DISEASE CONT WITH ADHS IIID AMD 1 (01).PDF

C-86-16-115-3-01 ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 150 N. 18th Avenue, Suite 260
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Specialist
Contract No: ADHS16-130023 Amendment No. 1 Delilah Gonzalez
INTERVIEW & INVESTIGATIONS OF INFECTIOUS DISEASES
Effective upon signature, it is mutually agreed that the Contract referenced is amended as follows:
1. Pursuant to Terms and Conditions, Provision Six (6), Contract Changes, Item (6.1) Amendments, Purchase
Orders and Change Orders, the Contract is amended as follows:
1.1 Add Provision twenty-one (21) to Terms and Conditions to read as follows:
21. CONTRACTING; PROCUREMENT; INVESTMENT; PROHIBITIONS
21.1 A public entity may not enter into a contract with a company to acquire or dispose of services,
supplies, information technology or construction unless the contract includes a written certification
that the company is not currently engaged in, and agrees for the duration of the contract to not
engage in, a boycott of Israel.
21.2 A public entity may not adopt a procurement, investment or other policy that has the effect of
inducing or requiring a person or company to boycott Israel.
21.3 Contractor hereby certifies that it is not currently engaged in, and will not for the duration of this
Contract engage in, a boycott of Israel as defined by A.R.S. § 35-393.01. Violation of this certification
by Contractor may result in action by the State up to and including termination of this Contract.
(CONTINUED ON NEXT PAGE)
ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED.
CONTRACTOR SIGNATURE
Maricopa County by and through its,
Maricopa County Deprartment of Public Health
Contractor Name Contractor Authorized Signature
4041 North Central
Address Printed Name
Phoenix ARIZONA 85012
City State Zip Title
CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be effective
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has the date indicated. The Public Agency is hereby cautioned not to
determined that this Intergovernmental Agreement is in proper form and is commence any billable work or provide any material, service or
within the powers and authority granted under the laws of the State of Arizona. construction under this IGA until the IGA has been executed by an
authorized ADHS signatory.
State of Arizona
Signed this ______ day of _______________________ 2017.
Signature Date
Denny Barney, Chairman, Board of Supervisors
Printed Name Procurement Officer
RESERVED FOR USE BY THE SECRETARY OF STATE
Attorney General Contract No. P0012014000078, 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:__________________________________. Clerk of the Board
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 150 N. 18th Avenue, Suite 260
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Specialist
Contract No: ADHS16-130023 Amendment No. 1 Delilah Gonzalez
1.2 The following is added and made part of the Scope of Work, section 4, Tasks, to read as follows:
4.7 Obtain medical records and conduct chart abstractions as needed and ensure information is recorded in
ADHS designated database.
4.8 Assist and support general HAI/AR Program activities, staff, and projects as needed. Including but not
limited to:
4.8.1 Identify antimicrobial stewardship needs in Arizona by analyzing Infection Prevention
Landscape Survey data to improve coordination and implementation of healthcare-associated
infection (HAI)/antibiotic resistance (AR) prevention efforts across the state;
4.8.2 Communicate results of carbapenem-resistant Enterobacteriaceae (CRE) analysis to
stakeholders;
4.8.3 Work with Arizona State Public Health Laboratory (ASPHL) to expand CRE testing;
4.8.4 Encourage facilities to submit epidemiological important isolates, such as CRE, for confirmatory
testing to the ASPHL;
4.8.5 Provide technical assistance concerning Antimicrobial Use and Resistance (AUR) module as
requested by state partners and stakeholders;
4.8.6 Perform CRE surveillance;
4.8.7 Provide education and resources based on Antibiotic Resistance Lab Network (ARLN) test
results distributed to Arizona healthcare facilities;
4.8.8 Develop CRE educational materials;
4.8.9 Assist in coordinating at least 1 antimicrobial stewardship & AUR module training;
4.8.10 Distribute antimicrobial stewardship training materials at various Arizona training events;
4.8.11 Coordinate the approval, submission, and test result distribution of isolate/specimens to ASPHL
and ARLN;
4.8.12 Track ARLN activities;
4.8.13 Participate in quarterly HAI Advisory Committee and bi-monthly Subcommittee meetings;
4.8.14 Assist in the completion of grant related documentation and activities as needed.
1.3 The following is added and made part of the Scope of Work, section 5, Deliverables, as follows:
1.3.1 Add to 5.1, Deliverable 1: Disease Investigations:
5.1.3 Provide a HAI/AR monthly summary including, but not limited to, activities that involving the
coordination of approval, submission, and test result distribution of isolate/specimens to ASPHL
and ARLN.
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 150 N. 18th Avenue, Suite 260
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Specialist
Contract No: ADHS16-130023 Amendment No. 1 Delilah Gonzalez
1.3.2 Add to 5.2, Deliverable 2: Stakeholder Meetings:
5.2.3 Provide monthly HAI/AR summary including, but not limited to, meeting minutes of each
quarterly HAI Advisory Committee and bi-monthly Subcommittee meeting attended.
5.2.4 Persons working on deliverable 3 shall attend designated meetings agreed upon at the start of
the contract.
1.3.3 Revise and replace 5.3, Deliverable 3: Monthly Investigation/Perfomance Measure Status Report, as
follows:
5.3.1 No later than thirty (30) days following the beginning of the contract, submit a monthly report by
the first week of the month. Report should include the number of cases investigated, the
number of abstractions completed, completion of key variables entered in MEDSIS or ADHS
designated database along with any other variables agreed upon during the stakeholder
meeting.
1.3.4 Revise and replace 5.4 Deliverable 4: Education, to read as follows:
5.4.1 Assist with development and dissemination of educational materials such as one health,
antibiotic stewardship and infectious disease prevention and control brochures, infographics and
posters and submit educational materials (proofs) developed to ADHS for review.
1.3.5 Revise and replace 5.5, Deliverable 5: Evaluation, as follows:
5.5.1 Develop annual evaluation report regarding timeliness of interviews, troubleshooting processes,
success stories, and lessons learned.
5.5.2 Within a HAI/AR monthly summary including, but not limited to, developing an HAI/AR
evaluation report/s of current HAI/AR surveillance and collaborative efforts.
1.3.6 Add Deliverable 7: Medical record absractions in a database provided by ADHS.
1.4 The Price Sheet in this Amendment is hereby added and made part of this Contract.
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 150 N. 18th Avenue, Suite 260
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Specialist
Contract No: ADHS16-130023 Amendment No. 1 Delilah Gonzalez
C-86-16-115-3-01 Revised Price Sheet
Deliverables Amount
Monthly Investigation/Performance Measure Reports $7317
Educational Materials - (for the development of one health
$1000/educational material
and infectious disease prevention and control brochures,
proof (up to $10,000)
infographics and posters)
Evaluation Report $0
$236 per abstraction
Monthly abstractions completed
completed
Monthly HAI/AR summary report $7100
Anticipated Total Budget $225,484
NOTE: With prior approval from the Infectious Disease Program Manager, the MCDPH is authorized to transfer up to a
maximum of 10% of the total budget amount between line items. Transfers of funds are only allowed between funded line
items. Transfers exceeding 10% or to a non-funded item shall require an amendment.
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