IGA AMD RE HEALTHY START WITH MIHS.PDF

CONTRACT NO: C-86-15-076-3-04 AMENDMENT NO: 4
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, Page 1, Item 3: Agreement amount is changed to an aggregate, not-to-exceed
amount from $575,957 to $776,680 (increased by $200,723 for the budget period
November 1, 2017 through October 31, 2018);
B. Year 4 Budget is replaced with the revised year 4 budget (Exhibit A) and budget
narrative (Exhibit B). The year budget is for a total of $200,723.
C. Section II. Special Provisions, add the following:
12. ISRAEL BOYCOTT
By submitting this Contract the Contractor certifies that they are in
compliance with Article 9, A.R.S. Section 35-393 et seq.
13. UNIFORM ADMINISTRATIVE REQUIREMENTS
By entering into this Contract the Contractor agrees to comply with all
applicable provisions of Title 2, Subtitle A, Chapter II, PART 200—
UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES,
AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS contained in
Title 2 C.F.R. § 200 et seq.
D. Section IV, Compensation, 1. Compensation, D. replace the first sentence with:
The Agreement amount is not-to-exceed $200,723 for Year four (4).
1

All other terms and conditions of the original IGA and its Amendments shall remain in
full force and effect.
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 (NHS)
By: By:
Denny Barney, 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
2

Budget Amount $32,418.40 $35,531.20 $55,190.40 $0.00 $0.00 $123,140.00 $13,612.41 $13,758.44 $21,643.67 $0.00 $0.00 $49,014.52 $172,154.52 $1,000.00 $2,000.00 $1,024.23 $4,024.23 $1,798.00 $290.00 $2,088.00 $1,508.70 $1,695.00 $1,005.00 S4,208.70 $182,475.45 $18,247.55 $200,723.00 $200,723.00 $0.00 $0.00
3.0 Start 25-1 FTE 0.50 1.00 1.00 - - 2.50 0.010 0.005 0.535 Actual 10.0%
309361 11/0112017-10131/2018 93.926 5-1
Healthy 90-1 41.99% 38.72% 39.22% 0.00% 0.00% 39.8% 2,820.00 Cale 10.0%
%
Fringe
FTE) FTE) 3
(1.0 (1.0
FTE) Khadka FTE) FIE) Khadka FTE) SERVICES SERVICES
(0.5 (1.0 (0.5 (1.0 SUPPLIES
System Wright Monika Panama Wright Monika Panama SUPPLIES
Health Kalil - - Worker Sandra Kelli - - Worker Sandra SUPPLIES SUPPLIES PROCESSING PROFESSIONAL PROFESSIONAL Services ALLOWANCE REIMBURSEMENT FEES
Integrated Name Coordinator Health - Coordinator Health - Benefits Fringe + EDUCATIONAL Services Expense Expense
A: Center Center Year Coordinator Salaries Benefits Coordinator Fringe Salary OFFICE OTHER DATA Supplies OTHER OTHER Purchased Expense MILEAGE TRAVEL SEMINAR Other Direct Expense Budget
Exhibit Maricopa Cost Cost Grant ft CFDA Contract* Salaries Program Community Care - - Total Fringe Program Community Care - - Total Total Supplies 760020 760040 790050 760050 Total Purchased 820100 820100 Total Other 880030 880020 880150 Total Total Indirect Total

Healthy Start Year 4 Budget Narrative Exhibit B:
Maricopa Integrated Health System
11/1 /2017-1013112018
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 $32,418.40
Employee Name: Kelli Wright (0.5 FTE)
Time Spent on Program: 0.50FTE (1040 hours/year)
Number of Months Assigned to Program: 12 months
Current Hourly Rate: $ 29.96
Nov 1, 2017 — Dec 31, 2017 =$ 29.96 x 200 $5,992.00
Jan 1, 2018 — Oct 31, 2018=$ 31.46 x 840 $26,426.40 I (5% salary increase)
!. Total $32,418.40
Community Health Worker $35,531.20
Employee Name: Monika Khadka (1.0 FTE)
Time Spent on Program: 1.00 FTE (2080 hours/year)
Number of Months Assigned to Program: 12 months
Current Hourly Rate: 16.42
Nov 1, 2017 — Dec 31, 2017 .$ 16.42 x 400
1 Jan 1, 2018 — Oct 31, 2018= 17.24 x 1680 $28,963.20 (5% salary increase)
Total
Care Coordinator
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 $10,200.00
Jan 1, 2018 — Oct 31, 2018 =$ 26.78 x 1680 $44,990.40 (5% salary increase)
Total $55,190.40
1
(cont. pg 3)
J.

Fringe Benefits: $49,014.52
Program Coordinator
Employee Name: Kelli Wright (0.5 FTE)
Total Salary for ERE Calculations: $ 32,418.40
Fringe Benefit —41.99%
FICA/Medicare $ 2,480.01
ASRS Retirement/Long-Term Disability $ 3,728.12
; Health Insurance $ 7,154.42
Dental Insurance $ 229.58
1 Life Insurance $ 20.28
Total ERE: $ 13,612.41 '
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 (LO FTE)
Total Salary for ERE Calculations: $ 21,643.67
Fringe Benefit 39.22%
1 FICA/Medicare $ 4,222,07
ASRS Retirement/Long-Term Disability $ 6,346.90
Health Insurance $ 10,670.40
Dental Insurance $ 357.76
Life Insurance $ 46.54
Total ERE: $ 21,643.67

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: $4,024.23
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.
Other Supplies $1,000.00
Other Supplies includes office supplies, outreach materials and folders, etc.
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 $18,24735
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.
10% of total Direct Expenses = $18,247.55
FY4 Total Budget $200,723.00