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ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT (IGA) 150 N. 18th Avenue, Suite 260 AMENDMENT Phoenix, Arizona 85007 Contract No.: ADHS18-177694 Amendment No.: 2 Procurement Officer: Bariah Steiner C-86-18-018-3-05 Immunization Services Pursuant to Uniform Terms and Conditions, Provision (6) Contract Changes, (6.1) Amendments, Purchase Orders, and Change Orders, it is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: The Scope of Work is hereby revised and replaced as follows: 1. Section Four (4), Tasks, Item 4.1.2, is hereby revised in this Amendment Two (2) to read: 4.1.2. Share the IAP and Immunization Quality Improvement for Providers (IQIP) Assessment Reports with the Medical Director, Local Health Officer (LHO), and/or other staff for review and/or approval as dictated by county health department protocol. 2. Section Four (4), Tasks, Item 4.5, Activity Five (5) AFIX Assessment Reports, is hereby revised and replaced in this Amendment Two (2) Continued onto the next page ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED. MARICOPA COUNTY Contractor Name: Authorized Signature 4041 N. CENTRAL AVE., SUITE 1400 Bill Gates . Address: Print Name Phoenix AZ 85012 Chairman, Board of Supervisors City State Zip Title This Intergovernmental Agreement Amendment shall be Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has determined effective the date indicated. The Public Agency is hereby that this Intergovernmental Agreement is in proper form and is within the powers and cautioned not to commence any billable work or provide any authority granted under the laws of Arizona 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 20__. Print Name County Attorney Title Procurement Officer Attorney General Contract No.: ADHS18-177694 _, which is an Agreement RESERVED FOR USE BY THE SECRETARY OF STATE 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 Title ATTEST:___________________________________ 1 Office of the Clerk of the Board ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT (IGA) 150 N. 18th Avenue, Suite 260 AMENDMENT Phoenix, Arizona 85007 SCOPE OF WORK Contract No.: ADHS18-177694 Amendment No.: 2 Procurement Officer: Bariah Steiner 4.5. Activity Five (5) Immunization Quality Improvement 4.5.1. AIPO will provide quality improvement assistance to the Contractor, on an annual basis, as part of the Immunization Quality Improvement for Providers (IQIP) program. This program replaces the current Assessment, Feedback, Incentives and eXchange (AFIX) program, per CDC directives, on July 1, 2019. As part of the IQIP requirements, the Contractor shall receive the following assistance: 4.5.1.1. An annual in-person site visit from AIPO staff to include an ASIIS-based coverage rate report for children ages 24-35 months and for adolescents aged thirteen (13) years, including a list of patients not up-to-date. The visit will include a discussion of current immunization practices and quality improvement goals; 4.5.1.2. Phone-based check-in calls at two (2) months and six (6) months post-site visit to include a discussion of the quality improvement objectives and any technical assistance requested by the Contractor; and 4.5.1.3. An email-based check-in at twelve (12) months post-site visit, to include a follow-up coverage rate assessment, a discussion of progress toward quality improvement goals, and any other technical assistance requested by the Contractor. 4.5.2. Removed. 2