AMD RE TOBACCO USE PREV WITH ADHS.PDF

Maricopa County — Formal (2017-04-26)

Extracted text (via pymupdf_layout) 7523 characters

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT HEALTH SERVICES
150 N. 18th Ave, Suite 280
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Specialist
Contract No: ADHS14-072483 Amendment No. 1 Manuel Gonzales Jr.
17. Health Insurance Portability and Accountability Act of 1996 (HIPAA).
17.1 The Contractor warrants that it is familiar with the requirements of HIPAA, as amended by the Health
Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009, and
accompanying regulations and will comply with all applicable HIPAA requirements in the course of
this Contract. Contractor warrants that it will cooperate with the Arizona Department of Health
Services (ADHS) in the course of performance of the Contract so that both ADHS and Contractor will
be in compliance with HIPAA, including cooperation and coordination with the Arizona Department of
Administration-Arizona Strategic Enterprise Technology (ADOA-ASET) Office, the ADOA-ASET
Arizona State Chief Information Security Officer and HIPAA Coordinator and other compliance
officials required by HIPAA and its regulations. Contractor will sign any documents that are
reasonably necessary to keep ADHS and Contractor in compliance with HIPAA, including, but not
limited to, business associate agreements.
17.2 If requested by the ADHS Procurement Office, Contractor agrees to sign a “Pledge To Protect
Confidential Information” and to abide by the statements addressing the creation, use and disclosure
of confidential information, including information designated as protected health information and all
other confidential or sensitive information as defined in policy. In addition, if requested, Contractor
agrees to attend or participate in HIPAA training offered by ADHS or to provide written verification that
the Contractor has attended or participated in job related HIPAA training that is: (1) intended to make
the Contractor proficient in HIPAA for purposes of performing the services required and (2) presented
by a HIPAA Privacy Officer or other person or program knowledgeable and experienced in HIPAA and
who has been approved by the ADOA-ASET Arizona State Chief Information Security Officer and
HIPAA Coordinator.
3. Pursuant to Terms and Conditions of the Agreement, Provision Six (6), Contract Changes, Item 6.1,
Amendments, Purchase Orders and Change Orders; Provision Twenty (20), is hereby added to the Terms and
Conditions as follows:
20. The Federal Funding Accountability and Transparency Act (FFATA or Transparency Act - P.L.109-
282, as amended by section 6202(a) of P.L. 110-252), found at https://www.fsrs.gov/
If applicable, the Contractor/Grantee shall submit to ADHS via email the Grant Reporting Certification Form.
This form and the instructions can be downloaded from the ADHS Procurement website at
http://www.azdhs.gov/operations/financial-services/procurement/index.php#ffata and must be returned to the
ADHS by the 15th of the month following that in which the award was received. The form shall be completed
electronically, and submitted using the steps outlined in the Grant Reporting Certification Form Instructions
to the following email address: ADHS_Grant@azdhs.gov. All required fields must be filled including Top
Employee Compensation, if applicable. Completing the Grant Reporting Certification Form is required for
compliance with the Office of Management and Budget (OMB), found at
http://www.whitehouse.gov/omb/open. Failure to timely submit the Grant Reporting Certification Form could
result in the loss of funds. This requirement applies to all subcontractors/sub-awardees utilized by the
Contractor/Grantee for amounts exceeding $30,000.00 during the term of the Award.
4. Pursuant to Terms and Conditions of the Agreement, Provision Six (6), Contract Changes, Item 6.1,
Amendments, Purchase Orders and Change Orders; Provision Twenty-one (21), is hereby added to the Terms
and Conditions 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
2