AMD RE EMERGENCY PREPAREDNESS PRGM WITH ADHS.PDF

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 North 18th Avenue, Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS17-133194 Amendment No: 5 Procurement Officer:
Ted Cooper
Emergency Preparedness Program
Effective upon signature, it is mutually agreed that the Agreement referenced above is amended as follows:
1. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, the Scope of Work is revised to add the Scope of Work of this Amendment Five (5).
2. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, The Contract Price Sheet is revised to include the Price Sheet of this Amendment Five (5).
All other provisions shall remain in their entirety.
CONTRACTOR SIGNATURE
Maricopa County by and through its,
Maricopa County Public Health
Contractor Name Contractor Authorized Signature
4041 N. Central Ave. Suite 1400 Steve Chucri
Address Printed Name
Phoenix AZ 85012 Chairman, Maricopa County Board of Supervisors
City State Zip Title
CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be
Pursuant to A.R.S. § 11-952, the undersigned public agency effective the date indicated. The Public Agency is hereby
attorney has determined that this Intergovernmental cautioned not to commence any billable work or provide
Agreement is in proper form and is within the powers and any material, service or construction under this IGA until
authority granted under the laws of the State of Arizona. the IGA has been executed by an authorized ADHS
signatory.
State of Arizona
Signed this _________ day of _________________ 2018
Signature Date
Printed Name Procurement Officer
Contract No. ADHS17-133194, which is an Agreement
between public agencies, has been reviewed pursuant to
A.R.S. § 11-952 by the undersigned Assistant Attorney
General, 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
Printed Name:
ATTEST:
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____________________________________
Clerk of the Board Date

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 North 18th Avenue, Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS17-133194 Amendment No: 5 Procurement Officer:
Ted Cooper
SCOPE OF SERVICES
The Contractor shall utilize one-time funding to implement all county specific work plan activities proposed as
part of the CDC Crisis Cooperative Agreement for opioid misuse and abuse prevention.
1. Tasks
1.1. Establishing Linkages to Care – National Center for Injury Prevention and Control (NCIPC).
1.1.1. Develop and implement an assessment that details what resources and/or training faith-based
organizations need to address the opioid epidemic and their readiness/capacity to implement
opioid-related strategies such as linkages to care.
1.2. Maricopa Mosaic Program Evaluation - NCIPC.
1.2.1. Evaluate the Maricopa County Mosaic Program and its impact on reducing opioid related harms
among formally incarcerated individuals.
1.3. Information Management - NCIPC
1.3.1. Increase local capacity to create or enhance public facing data dashboards that capture and convey
recent data on prescribing, overdose morbidity and mortality, and/or other opioid related harms.
1.4. Vulnerability Assessment - National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)
1.4.1. Assess the extent to which people who inject drugs (PWID) in Maricopa County are exposed to
blood borne pathogens, such as Hepatitis B and C, and HIV; and
1.4.2. Develop toolkit to assess social characteristics and exposure rates for the transmission of blood
borne pathogens among PWID; and
1.4.3. Disseminate findings, and share assessment toolkit with other Arizona Jurisdictions through the
completion of reports and presentations; and
1.4.4. Prepare and submit final report summarizing finding from countywide assessment of PWID. Report
shall include relevant social and demographic characteristics of this populations, as well as rates for
the transmission of infectious disease. Final report due August 31, 2019.
1.5. Biosurveillance - Special Projects
1.5.1. Enhance opioid biosurveillance activities through the use of systems such as MEDSIS, syndromic
surveillance, prescription drug monitoring program, death data, hospital discharge data, EMS data,
poison control and other data systems; and
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 North 18th Avenue, Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS17-133194 Amendment No: 5 Procurement Officer:
Ted Cooper
1.5.2. Participate in the Arizona BioSense Opioid Subgroup, including webinar attendance.
1.6. Syndromic Surveillance/HDD - Special Projects
1.6.1. Participate in a workgroup that determines methods and plans for analysis of data from the
Syndromic Surveillance system and Hospital Discharge Database; and
1.6.2. Perform a data comparison of the Syndromic Surveillance system and Hospital Discharge Database,
in accordance with workgroup plans, in order to determine how data for the same visit varies
between the two systems; and
1.6.3. Submit a written report of the data comparison findings to the workgroup.
1.7. General Tasks
1.7.1. Participate in bi-monthly meetings regarding the implementation of CDC Cooperative Agreement
(CoAg) grant activities with ADHS; and
1.7.2. Receive pre-approval before releasing any related PSA or new educational material; and
1.7.3. Prepare and submit monthly project narrative reports by the 1st of each month; and
1.7.4. Prepare and submit an annual summary of all grant activity no later than 30 days following the end
of the funding period.
2. Reference Document
2.1. CDC, Cooperative Agreement for Emergency Response: Public Health Crisis Response 2018 Opioid Overdose
Crisis Cooperative Agreement, CDC-RFA-TP18-1802.
3. State Provided Items
ADHS will provide:
3.1. Technical assistance to Contractor's staff that shall implement the CDC CoAg proposed activities; and
3.2. Any forms or guides that may be necessary to establish a certification process.
4. ADHS Will:
4.1. Monitor the implementation and operation of CDC CoAg grant related activities and compliance with
Contract provisions through site visits, review of submitted forms and other mechanisms; and
4.2. Hold phone conference calls for workgroup activities.
5. Financial Requirements
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 North 18th Avenue, Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS17-133194 Amendment No: 5 Procurement Officer:
Ted Cooper
5.1. This is one-time funding, and funds must be spent/expended within the performance and budget period,
September 1, 2018 – August 31, 2019.
5.2. Recipients are required to coordinate activities funded under this amendment with all other CDC-funded
and federally-funded opioid prevention activities to ensure alignment and reduce duplication.
5.3. Recipients shall complete the work plan and budget tool provided by ADHS, and return to ADHS for review
and approval. Funding will not be released until the budget has been approved by ADHS. Any deviations
from approved budget and work plan will require completion of redirection documentation and approval
from ADHS.
5.4. All activities and procurements funded through the Opioid Overdose Crisis grant shall be aligned with the
budget/spend plan and work plan. Monthly project updates and spending reports will be due to ADHS by
the 1st of each month. Additionally, quarterly CERs are due to provide expenditure detail. These
reports should describe all activities completed to date and an updated report of the funds spent during the
reporting month.
5.5. The following activities are unallowable costs per the CDC:
5.5.1. Research
5.5.2. Purchase of naloxone
5.5.3. Purchase of syringes
5.5.4. Drug disposal programs (drop-boxes, bags or other devices, and/or take-back events) are not
permissible under this funding opportunity.
5.5.5. Clinical care (except as allowed by law).
5.5.6. Publicity and propaganda (lobbying) - funds cannot be used for the preparation, distribution, or use
of any material (publicity/propaganda) or to pay the salary or expenses of grants, contract
recipients, or agents that aim to support or defeat the enactment of legislation, regulation,
administrative action, or executive order proposed or pending before a legislative body, beyond
normal, recognized executive relationships.
5.5.7. In addition, funds cannot be used for items covered by other federal sources, and cannot be used
to match funding on other federal awards.
6. Reporting Deliverables
6.1. Progress on the deliverables, performance measures and activities funded through the PHEP Opioid
Overdose Crisis grant shall be reported in a timely manner to ensure ADHS has adequate time to compile
the information and prepare if for submission at the federal level.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 North 18th Avenue, Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS17-133194 Amendment No: 5 Procurement Officer:
Ted Cooper
6.2. ADHS will host bimonthly conference calls to provide additional technical assistance to contracted counties
on the implementation of opioid related activities initiated as part of the grant and other grant
opportunities awarded through ADHS.
6.3. ADHS shall provide the Performance Measures templates (if applicable) in advance of the Due Date. End-of-
Year Report (dates covered: September 1, 2018 - August 31, 2019) templates will be provided in advance of
the Due Date.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 North 18th Avenue, Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS17-133194 Amendment No: 5 Procurement Officer:
Ted Cooper
Maricopa County Department of Public Health
PRICE SHEET (Funds Expire 8/31/2019)
CDC Crisis CoAg- NCIPC
Fixed Price
Description Quantity Unit Cost Total Cost
Implementation of CDC CoAg grant
related Activities- Establish Linkages To
Care (Case Management, Peer
1 $546,224.00 $546,224.00
Navigators, Outreach Services),
Mosaic Project evaluation,
Data Visualization
CDC Crisis CoAg- NCHHSTP
Fixed Price
Description Quantity Unit Cost Total Cost
Implementation of CDC CoAg Grant
related Activities- Vulnerability 1 $85,400.00 $85,400.00
Assessment
CDC Crisis CoAg- Special Projects
Fixed Price
Description Quantity Unit Cost Total Cost
Implementation of CDC CoAg grant
1 $3,000.00 $3,000.00
related Activities- Biosurveillance
CDC Crisis CoAg- Special Projects
Fixed Price
Description Quantity Unit Cost Total Cost
Implementation of CDC CoAg grant
related Activities- Perform data
1 $79,938.00 $79,938.00
comparison of Syndromic Surveillance
and HDD systems
Total $714,562.00
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 North 18th Avenue, Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS17-133194 Amendment No: 5 Procurement Officer:
Ted Cooper
AUTHORIZATION FOR PROVISION OF SERVICES: Authorization for purchase of services
under this contract shall be made only upon ADHS issuance of a Purchase Order that is
signed by an authorized agent. The Purchase Order will indicate the contract 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 changed or modified
with an official ADHS Procurement Change Order, and/or b) an additional Purchase Order is
issued for purchase of services under this contract.
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