AMD RE HEALTHY START WITH MIHS HS.PDF

CONTRACT NO: C-86-15-076-3-05 AMENDMENT NO: 5
Grant No. 90-15-125-1
AMENDMENT TO
INTERGOVERNMENTAL AGREEMENT (IGA)
Between
MARICOPA COUNTY By and Through the
DEPARTMENT OF PUBLIC HEALTH
4041 N Central Avenue, Suite 1400
Phoenix, Arizona 85012, and
Maricopa County Special Healthcare District
dba Maricopa Integrated Health System (MIHS)
I. The above named IGA is hereby amended as specified below:
A. Year 4 Budget is replaced with the revised year 4 budget (Attachment A) and;
B. Year 4 Budget budget narrative is replaced with revised Year 4 Budget Narrative
(Attachment B).
II. All other terms and conditions of the original IGA and its Amendments shall remain in
full force and effect.
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THE REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK
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IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF
MARICOPA COUNTY MARICOPA INTEGRATED HEALTH
SYSTEM (MIHS)
By: By:
Steve Chucri, Chairman
Board of Supervisors
Date Date
ATTEST ATTEST
Clerk of the Board
Date Date
APPROVED AS TO FORM APPROVED AS TO FORM
Attorney for Maricopa County
Date Date
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Total Indirect Total Total 880150 880020 880030 Other Total 820100 820100 Purchased Total 760050 790050 760040 760020 Supplies Total Total - Care Community Program Community Fringe Total Salary Care Community Program Community Salaries Contract CFDA # Grant Cost Cost Maricopa
Budget Expense Direct Other SEMINAR TRAVEL MILEAGE Expense Purchased OTHER OTHER Supplies DATA OTHER OFFICE Salary + Fringe Coordinator Benefits Salaries Accrual Coordinator- # 'fear Center Center ATTACHMENT
Expense Expense Services EDUCATIONAL Fringe Benefits - Health Coordinator Health Health Coordinator- Health Name Integrated
FEES ALLOWANCE Services PROFESSIONAL PROFESSIONAL PROCESSING SUPPLIES SUPPLIES Sandra Worker- - Worker Sandra Worker current Worker Health A
REIMBURSEMENT SUPPLIES Panama Monika current - TBH Panama - Monika - TBH System -
SUPPLIES (1.0 (.5 FTE) (1.0 incumbent—planned (1.0 Revised
SERVICES SERVICES FTE) Khadka incumbent—planned FTE) Khadka FTE) Year
(1.0 (1.0 4
FTE) exit FIE) exit
Budget
4/25/18 4/25/18-.5
( FTE)
(11/01/2017
Fringe
10.0% Cale 2,820.00 39.8% 0.00% 0.00% 39.22% 38.72% 41,99% 40,00% % -
Healthy
10.0% Actual 0.535 0.005 0.010 3.00 - - 1.00 1.00 0.50 0.50 FTE 90-15-125-1 93.926 11/01/2017-10/31/2018 Start 309361 10/31/2018)
3.0
$200,72341 $18,247.56 $18247546 $4,208.70 $1,005.00 $1,695.00 $1,508.70 $2,088.00 $290.00 $1,798.00 $4,024.23 $1,024.23 $2,000.00 $1,000.00 $172,154.53 $49,014.53 $0.00 $0.00 $21,643.67 $13,758.44 $6,856.20 $6,756.22 $123,140.00 $0.00 $0.00 $55,190.40 $35,531.20 $15,315.00 $17,103.40 Amount Budget
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Healthy Start Year 4 Budget Narrative ATTACHMENT B - Revised Budget Narrative
Maricopa Integrated Health System
11/1/2017-10/31/2018
CFDA 93.926 Grant 90-15-125-1
The purpose of the budget narrative is to provide more clarity and detail on the budget line items. The budget
narrative should explain the criteria used to calculate the amounts entered in the line-item budget. The
budget narrative should include all budgeted items and correspond directly with the proposed line-item
budget.
Personnel Services: $123,140.00
Program Coordinator $32,905.60
Employee Name: current incumbent—planned exit 4/25/18 (.25 FTE)
Time Spent on Program: .25FTE (520 hours/year)
Number of Months Assigned to Program: 6 months
Current Hourly Rate: $ 15.82
Nov 1, 2017 – Dec 31, 2017 =$ 15.826 x 200 $5,992.00
Jan 1, 2018 – April 25, 2018 $9,323.00 (5% salary increase)
Total $15,315.00
Community Health Worker $15,315.00
Employee Name: TBH (.50 FTE)
Time Spent on Program: .50FTE (1,040 hours/year)
Number of Months Assigned to Program: 5 months
Current Hourly Rate: $ 16.44
May 1, 2018 – Oct 31, 2018 =$ 16.44 x 1,040 $17,097.60
Total $17,097.60
Community Health Worker $17,097.60
Employee Name: Monika Khadka (1.0 FTE)
Time Spent on Program: 1.00 FTE (2080 hours/year)
Number of Months Assigned to Program: 12 months
Current Hourly Rate: 16.42
Nov 1, 2017 – Dec 31, 2017 =$ 16.42 x 400 $6,568.00
Jan 1, 2018 – Oct 31, 2018 =$ 17.24 x 1,680 $28,963.20 (5% salary increase)
Total $35,531.20
Care Coordinator $55,190.40
Employee Name: Sandra Panama (1.0 FTE)
Time Spent on Program: 1.00FTE (2080 hours/year)
Number of Months Assigned to Program: 12 months
Current Hourly Rate: $ 25.50
Nov 1, 2017 – Dec 31, 2017 =$ 25.50 x 400 $10,200.00
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Jan 1, 2018 – Oct 31, 2018 =$ 26.78 x 1680 $44,990.40 (5% salary increase)
Total $55,190.40
Fringe Benefits: $49,014.53
Program Coordinator $6,856.20
Employee Name: current incumbent—planned exit 4/25/18 (0.25 FTE)
Total Salary for ERE Calculations: $ 15,315
Fringe Benefit – 40%
FICA/Medicare $ 1,240.00
ASRS Retirement/Long-Term Disability $ 1,864.06
Health Insurance $ 3,627.21
Dental Insurance $ 114.79
Life Insurance $ 10.14
Total ERE: $ 6,856.20
Community Health Worker 13,758.44
Employee Name: Monika Khadka (1.0 FTE)
Total Salary for ERE Calculations: $ 35,531.20
Fringe Benefit - 38.72%
FICA/Medicare $ 2,718.13
ASRS Retirement/Long-Term Disability $ 4,086.09
Health Insurance $ 6,769.62
Dental Insurance $ 149.76
Life Insurance $ 34.84
Total ERE: $ 13,758.44
Care Coordinator 21,643.67
Employee Name: Sandra Panama (1.0 FTE)
Total Salary for ERE Calculations: $ 21,643.67
Fringe Benefit – 39.22%
FICA/Medicare $ 4,222.07
ASRS Retirement/Long-Term Disability $ 6,346.90
Health Insurance $ 10,670.40
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Dental Insurance $ 357.76
Life Insurance $ 46.54
Total ERE: $ 21,643.67
Community Health Worker $6,756.22
Employee Name: TBH (.50 FTE)
Total Salary for ERE Calculations: $ 17,103.40
Fringe Benefit
FICA/Medicare $ 1,240.00
ASRS Retirement/Long-Term Disability $ 1,864.06
Health Insurance $ 3,527.23
Dental Insurance $ 114.79
Life Insurance $ 10.14
Total ERE: $ 6,756.22
Professional/Contractual Services: $2,088.00
All contracts are procured in compliance with the MIHS and State Procurement policies and
Guidelines.
District Medical Group $1,798.00
Dr. Dean Coonrod will provide 20 hours as the Program Director for the Care Coordination / Medical
Home project.
20.22 contracted hours x $88.90 per hour = $1,798.00
District Medical Group $290.00
Mariposa staff will provide 11.7 hours through the Mariposa Wings to Safety program for domestic
violence training and advocacy.
11.66 contracted hours x $24.87 per hour = $290.00
Supplies: $3,987.20
Educational Materials/Supplies $2,000.00
Education Materials are ordered from the curriculum Partners for a Healthy Baby and focus on the
health educational needs for the target population. Materials are written at a fifth grade reading level
supporting the needs of most participants, and hold information on childbirth, safe sleep, smoking
cessation, prenatal, and postpartum support, among others.
Office Supplies $1,000.00
Other Supplies includes office supplies, outreach materials and folders, etc.
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Data Processing Supplies $1,024.23
Data processing supplies includes hardware and accessories such as laptops. Currently two laptops are
supplied to three staff total.
Other Expenses: $4,208.70
Mileage $1,508.70
Mileage is calculated at the federal rate of 53.5 cents per mile. Mileage is permitted to be billed by
staff traveling between the five clinics in the contracted region during staff work days.
2,820 miles over a 12 month period at 53.5 cents per mile calculates to $1,508.70.
Travel Reimbursement $1,695.00
Travel reimbursement is calculated at federal per diem rates and in accordance with MIHS Travel
policy. Travel costs include airfare, ground transportation, per diem, and miscellaneous reimbursable
costs as approved.
Seminar Fees (Conference/Workshop Registration) $1,005.00
Ensures updated information in the field is provided to staff, focused on Maternal Child Health. Staff
individual Professional Development plans are centered on increasing knowledge and skill based
training on case management healthcare support and services, and outreach techniques, among
others. Trainings can be obtained regionally and nationally.
2018 City Match – Annual Urban Maternal Child Health Leadership Conference, Portland, OR
1 staff registration at $500.00
Local conferences include but may not be limited to:
Prevent Child Abuse Arizona, Glendale, AZ
https://www.pcaaz.org/ 3 staff registrations at $50 per person = $150
First Things First, Annual Summit, Birth – 3 staff registrations at $199 per person = $597
https://summit.firstthingsfirst.org
The above noted local trainings build upon previous trainings MIHS Healthy Start staff has received,
with the goals of strengthening families with children birth – five including families with special needs
and families from diverse backgrounds, promoting cultural competency in the field. All trainings
support the daily work staff provides to MIHS patients in the clinic setting.
Up to three staff members can attend the above noted (local) conferences. Conference/training costs
are estimated based on current web site information available. If it is too early for an annual
conference rates to be posted, they are estimated on the previous year’s costs.
Administrative/Indirect Costs: $18,247.55
Indirect $18,247.55
Administrative costs are general or centralized expenses of overall administration of an
agency/organization that receives grant funds and does not include particular program costs.
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10% of total Direct Expenses = $18,247.55
FY4 Total Budget $200,723.00
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