access to virtual technical assistance and guidance from ADHS staff, Local Health
Department peers/mentors and subject matter experts related to the strategy for which the
County has received funding;
7.33.3 Provide Suicide Mortality Review Data Collection Tool User Guide and training; and
7.33.4 Provide the Suicide Mortality Review Case Narrative template and prevention measure form.
8. Requirements
The County Contractor shall meet the requirements listed below:
8.1 All revisions to the Annual Action Plan strategies, goals, objectives, and timelines will require joint review and
approval from ADHS staff;
8.2 All staffing and programmatic changes will be reported to the specific ADHS Program Manager and the
ADHS IGA Program Manager within fifteen (15) days.
Once someone is hired for a job vacancy, an email containing the new hire’s full name, contact information,
start date, areas of the IGA that she/he will work in, and a resume will be submitted to the specific ADHS
Program Manager and the ADHS IGA Program Manager within fifteen (15) days;
8.3 All requests for a single item of capital equipment at or above the purchase price of five thousand dollars
($5,000.00) will be requested in writing and submitted to the specific ADHS Program Manager and the ADHS
IGA Program Manager for approval;
8.4 Food purchases are allowed within guidelines for federally funded programs. Food and/or beverages served
at events/meetings are not to be paid for with State funds per the State of Arizona Accounting Manual (SAAM)
policy, found here:
https://gao.az.gov/sites/default/files/8010%20Food%20and%20Beverages%20at%20State-
sponsored%20Events%20181113.pdf.
Contractors shall submit a Request for Purchase of Food form to the HPHC IGA Program Manager. Food
provided must not exceed the allowable ADHS per diem rates, when provided at an event, or an activity. A
speaker/presenter during lunch is required, and the food request should have a strong justification. Please
see the ADHS Healthy Meeting Policy for further guidance on nutritional guidelines for events/meetings:
https://azdhs.gov/documents/prevention/nutrition-physical-activity/healthy-meeting-policy.pdf
Note: No food purchases shall be purchased and/or reimbursed until a Request for Purchase of Food form
has been approved and signed by the ADHS Chief Financial Officer;
8.5 Comply with all federal and State reporting requirements;
25

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
8.6 At least one Program Manager, or coordinator from each HPHC IGA program must be in attendance of the
Annual HPHC IGA Summit;
8.7 Funds cannot be used for any lobbying activities, including the preparation, distribution, or use of any kit,
pamphlet, booklet, publication, electronic communication, radio, television, or video presentation designed to
support or defeat any proposed or pending regulation, administrative action, or order issued by the executive
branch of any State or local government;
For the TPP Mental Health First Aid Training, the County Contractor shall do the following:
8.8 Complete the National Council for Behavioral Health (NCBH) “Coordinator Access” form to grant ADHS staff
viewer rights to pre and post training survey data from organizations trained, and
8.9 Participate in a technical assistance meeting to be hosted by ADHS and held after the certification training(s);
dates are to be determined.
8.10 Complete the National Council for Behavioral Health (NCBH) “Coordinator Access” form to grant ADHS staff
viewer rights to pre and post training survey data from organizations trained, and
8.11 Participate in a technical assistance meeting to be hosted by ADHS and held after the certification training(s);
dates are to be determined. (they will fix alignment)
9. Deliverables and Delivery Schedule
The County Contractor shall submit the deliverables listed below to the ADHS IGA Program Manager:
9.1 Contractor Expenditure Report (CER) to ADHS, due thirty (30) days after each quarter end (Q1: July –
September; Q2: October – December; Q3: January – March; and Q4: April – June); Supporting
Documentation is to also be submitted. Counties will select from a menu of acceptable forms of Supporting
Documentation found in Exhibit F;
9.2 A written Quarterly Report, due thirty (30) days after each quarter end (Q1: July – September; Q2: October –
December; Q3: January – March; and Q4: April – June);
9.3 A final CER invoice not later than forty-five (45) days following the end of each Agreement year;
9.4 Provide the name, email address and phone numbers of all program staff funded under this Agreement within
thirty (30) days of hire;
9.5 Notify ADHS IGA Program Manager of any change in program staff under this Agreement within fifteen (15)
days of the change. If there is a new employee, include the new hire’s work contact information (i.e. email
and phone number), and resume within the fifteen (15) days window period;
9.6 For the TPP Youth Mental Health First Aid Training, programs will submit the following
26

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
with their quarterly CERs:
9.6.1 Participant sign-in sheet (if in person) that includes organization’s name, date, and name of the
educator, or
9.6.2 “Chat Box” sign-in sheet (if virtual) that includes the organization's name, date, and name of the
educator.
Please note: Stipends can only be billed for training(s) conducted during the quarter.
9.7 Collaborate and participate with ADHS on the development of a logic model;
9.8 Submit an Annual Action Plan by August 15th;
9.9 Submit an Annual Budget Plan by August 15th;
9.10 Submit an Annual Report forty-five (45) days following the end of each Agreement year;
9.11 Submit a written request to use the ADHS Logo in any print, web documents, publications and video
recordings prior to use;
9.12 Submit a written request for the development of brochures, posters, public service announcements, paid
media, videos, sponsorships, etc., to be paid for with funds from this Agreement prior to development.
10. Notices, Correspondence, and Reports
10.1 Notices, correspondence, reports and invoices/CERs from the County contractor to ADHS shall be sent to:
For Overall Fixed Price IGA:
Healthy People Healthy Communities (HPHC) IGA Program Manager
Bureau of Chronic Disease and Health Promotions
Arizona Department of Health Services
150 N. 18th Avenue, Suite 310
Phoenix, AZ 85007
Office: 602-542-8953| Email: Desiree.Fields@azdhs.gov
For the Suicide Mortality Review:
Suicide Mortality Review Program Manager
Bureau of Chronic Disease and Health Promotions
150 N 18th Avenue, Suite 310
Phoenix AZ 85007
Office: (602) 542-7340| Email: Jacqueline.Kurth@azdhs.gov
27

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
10.2 Notices, correspondence, and reports (and payments if sent to same address) from ADHS to the contractor
shall be sent to:
Maricopa County
Attn: Cheryl Bucalo
4041 N. Central Avenue #1400
Phoenix, AZ 85012
Phone: 602-506-6886 | Email: Cheryl.Bucalo@maricopa.gov
28

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
PRICE SHEET
C-86-21-010-X-01
HEALTHY PEOPLE HEALTHY COMMUNITIES
MARICOPA – CTR055429 (formerly IGA 2020-013)
JULY 1, 2021 - JUNE 30, 2022
ACTION PLAN
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
Action Plan – HAPI – includes Tobacco
Prop 200 = $102,822.00; Chronic
Disease Prop 303 = $161,445.00; WIC EA 1 $399,541.00 $399,541.00
Lottery = $7,700.00; Healthy AZ
Worksite Prop 303 = $ 81,607.00; Teen
Pregnancy = $45,967.00
TOBACCO PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service Strategies
(i.e. Prevention, Cessation, Secondhand QTR 4 $488,404.00 $1,953,616.00
Smoke, Enforcement)
HEALTH IN ARIZONA POLICY INITIATIVE PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service Strategies
(i.e. Alzheimer’s, Chronic Pulmonary
Disease, Hypertension, Self-
Management, Procurement, Healthy
Community Design, School Health, QTR 4 $73,344.00 $293,376.00
Worksite Wellness, and Clinical Care)
(Funding Per Quarter includes:
Chronic Disease Prop 303 = $65,269.00;
WIC Lottery = $8,075.00;
HEALTHY ARIZONA WORKSITE PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service Strategies QTR 4 $81,607.00 $326,428.00
29

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
PUBLIC HEALTH IMPROVEMENT PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service Strategies
(i.e. Fees for ACCREDITATION, Quality
Improvement Projects, Workforce QTR 4 $82,570.00 $330,280.00
Development Implementation, Progress
Toward County Health Improvement Plan)
TEEN PREGNANCY PREVENTION PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service Strategies QTR 4 $45,967.00 $183,868.00
TEEN PREGNANCY PREVENTION PROGRAM – YOUTH MENTAL HEALTH FIRST AID INITIATIVE
MAX # UNIT RATE TOTAL
ITEM/SERVICE DESCRIPTION UNIT OF OF
MEASURE UNITS
PER YR
See SOW for Specific Service
Strategies QTR 6 $1,000.00 $6,000.00
SUICIDE MORTALITY REVIEW PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER OF UNIT RATE TOTAL
MEASURE UNITS
See SOW for Specific Service Strategies QTR 4 $50,000.00 $200,000.00
TOTAL
ITEM/SERVICE DESCRIPTION TOTAL
GRAND TOTAL $3,693,109.00
EXHIBIT A
30

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
EVIDENCE-BASED STRATEGIES FOR TOBACCO
The Office of Tobacco Prevention and Cessation (“Office of Tobacco”) within the Bureau of Chronic Disease and Health
Promotions (“BCDHP”) at Arizona Department of Health Services (ADHS) has historically supported evidence-based
programs and system level changes that assist smokers in disparate or high-risk populations with tobacco prevention
and cessation services. In Arizona, there are populations that are disproportionately impacted by tobacco use. Currently,
priority populations identified by the Office of Tobacco are: 1) youth, 2) the justice-involved, and 3) those enrolled in
the Arizona Healthcare Cost Containment System (AHCCCS).
County health department partners are required to identify three (3) populations that are disproportionately impacted
by tobacco use in their communities, which may include the three populations identified above or with other populations
which may be identified based on county-level data. Counties will provide the selected population groups with targeted
evidence-based programs and activities for two components: 1) Tobacco Prevention and 2) Tobacco Cessation. In
addition, counties will participate in three ADHS-led work groups that will explore innovative approaches to tobacco
programming that address 1) Youth; 2) Secondhand Smoke (SHS); and 3) Emerging Issues. Counties will also engage
in in-person and virtual meetings as identified by ADHS.
The strategies within the Healthy People Healthy Communities (HPHC) Intergovernmental Agreement (IGA) are
population-based approaches that will require collaboration and support from key community partners, as well as
promote health system level changes within healthcare systems and employers. These tobacco prevention and
cessation strategies align with the U.S. Surgeon General’s Report on Smoking Cessation 2020, the Centers for Disease
Control (CDC) National Comprehensive Tobacco Control Program (NTCP), and Arizona Health Improvement Plan
(AzHIP) 2021-2025.
The Tobacco component of the HPHC IGA is funded by Proposition 200, which states that tobacco tax dollars under
the Health Education Account (HEA) requires monies be spent on “programs for the prevention and reduction of tobacco
use.” Arizona Revised Statute (A.R.S. § 36-772) authorizes four types of expenditures by the HEA: contracts with county
health departments and other local partners, administrative expenses, advertising, and evaluation of programs.
Spending these monies for lobbying for political campaigns is expressly prohibited.
The County Contractor must select one (1) or more strategies from this strategic area.
This Exhibit defines the Program Strategy/s within each Strategic Area:
1. Strategic Area: Tobacco
1.1 Reduce tobacco-related disparities among target populations. Counties will select populations based on local
available data, including tobacco prevalence rates (BRFSS, AYS, YRBSS), CHIP, and CHA data, to inform
programming;
1.1.1 Prevent the initiation of tobacco use (including emerging products and e-cigarettes) among youth and
young adults (required),
1.1.1.1 Maintain current peer-to-peer youth programming to empower youth leadership and
engagement;
31

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
1.1.1.2 Support the ADHS-selected contractor with recruiting youth participants for statewide
Enforcement efforts; and
1.1.1.3 Facilitate and conduct in their county the AGO Arizona Retailer Tobacco Training Program
with retailers and clerks that have been cited for selling tobacco to underage youth
1.1.1.4 Collaborate with schools in their counties by:
1.1.1.4.1.1 Offering the American Lung Association’s INDEPTH: An Alternative to Teen
Nicotine Suspension or Citation, and
1.1.1.4.1.2 Establishing a Task Force with school districts, school administrators, or
superintendents to identify current needs in youth prevention. Task Force
efforts must include the development of a work plan, evaluation plan, and
identified evidence-based strategies.
1.2 Implement evidence-based, culturally appropriate community interventions to promote quitting
among adults and youth.
1.2.1 Counties will identify and eliminate tobacco-related disparities among two additional population
groups:
1.2.1.1 Individuals involved or at-risk for involvement with the criminal justice system, including
jails, prisons, probation, parole, or specialty court;
1.2.1.2 People of low socioeconomic status;
1.2.1.3 Individuals with behavioral health conditions (including mental health conditions and
substance use disorders); and/or
1.2.1.4 Other priority population not listed and pre-approved by ADHS. Counties will submit a
proposal to ADHS that will include surveillance and evaluation data to justify the
population selection,
1.2.2 Engage communities, partners, and community-based organizations to strengthen
capacity. Counties will identify and select community partners that may include:
1.2.2.1 Employers; and
1.2.2.2 Healthcare systems, including:
1.2.2.2.1 Federally Qualified Community Health Centers (FQHCs) or FQHC Look-
Alikes;
1.2.2.2.2 Hospitals;
1.2.2.2.3 Community clinics;
32

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
1.2.2.2.4 Private practices;
1.2.2.2.5 Behavioral Health Clinics; and/or
1.2.2.2.6 Substance Abuse Centers
1.3 Participate in at least one ADHS-led Tobacco Work Group that addresses one of the following
priority issues:
1.3.1 Youth,
1.3.2 Secondhand Smoke, and
1.3.3 Emerging Issues;
1.4 Participate in required ADHS Office of Tobacco update conference calls, virtual meetings, and in-
person meetings, including (but not limited to):
1.4.1 1:1 Calls,
1.4.2 Group monthly conference calls,
1.4.3 Annual HPHC IGA Summit, and
1.4.4 In-person semi-annual statewide partner meetings, to occur:
1.4.4.1 Spring (March/April); and
1.4.4.2 Fall (September/October;
1.5 Obtain ADHS approval on all county-level tobacco marketing or communications initiatives.
1.5.1 All marketing materials (the use of the ADHS logo, brochures, posters, public service
announcements, paid media, videos, etc.) which have been developed, written, published, or
recorded by the Grantee and paid for with funds from this grant award must be first approved by
ADHS prior to the dissemination of such materials or airing or use of such announcements.
33

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
EXHIBIT B
EVIDENCE-BASED STRATEGIES FOR HEALTH IN ARIZONA POLICY INITIATIVE (HAPI)
In January 2012, ADHS began the process of establishing contracts with local health departments to address health
policy. In April 2012, ADHS established contracts with 13 of the 15 local health departments (Cochise, Coconino, Gila,
Graham, Greenlee, La Paz, Maricopa, Mohave, Navajo, Pinal, Pima, Yavapai and Yuma). HAPI originally utilized
funding from three separate sources: Proposition 303 Tobacco Tax; Women’s, Infants and Children’s (WIC) Health
Lottery Revenue, and HRSA Title V Maternal & Child Health Block Grant. The overall goal of the Intergovernmental
Agreement (IGA) was established to increase local capacity to implement preventative health policy, system and
environmental (PSE) changes/ public health approaches through defined strategic areas.
The five (5) year IGA action plan(s) and activity/activities developed by the local health department will address the
following funding priorities:
1) The four (4) leading chronic disease deaths, as reported by the Centers for Disease Control and Prevention (CDC)
per ARS 36-770 (Proposition 303 Tobacco Tax), and
2) WIC participants and their families per WIC Health Lottery Revenue.
The County Contractor must select one (1) or more strategies from this strategic area.
This Exhibit defines the Program Strategy/s within each Strategic Area:
2. Strategic Area: Health in Arizona Policy Initiative (HAPI)
2.1 Social Determinants of Health (SDOH) / Health in All Policies (HiAP)
2.1.1 Assess and identify gaps in addressing public health and social determinants of health (SDOH),
with consideration of the 4 leading causes of chronic disease death, at-or-high risk populations,
co-morbidities, and / or health risks, and
2.1.2 Develop and implement an action plan that includes policy, systems or environmental (PSE) /
public health, and / or Health in All Policies (HiAP) approaches to address the gaps in addressing
public health and social determinants of health (SDOH), with consideration of the 4 leading
causes of chronic disease death, at-or-high risk populations, co-morbidities, and/or health risks;
2.2 Community Engagement
2.2.1 Increase community engagement of partners, with consideration of the four (4) leading causes of
chronic disease death, at-or-high risk populations, co-morbidities, and/or health risks,
2.2.2 Develop, create and/or participate in coalitions, with consideration of the four (4) leading causes of
chronic disease death, at-or-high risk populations, co-morbidities, and /or health risks,
34

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
2.2.3 Develop and implement a coalition action plan, with consideration of the four (4) leading causes of
chronic disease death, at-or-high risk populations, co-morbidities, and/or health risks, and
2.2.4 Develop coalition capacity to support advocacy, with consideration of the four (4) leading causes
of chronic disease death, at-or-high risk populations, co-morbidities, and/or health risks.
2.3 Systems Change
2.3.1 Assess and identify gaps in addressing “Little p” system changes, with consideration of the 4
leading causes of chronic disease death, at-or-high risk populations, co-morbidities, and/or health
risks, and
2.3.2 Develop and implement an action plan that addresses the gaps in addressing “Little p” systems
changes, with consideration of the 4 leading causes of chronic disease death, at-or-high risk
populations, co-morbidities, and/or health risks;
2.4 Emerging Issues
2.4.1 Assess and identify emerging issues with community partners that align with local, state or national
level emerging issues, with consideration of the 4 leading causes of chronic disease death, at-or-
high risk populations, co-morbidities, and/or health risks, and
2.4.2 Develop and implement action/ breakthrough plans to address emerging issues, with consideration
of the 4 leading causes of chronic disease death, at-or-high risk populations, co-morbidities, and/or
health risks;
2.5 Workforce Capacity Building/Professional Development
2.5.1 Increase knowledge of staff and community partners through professional development and
workforce capacity building, with consideration of the 4 leading causes of chronic disease death,
at-or-high risk populations, co-morbidities, and/or health risks; and
2.6 Evidence Based / Evidence Informed / Promising Practices or Public Health Approaches
2.6.1 Implement Evidence Based / Evidence Informed / Promising Practices or Public Health
Approaches, with consideration of the 4 leading causes of chronic disease death, at-or-high risk
populations, co-morbidities, and /or health risks.
35

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
EXHIBIT C
EVIDENCE-BASED STRATEGIES FOR PUBLIC HEALTH IMPROVEMENT
The purpose of the Public Health Improvement funding is to ensure a strong, inclusive, and connected state and local
government public health system in Arizona. By supporting county health departments and their directors in the practice
of public health, they can effectively perform essential public health services and meet Public Health Accreditation
Board (PHAB) and their performance standards. The county health departments may use several strategies to support
local initiatives to achieve healthy communities. As health departments often may not have identified funds and
resources to build and strengthen their organizations, the Public Health Improvement funds allow for that flexibility within
the established strategies. The funds may be used for activities to improve health department efficiency and
effectiveness, increase performance management capacity, and enhance public health readiness activities in the face
of emerging issues.
The County Contractor must select one (1) or more strategies from this strategic area.
This Exhibit defines the Program Strategy/s within each Strategic Area:
3. Strategic Area: Public Health Improvement
3.1 Seeking PHAB Accreditation or Reaccreditation
3.1.1 Implement activities, training, and tools for the Local Health Department (LHD) to apply for PHAB
accreditation, and
3.1.2 Implement activities, training, and tools for the Local Health Department (LHD) to achieve PHAB
reaccreditation sustainability;
3.2 Evaluate and Continuously Improve Processes, Programs, Quality Improvement, and Interventions
Performance Management
3.2.1 Implement tools or training to develop or maintain a performance management system supported
by leadership and management to monitor achievement of organizational objectives,
3.2.2 Implement activities, tools, or training to develop or maintain a culture of quality improvement
integrated into organizational practice, processes, and interventions, and
3.2.3 Conduct training or capacity building with local stakeholders to support the department’s and
county’s implementation of a quality improvement plan or quality improvement activities;
3.3 Maintain a Competent Workforce
3.3.1 Implement activities and training to build multidisciplinary skills needed for the health department
to achieve its mission, goals, and objectives,
36

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
3.3.2 Implement activities to build and support a health department with a supportive work environment,
employee recognition, employee wellness efforts, and professional development, and
3.3.3 Conduct activities to support the larger public health workforce of the community;
3.4 Conduct and Disseminate Assessments Focused on Population Health Status and Public Health
Issues Facing the Community
3.4.2 Conduct collaborative activities with the community to develop, enhance, and disseminate the
community health assessment;
3.5 Develop Policies and Plans
3.5.2 Conduct or participate in collaborative activities with the community to develop and implement the
community health improvement plan,
3.5.3 Conduct activities to track and implement goals set in the county health improvement plan,
3.5.4 Complete activities to develop, implement, and maintain a strategic plan, and
3.5.5 Complete activities to develop, implement, and maintain an all hazards emergency operations plan;
3.6 Other Activities
Health Equity
3.6.1 Develop and implement strategies that address health inequity and cultural competence,
Administrative and Management Capacity
3.6.2 Develop and maintain internal health department policies and procedures for operations, human
resources, information management, financial management, and management of ethical issues,
and
Emerging Issues
3.6.3 Conduct activities to address an emerging health issue aligned with state and nationally identified
emerging health issues (percentage of funds to be approved by ADHS).
37

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
EXHIBIT D
EVIDENCE-BASED STRATEGIES FOR TEEN PREGNANCY PREVENTION
The Teen Pregnancy Program offers strategic approaches to improve the health and social well-being of youth through
the reduction of teen pregnancies and sexually transmitted diseases, and the awareness of healthy relationships and
life skills, including financial literacy and educational and career success. The program provides youth with knowledge
and skills that can be applied throughout their lives. Program models are evidence-based, age appropriate, medically
accurate, and culturally relevant and incorporate a positive youth development approach.
The teen pregnancy prevention programs also offer a Parent/Youth Communication Education component which can
give parents the tools to actively engage in meaningful communication with their teens on a variety of topics including
sexual health issues. Parents, grandparents and guardians of a teen are welcome and encouraged to participate in
these educational sessions.
Proposition 203, The Healthy Arizona Initiative, was passed by Arizona voters in November 1995, authorizing the use
of lottery funds when available to be utilized for teen pregnancy prevention programs. The funds from the lottery
became available in July 2005. The Arizona Department of Health Services (ADHS), Bureau of Women’s and Children’s
Health (BWCH), Teen Pregnancy Prevention Program, is charged with the implementation of these funds.
Proposition 207, The Smart and Safe Act, was passed by Arizona voters in November 2020, authorizing the legal use
of recreational marijuana. The funds from this act will be available on July 1, 2021. The Arizona Department of Health
Services (ADHS), Bureau of Women’s and Children’s Health (BWCH), is charged with the implementation of a portion
of these funds.
The County Contractor must select one (1) or more strategies from this strategic area.
This Exhibit defines the Program Strategy/s within each Strategic Area:
4. Strategic Area: Teen Pregnancy Prevention
4.1 Implement with fidelity, abstinence plus evidence-based program models, through curriculum delivery to
youth ages eleven to nineteen (11-19) and implement core curricula that are on the ADHS TPP approved
curriculum list incorporating a positive youth development approach.
4.1.1 Program models shall be evidence-based, culturally relevant, medically accurate, and age
appropriate. Programs for youth shall be inclusive of at least three (3) of four (4) Adulthood
Preparation Subjects -Healthy Relationships, Healthy Life Skills, Adolescent Development,
Educational/Career Success, and/or Financial Literacy. Optionally, to parents/caregivers of youth
eleven to nineteen (11-19) years of age,
4.1.2 Program management, services, requirements, deliverables, etc. shall be in accordance with the
TPP Policy and Procedures Manual, and
4.1.3 Program tasks include but are not limited to:
38

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
4.1.3.1 Delivery of curriculum in a variety of settings – in school, after school, community-based,
juvenile detention/probation, foster care group homes, etc.;
4.1.3.2 Educating youth on both abstinence and contraception for the prevention of teen
pregnancy and sexually transmitted diseases/infections;
4.1.3.3 Obtaining active parental consent forms for youth participation in programming and
evaluation;
4.1.3.4 Maintaining up-to-date attendance records;
4.1.3.5 Administering pre and post surveys to youth, and submitting completed surveys to
ADHS;
4.1.3.6 Ensuring the number of youths proposed is served and that eighty percent (80%) of youth
participating in the curriculum complete at least seventy-five (75%) of curriculum dosage;
4.1.3.7 Completion of fidelity monitoring logs following each session delivered;
4.1.3.8 Submitting monthly unduplicated counts of youth served;
4.1.3.9 Submitting annual Forms A-D of reporting total unduplicated count of youth served,
program hours received, and type of programs received;
4.1.3.10 Attending meetings and/or calls, i.e., semi-annual contractor meetings, mid-year budget
review and youth served calls, Wyman Teen Outreach Program® review calls (if
applicable), summer professional development, etc.; and/or
4.1.3.11 Navigating the TPP SharePoint portal for entry of reporting data, program
announcements, discussion boards, and obtaining program forms.
Strategic Area: Teen Pregnancy Prevention Youth Mental Health First Aid Initiative
4.2 Certify staff in TPP Youth Mental Health First Aid Training with prior approval from ADHS;
4.3 Certified trainer must deliver at minimum three (3) trainings per year to maintain active certification in
YMHFA;
4.4 Trainers may co-facilitate and each facilitator can count co-facilitations towards their required three (3)
training(s) per year, for certification purposes;
4.5 Co-facilitated training(s) will only count as one training for payment of stipends;
4.6 Training events must follow the training outline identified by the National Council of Behavioral Health
(NCBH) Youth Mental Health First Aid;
39

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
4.7 During the pandemic, if in-person training is prohibited, training to youth serving organizations can be
conducted virtually;
4.8 Once pandemic restrictions are lifted and in-person training and travel are allowed, training to youth serving
organizations shall be conducted in one (1) of two (2) options: In-person or blended learning;
4.9 Each training shall consist of no less than five (5) participants and no more than thirty (30) and include
participant training materials; and
4.10 Course materials must be purchased for all training participants as this is a required component.
40

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
EXHIBIT E
EVIDENCE-BASED STRATEGIES FOR HEALTHY ARIZONA WORKSITE PROGRAM (HAWP)
In 2013, ADHS rolled out a statewide public health initiative aimed at the worksites/ business called the Healthy Arizona
Worksite Program (HAWP). The HAWP was initiated to engage worksites/ businesses in the Health in All Policies (HiAP)
framework that supported the local county’s Health in Arizona Policy Initiatives (HAPI) program. The HAWP was initially
housed at ADHS, and in 2015 when the HAPI program was folded into the Healthy People Health Communities (HPHC)
Integrated Intergovernmental Agreement (IGA), the HAWP followed. The HAWP, in partnership with ADHS, is currently
administered and implemented by the Maricopa County Department of Public Health. HAWP utilizes funding from two
separate sources: Proposition 303 Tobacco Tax; and Women’s, Infants and Children’s (WIC) Health Lottery Revenue.
The overall goal of the HPHC Integrated IGA was to increase local capacity to implement preventative health policy,
system and environmental (PSE) changes/ public health approaches through defined strategies.
The five (5) year IGA action plan(s) and activity(s) developed by the HAWP will address the following funding priorities:
1) The four (4) leading chronic disease deaths, as reported by the Centers for Disease Control and Prevention (CDC)
per ARS 36-770 (Proposition 303 Tobacco Tax), and
2) WIC participants and their families per WIC Health Lottery Revenue.
The County Contractor must select one (1) or more strategies from this strategic area.
This Exhibit defines the Program Strategy/s within each Strategic Area:
5 Strategic Area: Healthy Arizona Worksite Program Strategies:
5.1 HAWP will offer statewide professional development opportunities to statewide partners that address the
ADHS’ Arizona Health Improvement Plan (AzHIP) Priorities (2021-2026), with consideration given to the
four (4) leading causes of chronic disease death, at-or-high risk populations*, co-morbidities, and / or
health risks;
5.2 HAWP will implement a statewide recognition program for statewide worksites/ businesses, with
consideration given to the four (4) leading causes of chronic disease death, at-or-high risk populations*,
co-morbidities, and / or health risks as awards criteria;
5.3 HAWP will offer statewide technical assistance to worksites/ businesses, with consideration given to the
four (4) leading causes of chronic disease death, at-or-high risk populations*, co-morbidities, and / or
health risks;
5.4 HAWP will assess, identify, develop and implement a plan to address gaps in addressing “Little p” system
changes with/ for worksites/ businesses, with consideration given to the four (4) leading causes of chronic
disease death, at-or-high risk populations*, co-morbidities, and / or health risks;
5.5 As needed and upon approval by ADHS, HAWP will assess, identify, develop and implement a plan with
statewide partners, that includes worksites/ business partners, that align with local, state or nation level
41

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
emerging issues, with consideration given to the four (4) leading causes of chronic disease death, at-or-
high risk populations*, co-morbidities, and / or health risks;
5.6 HAWP will implement and disseminate Evidence Based / Evidence Informed / Promising Practices or
Public Health Approaches for worksites/ businesses, with consideration given to the four (4) leading
causes of chronic disease death, at-or-high risk populations*, co-morbidities, and / or health risks;
5.7 HAWP will assess and provide resources on worksite wellness, total worker health, and/ or HAWP;
5.8 HAWP, in partnership with ADHS, will develop, and update every two years, a Communication Plan that
promotes the efforts of HAWP and internal ADHS programs and media messages, and adheres to ADHS’
Marketing, Media and Communications Guidelines;
5.9 HAWP staff will participate, as a team member, on ADHS’ HAPI and HPHC Programs;
5.10 HAWP will assist in the development of healthcare partnerships, as to leverage resources, decrease
duplication, design interventions, and increase impact of worksite/ business wellness programs;
5.11 As needed, HAWP staff will participate in and attend ADHS strategic planning effort(s) related to but not
limited to, the AzHIP, State Health Assessment, Public Health Accreditation, HPHC, and HAPI;
5.12 HAWP will incorporate ADHS and County public health efforts, as to leverage resources, decrease
duplication, design interventions, and increase impact of worksite/ business wellness programs;
5.13 HAWP, in partnership with ADHS, will develop, an Evaluation Plan and Logic Model, as to measure the
progress and impact; such as health outcomes, employee engagement/morale, and/ or productivity; of
HAWP; and
5.14 HAWP, in partnership with ADHS, will develop a Sustainability Plan.
*includes WIC participants and their families
42

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
EXHIBIT F
EVIDENCE-BASED STRATEGIES FOR SUICIDE MORTALITY REVIEW
In Arizona, both the number and rate of suicides continues to rise. Arizona’s rate of suicide per 100,000 people was
24% higher than that of the United States in 2017. In 2018, suicide ranked 8th among the leading causes of death but
contributed substantially to premature mortality. Yet, suicide is preventable. Pursuant to A.R.S. § 36-199 and § 36-
199.01, ADHS is establishing a Suicide Mortality Review Team in the Department of Health Services. The program
will conduct an annual analysis on the incidences and causes of suicides in the state during the preceding fiscal
year. This analysis will help to inform what changes are needed to decrease the incidence of preventable suicides,
and as appropriate, take steps to implement these changes. ADHS will fund, encourage and assist in the
development of local county health department Suicide Mortality Review Teams in their local jurisdiction and to
develop suicide prevention recommendations for their communities.
On March 3, 2020 Governor Doug Ducey joined mental health advocates, legislators and family members affected by
suicide to sign Senate Bill 1523, also known as Jake's Law. The bill is named in honor of Jake Machovsky, an Arizona
teen who lost his life to suicide in 2016 after battling mental health issues. The law requires insurance companies to
cover mental health treatment and creates the Children's Behavioral Health Services Fund and provides $8 million for
behavioral health services for children who are uninsured or underinsured. The law prohibits insurance companies from
denying coverage for services that are covered by the plan simply because they are delivered in an educational setting.
This law also establishes a mental health parity advisory committee to ensure that all parties including families,
providers, advocacy organizations, and insurers have a voice at the table, creates a suicide mortality review team to
review deaths by suicide and provide policymakers with improved data and recommendations, and helps increase
follow-up services for patients at risk for suicide.
Proposition 207, The Smart and Safe Act, was passed by Arizona voters in November 2020, authorizing the legal use
of recreational marijuana. The funds from this act will be available on July 1, 2021. The Arizona Department of Health
Services (ADHS), Bureau of Women’s and Children’s Health (BWCH), is charged with the implementation of a portion
of these funds.
The County Contractor must select one (1) or more strategies from this strategic area.
This Exhibit defines the Program Strategy/s within each Strategic Area:
6. Strategic Area: Suicide Mortality Review
Strategies are to be determined with program development
43

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
EXHIBIT G
SUPPORTING DOCUMENTATION
Please provide documentation that supports the work that you have outlined on your Action Plan and quarterly reports.
Note: Supporting Documentation will be due on the 2nd and 4th quarters. The following are approved types of supporting
documentation that can be submitted. Counties are expected to keep supporting documentation on hand for all quarters
and to provide to ADHS upon request. This information can also be found on the new Quarterly Report + Supporting
Documentation Template.
Required Documentation: For each program of the IGA, provide documentation of evidence of work performed. The
following are acceptable submissions for documentation of work completed. Approved examples are below by
program:
Tobacco
Youth Prevention: Anti-Tobacco Coalition:
• Recruitment: Copies of flyers pertaining to events for recruitment and expanding youth membership, as submission
of coalition roster form,
• Youth Coalition Action Plan: Copy of the coalition action plan developed by the youth members,
• Coalition Meetings: Copies of meeting agenda along with a sign-in sheet of those attending the meeting,
• Peer to Peer Education/Community Education: The Office of Tobacco has created the following event form for
partners to fill out and submit for each of their coalition events: Youth Coalition Event Form. The coalition can also
include pictures from events, and
• Presentation to Community Leadership (Board of Supervisors, City Councils, or any other governing body): Partners
can utilize the Youth Coalition Event Form for this activity as well.
AGO/FDA Inspection Recruitment & Arizona Retail Tobacco Training:
• The number of recruitment events held: Date of event, youth recruited, completed paperwork submitted,
• Dates of inspections and how many youths participated in inspections, and
• ARTT: Copy of flyer advertising training, dates of training and sign-in sheet for attendees. Evaluation forms sent to
Tracy Lenartz.
Cessation: ASHLine Outreach/Group Cessation Meetings- The following documents are acceptable submission for
documentation of work.
• ASHLine Outreach: The County should provide a copy of ASHLine Cessation Referral report covering the
documentation period. ASHLine & county partners will develop a report that partners can utilize to track referrals
for cessation for their county. This report, once developed, will be sent to county partners for their utilization in
monitoring location referrals and for contract reporting and documentation,
• County Partners Cessation Referral Trainings and Presentations: The Office of Tobacco has created the following
form for partners to fill out and submit for each of cessation referral training and presentations: County Cessation
Training & Presentation Form, and
44

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
• Group Cessation Meetings: Copy of flyers regarding meetings, date(s) of meetings, number of participants in
training, name are not required due to HIPPA. Are any of the participants enrolled in group classes as well as
ASHLine?
Priority Population Initiative:
• If a task group/work group is created to address the chosen population please provide the following information:
• Copies of meeting agenda along with sign-in sheet,
• Action plan or work plan for addressing issues with the work group, and
• Evaluation Plan that will assess the success/status of the goal.
Health in Arizona Policy Initiative (HAPI)
• Sign-in sheet for a training, meeting or wellness activity (should include date, time, and name of training/meeting,
etc.); Event flyer or meeting/training agendas (should include date, time and name of training/ meeting, etc.);
• Certificate of Completion;
• Documentation of participation in coalition/advisory boards, etc. such as an agenda, minutes from the meeting,
membership letter;
• Final Reports of activity;
• Photographs (i.e. proof of water station installation), please note that if you send pictures of individuals, you must
have consent to use the picture of the individual;
• Pre and post survey results of participants in Self-Management Programs;
• Attendance/participation sheet for chronic disease self-management programs;
• Communication plan or materials used for any public awareness campaigns;
• Reporting of process or intermediate performance measures related to the activity within the strategic area(s);
• Partner list or partner meeting agendas;
• Completed Assessments; and
• Developed Action Plans for implementation.
Public Health Improvement
• Quality Improvement or Performance Management Training
• Sign-in sheets and training materials (slide deck, resources),
• Quality Improvement Project Completion
• Storyboard of project work,
• Strategic Planning Development
• Documentation of in-person sessions resources/slides used and sign-in sheets, the outcome of planning (action
plan), and
• Establishment of Performance Management system
• Artifacts of system integration (tracking of visual management, metric review).
Teen Pregnancy Prevention (TPP)
• Certificates of Completion.
• Parent nights/health fairs: Flier signed by authorized representative of event and/or County Program Supervisor
45

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Agreement No.: CTR055429 IGA Amendment No: 1 Procurement Officer
(formerly: IGA 2020-013) Karla Varela
• Instead of submitting attendance records as proof of services performed, counties will submit the TPP Verification
of Curriculum Delivery Form. The Teen Pregnancy Prevention Program Manager will access the delivery of
curriculum form to verify the classes provided are reflective of the narrative in the quarterly reports.
• Teen Pregnancy Prevention Work Summary Report Form (for COVID-19 reassignments.
Please Note: If TPP staff has been reassigned, make sure to include a separate Labor Activity Report and
General Ledger, clearly indicating a breakdown of FTE percentages applied to TPP State Lottery dollars and
another funding source.
See below for further clarification:
• TPP Lottery funds cannot be used to pay for staff temporarily reassigned to the COVID-19 emergency response.
However, TPP staff can be reassigned for COVID-19 related activities by using another funding source. Within the
TPP Action Plan and Quarterly Narrative Reports, counties should indicate whether service activities have been
provided and include any updates. If TPP services have not been provided, note the following, “Services have not
been conducted within the period of (insert dates). TPP staff have been temporarily reassigned to COVID-19
activities using a different funding source.” If staff have been partially assigned to TPP and COVID-19 activities,
include the FTE breakdown in the quarterly report as well.
• For CERs, provide Year to Date expenses of what was actually incurred; do not bill for the full fixed price amount.
When submitting supporting documentation, during Quarters 2 and 4 only, submit the corresponding Labor Activity
Reports and General Ledgers as supporting documentation to illustrate what the TPP staff have been working on.
Teen Pregnancy Prevention (TPP) Youth Mental Health First Aid Initiative
• Participant sign-in sheet (if in person) that includes organization’s name, date, and name of the educator, or
• “Chat Box” sign-in sheet (if virtual) that includes the organization's name, date, and name of the educator.
Please note: Stipends can only be billed for training(s) conducted during the quarter.
Healthy Arizona Worksite
• Invoices/Payments for paying the HAWP Trainer for HAWP 101
Suicide Mortality Review
• A sign in sheet and agenda for all review meetings
• Annual Report
46