ADHS IGA FOR HIV SERVICES PART B.DOCX

Project Title: HIV Care Services Begin Date:
Geographic Service Area: Maricopa and Pinal County Termination Date:
Arizona Department of Health Services has authority to contract for services specified herein in accordance with A.R.S. §§ 11-951, 11-952, 36-
104 and 36-132. The Contractor represents that it has authority to contract for the performance of the services provided herein pursuant to:
X Counties: A.R.S. §§ 11-201, 11-951, 11-952 and 36-182.
Indian Tribes: A.R.S. §§ 11-951, 11-952 and the rules and sovereign authority of the contracting Indian Nation.
School Districts: A.R.S. §§ 11-951, 11-952, and 15-342.
City of Phoenix: Chapter II, §§ 1 & 2, Charter, City of Phoenix.
City of Tempe: Chapter 1, Article 1, §§ 1.01 & 1.03, Charter, City of Tempe.
Amendments signed by each of the parties and attached hereto are hereby adopted by reference as a part of this Contract, from the effective
date of the Amendment, as if fully set out herein.
FOR CLARIFICATION, CONTACT:
Arizona Transaction (Sales) Privilege: 072-90681-D
Federal Employer Identification No.:86-6000472 Name:
Tax License No.:86-6000472 Phone:
Contractor Name: Maricopa County, Ryan White Part A Program FAX No:
Address: 301 W. Jefferson Street, Suite 3200
Phoenix, AZ 85003
CONTRACTOR SIGNATURE: This Contract shall henceforth be referred to as Contract
The Contractor agrees to perform all the services set forth in the
Agreement and Work Statement. No. The Contractor is hereby
cautioned not to commence any billable work or provide any
material, service or construction under this Contract until
Contractor receives a fully executed copy of the Contract.
Signature of Person Authorized to Sign Date State of Arizona
Clint L. Hickman, Chairman of the Board of Supervisors
Signed this day of , 2013
Print Name and Title
Procurement Officer
CONTRACTOR ATTORNEY SIGNATURE: RESERVED FOR USE BY THE SECRETARY OF STATE
Pursuant to A.R.S. § 11-952, the undersigned Contractor’s
Attorney has determined that this Intergovernmental Agreement is
in proper form and is within the powers and authority granted Under House Bill 2011, A.R.S. § 11-952 was
under the laws of Arizona.
amended to remove the requirement that
Intergovernmental Agreements be filed with the
Signature of Person Authorized to Sign Date
Secretary of State.
Print Name and Title
Attorney General Contract, No, 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 the proper form
and is within the powers granted under the laws of the State of
Arizona to those parties to the Agreement represented by the
Attorney General.
The Attorney General, BY:
Signature Date
Assistant Attorney General:
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Contract Number INTERGOVERNMENTAL AGREEMENT
TERMS AND CONDITIONS
1. Definition of Terms. As used in this Contract, the terms listed below are defined as follows:
1.1 “Attachment” means any document attached to the Contract and incorporated into the Contract.
1.2 “ADHS” means Arizona Department of Health Services.
1.3 “Budget Term” means the period of time for which the contract budget has been created and during
which funds should be expended.
1.4 “Change Order” means a written order that is signed by a Procurement Officer and that directs the
Contractor to make changes authorized by the Uniform Terms and Conditions of the Contract.
1.5 “Contract” means the combination of the Uniform and Special Terms and Conditions, the
Specifications and Statement or Scope of Work, Attachments, Referenced Documents, any Contract
Amendments and any terms applied by law.
1.6 “Contract Amendment” means a written document signed by the Procurement Officer and the
Contractor that is issued for the purpose of making changes in the Contract.
1.7 “Contractor” means any person who has a Contract with the Arizona Department of Health Services.
1.8 “Cost Reimbursement” means a contract under which a contractor is reimbursed for costs, which are
reasonable, allowable and allocable in accordance with the contract terms and approved by ADHS.
1.9 “Days” means calendar days unless otherwise specified.
1.10 “Fixed Price” establishes a set price per unit of service. The set price shall be based on costs, which
are reasonable, allowable and allocable.
1.11 “Gratuity” means a payment, loan, subscription, advance, deposit of money, services, or anything of
more than nominal value, present or promised, unless consideration of substantially equal or greater
value is received.
1.12 “Materials” unless otherwise stated herein, means all property, including but not limited to equipment,
supplies, printing, insurance and leases of property.
1.13 “Procurement Officer” means the person duly authorized by the State to enter into and administer
Contracts and make written determinations with respect to the Contract.
1.14 “Purchase Order” means a written document that is signed by a Procurement Officer, that requests a
vendor to deliver described goods or services at a specific price and that, on delivery and acceptance
of the goods or services by ADHS, becomes an obligation of the State.
1.15 “Services” means the furnishing of labor, time or effort by a Contractor or Subcontractor.
1.16 “Subcontract” means any contract, express or implied, between the Contractor and another party or
between a subcontractor and another party delegating or assigning, in whole or in part, the making or
furnishing of any material or any service required for the performance of this Contract.
1.17 “State” means the State of Arizona and/or the ADHS. For purposes of this Contract, the term “State”
shall not include the Contractor.
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2. Contract Type.
This Contract shall be:
Fee for Service
X Cost Reimbursement
3. Contract Interpretation.
3.1 Arizona Law. The law of Arizona applies to this Agreement including, where applicable, the Uniform
Commercial Code as adopted by the State of Arizona.
3.2 Implied Agreement Terms. Each provision of law and any terms required by law to be in this Agreement
are a part of this Agreement as if fully stated in it.
3.3 Agreement Order of Precedence. In the event of a conflict in the provisions of the Contract, as accepted by
the State and as they may be amended, the following shall prevail in the order set forth below:
3.3.1 Terms and Conditions;
3.3.2 Statement or Scope of Work;
3.4 Relationship of Parties. The Contractor under this Contract is an independent Contractor. Neither party to
this Contract shall be deemed to be the employee or agent of the other party to the Contract.
3.5 Severability. The provisions of this Contract are severable. Any term or condition deemed illegal or invalid
shall not affect any other term or condition of the Contract.
3.6 No Parole Evidence. This Contract is intended by the parties as a final and complete expression of their
agreement. No course of prior dealings between the parties and no usage of the trade shall supplement or
explain any terms used in this document.
3.7 No Waiver. Either party’s failure to insist on strict performance of any term or condition of the Contract
shall not be deemed a waiver of that term or condition even if the party accepting or acquiescing in the
nonconforming performance knows of the nature of the performance and fails to object to it.
3.8 Headings. Headings are for organizational purposes only and shall not be interpreted as having legal
significance or meaning.
4. Contract Administration and Operation.
4.1 Term. As indicated on the signature page of the Contract, the Contract shall be effective as of the Begin
Date and shall remain effective until the Termination Date.
4.2 Contract Renewal. This Contract shall not bind, nor purport to bind, the State for any contractual
commitment in excess of the original Contract period. The term of the Contract shall not exceed five years.
However, if the original Contract period is for less than five years, the State shall have the right, at its sole
option, to renew the Contract, so long as the original Contract period together with the renewal periods does
not exceed five years. If the State exercises such rights, all terms, conditions and provisions of the original
Contract shall remain the same and apply during the renewal period with the exception of price and Scope
of Work, which may be renegotiated.
4.3 New Budget Term. If a budget term has been completed in a multi-term Contract, the parties may agree to
change the amount and type of funding to accommodate new circumstances in the next budget term. Any
increase or decrease in funding at the time of the new budget term shall coincide with a change in the
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Scope of Work or change in cost of services as approved by the Arizona Department of Health Services.
4.4 Non-Discrimination. The Contractor shall comply with State Executive Order No. 2009-09 and all other
applicable Federal and State laws, rules and regulations, including the Americans with Disabilities Act.
4.5 Records and Audit. Under A.R.S. § 35-214 and A.R.S. § 35-215, the Contractor shall retain and shall
contractually require each subcontractor to retain all data and other records (“records”) relating to the
acquisition and performance of the Contract for a period of five years after the completion of the Contract.
All records shall be subject to inspection and audit by the State and where applicable the Federal
Government at reasonable times. Upon request, the Contractor shall produce a legible copy of any or all
such records.
4.6 Financial Management. For all contracts, the practices, procedures, and standards specified in and
required by the Accounting and Auditing Procedures Manual for the ADHS funded programs shall be used
by the Contractor in the management of Contract funds and by the State when performing a Contract audit.
Funds collected by the Contractor in the form of fees, donations and/or charges for the delivery of these
Contract services shall be accounted for in a separate fund.
4.6.1 Federal Funding. Contractors receiving federal funds under this Contract shall comply with the
certified finance and compliance audit provision of the Office of Management and Budget (OMB)
Circular A-133, if applicable. The federal financial assistance information shall be stated in a
Change Order or Purchase Order.
4.6.2 State Funding. Contractors receiving state funds under this Contract shall comply with the certified
compliance provisions of A.R.S. § 35-181.03.
4.7 Inspection and Testing. The Contractor agrees to permit access, at reasonable times, to its facilities.
4.8 Notices. Notices to the Contractor required by this Contract shall be made by the State to the person
indicated on the signature page by the Contractor, unless otherwise stated in the Contract. Notices to the
State required by the Contract shall be made by the Contractor to an ADHS Procurement Officer, unless
otherwise stated in the Contract. An authorized ADHS Procurement Officer and an authorized Contractor
representative may change their respective person to whom notice shall be given by written notice, and an
amendment to the Contract shall not be necessary.
4.9 Advertising and Promotion of Contract. The Contractor shall not advertise or publish information for
commercial benefit concerning this Contract without the prior written approval of an ADHS Procurement
Officer.
4.10 Property of the State.
4.10.1 Equipment. Except as provided below or otherwise agreed to by the parties, the title to any and all
equipment acquired through the expenditure of funds received from the State shall remain the
property of the State by and through the ADHS and, as such, shall remain under the sole direction,
management and control of the ADHS. When this Contract is terminated, the disposition of all
such property shall be determined by the ADHS. For Fixed Price contracts, when the Contractor
provides the services/materials required by the Contract, any and all equipment purchased by the
Contractor remains the property of the Contractor. All purchases of equipment need to be reported
to the ADHS Office of Inventory Control.
4.10.2 Title and Rights to Materials. As used in this section, the term “Materials” means all products
created or produced by the Contractor under this Contract, including, but not limited to: written and
electronic information, recordings, reports, research, research findings, conclusions, abstracts,
results, software, data and any other intellectual property or deliverables created, prepared, or
received by the Contractor in performance of this Contract. Contractor acknowledges that all
Materials are the property of the State by and through the ADHS and, as such, shall remain under
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the sole direction, management and control of the ADHS. The Contractor is not entitled to a patent
or copyright on these Materials and may not transfer a patent or copyright on them to any other
person or entity. To the extent any copyright in any Materials may originally vest in the Contractor,
the Contractor hereby irrevocably transfers to the ADHS, for and on behalf of the State, all
copyright ownership. The ADHS shall have full, complete and exclusive rights to reproduce,
duplicate, adapt, distribute, display, disclose, publish, release and otherwise use all Materials. The
Contractor shall not use or release these Materials without the prior written consent of the ADHS.
When this Contract is terminated, the disposition of all such Materials shall be determined by the
ADHS. Further, the Contractor agrees to give recognition to the ADHS for its support of any
program when releasing or publishing program Materials.
Notwithstanding the above, if the Contractor is a State agency, the following shall apply instead: It
is the intention of ADHS and Contractor that all material and intellectual property developed under
this Agreement be used and controlled in ways to produce the greatest benefit to the parties to this
Contract and the citizens of the State of Arizona. As used in this paragraph, “Material” means all
written and electronic information, recordings, reports, findings, research information, abstracts,
results, software, data, discoveries, inventions, procedures and processes of services developed
by the Contractor and any other materials created, prepared or received by the Contractor and
subcontractors in performance of this Agreement. “Material” as used herein shall not include any
pre-existing data, information, materials, discoveries, inventions or any form of intellectual property
invented, created, developed or devised by Contractor (or its employees, subcontractors or agents)
prior to the commencement of the services funded by this Agreement or that may result from
Contractor’s involvement in other service activities that are not funded by the Agreement.
Title and exclusive copyright to all Material shall vest in the State of Arizona, subject to any rights
reserved on behalf of the federal government. As State agencies and instrumentalities, both ADHS
and Contractor shall have full, complete, perpetual, irrevocable and non-transferable rights to
reproduce, duplicate, adapt, make derivative works, distribute, display, disclose, publish and
otherwise use any and all Material. The Contractor’s right to use Material shall include the
following rights: the right to use the Material in connection with its internal, non-profit research and
educational activities, the right to present at academic or professional meetings or symposia and
the right to publish in journals, theses, dissertations or otherwise of Contractor’s own choosing.
Contractor agrees to provide ADHS with a right of review prior to any publication or public
presentation of the Material, and ADHS shall be entitled to request the removal of its confidential
information or any other content the disclosure of which would be contrary to the best interest of
the State of Arizona. Neither party shall release confidential information to the public without the
prior expressly written permission of the other, unless required by the State public records statutes
or other law, including a court order. Each party agrees to give recognition to the other party in all
public presentations or publications of any Material, when releasing or publishing them.
In addition, ADHS and Contractor agree that any and all Material shall be made freely available to
the public to the extent it is in the best interest of the State. However, if either party wants to
license or assign an intellectual property interest in the material to a third-party for monetary
compensation, ADHS and Contractor agree to convene to determine the relevant issues of title,
copyright, patent and distribution of revenue. In the event of a controversy as to whether the
Material is being used for monetary compensation or in a way that interferes with the best interest
of the state or ADHS, then the Arizona Department of Administration shall make the final decision.
Notwithstanding the above, “monetary compensation’ does not include compensation paid to an
individual creator for traditional publications in academia (the copyrights to which are Employee-
Excluded Works under ABOR Intellectual Property Policy Section 6-908C.4.), an honorarium or
other reimbursement of expenses for an academic or professional presentation, or an unprofitable
distribution of Material.
4.11 E-Verify Requirements In accordance with A.R.S. § 41-4401, Contractor warrants compliance with all
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Federal immigration laws and regulations relating to employees and warrants its compliance with Section
A.R.S. § 23-214, Subsection A.
4.12 Scrutinized Businesses In accordance with A.R.S. § 35-391 and A.R.S. § 35-393, Contractor certifies that
the Contractor does not have scrutinized business operations in Sudan or Iran.
4.13 Federal Immigration and Nationality Act The Contractor shall comply with all federal, state and local
immigration laws and regulations relating to the immigration status of their employees during the term of the
Contract. Further, the Contractor shall flow down this requirement to all subcontractors utilized during the
term of the Contract. The State shall retain the right to perform random audits of Contractor and
subcontractor records or to inspect papers of any employee thereof to ensure compliance. Should the State
determine that the Contractor and/or any subcontractors be found noncompliant, the State may pursue all
remedies allowed by law, including, but not limited to; suspension of work, termination of the Contract for
default and suspension and/or debarment of the Contractor.
5. Costs and Payments
5.1 Payments. Payments shall comply with the requirements of A.R.S. Titles 35 and 41, net 30 days. Upon
receipt and acceptance of goods or services, the Contractor shall submit a complete and accurate
Contractor’s Expenditure Report for payment from the State within thirty (30) days, as provided in the
Accounting and Auditing Procedures Manual for the ADHS.
5.2 Recoupment of Contract Payments.
5.2.1 Unearned Advanced Funds. Any unearned State funds that have been advanced to the Contractor
and remain in its possession at the end of each budget term, or at the time of termination of the
Contract, shall be refunded to the ADHS within forty-five (45) days of the end of a budget term or of
the time of termination.
5.2.2 Contracted Services. In a fixed price contract, if the number of services provided is less than the
number of services for which the Contractor received compensation, funds to be returned to the
ADHS shall be determined by the Contract price. Where the price is determined by cost per unit of
service or material, the funds to be returned shall be determined by multiplying the unit of service
cost by the number of services the Contractor did not provide during the Contract term. Where the
price for a deliverable is fixed, but the deliverable has not been completed, the Contractor shall be
paid a pro rata portion of the completed deliverable. In a cost reimbursement contract, the ADHS
shall pay for any costs that the Contractor can document as having been paid by the Contractor
and approved by ADHS. In addition, the Contractor will be paid its reasonable actual costs for
work in progress as determined by Generally Accepted Accounting Procedures up to the date of
contract termination.
5.2.3 Refunds. Within forty-five (45) days after the end of each budget term or of the time of termination
of the Contract, the Contractor shall refund the greater of: 1) the amount refundable in accordance
with paragraph 4.2.1, Unearned Advanced Funds; or ii) the amount refundable in accordance with
paragraph 5.2.2, Contracted Services.
5.2.4 Unacceptable Expenditures. The Contractor agrees to reimburse the ADHS for all Contract funds
expended, which are determined by the ADHS not to have been disbursed by the Contractor in
accordance with the terms of this Contract. The Contractor shall reimburse ADHS within 45 days
of the determination of unacceptability.
5.3 Unit Costs/Rates or Fees. Unit costs/rates or fees shall be based on costs, which are determined by ADHS
to be reasonable, allowable and allocable as outlined in the Accounting and Auditing Procedures Manual
for the ADHS.
5.4 Applicable Taxes.
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TERMS AND CONDITIONS
5.4.1 State and Local Transaction Privilege Taxes. The State of Arizona is subject to all applicable state
and local transaction privilege taxes. Transaction privilege taxes apply to the sale and are the
responsibility of the seller to remit. Failure to collect taxes from the buyer does not relieve the
seller from its obligation to remit taxes.
5.4.2 Tax Indemnification. The Contractor and all subcontractors shall pay all federal, state and local
taxes applicable to its operation and any persons employed by the Contractor. Contractor shall
require all subcontractors to hold the State harmless from any responsibility for taxes, damages
and interest, if applicable, contributions required under Federal, and/or state and local laws and
regulations and any other costs, including transaction privilege taxes, unemployment compensation
insurance, Social Security and Worker’s Compensation.
5.4.3 I.R.S. W9 Form. In order to receive payment under any resulting Contract, the Contractor shall
have a current I.R.S. W9 Form on file with the State of Arizona.
5.5 Availability of Funds for the Next Fiscal Year. Funds may not be presently available for performance under
this Contract beyond the first year of the budget term or Contract term. The State may reduce payments or
terminate this Contract without further recourse, obligation or penalty in the event that insufficient funds are
appropriated in the subsequent budget term. The State shall not be liable for any purchases or
Subcontracts entered into by the Contractor in anticipation of such funding. The Procurement Officer shall
have the discretion in determining the availability of funds.
5.6 Availability of Funds for the Current Contract Term. Should the State Legislature enter back into session
and decrease the appropriations through line item or general fund reductions, or for any other reason these
goods or services are not funded as determined by ADHS, the following actions may be taken by ADHS:
5.6.1 Accept a decrease in price offered by the Contractor;
5.6.2 Reduce the number of goods or units of service and reduce the payments accordingly;
5.6.3 Offer reductions in funding as an alternative to Contract termination; or
5.6.4 Cancel the Contract.
6. Contract Changes
6.1 Amendments, Purchase Orders and Change Orders. This Contract is issued under the authority of the
Procurement Officer who signed this Contract. The Contract may be modified only through a Contract
Amendment, Purchase Order and/or Change Order within the scope of the Contract, unless the change is
administrative or otherwise permitted by the Special Terms and Conditions. Changes to the Contract,
including the addition of work or materials, the revision of payment terms, or the substitution of work or
materials, directed by an unauthorized State employee or made unilaterally by the Contractor are violations
of the Contract and of applicable law. Such changes, including unauthorized Contract Amendments,
Purchase Orders and/or Change Orders, shall be void and without effect, and the Contractor shall not be
entitled to any claim under this Contract based on those changes.
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6.2 Subcontracts. The Contractor shall not enter into any subcontract under this Contract without the advance
written approval of the Procurement Officer. The subcontract shall incorporate by reference all material
and applicable terms and conditions of this Contract.
6.3 Assignments and Delegation. The Contractor shall not assign any right nor delegate any duty under this
Contract without the prior written approval of the Procurement Officer. The State shall not unreasonably
withhold approval.
7. Risk and Liability
7.1 Risk of Loss. The Contractor shall bear all loss of conforming material covered under this Contract until
received and accepted by authorized personnel at the location designated in the Purchase Order, Change
Order or Contract. Mere receipt does not constitute final acceptance. The risk of loss for nonconforming
materials shall remain with the Contractor regardless of receipt.
7.2 Mutual Indemnification. Each party (as “indemnitor”) agrees to indemnify, defend and hold harmless the
other party (as “indemnitee”) from and against any and all claims, losses, liability, costs or expenses
(including reasonable attorney’s fees) (hereinafter collectively referred to as “claims”) arising out of bodily
injury of any person (including death) or property damage, but only to the extent that such claims, which
result in vicarious/derivative liability to the indemnitee, are caused by the act, omission, negligence,
misconduct, or other fault of the indemnitor, its officers, officials, agents, employees or volunteers.
7.3 Indemnification - Patent and Copyright. To the extent permitted by A.R.S. § 41-621 and A.R.S. § 35-154,
the Contractor shall indemnify and hold harmless the State against any liability, including costs and
expenses, for infringement of any patent, trademark or copyright arising out of performance of the Contract
or use by the State of materials furnished by or work performed under this Contract. The State shall
reasonably notify the Contractor of any claim for which it may be liable under this paragraph.
7.4 Force Majeure.
7.4.1 Liability and Definition. Except for payment of sums due, neither party shall be liable to the other
nor deemed in default under this Contract if and to the extent that such party’s performance of this
Contract is prevented by reason of force majeure. The term “force majeure” means an occurrence
that is beyond the control of the party affected and occurs without its fault or negligence. Without
limiting the foregoing, force majeure includes acts of God; acts of the public enemy; acts of
terrorism; war; riots; strikes; mobilization; labor disputes; civil disorders; fire; flood; lockouts;
injunctions-interventions not caused by or resulting from the act or failure to act of the parties;
failures or refusals to act by government authority not caused by or resulting from the act or failure
to act of the parties; and other similar occurrences beyond the control of the party declaring force
majeure, which such party is unable to prevent by exercising reasonable diligence.
7.4.2 Exclusions. Force Majeure shall not include the following occurrences:
7.4.2.1 Late delivery of Materials caused by congestion at a manufacturer’s plant or elsewhere, or
an oversold condition of the market;
7.4.2.2 Late performance by a subcontractor unless the delay arises out of a force majeure
occurrence in accordance with this force majeure term and condition; or
7.4.2.3 Inability of either the Contractor or any subcontractor to acquire or maintain any required
insurance, bonds, licenses or permits.

Contract Number INTERGOVERNMENTAL AGREEMENT
TERMS AND CONDITIONS
7.4.3 Notice. If either party is delayed at any time in the progress of the work by force majeure, the
delayed party shall notify the other party in writing of such delay, as soon as is practicable and no
later than the following working day of the commencement thereof, and shall specify the causes of
such delay in such notice. Such notice shall be delivered or mailed certified-return receipt and
shall make a specific reference to this article, thereby invoking its provisions. The delayed party
shall cause such delay to cease as soon as practicable and shall notify the other party in writing
when it has done so. The time of completion shall be extended by Contract Amendment for a
period of time equal to the time that the results or effects of such delay prevent the delayed party
from performing in accordance with this Contract.
7.4.4 Default. Any delay or failure in performance by either party hereto shall not constitute default
hereunder or give rise to any claim for damages or loss of anticipated profits if, and to the extent
that, such delay or failure is caused by force majeure.
7.5 Third Party Antitrust Violations. The Contractor assigns to the State any claim for overcharges resulting
from antitrust violations to the extent that those violations concern materials or services supplied by third
parties to the Contractor for or toward the fulfillment of this Contract.
8. Description of Materials
The following provisions shall apply to Materials only:
8.1 Liens. The Contractor agrees that the Materials supplied under this Contract are free of liens. In the event
the Materials are not free of liens, Contractor shall pay to remove the lien and any associated damages or
replace the Materials with Materials free of liens.
8.2 Quality. Unless otherwise modified elsewhere in these terms and conditions, the Contractor agrees that, for
one year after acceptance by the State of the Materials, they shall be:
8.2.1 Of a quality to pass without objection in the Contract description;
8.2.2 Fit for the intended purposes for which the Materials are used;
8.2.3 Within the variations permitted by the Contract and are of even kind, quantity, and quality within
each unit and among all units;
8.2.4 Adequately contained, packaged and marked as the Contract may require; and
8.2.5 Conform to the written promises or affirmations of fact made by the Contractor.
8.3 Inspection/Testing. Subparagraphs 8.1 through 8.2 of this paragraph are not affected by inspection or
testing of or payment for the Materials by the State.
8.4 Compliance with Applicable Laws. The Materials and services supplied under this Contract shall comply
with all applicable federal, state and local laws, and the Contractor shall maintain all applicable licenses
and permit requirements.
8.5 Survival of Rights and Obligations after Contract Expiration and Termination.
8.5.1 Contractor’s Representations. All representations and warranties made by the Contractor under
this Contract in paragraphs 7 and 8 shall survive the expiration or termination hereof. In addition,
the parties hereto acknowledge that pursuant to A.R.S. § 12.510, except as provided in A.R.S. §
12-529, the State is not subject to or barred by any limitations of actions prescribed in A.R.S. Title
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12, Chapter 5.
8.5.2 Purchase Orders and Change Orders. Unless otherwise directed in writing by the Procurement
Officer, the Contractor shall fully perform and shall be obligated to comply with all Purchase Orders
and Change Orders received by the Contractor prior to the expiration or termination hereof,
including, without limitation, all Purchase Orders and Change Orders received prior to but not fully
performed and satisfied at the expiration or termination of this Contract.
9. State’s Contractual Remedies
9.1 Right to Assurance. If the State, in good faith, has reason to believe that the Contractor does not intend to,
or is unable to, perform or continue performing under this Contract, the Procurement Officer may demand
in writing that the Contractor give a written assurance of intent to perform. Failure by the Contractor to
provide written assurance within the number of Days specified in the demand may, at the State’s option, be
the basis for terminating the Contract.
9.2 Stop Work Order.
9.2.1 Terms. The State may, at any time, by written order to the Contractor, require the Contractor to
stop all or any part of the work called for by this Contract for a period up to ninety (90) Days after
the order is delivered to the Contractor, and for any further period to which the parties may agree.
The order shall be specifically identified as a stop work order issued under this clause. Upon
receipt of the order, the Contractor shall immediately comply with its terms and take all reasonable
steps to minimize the incurrence of costs allocable to the work covered by the order during the
period of work stoppage.
9.2.2 Cancellation or Expiration. If a stop work order issued under this clause is canceled or the period
of the order or any extension expires, the Contractor shall resume work. The Procurement Officer
shall make an equitable adjustment in the delivery schedule or Contract price, or both, and the
Contract shall be amended in writing accordingly.
9.3 Non-exclusive Remédies. The rights and remedies of ADHS under this Contract are not exclusive, and
ADHS is entitled to all rights and remedies available to it, including those under the Arizona Uniform
Commercial Code and Arizona common law.
9.4 Right of Offset. The State shall be entitled to offset against any sums due the Contractor in any Contract
with the State or damages assessed by the State because of the Contractor’s non-conforming performance
or failure to perform this Contract. The right to offset may include, but is not limited to, a deduction from an
unpaid balance and a collection against the bid and/or performance bonds. Any offset taken for damages
assessed by the State shall represent a fair and reasonable amount for the actual damages and shall not
be a penalty for non-performance.
10. Contract Termination
10.1 Cancellation for Conflict of Interest. Pursuant to A.R.S. § 38-511, the State may cancel this Contract within
three (3) years after Contract execution without penalty or further obligation if any person significantly
involved in initiating, negotiating, securing, drafting or creating the Contract on behalf of the State is, or
becomes at any time while the Contract or an extension of the Contract is in effect, an employee of or a
consultant to any other party to this Contract with respect to the subject matter of the Contract. The
cancellation shall be effective when the Contractor receives written notice of the cancellation, unless the
notice specifies a later time. If the Contractor is a political subdivision of the State, it may also cancel this
Contract as provided in A.R.S. § 38-511.
10.2 Gratuities. The State may, by written notice, terminate this Contract, in whole or in part, if the State
determines that employment or a Gratuity was offered or made by the Contractor or a representative of the
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Contract Number INTERGOVERNMENTAL AGREEMENT
TERMS AND CONDITIONS
Contractor to any officer or employee of the State for the purpose of influencing the outcome of the
procurement, securing the Contract or an Amendment to the Contract, or receiving favorable treatment
concerning the Contract, including the making of any determination or decision about Contract
performance. The State, in addition to any other rights or remedies, shall be entitled to recover exemplary
damages in the amount of three times the value of the Gratuity offered by the Contractor.
10.3 Suspension or Debarment. The State may, by written notice to the Contractor, immediately terminate this
Contract if the State determines that the Contractor or its subcontractor has been debarred, suspended or
otherwise lawfully prohibited from participating in any public procurement activity, including but not limited
to, being disapproved as a subcontractor of any public procurement unit or other governmental body.
10.4 Termination without Cause.
10.4.1 Both the State and the Contractor may terminate this Contract at any time with thirty (30) days’
notice in writing specifying the termination date. Such notices shall be given by personal delivery
or by certified mail, return receipt requested.
10.4.2 If the Contractor terminates this Contract, any monies prepaid by the State, for which no service
or benefit was received by the State, shall be refunded to the State within 5 days of the
termination notice. In addition, if the Contractor terminates the Contract, the Contractor shall
indemnify the State for any sanctions imposed by the funding source as a result of the
Contractor’s failure to complete the Contract.
10.4.3 If the State terminates this Contact pursuant to this Section, the State shall pay the Contractor the
Contract price for all Services and Materials completed up to the date of termination. In a fixed
price contract, the State shall pay the amount owed for the Services or Materials by multiplying
the unit of service or item cost by the number of unpaid service units or items. In a cost
reimbursement contract, the ADHS shall pay for any costs that the Contractor can document as
having been paid by the Contractor and approved by ADHS. In addition, the Contractor will be
paid its reasonable actual costs for work in progress as determined by GAAP up to the date of
termination. Upon such termination, the Contractor shall deliver to the ADHS all deliverables
completed. ADHS may require Contractor to negotiate the terms of any remaining deliverables
still due.
10.5 Mutual Termination. This Contract may be terminated by mutual written agreement of the parties
specifying the termination date and the terms for disposition of property and, as necessary, submission of
required deliverables and payment therein.
10.6 Termination for Default. The State reserves the right to terminate the Contract in whole or in part due to
the failure of the Contractor to comply with any material obligation, term or condition of the Contract, to
acquire and maintain all required insurance policies, bonds, licenses and permits, or to make satisfactory
progress in performing the Contract. In the event the ADHS terminates the Contract in whole or in part as
provided in this paragraph, the ADHS may procure, upon such terms and in such manner as deemed
appropriate, Services or Materials, similar to those terminated, and Contractor shall be liable to the ADHS
for any excess costs incurred by the ADHS in obtaining such similar Services or Materials.
10.7 Continuation of Performance through Termination. Upon receipt of the notice of termination and until the
effective date of the notice of termination, the Contractor shall perform work consistent with the
requirements of the Contract and, if applicable, in accordance with a written transition plan approved by the
ADHS. If the Contract is terminated in part, the Contractor shall continue to perform the Contract to the
extent not terminated. After receiving the notice of termination, the Contractor shall immediately notify all
subcontractors, in writing, to stop work on the effective date of termination, and on the effective date of
termination, the Contractor and subcontractors shall stop all work.
10.8 Disposition of Property. Upon termination of this Contract, all property of the State, as defined herein, shall
be delivered to the ADHS upon demand.
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Contract Number INTERGOVERNMENTAL AGREEMENT
TERMS AND CONDITIONS
11. Arbitration Pursuant to A.R.S. § 12-1518, disputes under this Contract shall be resolved through the use of
arbitration when the case or lawsuit is subject to mandatory arbitration pursuant to rules adopted under A.R.S. §
12 -133.
12. Communication
12.1 Program Report. When reports are required by the Contract, the Contractor shall provide them in the
format approved by ADHS.
12.2 Information and Coordination. The State will provide information to the Contractor pertaining to activities
that affect the Contractor’s delivery of services, and the Contractor shall be responsible for coordinating
their activities with the State’s in such a manner as not to conflict or unnecessarily duplicate the State’s
activities. As the work of the Contractor progresses, advice and information on matters covered by the
Contract shall be made available by the Contractor to the State throughout the effective period of the
Contract.
13. Client Grievances If applicable, the Contractor and its subcontractors shall use a procedure through which
clients may present grievances about the operation of the program that result in the denial, suspension or
reduction of services provided pursuant to this Contract and which is acceptable to and approved by the State.
14. Sovereign Immunity Pursuant to A.R.S. § 41-621(O), the obtaining of insurance by the State shall not be a
waiver of any sovereign immunity defense in the event of suit.
15. Fingerprint and Certification Requirements/Juvenile Services.
15.1 Paid and Unpaid Personnel. Pursuant to A.R.S. § 36-425.03, the Contractor shall ensure that all paid and
unpaid personnel who are required or are allowed to provide Services directly to juveniles have obtained
fingerprint clearance cards in accordance with A.R.S. § 41-1758 et. seq.
15.2 Costs. The Contractor shall assume the costs of fingerprint certifications and may charge these costs to its
fingerprinted personnel.
16. Administrative Changes The Procurement Officer, or authorized designee, reserves the right to correct any
obvious clerical, typographical or grammatical errors, as well as errors in party contact information (collectively,
“Administrative Changes”), prior to or after the final execution of a Contract or Contract Amendment.
Administrative Changes subject to permissible corrections include: misspellings, grammar errors, incorrect
addresses, incorrect Contract Amendment numbers, pagination and citation errors, mistakes in the labeling of the
rate as either extended or unit, and calendar date errors that are illogical due to typographical error. The
Procurement Office shall subsequently send to the Contractor notice of corrections to administrative errors in a
written confirmation letter with a copy of the corrected Administrative Change attached.
17. Survival of Terms after Termination or Cancellation of Contract All applicable Contract terms shall survive
and apply after Contract termination or cancellation to the extent necessary for Contractor to complete and for the
ADHS to receive and accept any final deliverables that are due after the date of the termination or cancellation.
18. Health Insurance Portability and Accountability Act of 1996 (HIPAA) 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 Government
Information Technology Agency (GITA), Statewide Information Security and Privacy Office (SISPO) Chief Privacy
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,
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Contract Number INTERGOVERNMENTAL AGREEMENT
TERMS AND CONDITIONS
including, but not limited to, business associate agreements.
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 GITA/SISPO Chief Privacy Officer and HIPAA
Coordinator.
19. Invoicing Contractor shall prepare and submit Invoice(s) utilizing the State of Arizona, Electronic Billing
System located at the following Web site address: http://www.ecfr.gov/cgi-bin/text-
idx?SID=7da859deb759be3985e358134aeb1b20&mc=true&tpl=/ecfrbrowse/Title02/2cfr200_main_02.t
pl
20. Comments Welcome The ADHS Procurement Office periodically reviews the Uniform Terms and Conditions
and welcomes any comments you may have. Please submit your comments to: ADHS Procurement
Administrator, Arizona Department of Health Services, 1740 West Adams, Suite 303, Phoenix, Arizona, 85007.
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Contract Number INTERGOVERNMENTAL AGREEMENT
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1. Background
1.1 The mission of the Arizona Department of Health Services (ADHS) Office of Disease
Integration and Services and the Office of HIV Prevention, Ryan White Part B HIV Care and
Services Program (Program) is to provide medically necessary health care and support
services for low-income individuals with HIV infection who do not have sufficient health care
coverage or financial resources for coping with HIV/AIDS. The Arizona Ryan White Part A
Program provides services to eligible clients residing in Maricopa and Pinal counties of Arizona.
.
1.2 Services to be provided under this Contract are fully funded through the Ryan White HIV/AIDS
Treatment Extension Act of 2009, formerly known as the Ryan White HIV/AIDS Treatment
Modernization Act of 2006, administered by the Health Resources Services Administration
(HRSA), HIV/AIDS Bureau (HAB). Ryan White funding fills gaps in care not covered by other
resources. Services funded by this contract are also funded by rebate funding. The ADHS
Office of Disease Integration and Services is the only authorized administrator for rebate
funding. The ADHS Office of Disease Integration and Services is the only authorized
administrator for Part B of the Ryan White HIV/AIDS Treatment Extesion Act of 2009 and is
mandated to ensure the provision of Core Medical and Support Services as specified by the
Health Resources and Services Administration (HRSA).
1.3 The ADHS Office of Disease Integration and Services has the responsibility for administering:
1.3.1 the HIV Surveillance Program Cooperative Agreement funds,
1.3.2 the Ryan White HIV/AIDS Treatment Extension Act of 2009 administered by the Health
Resources Services Administration (HRSA), HIV/AIDS Bureau (HAB) Ryan White
funding.
1.3.3 TB Funds, and
1.3.4 STD Funds
1.4 The current National HIV/AIDS strategy has four (4) goals:
https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf
1.4.1 Reducing New HIV Infections;
1.4.2 Increasing Access to Care and Improving Health Outcome for People Living with HIV;
1.4.3 Reducing HIV-related Disparities and Health Inequities; and
1.4.4 Achieving a More Coordinated National Response
1.5 Sevices to be provided:
Although the Ryan White legislation provides for other service catagories, the Arizona Ryan
White Part B Program will fund only services in caegories listed below. These servics are to be
delivered to eligible clients in Maricopa and Pinal Counties. Services provided in Maricopa and
Pinal Counties deliverd under this contract shall adhere to the most recent guidelines for the
treatment of HIV disease and related opportunistic infections established by the United States
Public Health Service http;//www.aidsinfonih.gov/guidelines Eligibiility Documentation

Contract Number INTERGOVERNMENTAL AGREEMENT
SCOPE OF WORK
Services to be funded under this contrasct are:
1.5.1 Core Medical Services:
 Outpatient Ambulatory Medical Care;
 Medical Case Management including Treatment Adherence Services;
 Oral Health Care Services;
 Health Insurance Premium and Cost Sharing Assistance;
 Early Interventiion Services;
 Mental Health Services;
 Substance Abuse Services (Outpatient); and
 Medical Nutrition Services.
1.5.2 Support Services:
 Case Management (non-medical);
 Food Bank/Home delivered Meals;
 Treatment Adherence Counseling;
 Housing Services; and
 Medical Transportation Services
1.5.3 Assessment of Client Charges:
Contractor must have documented policies and procedures relating to the collection
of fees for client services and must make available for review the following:
 Sliding fee discount policy and schedule
 Sliding fee eligibility applications within client files
 Actual client charges made and received
 Process for charging, obtaining and documenting client charges through a
manual or electronic system
 File of individuals refused services with reasons for refusal
specified; this file must include documentation of any client
complaints with complaint review and decision.
The sliding fee discount policy and schedule should not allow clients
below 100% of the Federal Poverty Level (FPL) to be charged for
services. For clients with incomes greater than 100% of FPL, caps
should be placed on total annual charges for Ryan White Services
(including ADAP) based on a percentage of the client’s annual income
as follows:
 5% for patients with incomes between 100% and 199% of FPL
 7% for patients with incomes between 200% and 300% of FPL
 10% for patients with incomes greater than 300% of FPL
Contractor must ensure through appropriate staff training, policies and
implementation that:
 Access to care is provided regardless of ability to pay
 Clients are annually evaluated to establish individual fees and caps
 The C o n t r a c t o r is tracking Part B charges or medical expenses
incurred by the client inclusive of enrollment fees, deductibles, co-
payments, etc.
 a process for alerting the billing systems that the client has reached
the cap and should not be further charged for the remainder of the
year
 Documentation of policies, fees and implementation, including
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Contract Number INTERGOVERNMENTAL AGREEMENT
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evidence that staff understand the policies and procedures
See the HAB Fiscal Monitoring Standards Section D
( http://www.careacttarget.org/library/part-b-fiscal-monitoring- standards) for additional
information.
1.5.4 Accessibility and Availability of Services:
Part B-funded HIV primary care and support services must be funded to the
maximum extent possible without regard to either the ability of the individual to pay
for such services or the current or past health conditions of the individuals being
served and must be provided in settings that are accessible to low-income individuals
with HIV disease and compliant with ADA requirements. Services must be provided
at a facility accessible by public transportation or else transportation assistance must
be provided. The C o n t r a c t o r must make efforts to inform low-income individuals
for the availability of HIV- related services and how to access them through Program
approved informational materials. See the HAB Universal Monitoring Standards
Section a (http://hab.hrsa.gov/manageyourgrant/files/universalmonitoringpartab.pdf)
for additional information.
1.5.5 Further Requirements:
Contractor who proposes to provide Outpatient and Ambulatory Health Services or
Medical Case Management including Treatment Adherence Services shall also
provide Health Insurance Premium and Cost Sharing Assistance (HPCSA) for Low
Income Individuals. Many clients receiving Ryan White services will be insured by
other payers. It is important coordination of benefits is done at this time for continuity
of care. The combination of these services is intended to support the transition of
AIDS Drug Assistance Program enrollees into health insurance continuation, and to
support the Ryan White Part B response to HRSA Early Identification of Individuals
with HIV/AIDS (EIIHA) requirements. Contractor who is unable to provide Health Insurance
Premium Assistance may refer clients to another agency that can provide this service.
Contractor must be able to provide Cost Sharing Assistance to coordinate benefits with other
payers.
In accordance with payer of last resort requirement, Contractor funded to deliver
Ryan White services are responsible to show services delivered to enrolled clients are
not duplicated by similar services delivered to the same client by other Ryan Whit e
providers. Policy manuals must clearly alert staff that Ryan White should be the
payer of last resort. As the payer of last resort, Contractor must have the capability of
billing the state Medicaid program (AHCCCS), and other third party payers (i.e.,
Medicare, Veteran’s Administration, private insurance). Contractor are required to
maximize and monitor third party reimbursements including those from AHCCCS,
Medicare, the Veteran’s Administration, and private insurance (including medical,
drug, dental and vision benefits) and must carry out internal reviews of files and billing
systems to ensure that Ryan White resources are only used when a third party payer
is not available. See the HAB Fiscal Monitoring Standards Section C
(http://www.careacttarget.org/library/part-b-fiscal-monitoring-standards) for additional
information.
1.5.6 Service Definitions and Requirements:
Refer to the Part B Program Monitoring Standards Sections B and C for complete
requirements and citations for delivery of core and support services.
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Contract Number INTERGOVERNMENTAL AGREEMENT
SCOPE OF WORK
(http://hab.hrsa.gov/manageyourgrant/files/programmonitoringpartb.pdf). Contractor
is expected to integrate client-provided services with other available programs
(including Medicaid) to enhance continuity of care and prevention services while
ensuring no duplication of services. Contractor must document that all core and
support services are provided by or under the supervision of a physician or other
qualified personnel with appropriate and valid licensure or certification as required
by the State of Arizona
1.5.7 Core Medical Services
Outpatient and Ambulatory Medical Care-the provision of professional diagnostic and
therapeutic services rendered by a physician, physician's assistant, clinical nurse
specialist, or nurse practitioner in an outpatient setting. Settings include clinics, medical
offices, and mobile vans where clients generally do not stay overnight. Emergency room
services are not outpatient settings. Services includes diagnostic testing, early
intervention and risk assessment, preventive care and screening, practitioner
examination, medical history taking, diagnosis and treatment of common physical and
mental conditions, prescribing and managing medication therapy, education and
counseling on health issues, well-baby care, continuing care and management of chronic
conditions, and referral to and provision of specialty care (includes all medical
subspecialties). Primary medical care for the treatment of HIV infection includes the
provision of care that is consistent with the Public Health Service’s guidelines. Such care
must include access to antiretroviral and other drug therapies, including prophylaxis and
treatment of opportunistic infections and combination antiretroviral therapies.
Diagnostic testing performed must be integral to the treatment of HIV and related
complications, necessary based on established clinical practice, ordered by a registered,
certified, or licensed provider; consistent with medical and laboratory standards;
approved by the Food and Drug Administration (FDA) and/or Certified under the Clinical
Laboratory Improvement Amendments Program (CLIA).
Documentation Requirements:
Client files must include the following:
• Document the type, date and frequency of services provided;
• Document that services are for the treatment of HIV infections;
• Include clinician notes signed by the licensed provider of services
• Document the number of laboratory tests performed
• Provide the certification, licenses or FDA approval of the laboratory from which
the tests were ordered
• Document the credentials of the individual ordering the test
1.5.8 Oral Health Care
Oral Health Care - diagnostic, preventive, and therapeutic services provided by general
dental practitioners, dental specialists, dental hygienists and auxiliaries, and other trained
primary care providers that meet current dental care guidelines. Oral health service
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Contract Number INTERGOVERNMENTAL AGREEMENT
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provision is limited to $3500 per client unless a letter of medical necessity is approved by
the Program to exceed this cap.
Documentation Requirements:
The client chart must include a dental chart signed by a licensed provider and including a
treatment plan, services provided and any referrals made.
1.5.9 Early Intervention Services (EIS) – provides HIV testing and target counseling,
referral services, linkages to care, and health education and literacy training that
enable clients to navigate the HIV system of care. These services shall only be provided
at specific points of entry defined as health care access points frequently used by
traditionally underserved HIV- positive individuals to help meet their medical and social
service needs. All of the above-listed components must be present, but Part B funding is
to be used for HIV testing only as necessary to supplement, not supplant existing
funding. Provision of EIS must be coordinated with HIV prevention efforts and programs
and providers of prevention services.
The Contractor is required to establish written memoranda of understanding
(MOUs) with key points of entry into care (e.g., emergency rooms, substance abuse
treatment programs, detoxification centers, adult and juvenile detention facilities,
sexually transmitted disease clinics, HIV counseling and testing sites, mental
health programs, federally qualified health centers, and homeless shelters) to
facilitate access to care for those who test positive. Linkage agreements must be
established with testing sites where Part B is not funding testing but is funding
referral and access to care, education and system navigation services. Contractor
must document:
 Provision of all four required EIS service components with Part B and other
funding
 numbers of HIV tests and positives as well as where and when Part B-funded HIV
testing occurs
 That HIV testing activities and methods meet CDC and state requirements
 Referrals from key points of entry to EIS programs
 Training and education sessions designed to help individuals navigate and
understand the HIV system of care
For additional information on EIS, please refer to the Part B Program
Monitoring Standards Section B
(http://hab.hrsa.gov/manageyourgrant/files/programmonitoringpartb.pdf).
EIS and enhanced referrals are defines as follows for purposes of part B
funding:
Early Intervention Services under Part B include counseling, testing, referral, and
information services designed to bring HIV-positive individuals into the local HIV
continuum of care.
Points of Entry are health care access points frequently used by traditionally
underserved HIV-positive individuals to help meet their medical and social service
needs. They are therefore key access points for referring such individuals into the
HIV care system.
Referral Relationships are written agreements between CARE Act-funded Part B
providers and key points of entry. They detail linkages that will be established and
maintained to promote access to HIV-related services for HIV-positive individuals not
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Contract Number INTERGOVERNMENTAL AGREEMENT
SCOPE OF WORK
in care.
Coordinate CARE Act services with other health care delivery systems.
Programs need to use CARE Act services to fill gaps in care. This requires
coordination across CARE Act programs and with other Federal/State/local
programs. Such coordination can help maximize efficient use of resources, enhance
systems of care, and ensure coverage of HIV/AIDS-related services within managed
care plans (particularly Medicaid managed care).
Conditions required to request EIS funding. With respect to an entity that
proposes to provide early intervention services under subparagraph (A), such
subparagraph applies only if the entity demonstrates to the satisfaction of the chief
elected official for the eligible area involved that—
1) Federal, State, or local funds are otherwise inadequate for the early
intervention services the entity proposes to provide; and
2) The entity will expend funds pursuant to such subparagraph to
supplement and not supplant other funds available to the entity for the provision of
early intervention services for the fiscal year involved.
Targeted Testing for at risk persons: Belonging to a group: MSM, IDU, High Risk
Heterosexual (multiple partner, unprotected sex). Additionally Men and Women of color;
Black, African American and Hispanic are infected with HIV at a higher rate.
Getting Outreach services receive Part B funds may be used for ―outreach activities that Section VIII, Program
HIV- increased emphasis are intended to identify individuals with HIV disease Guidance, Chapter 5,
positive who know their HIV status and are not receiving HIV- Early Intervention
people related services‖—in order to get them into care. Services
who know
their Part B funds may now be Part B funds may now be used for EIS, if the grantee
status used to fund Early demonstrates (a) unmet need for these services, and
into care Intervention Services (b) that other sources of funds are insufficient to
(EIS) respond.
Relationships must be Providers receiving Part B funds must maintain
developed with entities that ―appropriate relationships with entities that constitute
serve as ―Points of Entry‖ to key points of access to the health care
care system.‖ Points of access include: emergency rooms,
substance abuse treatment programs, detoxification
centers, adult and juvenile detention facilities, sexually
transmitted disease clinics, HIV counseling and testing
sites, mental health programs, and homeless shelters,
among other entities
1.5.10 Health Insurance Premium and Cost Sharing Assistance for Low Income Individuals - the
provision of financial assistance for eligible individuals living with HIV to maintain a continuity of
health insurance or to receive medical benefits under a health insurance program. This includes
purchasing health insurance that provides comprehensive primary care and pharmacy benefits for
low income clients that provide a full range of HIV medications, paying co-pays and deductibles
on behalf of the client, and providing funds to contribute to a client’s Medicare Part D true out-
of-pocket (TrOOP) costs. Part B funding must be used to supplement, NOT supplant existing
federal, state, or local funding for Health Insurance Premium and cost-sharing assistance.
18

Contract Number INTERGOVERNMENTAL AGREEMENT
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Offeror is required to comply with the following:
 Where premiums are covered by Ryan White funds, provide proof that the insurance policy
provides comprehensive primary care and formulary with a full range of HIV medications
 Maintain proof or low-income status
 Provide documentation that demonstrates that funds were not used to cover costs
associated with the creation, capitalization or administration of a liability risk pool or social
security costs
 when funds are used to cover prescription eye-wear, provide a physician’s written statement that
the eye condition is related to HIV infection.
For additional information, please refer to the Part B Program Monitoring Standards Section B
(http://hab.hrsa.gov/manageyourgrant/files/programmonitoringpartb.pdf).
1.5.11 Mental Health Services - psychological and psychiatric treatment and counseling services
offered to individuals with a diagnosed mental illness, conducted in a group or individual
setting, based on a detailed treatment plan and provided by a mental health professional
licensed or authorized within the State to render such services. This typically includes
psychiatrists, psychologists, and licensed clinical social workers. As detailed below, all
client charts must document the treatment plan as well as dates of services provided and
their consistency with Ryan White requirements and with the treatment plan. Please see
RW Part B 2612 (b) (3) (K) for additional information.
Documentation Requirements:
The following must be included in the client chart:
 Detailed treatment plan for each eligible client that includes:
o The diagnosed mental illness or condition
o the treatment modality (group or individual)
o Date for mental health services
o Recommended number of sessions
o Date for reassessment
o Projected treatment end date
o Any recommendations for follow up
o The signature of the mental health professional rendering services
 Documentation of services provided, dates, and consistency with Ryan White
requirements and individual client treatment plan
1.5.12 Medical Case Management Services Including Treatment Adherence - ensure
timely and coordinated access to medically appropriate levels of health and support
services and continuity of care, provided by trained professionals, including both
medically credentialed and other health care staff who are part of the clinical care team,
through all types of encounters including face-to-face, phone contact, and any other form
of communication. Key activities include (1) initial assessment of service needs; (2)
Development of a comprehensive, individualized service plan; (3) Coordination of services
required to implement the plan; (4) Continuous client monitoring to assess the efficacy of
the plan; and (5) periodic reevaluation and adaptation of the plan at least every 6 months
as necessary over the life of the client. It includes client- specific advocacy and/or review of
utilization of services. Service components may include:
Benefits/entitlement counseling and referral activities assisting them to access other public
and private programs for which they may be eligible (e.g., AHCCCS, Medicare Part D,
ADAP, Pharmaceutical Manufacturers’’ Patient Assistance Programs, and other State and
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Contract Number INTERGOVERNMENTAL AGREEMENT
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local health care and supportive services)
 coordination and follow up of medical treatments
 Ongoing assessment of the client’s and other key members’ needs and personal support
systems
 treatment adherence counseling to ensure readiness for, and adherence to, complex HIV/AIDS
treatments
 Client-specific advocacy and/or review of utilization of services
Medical Case Management within Ryan White Part B delivery system is responsible for
coordination of all core services for clients enrolled in Medical Case Management service. Medical
Case Management must adhere to documentation requirements established by the Program for
Medical Case Management. See above for information related to Medical Case Management that
must be included in the client chart.
Documentation Requirements:
All client records must include documentation of each case management encounter detailing
types of services provided, types of encounter/communication (including phone encounters), and
duration and frequency of the encounter. Services provided should be documented in detail. In
addition client charts should include documentation indicating that all of the following activities
are being carried out for clients:
 Initial assessment of service needs
 Comprehensive, individualized care plan
 Documentation of coordination of services required to implement the plan
 Notes on continuous client monitoring to assess the efficacy of the plan
 Results from periodic re-evaluation and adaptation of the plan at least every six months
1.5.13 Substance Abuse Services (Outpatient) - the provision of medical or other treatment and/or
counseling to address substance abuse problems (i.e., alcohol and/or legal and illegal drugs) in
an outpatient setting, rendered by a physician or under the supervision of a licensed physician,
or by other qualified, licensed healthcare provider. This service must be delivered by
Contractor who also deliver outpatient ambulatory health services and can only be provided
on an outpatient basis. Services are limited to the following:
 Pre-treatment/recovery readiness programs
 Harm reduction
 Mental health counseling to reduce depression, anxiety and other disorders associated with
substance abuse
 Outpatient drug-free treatment and counseling
 Opiate Assisted Therapy
 Euro-psychiatric pharmaceuticals
 Relapse prevention
Documentation Requirements:
Client charts must include:
:
 Detailed treatment plan specifying only allowable activities under this service category
 The quantity, frequency, and modality of treatment provided
 The date treatment begins and ends
 Regular monitoring and assessment of client progress
 The signature of the individual providing the service or the supervisor as applicable
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Contract Number INTERGOVERNMENTAL AGREEMENT
SCOPE OF WORK
1.5.14 Support Services:
1.5.14.1 Case Management (Non-Medical) – the provision of advice and assistance in
obtaining medical, social, community, legal, financial, and other needed services.
This may include:
 Benefits/entitlement counseling and referral activities to assist eligible
clients to obtain access to public and private programs for which they
may be eligible. These counseling and referral activities should assist
clients in obtaining access to both public and private programs.
 All types of case management encounters and communication (face-to-
face, telephone, etc.)
 Transitional case management for incarcerated persons as they prepare to
exit the correctional system.
Nonmedical case management does not involve coordination and follow-
up of medical treatments, as medical case management does.
Documentation Requirements:
Client charts must include the date, type and duration and key activities of
each encounter.
1.5.14.2 Food Bank/Home-delivered Meals – the provision of actual food items, hot
meals or vouchers to purchase food. This can also include the provision of
non-food items that are limited to personal hygiene products, household
cleaning supplies, and water filtration/purifications systems on communities
where issues with water purity exists. Appropriate licensure or certification
must be in place for food banks and home-delivered meals under state and
local regulations. Funds must not be used for permanent water filtration
systems entering the house, household appliances, pet foods, or other
non-essential products.
Documentation Requirements:
The Contactor must document the type of services provided, number of
clients served and levels of service as well as the amount and use of funds
for purchase of allowable non-food items.
1.5.14.3 Housing Services - the provision of short-term assistance to support
emergency, temporary or transitional housing to enable an individual or
family to gain or maintain medical care. Assistance should be designed to
assist clients in obtaining stable, long-term housing through a strategy to
identify, re-locate, and/or ensure the individual or family is moved to or
capable of maintaining a stable long-term living situation. Housing-related
referral services include assessment, search, placement, advocacy, and the
fees associated with them. Eligible housing can include both housing that
does not provide direct medical or supportive services and housing that
provides some type of medical or supportive services such as
Residential mental health services, foster care, or assisted living residential
services. Ryan White Part B funds must not be used for direct payments to
recipients of services for rent or mortgages.
Documentation Requirements:
Contractor must document the services provided including number of
clients served, duration of housing services, types of housing provided, and
housing referral services. Client records should include:
 Client eligibility
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Contract Number INTERGOVERNMENTAL AGREEMENT
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 Housing services, including referral services provided
 Assistance provided to clients to help them obtain stable long-term housing
1.5.14.4 Medical Transportation Services - conveyance services provided, directly or
through voucher, to an eligible client so that he or she may access HIV-related
health and support services. Medical transportation is classified as a support service
and is used to provide transportation for eligible Ryan White HIV/AIDS Program
clients to core medical services and support services. Medical transportation must
be reported as a support service in all cases, regardless of whether the client is
transported to a medical core service or a support service. Medical transportation
services may only be provided through the following methods. No direct payments for
transportation services are allowed.
 a contract with a provider of transportation services, limited to shuttles and taxi cabs
 A voucher or token system that allows for tracking the distribution of the
vouchers or tokens; provision through gas cards, bus passes, etc.
The Contractor must maintain program records that document:
 The level of services/number of trips provided
 The reason for each trip and its relation to accessing health and support services
 Trip origin and destination
 Client eligibility
 Cost per trip
 Method used to meet the transportation need
1.5.14.5 Treatment Adherence Counseling - the provision of counseling or special
programs to ensure readiness for, and adherence to, complex HIV/AIDS
treatments by nonmedical personnel outside of the medical case management and
clinical setting. Contractor must verify with the Program whether proposed services
under treatment adherence counseling are allowable prior to providing the service.
Documentation Requirements:
The Contractor must maintain program records that document the type and duration of
treatment adherence counseling provided as well as verification that this service was
approved by the Program.
2. Objective
2.1 To fill gaps in Core Medical and Support Services to low-income individuals with HIV
infection who do not have sufficient health care coverage or financial resources for
coping with HIV/AIDS;
2.2 To assist the RWPA Program in financing HIV related costs that RWPA is unable to fund
due to costs that exceed authority due to billing received after the end of the Ryan White
Part A Program, not to exceed one (1) year after the close of the prior RWPA Program
grant year.
3.0 Scope of Work
3.1 The Contract Services to be provided during the term of this agreement shall address
problems and needs and seek to achieve the program goals described below:
3.1.1 The RWPA Program identifies costs that exceed RWPA funding levels due to
additional community need and submits those to RWPB for review and
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Contract Number INTERGOVERNMENTAL AGREEMENT
SCOPE OF WORK
reimbursement. RWPA will provide summary data not to include client level data
as part of the reimbursement. Contractor shall provide core medical and support
services to eligible Ryan White Part A clients in accordance with the HRSA
guidelines found at http:/hab.hrsa.gov;
3.1.2 RWPA will retain all documentation related to client services, including client
level data, RSR reporting data and billing data. Aggregate data on client
services will be submitted to Ryan White Part B annually in accordance with the
RWPA/RWPB Data Sharing Agreement.
4.0 Tasks
The Contractor shall:
4.1 Implement services in accordance with Maricopa County Contractual Services in place at the
time service(s) are rendered. These include, but are not limited to HRSA Universal and
Programmatic Standards, RWPA Policies and Procedures and HRSA Uniform Guidance.
4.2 Identify a Project Manager who shall be the primary contact person for the ADHS Office Chief
to discuss all contractual projects and tasks, including financial status, tasks and information
and responsibility to assign projects or tasks; All services shall be provided by Maricopa
County Contactors who have appropriate training for staff that has the responsibility for fulfilling
any components of the services categories;
4.3 Maintain and update, as necessary, a Data Sharing Agreement, as provided in Attachment 1
and Exhibit 1 Security and Confidentiality Standards. The Data Sharing Agreement shall
become effective upon acceptance by both parties to this Agreement and may be revised as
necessary. Revisions to the Data Sharing Agreement shall not require an Amendment to
become enforceable.
4.4 Provide a quality management plan to ADHS
4.5 Provide other reporting as required by ADHS;
4.6 Provide culturally competent services in accordance with HRSA Cultural Competency
Standards as provided in Attachment 2; and
4.7 Fully cooperate with other contractors and state employees. The Contractor shall not commit
or permit any act that interferes with the performance of any other ADHS Contractors or of state
employees.
5. Requirements:
The Contractor shall assure that their Subcontractor’s:
5.1 Have familiarity and compliance with applicable sub grantee responsibilities as outlined
below:
5.1.1 HRSA/HAB Fiscal Monitoring Standards
(http./hab.hrsa.gov/manageyougrant/files/fiscalmonitoringpartb.pdf),
5.1.2 Program Monitoring Standards
(http./hab.hrsa.gov/manageyougrant/files/programmonitoringpartb.pdf,)
5.1.3 Universal Standards
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Contract Number INTERGOVERNMENTAL AGREEMENT
SCOPE OF WORK
(http./hab.hrsa.gov/manageyougrant/files/fiscalmonitoringpartb.pdf)
Including compliance with requirements of the following documents:
5.1.3.1 Ryan White Part B Assurances;
5.1.3.2 45 CFR 74 or 45 CFR 92or 2 CFR215 or 230 or 220;
5.1.3.3 HHS Grant Policy Statement (Terms and Conditions); and
5.1.3.4 Notice of Grant Award terms.
5.1.4 Statement of Assurance, Attachment 4
5.1.5 Allowable Costs Certification, Attachment 5
5.2 Maintain compliance with all requirements of the Ryan White HIV/AIDS Treatment
Extension Act of 2009, found at (http./www.apo.gov/fdsys/pkg/PLAW-11pub187/content-
detail.htm) to include all applicable quality and program management standards, or
performance measures as required, established and defines by ADHS for the Program.
5.2.1 Based on HRSA materials dated April 2012; Ryan White Part A providers who
provide services covered by Medicaid must be a Medicaid provider and must
maintain files documenting compliance with this requirement. The Ryan White
HIV/AIDS Program legislation, Section 2604(g), describes thee as “any such
service that is available pursuant to the State plan approved under title XIX of the
Social Security Act for the State.” This is related to Ryan White funds being used
as payee of last resort.
6. Approvals
6.1 The following activities or elements of the program and service categories require prior
approval by the ADHS Ryan White Program Manager for any instance during the full term of
the Agreement:
Modification of program, based on evaluation and justified as program improvement;
6.1.1 Changes to implementation of the program goals, objectives and activities;
6.1.1.1 All materials developed or used by the program shall be approved by the ADHS
prior to use. Exhibit 2, Materials Review Standards. Complete Attachment 3,
Materials Review Acceptance
6.1.2 Shifts of funding in either budget amounts or lines, See Exhibit 3
6.1.3 Subcontractors, including but not limited to, budgets and agreements;
6.1.4 Changes in key personnel as described in the Agreement; and
6.1.5 Out of State travel is an allowable expense with ADHS prior approval.
6.1.6 The Ryan White Part B Care and Services Manager in the Office of Disease
Integration and Services, or their designee, upon completion, submission, and
approval of all deliverables and reporting requirements will accept the quarterly
Contractor Expenditure Report.
7. Deliverables
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Contract Number INTERGOVERNMENTAL AGREEMENT
SCOPE OF WORK
The Contractor shall submit to ADHS the following deliverables.
Deliverable Name Deliverable Due Date Submit to:
Contactor’s Expenditure and Thirty (30) days after month or Fiscal Manager
Activity Report quarter identified in Claim for
services rendered.
Quarterly Management Plan Annually Qualtiy Manager
Annual Budget Projection Annually Fiscal Manager
Care Continuum by Service Annually Program and Quality
Category Manger
8. Notices, Correspondence and Reports:
8.1. Notices, Correspondence and Reports from the Contractor to ADHS shall be sent to:
Arizona Department of Health Services
Office of Disease Integration and Services
Attn: Care and Services Program Manager
150 N. 18th Avenue, Suite #130
Phoenix, AZ 85007
Telephone Number: 602-364-3610
Facsimile Number: 602-364-3263
E-mail: Carmen.Batista@azdhs.gov
8.2. Notices, Correspondence and Payments from the ADHS to the Contractor shall be sent
to:
Maricopa County, Ryan White Part A Program
Attn: RWPA Program Manager
301 W. Jefferson, Suite 3200
Phoenix, AZ 85003
Telephone Number: 602-506-5341
Facsimile Number: 602-506-6300
E-mail: RyanWhitePartA@mail.maricopa.gov
25

populations. Shared, aggregate level data will be used primarily for evaluation.
Data Elements Requested:
The following data elements are for detecting the current status and developing responses t
Contract Number appear. INTERGOVERNMENTAL AGREEMENT
PRICE SHEET/FEE SCHEDULE
Monthly or Quarterly Reports and Annual Summary Report
1. List of all service categories that RWPA is requesting funding for from RWPB to sup
2. Aggregate data related to each service category funding request including:
i. Number of Clients that were served during the timeframe;
See attachment 6, RW Part B Budget
ii. Types of services provided with Part B funds by definition of service;
Cost Annual Amount
iii. Total amount of funding requested; and
Core Services Personnel/ERE $0
Core Services Delivered iv. Certification $730,000 from RWPA Program Manager that all RWPA funds for the ser
expended prior to requesting Part B funds.
Support Services Personnel/ERE v. Care $0 Continuum data will be by service category provided on an annual bas
Support Services Delivered $22,000
Administration Personnel/ERE $0
Administration Services Delivered Agreed to on behalf $8,000 of Arizona Department of Health Services, Ryan White Part B Progr
Total not to exceed: $760,000
by: __________________________________________________________ Date ________
Agreed to on behalf of Maricopa County Ryan White Part A Program:
by: __________________________________________________________ Date: ________