HEALTHY START WITH MIHS AMD 3 (03).PDF

CONTRACT NO: C-86-15-076-3-03 AMENDMENT NO: 3
AMENDMENT TO
INTERGOVERNMENTAL AGREEMENT (IGA)
Between
MARICOPA COUNTY By and Through the
DEPARTMENT OF PUBLIC HEALTH
4041 N Central Avenue, Suite 1400
Phoenix, Arizona 85012, and
Maricopa County Special Healthcare District
dba Maricopa County Integrated Health Systems (MINS)
I. The above named IGA is hereby amended as specified below:
A. Page 1 ; Item 3: Agreement amount is changed to an aggregate, not-to-exceed
amount from $375,234 to $575,957 (increased by $200,723 for the budget period
November 1,2016 through October 31, 2017);
B. Year 3 Budget is replaced with the revised year 3 budget (Exhibit A). The year 3
budget is for a total of 8200,723.
C. Section III, 4, Add item K: South Phoenix Healthy Start (SPHS) will work alongside
MIHS's care coordination team to provide support services for pregnant and
postpartum patients eligible for enrollment in the Healthy Start Home Visitation
Program through the County. Services shall be provided in a private setting to
protect confidentiality, either before or after patient's provider appointment.
D. Section III, 4, Add item L: SPHS will assist eligible patients with enrollment into the
Healthy Start home visitation program to support prenatal and postpartum
education and care/support for patient.
E. Section III, 4, Add item M: 1-3 SPHS staff members will work at the
Comprehensive Health Center, Maryville, South Central, Seventh Avenue, and
Prendergast Clinics for no more than a combined total of 15 hours a week.
All other terms and conditions of the original IGA and its Amendments shall remain in
full force and effect,
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IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF
MARICOPA COUNTY MARICOPA COUNTY INTEGRATED
HEALTH SYSTEMS (MIHS)
By: By:
Clint Hickman, Chairman
Board of Supervisors
Date Date
ATTEST ATTEST
Clerk of the Board
Date Date
APPROVED AS TO FORM APPROVED AS TO FORM
Attorney for Maricopa County
Date Date
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Healthy Start Year 3 Budget ATTACHMENT A
MarIcopa Integrated Health System
1111/2016-10/31/2017
CFDA 93.926 Grant 90-15-125-1
Line Item Year 3 Total Budget
Program Personnel Annual Salary % FTE
Program Coordinator - Kohn Wright (0.5 FTE) $61,006 0.50 $30,503 $30,503
Community Health Worker - Monika Khadka (1.0 FTE) $34,486 1.00 $34,486 $34,486
Care Coordinator - Sandra Panama (1,0 FTE) $53,560 1,00 $53,560 $53,560
Epic Report Writer - $72,800 0.05 $4,000 $4,000
Total Personnel $122,549 $122,549
Fringe Benefits Fringe %
Program Coordinator. Kell! Wright (0.5 FTE) 38.8% $11,843 $11,843
Community Health Worker - Monika Khadka (1.0 FTE) 39,4% $13,575 $13,575
Care Coordinator - Sandra Panama (1.0 FTE) 39.8% $21,335 $21,335
Epic Report Writer - 32.0% $1,281 $1,281
Sub-total Fringe Benefits 39.2% $48,034 $48,034
Travel -
Travel Expense $2,727 $2,727
$0
Total Travel $2,727 $2,727
Equipment
Total Equipment $0 $0
Supplies. .
Mileage Reimbursement $1,690 $1,690
Educational Supplies $4,400 $4 1 400
Professional Development $1,005 $1,005
Total Supplies $7,095 $7,095
Contractual/Subcontracts Base % FTE
District Medical Group - Medical Oversight - Dr. Coonrod $185 1 099 0.010 $1,780 $1,780
District Medical Group - Domestic Violence Training - $60,403 0.005 $290 $290
Yolanda Alonzo
Subtotal Contractual/Subcontracts 0.01 $2,070 $2,070
Subtotal Fringe Benefits $0 $0
Total Contractual/Subcontracts $2,070 $2,070
Other
Total Other $0 $0
Total Direct Expenses $182,475 $182,475
Indirect Expenses 10.0% $18,248 $18,248
Total Requested Grant Funds $200,723 $200,723
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