ADHS WITH OPR FOR ZIKA (01).PDF

Maricopa County — Formal (2016-11-16)

Extracted text (via pymupdf_layout) 14739 characters

C-86-16-112-3-01
ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 1 Procurement Officer:
Russell Coplen
Emergency Preparedness Program
Effective upon signature, it is mutually agreed that the Agreement referenced above is amended as follows:
1. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, the Scope of Services is revised to add Scope of Services, Attachment A, of this Amendment One
(1).
2. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, the Scope of Services is revised to add Scope of Services, Attachment B, of this Amendment One
(1).
3. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, the Price Sheet is revised to add the Price Sheet of this Amendment One (1).
All other provisions shall remain in their entirety.
CONTRACTOR SIGNATURE
Maricopa County
Contractor Name Contractor Authorized Signature
4041 N. Central Ave. Suite 1400 Clint Hickman
Address Printed Name
Phoenix AZ 85012 Chairman, Board of Supervisors
City State Zip Title
CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be
Pursuant to A.R.S. § 11-952, the undersigned public effective the date indicated. The Public Agency is hereby
agency attorney has determined that this cautioned not to commence any billable work or provide
Intergovernmental Agreement is in proper form and is any material, service or construction under this IGA until
within the powers and authority granted under the laws of the IGA has been executed by an authorized ADHS
the State of Arizona. signatory.
State of Arizona
Signed this _________ day of _________________ 2016
Signature Date
Printed Name Procurement Officer
Attorney General Contract No. P0012014000078, which
is an Agreement between public agencies, has been
reviewed pursuant to A.R.S. § 11-952 by the undersigned
Assistant Attorney General, who has determined that it is
in proper form and is within the powers and authority
granted under the laws of the State of Arizona.
Signature Date
Assistant Attorney General
Printed Name:
ATTEST:________________________________, Clerk of the Board
Page 1 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 1 Procurement Officer:
Russell Coplen
Attachment A
Scope of Services
Emergency Preparedness Program
July 1, 2016 to June 30, 2017
1. BACKGROUND
As of April 11, 2016, local vector-borne transmission of Zika virus was identified in more than 40 countries and
U.S. territories in the Americas, including Puerto Rico, U.S. Virgin Islands, Marshall Islands, and American
Samoa. To date, Zika has spread by mosquitoes in the continental United States has only been documented in
Florida, but travel-associated cases are being reported nationwide. CDC continues to evaluate cases of Zika
transmission in the United States and U.S. territories and has developed response plans to reduce the spread of
ZVD associated with Aedes aegypti and Aedes albopictus mosquitoes and minimize maternal-fetal transmission
of Zika virus. As the recipient of Zika supplemental funding (Sub-awardee) from the Arizona Department of
Health Services (ADHS), your organization is required to adhere to Federal and State grant requirements.
2. DELIVERABLES
2.1. Budget Allocation
2.1.1. Complete the budget tool and work plan attached and return to ADHS for review and approval no later
than July 31st, 2016. ADHS will not release funding until the work plan and budget tool have been
approved.
2.1.2. All activities and procurements funded through this grant shall be aligned with your budget tool and
activities that are not specifically identified within the budget tool must be approved by ADHS before
the funds are utilized on those activities/items.
2.1.3. Applicable Office of Management and Budget (OMB) Circulars and Cost Principles must be followed
when developing the budget and throughout the period of performance.
2.2. Grant Activity Oversight
2.2.1. Your organization’s PHEP Coordinator will be the main point of contact for ADHS in regards to this
grant. This individual will work closely with ADHS to ensure all deliverables and requirements are
met, and will also direct all activities surrounding any onsite monitoring visits.
2.3. Performance
2.3.1. Failure to meet the deliverables and performance measures described in the Scope of Work may
result in a reimbursement of funds to ADHS by the sub-awardee.
2.3.2. At the end of the performance period, July 30, 2018, any unexpended funds that have been
awarded to sub-awardees for approved activities are subject to be returned to ADHS.
3. ACTIVITIES
3.1. Specific Activities Relating to this Zika Grant
3.1.1. Activity 1: Community Preparedness Strengthen Public Health Incident Management and Emergency
Operations Coordination.
Page 2 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 1 Procurement Officer:
Russell Coplen
3.1.1.1. Sub-Awardee Output Requirements:
3.1.1.1.1. The Sub-awardee shall collaborate with state and local partners to evaluate and
clarify elements from the state Arboviral Response Plan;
3.1.1.1.2. If one or more locally-acquired Zika case(s) if identified, develop a Zika specific
AAR/IP that addresses the Sub-awardee’s respective jurisdiction’s actions; and
3.1.1.1.3. Development of comprehensive Arbovirus readiness, response and/or recovery
plans.
3.1.2. Activity 2: Public Health Surveillance And Epidemiological Investigation
3.1.2.1. Sub-Awardee Output Requirements:
3.1.2.1.1. Create and/or update surveillance and investigation protocols to include Zika and
other emerging/exotic disease monitoring and surveillance that will be reviewed
with ADHS;
3.1.2.1.2. Identify personnel who are capable of conducting health surveillance and
epidemiological investigations for Zika and other emerging/exotic diseases; and
3.1.2.1.3. Attend ADHS sponsored “How To” trainings and an Infectious Disease Training and
Exercise that addresses epidemiology, disease surveillance, investigation and
control measures and emerging public health issues.
3.1.3. Activity 6A: Emergency Public Information And Warning/Information Sharing
3.1.3.1. Sub-Awardee Output Requirements:
3.1.3.1.1. Participate in the development of Zika messaging; e.g. talking points and message
maps; and
3.1.3.1.2. Participate in ADHS offered spokesperson training to address public and media
inquiries related to Zika cases.
3.1.4. Activity 6B: Emergency Public Information And Warning/Information Sharing (Webeoc)
3.1.4.1. Sub-Awardee Output Requirements:
3.1.4.1.1. Utilize mobile technology (e.g. AZ Infectious Disease Resource mobile app)
allowing access to disease information and the ability to receive alert messaging
on hand held devices.
3.1.5. Activity 7: Medical Surge
3.1.5.1. Sub-Awardee Output Requirements:
3.1.5.1.1. Contribute to the collaboration among hospital, ambulatory facilities, county and
tribal public health, schools, public safety agencies, non-profit organizations,
community based special events and the community at large to respond to
infectious disease threats;
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 1 Procurement Officer:
Russell Coplen
Attachment B
Scope of Services
Epidemiology and Disease Control - Zika Counties
August 1, 2016 to July 31, 2017
1. BACKGROUND
1.1. With the increase of emerging infectious diseases such as Zika, local public health partners should maintain
the capacity for surveillance, investigation and control of infectious diseases and public health incidents.
1.2. The first section of this document will outline the requirements set forth by Center for Disease Control (CDC)
and ADHS that all County partners will need to address to ensure they are met during the reporting period.
Progress on these requirements will be measured throughout the year through frequent communication and
mid-year reporting.
1.3. Electronic exchange of personal health information should meet applicable patient privacy-related laws and
standards, including state or territorial laws. These include the Health Insurance Portability and
Accountability Act, the Health Information Technology for Economic and Clinical Health Act, and standards
from the National Institute of Standards and Technology and the Office of the National Coordinator for Health
Information Technology of the U.S. Department of Health and Human Services.
2. REQUIREMENTS
2.1. As a recipient of Epidemiology and Laboratory Capacity (ELC) Zika funds from the Arizona Department of
Health Services (ADHS), you are required to adhere to Federal and State grant requirements. Below you will
find a list of the program requirements for the funding.
2.1.1. County shall investigate 100% of suspected cases of Zika and provide public health actions.
2.1.1.1. Public health actions could include, but are not limited to:
2.1.1.1.1. Vector control strategies as new cases are identified;
2.1.1.1.2. Education about mosquito abatement;
2.1.1.1.3. Education about mosquito bite prevention;
2.1.1.1.4. Education about sexual transmission;
2.1.2. County shall create a Zika protocol within 90 days of receiving funds and share on the Health
Services Portal (HSP) with ADHS.
2.1.2.1. Zika protocol must include:
2.1.2.1.1. Public health investigation: case investigation processes, contact lists, etc.
2.1.2.1.2. Case Follow-Up: follow up of women and infants in the pregnancy or birth defects
registries
2.1.2.1.3. Communication: messaging templates, educational materials, etc.
2.1.2.1.4. Vector Control: processes and thresholds for mosquito surveillance, environmental
assessment, mosquito control, etc.
Page 5 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 1 Procurement Officer:
Russell Coplen
2.1.2.1.5. Laboratory: specimen collection, transport to ASPHL, etc.
2.1.2.2. Acceptable uses of funding include, but are not limited to:
2.1.2.2.1. Hiring staff or contractors to support the activities of the jurisdiction’s Zika protocol
2.1.2.2.2. Developing, printing and/or disseminating educational materials for providers or
the public
2.1.2.2.3. Ordering equipment for mosquito trapping or control. (ADHS has received funding
to provide mosquito trapping equipment to local health departments and to
develop an educational media campaign).
2.1.3. At the end of the performance period, July 30, 2018, any unexpended funds that have been
awarded to sub-awardees for approved activities are subject to be returned to ADHS.
3. REPORTING DELIVERABLES
3.1. The Contractor shall:
3.1.1. Deliverables and activities funded through the ELC Zika funds must be reported in a timely manner
to ensure ADHS has adequate time to compile the information and submit to CDC.
3.1.2. Zika Interim Report. ADHS will send out the Report template in advance of the Due Date. DUE
DATE: April 1st, 2017.
4. NOTICES, CORRESPONDENCE, AND REPORTS
4.1. Notices, Correspondence and Program Reports from the Contractor to ADHS shall be sent to:
Bureau of Epidemiology and Disease Control
Infectious Disease Epidemiology Program Manager
150 N 18 th Avenue Ste.140
Phoenix, AZ 85007
CER Invoices shall be sent to:
Bureau of Epidemiology and Disease Control
Infectious Disease Epidemiology Program Manager
150 N 18 th Avenue Ste.140
Phoenix, AZ 85007
4.2. Notices, Correspondence and Reports from the ADHS to the Contractor shall be sent to:
Maricopa County Health Department
4041 N. Central Ave. Suite 1400
Phoenix, AZ 85012
Attn: Mitchell Lach
Phone: 602-372-2657
Mitchelllach@mail.maricopa.gov
4.3. Payments from ADHS to the Contractor shall be sent to the “Remit To” Address listed on the Contractor’s
ProcureAZ vendor profile.
Page 6 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 1 Procurement Officer:
Russell Coplen
PRICE SHEET
PHEP Zika Funding
July 1, 2016 through June 30, 2017
Fixed Price
Description Quantity Unit Rate Total Cost
Attachment A
1 $44,000.00 $44,000.00
Deliverables and Activities per the Scope of Work
EDC Zika Funding
August 1, 2016 through July 31, 2017
Fixed Price
Description Quantity Unit Rate Total Cost
Attachment B
1 $313,810.00 $313,810.00
Deliverables and Activities per the Scope of Work
CARRYOVER PHEP Ebola Funding
July 1, 2016 through June 30, 2017
Cost Reimbursement
Description Quantity Unit Rate Total Cost
Deliverables and Activities per the Scope of Work
1 $280,132.70 $280,132.66
Contract ADHS12-007891, Amendment 11
TOTAL $637,942.66
Page 7 of 7