CTR040876 A5 MARICOPA COUNTY DEPARTMENT PUBLIC HEALTH.PDF

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
WIC AND BFPC SERVICES
It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows:
1. Pursuant to Terms and Conditions, Page Seven (7), Provision Six (6), Contract Changes; the Intergovernmental Agreement is
amended as follows:
1.1 The Terms and Conditions has been revised to add the following language:
23. § 200.216 Prohibition on certain telecommunications and video surveillance services or equipment.
23.1. Recipients and sub recipients are prohibited from obligating or expending loan or grant funds to:
23.1.1. Procure or obtain;
23.1.2. Extend or renew a contract to procure or obtain; or
All other provisions of this agreement remain unchanged.
Contractor Name: MARICOPA COUNTY, By and Through its Authorized Signature
DEPARTMENT of PUBLIC HEALTH
Address: 4041 N. CENTRAL AVENUE, SUITE 1400 Print Name
PHOENIX ARIZONA 85012
City State Zip Title
Pursuant to A.R.S. § 11-952, the undersigned public agency This Intergovernmental Agreement Amendment shall be effective the
attorney has determined that this Intergovernmental Agreement date indicated. The Public Agency is hereby cautioned not to
is in proper form and is within the powers and authority granted commence any billable work or provide any material, service or
under the laws of Arizona 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.
Print Name
Procurement Officer
Contract No.: CTR040876, 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 ATTEST:
granted under the laws of the State of Arizona.
_______________________________
Office of the Clerk of the Board
Signature Date
_______________________________
Assistant Attorney General Date
Print Name
1

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
23.1.3. Enter into a contract (or extend or renew a contract) to procure or obtain equipment, services, or systems
that uses covered telecommunications equipment or services as a substantial or essential component
of any system, or as critical technology as part of any system. As described in Public Law 115232,
section 889, covered telecommunications equipment is telecommunications equipment produced by
Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities).
23.1.3.1. For the purpose of public safety, security of government facilities, physical security
surveillance of critical infrastructure, and other national security purposes, video
surveillance and telecommunications equipment produced by Hytera Communications
Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology
Company (or any subsidiary or affiliate of such entities).
23.1.3.2. Telecommunications or video surveillance services provided by such entities or using
such equipment.
23.1.3.3. Telecommunications or video surveillance equipment or services produced or provided by
an entity that the Secretary of Defense, in consultation with the Director of the National
Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to
be an entity owned or controlled by, or otherwise connected to, the government of a covered
foreign country.
1.2. The Price Sheet is revised and replaced by the Price Sheet of this Amendment Five (5).
2

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
1. Background
The Arizona Department of Health Services (ADHS) Bureau of Nutrition and Physical Activity (BNPA) administers funds
provided by the United States Department of Agriculture (USDA) for the operation of the Special Supplemental Nutrition
Program for Women, Infants and Children (WIC), Breastfeeding Peer Counseling Program (BFPC), and the Women and
Children's Farmers Market Nutrition Programs (FMNP) for the State of Arizona. The USDA nutrition programs are discretionary,
and each provides a specific service to women, infants, and children who are low income and at nutrition risk. The overall goal
of all the USDA Nutrition Programs is to improve the health status of eligible participants through adoption of healthy behavioral
lifestyle changes and to help prevent the occurrence of health problems.
1.1. WIC Nutrition Services
The WIC Program accomplishes this goal by providing participant-centered services (PCS) including nutrition and
breastfeeding information and support, specific supplemental healthy foods through the issuance of food benefits that can
be used at ADHS-approved grocery stores and farmers’ markets, and referrals to other health and human services as an
adjunct to good health care during critical times of growth and development. Service population eligibility for the WIC
Program is based upon federal regulations such as participant category (pregnant and breastfeeding woman, infant or
child under five years of age), a household income at or below 185% of federal poverty guidelines, residence within the
service area, and nutrition risks.
To be considered as a WIC Local Agency, the organization must be a local public or private non-profit organization, County
health department, or tribal entity under contract with ADHS to provide WIC services according to the WIC Program federal
regulations and state policies and procedures. The State awards a WIC Contract based on the ability of the organization
to provide WIC services, potential eligible population, need, response to the Scope of Work, information technology
capacity, and available funds. The State determines and awards the WIC contract amount based on a funding formula
using several factors such as a base level for a program to function, the amount of caseload negotiated with each Local
Agency, and quality of performance.
1.1.1. Specific objectives for nutrition services (based on Healthy People 2020 goals) are:
1.1.1.1. To increase the incidence of breastfeeding to 82% of women initiating breastfeeding;
1.1.1.2. To increase the duration of breastfeeding to 61% of women breastfeeding for the first six (6) months
of their baby’s life;
1.1.1.3. To increase the duration of breastfeeding to 34% of women breastfeeding for the first year of their
baby’s life;
1.1.1.4. To increase the rate infants are exclusively breastfed to 44% at three (3) months and 24% at six
months;
1.1.1.5. To reduce the proportion of adults who are considered obese to 31%;
1.1.1.6. To reduce the proportion of children ages 2-5 who are considered obese to 10%;
1.1.1.7. To increase the consumption and variety of fruits and vegetables by those two (2) and older;
1.1.1.8. To increase the consumption of whole grains by those two (2) and older; and
1.1.1.9. To increase the proportion of children ages 0-2 who view no television or videos on an average day to
45%.
1.2. Breastfeeding Peer Counseling (BFPC)
1.2.1. In 2003, the USDA Food and Nutrition Service (FNS) entered into a cooperative agreement with Best Start Social
Marketing (Best Start) to gather information to obtain a clear understanding of the components that are necessary
3

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
to sustain effective peer counseling programs and how to structure these programs so they are cost effective and
manageable. They developed the program "Using Loving Support to Implement Best Practices in Peer
Counseling", which is a training and technical assistance project that will be used as a model to aid WIC in
designing, building, maintaining, and sustaining peer counseling programs that will improve breastfeeding
initiation and duration rates. Arizona will be using this program to guide and develop the state peer counseling
program.
1.2.2. The discretionary peer counseling services are considered an adjunct support to WIC breastfeeding services to
help achieve the WIC Nutrition Services objectives regarding breastfeeding.
1.2.3. Peer counseling has been a significant factor in improving initiation and duration rates of breastfeeding among
women in a variety of settings, including disadvantaged and WIC populations representing diverse cultural
backgrounds and geographical locations. Peer counselors are especially effective in communities where role
models for breastfeeding behaviors, knowledgeable health care providers, and cultural practices that include
breastfeeding as the norm, are scarce. Combining peer counseling with the ongoing WIC breastfeeding promotion
and support efforts has the potential to significantly impact breastfeeding rates among WIC participants, and most
significantly, increase the harder to achieve breastfeeding duration rates. WIC Local Agencies are strongly
encouraged to provide peer counseling services in addition to the ongoing breastfeeding support to their WIC
participants. Contractors must provide a breastfeeding friendly environment and have policies to accommodate
participants and staff who are breastfeeding.
1.3. Farmer's Market Nutrition Program (FMNP)
The Women and Children Farmers' Market Nutrition Program (FMNP) is intended to increase consumption of locally grown
fresh fruits and vegetables by providing FMNP checks to a limited number of WIC women, children, and infants as ADHS
allows to purchase these items directly from growers at ADHS-approved farmers' markets. FMNP is also intended to
support local agriculture by expanding the awareness, use of, and sales at farmers' markets.
2. Objective
At a minimum, to provide WIC services while allowing each Local Agency to provide, at their discretion, Breastfeeding Peer
Counseling Services and / or Farmers’ Market Nutrition Program Services.
3. Scope of Service
3.1. WIC Services
The WIC Program Contractor shall perform all the work required to administer and provide WIC services to eligible
participants according to the Arizona WIC Program Policies and Procedures Manual (WIC PPM). These include, but are
not limited to the following activities:
3.1.1. Perform WIC certification procedures such as categorical and income screening and health and nutrition
assessments;
3.1.2. Provide participant centered nutrition and breastfeeding support services to WIC participants;
3.1.3. Provide the mandatory and appropriate additional referrals reflecting the needs of the individual WIC participants;
3.1.4. Issue WIC food benefits tailored to meet the needs of the participants;
3.1.5. Ensure the collection and recording of accurate information;
3.1.6. Provide professional training, mentoring and monitoring of WIC staff competencies necessary for delivery of
required services;
3.1.7. Provide administrative functions for operation of the WIC Program; and
4

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
3.1.8. Prepare and submit all required plans/reports in accordance with this contract and the WIC PPM.
3.2. Breastfeeding Peer Counseling (BFPC)
WIC BFPC Contractors shall perform all the work required to administer and provide additional breastfeeding support
services to WIC mothers following the Loving Support best practice guidelines for peer counseling services and according
to the Contractor's proposal in order to increase the breastfeeding rate and duration of breastfeeding.
3.3. Farmer's Market Nutrition Program (FMNP)
WIC FMNP Contractors shall perform all the work required to administer and provide WIC FMNP services to
eligible participants including but not limited to:
3.3.1. Identifying participants and offering program services;
3.3.2. Distributing information to participants;
3.3.3. Issuing of FMNP benefits;
3.3.4. Safeguarding FMNP benefits;
3.3.5. Documenting accurately all required information;
3.3.6. Providing administrative functions necessary for operation of the FMNP;
3.3.7. Preparing and submitting all required reports in accordance with this Contract; and
3.3.8. Adhering to all provisions of the Arizona Farmers' Market Nutrition Program Policies and Procedures Manual.
4. Tasks
4.1. WIC Services Outreach and Referrals
4.1.1. Conduct outreach activities targeting high risk and underserved populations by developing written and verbal
presentations or utilizing available materials to inform potentially WIC eligible individuals of the availability of the
WIC Program and to explain the benefits of participation according to the outreach plan proposal submitted and
accepted with this Contract.
4.1.2. Establish community partnerships with, at a minimum, the mandatory referral agencies, local hospitals, OB/GYN
and pediatricians offices, and provide regular contacts according to the outreach and plan proposal submitted and
accepted with this Contract.
4.1.3. Establish community partnerships with community organizations such as food banks, community organizations,
human and social services, school districts, etc. according to the outreach and referral plan proposal submitted
and accepted with this Contract.
4.1.4. Establish a referral system with breastfeeding/lactation specialists, including but not limited to, International Board
Certified Lactation Consultants (IBCLC), Certified Lactation Counselors (CLC), Certified Breastfeeding
Counselors (CBC), and Certified Lactation Educators (CLE) according to the outreach and referral plan proposal
submitted and accepted with this Contract.
4.2. Additional BFPC Outreach Tasks:
4.2.1. Develop and document an internal referral link between WIC Program and WIC Peer Counseling Program when
applicable. Interaction between WIC Program and WIC Peer Counseling Program shall occur at least monthly
and may be in the form of site visits from Peer Counselors, participation of Peer Counselors in WIC clinic meetings,
and/or additional training for WIC clinic staff and Peer Counselors.
5

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
4.3. Participant Records:
4.3.1. Follow and maintain documentation of participant centered certification and administrative procedures as
described in the WIC PPM, including but not limited to:
4.3.1.1. Eligibility and ineligibility determinations;
4.3.1.2. Nutrition assessments;
4.3.1.3. Nutrition and breastfeeding education and support;
4.3.1.4. Nutrition and breastfeeding counseling;
4.3.1.5. Encourage participants in setting behavioral goals;
4.3.1.6. Appropriate referrals;
4.3.1.7. Program abuse; and
4.3.1.8. Food benefit issuances.
4.3.2. Maintain inventory and accountability records, as set forth in the WIC PPM, of paper food instrument stock, food
instruments issued by the Contractor, eWIC cards, and eWIC cards issued by the Contractor.
4.3.3. Assure participant confidentiality by obtaining written permission from affected program participant(s) prior to the
release of participant information to any agency. The Contractor shall have a written agreement, completed in
accordance with 7 CFR (Code of Federal Regulations) 246.26 (h) (3), and the Arizona WIC Policy and Procedure
Manual, with any agency or program that will share participant information. The above federal regulation details
the implementation of a written agreement and state plan to regulate use and disclosure of confidential applicant
and participant information.
4.3.4. Staff shall only access the WIC Computer Data System and client files for business related reason(s).
4.3.5. Ensure paper files containing confidential participant information are stored in a secure location in the clinic,
archived when appropriate, and destroyed according to the retention schedule. All files should be destroyed in an
appropriate manner.
4.3.6. The Local Agency shall notify the State Agency immediately by telephone call and email upon the discovery of a
breach of a participant’s confidentiality.
4.3.7. The Local Agency shall immediately investigate such security incident, breach, or unauthorized use or disclosure
of participant information, including:
4.3.7.1. What data elements were involved and the extent of the data involved in the breach;
4.3.7.2. A description of the unauthorized person(s) known or reasonably believed to have improperly used or
disclosed the protected information;
4.3.7.3. A description of where the protected information is believed to have been improperly transmitted,
sent, or utilized;
4.3.7.4. A description of the probable causes of the improper use or disclosure; and
4.3.7.5. Whether Arizona Revised Statutes (A.R.S) § 18-545 or any other federal or state laws requiring
individual notifications of breaches are triggered.
4.3.8. The Local Agency shall provide a written report of the investigation to the Chief of the Bureau of Nutrition and
6

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
Physical Activity (BNPA)/WIC Director and Program Integrity Manager within ten (10) working days of the
discovery of the breach or unauthorized use or disclosure. The report shall include the information specified
above, as well as a full, detailed corrective action plan, including information on measures that were taken to halt
and/or contain the improper use or disclosure.
4.3.9. The Local Agency shall notify individuals of the breach or unauthorized use or disclosure when notification is
required under state or federal law and shall pay any costs of such notifications, as well as any costs associated
with the breach. The BNPA Chief/WIC Director, Program Integrity Manager, and Assistant Attorney General shall
approve the time, manner and content of any such notifications. The Local Agency will arrange and pay for any
mitigation (e.g. LifeLock) for participants at risk for identity theft because of breach of security of information.
4.4. Additional FMNP Participant Records Tasks:
4.4.1. Document nutrition education and distribution of FMNP benefits and submit reports to ADHS according to the
Arizona Farmers' Market Nutrition Program Policies and Procedures Manual.
4.5. Service Delivery and Program
The Contractor shall:
4.5.1. Determine eligibility of persons requesting WIC services by screening individuals in accordance with procedures
set forth in the WIC PPM; Eligible program participants shall include the following categories whose household
income does not exceed 185% of the current designated federal poverty guidelines, who have a nutritional risk
as defined in the WIC PPM, and reside in Arizona as defined by the WIC PPM;
4.5.1.1. Pregnant women, breastfeeding women up to 12 months post-partum, and non-breastfeeding women
up to six (6) months following the end of a pregnancy;
4.5.1.2. Infants from birth to age one (1), and
4.5.1.3. Children from age one (1) year up to five (5) years of age.
4.5.2. Provide complete nutrition assessment and document results and follow-up in accordance with Value Enhanced
Nutrition Assessment (VENA) initiative as outlined in Chapter 2 and 7 of the Arizona WIC Policy and Procedure
Manual;
4.5.3. Provide participant-centered nutrition education to participants and appropriately utilize emotion-based materials
provided by the State;
4.5.4. Assist participants in setting goals for behavioral change and follow-up on goals set;
4.5.5. Promote breastfeeding to WIC participants and provide breastfeeding education and support, and refer to and
promote the Breastfeeding Peer Counseling Program, when appropriate;
4.5.6. Prescribe and tailor a food package appropriate to the participant's nutritional risk(s), category, and cultural
preferences and issue food benefits as set forth in the WIC PPM;
4.5.7. Provide program participants with information about available health and social services to which the participant
could be referred. The participant shall be provided with written information regarding community services and
referrals in accordance with the WIC PPM and Local Agency referral procedures;
4.5.8. Coordinate WIC Services with other health and social services available within the service area, including but not
limited to immunizations, voter registration, and breastfeeding support;
4.5.9. Provide information, check for understanding, and document training to participants on program rules, regulations,
WIC approved foods, use of eWIC cards, food benefit use and redemption, and if applicable, FMNP benefits. The
training shall be documented in the participant's record as set forth in the WIC PPM and/or AzFMNP Manual;
7

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
4.5.10. Additional BFPC Service Delivery tasks:
4.5.10.1. Accept referrals generated from calls to the ADHS Pregnancy and Breastfeeding Hotline into the
Peer Counseling Program;
4.5.10.2. Provide peer counseling services, when appropriate. Services shall be made available outside of
usual clinic hours and outside of the WIC clinic, but may also be available during usual clinic hours
and in the WIC clinic; and
4.5.10.3. Provide supervision, mentoring, monitoring, and evaluation of peer counselors, when appropriate.
4.5.11. Additional FMNP Delivery tasks:
4.5.11.1. Identify eligible participants, offer FMNP benefits, and provide services to participants in accordance
with the Arizona Farmers' Market Nutrition Program Policies and Procedures Manual;
4.5.11.2. Issue a unique series of ADHS-provided FMNP check numbers after participant has been certified
as an eligible WIC participant and has expressed a desire to participate in the program, through the
Arizona electronic participant record system;
4.5.11.3. Submit a written request to the ADHS FMNP Manager for authorization to utilize a Local Agency WIC
staff to train and certify local growers at no extra cost to ADHS. Grower training shall be conducted
only by ADHS authorized individuals. Each request to conduct training will be granted on a case-by-
case basis, and shall not be performed without receipt of prior written approval from the ADHS FMNP
Manager;
4.5.11.4. Distribute information to all participants regarding the authorized WIC vendors and the location and
hours of ADHS approved Arizona Farmers' Markets;
4.5.11.5. Distribute to participants a brief description of non-allowable and allowable items (Participant Guide
and other information provided by ADHS) and the time period for redeeming FMNP benefits;
4.5.11.6. Notify ADHS within five (5) working days of receipt of any notification of change to the date, time or
location of an individual Farmers' Market; and
4.5.11.7. If funding for additional FMNP benefits becomes available and the contract budget (as shown on the
Contract Price Sheet) has been fully expended, the Contractor may choose whether or not to
distribute the additional checks with no increase in the Contract budget.
4.6. Participant-Centered Nutrition Education
The Contractor shall:
4.6.1. Prepare and submit a two (2) year Nutrition Services and Training Plan for participants to include, but not be
limited to:
4.6.1.1. Adoption and Implementation of ADHS goals for nutrition services. In addition, Local Agencies will
identify their own goals for nutrition services in this plan; and
4.6.1.2. Adoption and implementation of the State objectives for staff training and client interventions related
to the goals for nutrition services. In addition, Local Agencies are required to provide at least one
additional objective for each goal.
4.6.2. Provide and document participant-centered nutrition education to all WIC adult participants, and to parents or
caretakers of participants according to the guidelines of the State Nutrition Services Plans. A minimum of two (2)
nutrition education contacts in each six (6) month certification period shall be made and documented in the
participant's record. Breastfeeding women, children, infants and migrants from any eligibility category are certified
for one (1) year and will receive one (1) nutrition education contact for each three (3) month period. Pregnant
8

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
women certified through six (6) weeks postpartum will receive one (1) nutrition education contact for each three
(3) month period.
4.6.3. Provide and document professional supervision, mentoring and monitoring of staff at the clinic level on a regular
basis, in accordance with Local Agency Self-Assessment requirements and as often as necessary, to ensure
competence.
4.6.4. Offer, as often as necessary, high- and medium-risk nutrition education/counseling by an RD to all participants
deemed high-risk upon assessment. As defined in the WIC PPM Local Agencies may designate a Bachelor's
degree nutritionist or Dietetic Technician Registered to provide medium-risk counseling to participants under the
supervision of the RD.
4.6.5. Expend for nutrition education activities an aggregate amount that is not less than the sum of one-sixth (1/6) of
the amount the Contractor receives for provision of WIC services each contract year. If the one- sixth (1/6) amount
is not expended for nutrition education activities, ADHS may request the Contractor to return an amount equal to
the difference between the one-sixth (1/6) requirement and the actual amount expended IF ADHS must pay a
penalty to the Federal Government. Costs that can be applied to meet the one-sixth (1/6) requirement for nutrition
education include:
4.6.5.1. Salary and other costs for time spent on nutrition education, whether with an individual or group;
4.6.5.2. The cost of procuring and producing nutrition education materials;
4.6.5.3. The cost of training nutrition educators, including costs related to conducting training sessions and
purchasing and producing training materials;
4.6.5.4. The cost of conducting participant evaluations of nutrition education;
4.6.5.5. The salary and other costs incurred in developing the nutrition education plan; and
4.6.5.6. Other ADHS-approved costs.
4.6.6. Coordinate nutrition education activities and messages. Wherever possible, the Contractor shall utilize USDA
and/or AZ Health Zone materials and messages to ensure common nutrition messages.
4.6.7. The Local Agency will provide documentation that a minimum of 4% of their annual WIC expenditures have been
used to support breastfeeding promotion and education. If the 4% is not expended for breastfeeding promotion
and education activities, ADHS may request the Contractor to return an equal to the difference between the 4%
and the actual amount expended IF ADHS must pay a penalty to the Federal Government.
4.7. Staffing
The Contractor shall:
4.7.1. Designate a WIC Program Director/Manager who is an RD, with previous WIC and/or community health
experience to manage and administer the WIC Program and may provide high-risk nutrition counseling and/or
formula authorization to WIC participants. If an RD is on staff to provide the WIC RD services and with prior
approval from ADHS, the Contractor shall designate a Director with a minimum of an undergraduate degree from
an accredited institution in nutrition (community nutrition, public health nutrition, nutrition education, human
nutrition or nutrition science) or a related field such as home economics or biochemistry with an emphasis in
nutritional science or public health administration.
4.7.2. Identify an RD to serve as the Local Agency Nutrition Coordinator as defined in the WIC PPM. The Nutrition
Coordinator will oversee all WIC nutrition services for the Local Agency. If a Local Agency has barriers to this
staffing standard, they must be submitted in writing to ADHS with their plan for coordination of nutrition services
within the Local Agency to be approved by ADHS.
4.7.3. Provide an appropriate number of RDs to perform high-risk and medium-risk counseling, formula authorization,
9

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
and as necessary, certification of participants. The Contractor shall provide the RD services in a number
proportional to the agency's high-risk caseload in accordance with the WIC PPM, The Contractor may hire
nutrition degree graduates or Registered Dietetic Technicians, to do medium-risk counseling, formula
authorization, and as necessary participant certification under the direction of an RD. If a Local Agency has a
barrier to having an RD on staff, the agency must submit in writing to ADHS with their plan for providing high risk
nutrition counseling to participants.
4.7.4. Provide staff to conduct outreach activities targeting high risk and underserved populations, including but not
limited to homeless and migrants, by developing written and verbal presentations or utilizing available materials
to inform the potentially eligible individuals of the availability of WIC Program and explain the benefits of
participation
4.7.5. When applicable and necessary, provide an appropriate number of adequately trained certification specialists to
provide categorical and financial eligibility screening, pre-certification and record required documentation, in
accordance with the WIC PPM, as well as administrative support services when necessary. Such individuals shall
have the minimum of a high school degree or equivalent and must complete the state training requirements and
be certified by the Contractor as competent according to the competencies for the position. Previous nutrition or
health related job experience is desirable. These individuals shall meet individual ADHS competencies as set
forth in the WIC PPM prior to providing each service such as certifying applicants for participation and/or providing
health assessments in the Arizona WIC Program Staff should be observed and certified by the supervising
authority to be competent in an activity before being allowed to perform on their own without supervision.
4.7.6. Provide an appropriate number of adequately trained nutrition education specialists to provide certification and
nutrition education services to participants in accordance with the WIC PPM. Such individuals will have the
minimum of a high school diploma with nutrition experience, education, and training that have been certified by
local or state agencies to be competent for the position. An Associate or Bachelor's degree is highly preferred.
These individuals shall meet the ADHS competencies for Nutrition Education Specialists as set forth in the WIC
PPM prior to certifying applicants for participation and/or providing nutrition education in the Arizona WIC
Program. Staff should be observed and certified by the supervising authority to be competent in an activity before
being allowed to perform on their own without supervision.
4.7.7. Identify an International Board Certified Lactation Consultant (IBCLC) to serve as the local agency Breastfeeding
Coordinator as defined in the WIC PPM. The Breastfeeding Coordinator will oversee all WIC breastfeeding
services for the local agency to ensure all participants have access to breastfeeding promotion and support
services. If a local agency has barriers to this staffing standard, they must be submitted in writing to ADHS with
their plan for coordination of breastfeeding services within the local agency to be approved by ADHS.
4.7.8. All Local Agencies will identify a Training Coordinator as defined in the WIC PPM. The Training Coordinator will
oversee and facilitate both new employee and ongoing WIC training for the Local Agency including certifying that
staff has met competencies prior to providing services without supervision. If a Local Agency has barriers to this
staffing standard, they must submit in writing to ADHS their plan for coordination of training services within the
Local Agency to be approved by ADHS.
4.7.9. When applicable and necessary, provide WIC Clerks to perform administrative support within WIC clinics at the
option of the Contractor. Such individuals shall have the minimum of a high school degree or equivalent. They
must meet WIC Program competencies. Previous clerical or work experience is desirable.
4.7.10. Maintain a record of training provided, monitoring, and observation results of staff competencies in each staff file
and/or the state Learning Management System (LMS)
4.8. Additional BFPC Service Staffing
4.8.1. Employ a BFPC Program Manager to plan, direct and coordinate general operation of Peer Counseling Program.
Ideal candidate will be an International Board Certified Lactation Consultant (IBCLC), have WIC experience, and
be familiar with community resources.
4.8.2. Develop a support referral system for peer counselors with community Lactation Consultants, including IBCLCs,
if the BFPC Program Manager is not an IBCLC or is unable to fulfill consultation duties for any reason.
10

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
4.8.3. Employ Breastfeeding Peer Counselors to provide services. Qualifications for peer counselors shall be previous
personal experience with breastfeeding, enthusiasm for helping others to succeed at breastfeeding, and
similarities with the WIC population the program serves (including similar age, ethnic background, and language
spoken). Exemptions to the peer counselor qualifications must be approved by ADHS before hire. When possible,
peer counselors should be current or previous WIC participants
4.9. Staff Training
The Contractor shall:
4.9.1. Train new staff as outlined in the ADHS developed new employee training plan.
4.9.2. Register and ensure all WIC staff complete all ADHS required WIC on-line courses according to the time
requirements set forth by the State through ADHS Learning Management System (LMS) at az.train.org, or state-
assigned LMS System in accordance with the ADHS WIC PPM.
4.9.3. In addition to state requirements for competency trainings, Local Agencies must implement and adopt the state
training standards as reflected in the Nutrition Education Plan and the ADHS WIC PPM. In addition, Local
Agencies must participate in any mandatory training provided by ADHS due to changes in policy, procedures,
and / or federal regulations.
4.9.4. Provide training for all new staff members regarding Civil Rights, Americans with Disabilities Act (ADA), and Voter
Registration during their orientation and, annually, provide all staff with training on Civil Rights, ADA, and Voter
Registration issues by completing the ADHS LMS courses on Civil Rights and Voter Registration or other courses
or trainings that will be required by ADHS.
4.9.5. Provide one (1) representative for a maximum of six (6) mandatory, face-to-face, two (2) day meetings or trainings
sessions in Phoenix, as scheduled by ADHS on a yearly basis. These meetings will be opportunities for the Local
Agency to discuss issues with regards to WIC policies and procedures, federal rules and regulations, and nutrition
standards.
4.9.6. Provide one (1) representative for a maximum of 12 GoToMeeting teleconference meetings to receive information
updates on WIC operations, policies and procedures, and other relevant materials being held in lieu of face to
face meetings.
4.9.7. Provide one (1) representative to attend a two (2) day trainer conference in Phoenix during each fiscal year for
skill and knowledge building.
4.10. Additional BFPC Staff Training:
4.10.1. Send the WIC Director or designee and the Breastfeeding Peer Counselor Program Manager to a two (2) day
training at the ADHS office in Phoenix during each Peer Counseling Program contract term.
4.10.2. Provide training of Breastfeeding Peer Counselors using the Loving Support through Peer Counseling
Curriculum within one (1) month of employment.
4.10.3. Provide continual education and adequate resources to peer counselors. Continual education shall include basic
and continuing breastfeeding training, and may include opportunities to shadow lactation consultants,
opportunities to meet with other peer counselors, and related training such as counseling skills, adult learning
styles, and others.
4.10.4. Provide all WIC clinic staff the PowerPoint presentation "Peer Counseling: Making a Difference for W IC Families"
through the Loving Support curriculum at least once during each Peer Counseling Program contract term.
11

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
4.11. Data Collection
The Contractor shall:
4.11.1. Utilize the hardware, software, and training provided by the Arizona WIC Program to operate the Contractor's
portion of the WIC Computer Data System.
4.11.2. Complete all data elements required on the WIC Computer Data System as outlined in the WIC PPM.
4.11.3. WIC Computer Data System users are required to maintain integrity by keeping their username and password
secure. Users shall not share their login information with others.
4.11.4. When applicable and necessary to fulfill WIC business functions, local WIC IT shall coordinate with ADHS WIC IT
to ensure immediate restoration of technical equipment (i.e. ADHS owned equipment) to include but not limited
to providing a temporary administrative account.
4.12. Administrative Services
The Contractor shall:
In addition to complying with the Guidance for Federal Grant Award Management (Blue Book), State of Arizona
Accounting Manual (SAAM) for Contractors of ADHS Funded programs, AND Chapter 12 and 13 of the Policy
and Procedure Manual (PPM):
4.12.1.1. Maintain a formal inventory listing or subsidiary record of all equipment owned by the Contractor in
an organized manner as a part of the official accounting system. Ensure the non-capital and capital
equipment listing includes the following: Tag or ID number, Description, Purchase cost or fair market
value on date of donation, Purchase or donation date, Location, Disposal Date, Funding Source,
Serial Number, Manufacturer, Model Number, RAM size (if applicable), Specifications (if applicable),
and Receipt/Invoice (proof of purchase).
4.12.1.2. Provide maintenance and upkeep for all equipment purchased with WIC funds. Maintenance may be
provided through the Contractor's own organization or the Contractor may participate in State
maintenance contracts where available.
4.12.1.3. Obtain written permission from ADHS prior to expending WIC funds to purchase equipment with a
value of five thousand dollars ($5,000) or more.
4.12.1.4. Obtain written permission from ADHS prior to expending WIC funds for the purchase of any asset
resource related item: hardware (e.g. computers, printers) or software, regardless of cost as well as
their transfer or disposal;
4.12.1.4.1. Once the asset resource related item is purchased ADHS must be provided the
information listed in 8.1.1 within 10 business days of the item being received
4.12.1.4.2. Transfer and disposals must follow the procedures outlined in the PPM.
4.12.1.4.3. Destroyed/Missing/Stolen asset resources must be reported upon discovery no
later than 10 business days from the time of incident.
4.12.1.5. Submit to ADHS for approval in writing any policy or procedure that deviates from those set forth in
the Arizona WIC PPM.
4.12.1.6. Update the Local Agency information on a timely basis on the WIC Clinic Search administrative
website including but not limited to names of CEO/Health Officer, WIC Director, Clinic Supervisors,
Nutrition Coordinator, Breastfeeding Coordinator, Training Coordinator, FMNP Coordinator, IT
lead(s), clinic names, addresses, phone numbers, days and hours of operations, closure days, and
other pertinent information for the public to know.
12

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
4.12.1.7. Provide at least 10 weeks written notice when planning on opening, moving, or suspending WIC
services at any location.
4.12.1.8. Read, timely, all ADHS provided documents and provide requested response, if applicable.
4.12.1.9. The Local Agency Director shall ensure the State Agency has their most recent contact information
in an effort to maintain current and accurate information in the Arizona Health Alert Network (AzHAN)
account.
4.12.1.10. Maintain records of WIC services in WIC Computer Data System, if applicable, according to the WIC
PPM, including but not limited to:
4.12.1.10.1. Signed consent for anemia screening and anthropometrics;
4.12.1.10.2. Signed Rights and Obligations for enrolled participant files (active and inactive);
4.12.1.10.3. Eligible participant files (active and inactive);
4.12.1.10.4. Ineligible applicant signatures;
4.12.1.10.5. Monthly Participation Reports by Category and Ethnicity;
4.12.1.10.6. Outreach files;
4.12.1.10.7. Medical documentation;
4.12.1.10.8. Staff files: Trainings attended, skill observations, and annual evaluations;
4.12.1.10.9. Documentation of dual participation actions;
4.12.1.10.10. Waiting lists (when applicable);
4.12.1.10.11. Reconciliation of eWIC cards;
4.12.1.10.12. Civil rights file to include documentation and resolution of all civil rights complaints;
4.12.1.10.13. Documentation of annual civil rights and voter registration training of all employees;
and
4.12.1.10.14. Documentation of WIC Confidentiality and Conflict of Interest forms.
4.12.1.11. Correct and resolve inappropriate or missing participant information, improbable assessment values,
duplicate participation, and other quality assurance WIC Computer Data System issues identified in
the report provided to the Contractor by ADHS within the timeframes specified in the WIC PPM.
4.12.1.12. Correct any regulatory deficiency or discrepancy noted during any of the three program Management
Evaluations, Audits, Local Agency Compliance Investigations or Program Financial Reviews within
sixty (60) calendar days of the date of the audit report unless an extension date is granted by the
auditing/reviewing agency and documented.
4.12.1.13. Prepare and submit individual electronic copies of the Contractor's Expenditure Reports (CER) for
each contracted program according to the instructions and requirements of the WIC PPM.
4.12.1.14. Local agencies not meeting their monthly participation level as outlined in Section H of this document
shall prepare and submit monthly status reports of caseload countermeasures taken.
4.12.1.15. Prepare and submit Final Closeout CER invoice for each contracted program reflecting the
cumulative expenditures for a contract year.
13

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
4.12.1.16. Prepare and submit WIC Local Agency Quarterly Cost Summary Reports that matches the amount
of each quarter’s expenditures including the Final Closeout CER invoice respectively in accordance
with the requirements in the WIC PPM.
4.12.1.17. Prepare and submit an annual evaluation on the annual Contractor's Outreach Plan and a progress
report on activities accomplished during the year.
4.12.1.18. Prepare and submit an annual evaluation on the Two (2) Year Nutrition Services and Training Plan
and a progress report on activities accomplished during the year.
4.12.1.19. Prepare and submit an annual Amendment Application in accordance with the individual program
requirements that will include budget breakdown of line items and budget justifications of any budget
changes.
4.12.1.20. Prepare and submit a Local Agency Annual Summary of the Local Agency self-assessment(s). Local
Agency self-assessments must be done annually in the year that the Local Agency has a
Management Evaluation, and semi-annually in the year that they do not have a Management
Evaluation.
4.12.1.21. Prepare and submit all required plans, reports, and documents in accordance with the requirements
in the WIC PPM.
4.13. Additional Peer Counseling Administrative Services:
4.13.1. Prepare and submit a Quarterly Report for the Peer Counseling services in the format provided by ADHS.
4.13.2. Present program logistics, highlights, and data at a Nutrition Programs meeting at a time and location to be
determined by ADHS.
4.14. Additional FMNP Administrative Services:
4.14.1. Assume liability for the distribution and reconciliation of all FMNP checks, and assume financial liability for any
checks that cannot be accounted for and reconciled.
5. Deliverables
If applicable, any work plan or other documentation submitted to and accepted by ADHS regarding participation in WIC, BFPC
or FMNP shall be incorporated into this Agreement. Furthermore, any policy or procedure that deviates from those set forth in
the Arizona WIC Program and / or Arizona Farmers' Market Nutrition Program Policies and Procedures Manuals requires
approval from ADHS prior to implementation.
The Contractor shall submit to ADHS:
5.1. Updated copies of Local Agency Policies and Procedures that will include coordination and referral procedures with
internal and external programs and agencies, i.e. WIC and Peer Counseling;
5.2. Prepare and submit individual electronic CER copies invoice for each program, not later than thirty (30) days following
the end of each report month of the program year;
5.3. WIC Local Agency Quarterly Cost Summary matching the WIC Contractor's Quarterly CER not later than thirty
(30) days following the end of each quarter report of the program year;
5.4. Final CER invoice for each program not later than forty-five (45) days following the end of each Contract year;
5.5. WIC Local Agency 4th Quarterly Final Cost Summary matching the WIC Contractor's Final CER, not later than
forty-five (45) days following the end of each Contract year;
14

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
5.6. Each Contracted Program's amendment application by the specified deadline for the following contract year which
contains the following information:
5.6.1. Request for Caseload to be served;
5.6.2. Request for budget and budget justification;
5.6.3. Updated Participant Nutrition Services and Training Plan for the following contract year and a evaluation of the
previous year's activities;
5.6.4. Updated Outreach Plan of each contract year and a progress report of previous year’s activities; and
5.6.5. Any additional services and other documents specified
5.7. All required responses to federal and state audits and reviews submitted in a timely manner
5.8. Additional Peer Counseling Deliverables:
5.8.1. Quarterly reports for the Peer Counseling Program to be submitted 15 days after each quarter of the Contract
year.
6. Performance Standards And Awards
6.1. Upon Contract finalization, ADHS shall notify the Contractor by certified mail of the assigned caseload, and throughout
the term of the Contract, of any changes to the assigned caseload. The Contractor shall maintain an average monthly
participation level in accordance with the following table:
Caseload Assignment % Maintained
<10,000 participants/month 97%
10,000 to <49,999 participants/month 98%
>50,000 participants/month 99%
6.2. If, after each quarter of the Federal Fiscal Year (October through September), the Contractor has not attained the required
participation level, ADHS will have the option of reducing the assigned caseload and resources to the Contractor's current
service level. ADHS may also then move the unused caseload and corresponding resources to other WIC Local Agencies
in order to fully utilize the resources.
6.3. Local Agencies shall be eligible for one (1) or more of the following awards:
6.3.1. Any local agency which meets 100% or more of its caseload assignment for three (3) consecutive months during
the previous 12 month period (April 1 through March 31) may receive an award of $10,000 added to that agency's
following fiscal year WIC funding formula award if the Contract is extended and additional expenditures can be
identified;
6.3.2. Utilizing the “Nutrition Discussion Contact” report ran for the last 6 months preceding time of application (September
through February), any Local Agency meeting 95% of its nutrition education documentation requirement for each
participation time period may receive an award of $10,000 added to that agency's following fiscal year WIC funding
formula award if the Contract is extended and additional expenditures can be identified;
6.3.3. The agency with the highest percentage of IENs in the first quarter (Oct 1 through Dec 31) of each fiscal year within
their Assigned Caseload Cohort may be eligible to receive an award added to the following fiscal year WIC funding
formula award if the Contract is extended and additional expenditures can be identified. Assigned Caseload
Cohorts and award amounts will be determined as follows:
15

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
Assigned Caseload Cohort Award Amount
Less than 2000 $5,000
2000 - 8000 $10,000
More than 8000 $15,000
6.3.4. Pursuant to 7 CFR 246. 14, which allows the WIC program to fund nutrition services and administrative expenses,
the Performance Awards may be part of the annual funding formula and awarded to the Contractor in the next
contract year; and
6.3.5. USDA has the option to award breastfeeding performance awards to State Agencies who exceed the national
average. If funds are awarded to Arizona, each Local Agency programs will receive a proration of the amount
based upon the number of exclusively nursing women in their Local Agency. It will be a set amount, and may only
be used for purposes outlined in the current federal guidelines.
7. State Provided Items
ADHS shall provide the following:
7.1. Paper copies of the Arizona WIC Program and the Arizona FMNP Policies and Procedures Manual, upon request.
7.2. Hardware and software necessary for operation of the WIC Computer Database System.
7.3. Learning Management courses for software training and nutrition education courses for staff to complete and/or pass.
7.4. FMNP Food Instrument stock and blank eWIC Cards.
7.5. Method for submitting expenditures. The ADHS WIC Program Manager or designee will accept and approve the
expenditures prior to payment.
7.6. Nutrition Education Materials for participants.
7.7. Quarterly Report template (electronic) for Peer Counseling Program.
7.8. Technical assistance and support.
7.9. Breastfeeding material lending and library for Peer Counselor use.
7.10. Assistance with International Board Certified Lactation Consultant (IBCLC) career track or advanced lactation
consultant education, when appropriate.
7.11. Loving Support through Peer Counseling curriculum, which includes the PowerPoint presentation "Peer Counseling:
Making a Difference for WIC Families," when appropriate.
7.12. FMNP Participant Guides.
7.13. Online, downloadable information regarding the location and hours of approved Arizona Farmers' Markets.
7.14. Monitoring of WIC Authorized Vendors and Farmers' Markets for compliance with regulations, and coordination with
tribal and county officials when doing compliance buys for markets on a reservation.
7.15. Periodic redemption reports for issued benefits.
7.16. Formats for required reports.
16

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
8. Reference Documents
8.1. Arizona WIC Program Policies and Procedures Manual, refer to:
http://azdhs.gov/azwic/local_agencies_policyManual.htm
8.2. Arizona FMNP Manual, refer to:
http://azdhs.gov/documents/prevention/azwic/fmnp/fmnp-local-agency-manual.pdf
8.3. Guidance for Federal Grant Award Management (Blue Book): https://www.azdhs.gov/documents/prevention/womens-
childrens-health/childrens-health/homevisiting/guidance- for-federal-grant-award-management.pdf
8.4. State of Arizona Accounting Manual (SAAM): https://gao.az.gov/publications/SAAM/
8.5. Federal Regulations: Refer to:
https://www.ecfr.gov/cgi-bin/text-idx?SID=a42889f84f99d56ec18d77c9b463c613&node=7:4.1.1.1.10&rgn=div5
8.6. 7 CFR 246.14: program costs
8.7. 7 CFR 246.26 (h)(2): notice to applicants and participants about the use and disclosure of confidential applicant and
participant information
8.8. 7 CFR 246.26 (h)(3): implementation of a written agreement and state plan to regulate use and disclosure of
confidential applicant and participant information
9. Notices, Correspondence, and Reports
9.1. Notices, correspondence, reports and invoices/CERs from the contractor to ADHS shall be sent to:
Arizona Department of Health Services
150 N. 18th Avenue, Suite 310
Phoenix, Arizona 85007
Attention: WIC Program
Manager
9.2. Notices, correspondence, and reports (and payments if sent to same address) from ADHS to the contractor shall be
sent to:
Contractor:
Attention:
Address:
Address:
City, State, ZIP:
Phone:
Fax:
Email:
17

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
PRICE SHEET
October 1, 2020 to September 30, 2021
Agency Name: Maricopa County Health Department
Federal Award Date: October 1, 2020
CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children
WIC Services
Cost Reimbursement Line Item Budget
Account Classification Amount
Personnel $3,872,527.00
Employee Related Expenses $2,022,012.00
Professional & Outside Services $105,000.00
Travel Expense $10,550.00
Occupancy Expenses $397,086.00
Other Operating Expenses $88,531.00
Capital Expenditures $1.00
Indirect Cost $1,221,193.00
RD Supplement $1,038,016.00
Total $8,754,916.00
Federal Award Date: October 1, 2020
CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children
Breastfeeding Peer Counseling Services
Cost Reimbursement Line Item Budget
Account Classification Amount
Personnel $275,028.00
Employee Related Expenses $142,747.00
Professional & Outside Services $1.00
Travel Expense $2,500.00
Occupancy Expenses $1.00
Other Operating Expenses $9,016.00
Capital Expenditures $0.00
Indirect Costs $80,707.00
Total $510,000.00
18

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
Federal Award Date: October 1, 2020
CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children
WIC SPECIAL PROJECTS
Cost Reimbursement Line Item Budget
Account Classification Amount
Personnel $179,234.00
Employee Related Expenses $106,728.00
Professional & Outside Services $1.00
Travel Expense $1.00
Occupancy Expenses $85,875.00
Other Operating Expenses $0.00
Capital Expenditures $0.00
Registered Dietitian $36,608.00
Indirect Costs $76,788.00
Total $485,236.00
Additional Terms and Conditions:
With prior written approval from the Program Manager, the Contractor is authorized to transfer up to a maximum of ten
percent (10%) of the total budget amount between funded line items except for Registered Dietitian Expenses.
Transfers of funds are only allowed between funded line items. Transfers exceeding ten percent (10%) or to a non-
funded line item shall require an amendment. The Registered Dietitian line item may only be used to fund additional
Registered Dietitian position(s) to meet high risk counseling requirements.
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 funds authorized. The Contractor shall only be authorized to perform services up to the amount on 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 a.) The Purchase Order
is modified with an official ADHS Procurement Change Order, and/or b.) An additional Purchase Order is issued for
purchase of services under this Contract.
ADHS reserves the right to adjust awards given to local agencies depending on federal dollars received. Adjustments
will be at the discretion of ADHS.
Additional WIC Program:
Should additional administrative monies become available through state or federal grants, ADHS may increase the
purchase order to increase the number of participants served and increase the total of this contract.
The assigned caseload for FFY 2020 is: 48,000
Additional Breastfeeding Peer Counseling Program:
Allowable costs for the Peer Counseling Program include compensation for peer counselors and designated peer
counselor managers/coordinators, and related costs such as training and training materials; telephone expenses for
participant contacts (including pager, cell phones and answering machines); travel for training and home and hospital
19

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
visits; recruitment of peer counseling staff; and the purchase of demonstration materials (e.g., breast pumps for
demonstration purposes, videos). Out of state travel must be pre-approved by ADHS. Items and materials for
distribution to WIC participants (e.g. breast pumps, breastfeeding aids) are not allowable costs.
WIC Special Projects
Monies are provided for WIC Special Projects that will include the following:
a. Cover occupancy, security, and cleaning services costs for an ADHS WIC computer lab training room
housing up to 40 computers at 2737 W Southern Ave, Suite 10, Tempe, AZ 85282. The WIC computer lab
training room will be for the priority use of the Arizona State WIC Program and be made available to other
Arizona WIC local agencies. ADHS Information Technology staff will be responsible for installation and
maintenance of computer and networking hardware and software. The training room computers will not be
connected to the Maricopa internal network, but the training room will share the same internet line as the
adjacent WIC clinic.
b. Additional monies have been added to Personnel Services, Employee Related Expenses, Occupancy, and
Indirect Cost Line Items to support the Thunderbird Clinic’s supervisor and rent costs and have been
adjusted to support the clinic supervisors’ and rent costs due to moving from the Thunderbird clinic location
to the MCDPH WIC Clinic at Valleywise Comprehensive Health Center.
c. Additional monies have been added to the Registered Dietitian (RD) line item for Maricopa County WIC
Program to provide RD services to other local WIC agencies as agreed upon in the Scope of Work
documents between Maricopa and each local WIC program that services are provided.
d. Additional monies have been added to the Personnel Services, Employee Related Expenses, and Indirect
Cost line items to the Maricopa WIC Program Special Project Budget to provide State-wide secondary
nutrition education for families enrolled with local agencies utilizing the WIC Your Way virtual services
approach by providing staff to support this program at the state office full time. The staff provided will assist
the ADHS team with outreach and retention campaigns involving text messaging and/or virtual services,
provide virtual secondary nutrition education and high-risk services through this project, support local
agencies with their training needs related to this service, and support local agency services state-wide by
facilitating group education classes and completing administrative work related to providing these services.
The staff will also work with the ADHS WIC Evaluator to evaluate measurable outcomes from the service
including data on nutrition related attitudes and behaviors, ease and satisfaction of technology use, and
increasing attendance at the nutrition education sessions, and then implement a process to improve the
services.
20

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
February 1, 2021 to September 30, 2021
Agency Name: Maricopa County Health Department
Local Agency (LA) Projects Funding
Federal Award Date: February 1, 2021
CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children
Cost Reimbursement Line Item Budget
Account Classification Amount
Personnel $0.00
Employee Related Expenses $0.00
Professional & Outside Services $47,500.00
Travel Expense $0.00
Occupancy Expenses $0.00
Other Operating Expenses $5,550.00
Capital Expenditures $0.00
Indirect Cost $9,973.00
Total $63,023.00
Additional Local Agency (LA) Projects Funding
LA Project(s) funding can be used towards special projects that enhance Program Integrity, WIC Services or WIC Facilities.
Allowable costs for the LA Project(s) funding include items specifically outlined on the agencies project description and
application ONLY. Any additional items will need written justification and approval before being charged to the LA Project(s)
funding. These allowable costs adhere to the WIC program’s allowable and unallowable cost principles.
21

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
Exhibit A
Exhibit - 2 CFR 200.332
§ 200.332
Requirements for pass-through entities.
All pass-through entities must:
(a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following
information at the time of the subaward and if any of these data elements change, include the changes in
subsequent subaward modification. When some of this information is not available, the pass-through entity must
provide the best information available to describe the Federal award and subaward.
Arizona Department of Health
Prime Awardee: Services
DUNS # 804745420
Federal Award Identification (Grant Number): 216AZ008W1003
Subrecipient name (which must match the name associated with its unique entity
identifier): Maricopa County Public Health
Subrecipient's unique entity identifier (DUNS #): 602062515
Federal Award Identification Number (FAIN, sometimes it’s the same as the Grant
Number): 216AZ008W1003
Federal Award Date (see the definition of Federal award date in § 200.1 of this part)
of award to the recipient by the Federal agency: 10/01/2020
Subaward Period of Performance Start and End Date: 10/01/2020 - 9/30/2021
Subaward Budget Period Start and End Date: 10/01/2020 - 9/30/2021
Amount of Federal Funds Obligated by this action by the pass-through
entity to the subrecipient (this is normally the contract amount): $63,023.00
Total Amount of Federal Funds Obligated to the subrecipient by the
pass-through entity including the current financial obligation (how
much is available for contracts): $9,457,175.00
Total Amount of the Federal Award committed to the subrecipient by
the pass-through entity: $9,457,175.00
22

ARIZONA DEPARTMENT
INTERGOVERNMENTAL AGREEMENT (IGA) OF HEALTH SERVICES
150 18th Ave Suite 530
Amendment Phoenix, Arizona 85007
Contract No.: IGA Amendment No: 5 Procurement Officer
CTR040876 Arizona Procurement Portal Amendment No.: 5 Kailee Gray
Arizona local implementation of the WIC
Federal award project description, as required to be responsive to the Special Supplemental Nutrition Program for
Federal Funding Accountability and Transparency Act (FFATA): Women, Infants, and Children
United States Department of Agriculture,
FNS Southwest Regional Office,
Food and Nutrition Service,
1100 Commerce Street Room 522,
Name of Federal awarding agency, pass-through entity, and contact Dallas, TX 75242-9980,
information for awarding official of the Pass-through entity: Telephone: (214)290-9810
Assistance Listings number and Title; the pass-through entity must
identify the dollar amount made available under each Federal award 10.557 WIC Special Supplemental Nutrition
and the Assistance Listings Number at time of disbursement: Program for Women, Infants, and Children
Identification of whether the award is R&D: Not R&D award
Indirect cost rate for the Federal award (including the de minimis rate
is charged) per § 200.414: 0.188
23