ADHS16-108068 FOR CHILDHOOD AND ADOLESCENT OBESITY PREVENTION AMD 1 (01).PDF

Maricopa County — Formal (2016-10-19)

Extracted text (via pymupdf_layout) 11219 characters

C-86-16-049-3-01
ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) 150 N. 18th Avenue, Suite #280
Phoenix, Arizona 85007
AMENDMENT (602) 542-1040
PROCUREMENT OFFICER
CONTRACT No.: ADHS16-108068 AMENDMENT No.: 1 Jacqueline S. Ortega-Avila
CHILDHOOD AND ADOLESCENT OBESITY PREVENTION PROGRAM
Effective upon signature, it is mutually agreed that the Intergovernmental Agreement (IGA) referenced is amended
as follows:
1. Pursuant to the Terms and Conditions, Provision Six (6), Contract Changes, Item 6.1, Amendments, Purchase
Orders and Change Orders, the Scope of Services is hereby revised and replaced with the Scope of Services of
this Amendment One (1).
2. Pursuant to the Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders
and Change Orders, the Original Price Sheet is revised and replaced with the Price Sheet of this Amendment One
(1).
3. In ProcureAZ the “Items” Tab of the Master Blanket Purchase Order will be revised to reflect the pricing upon
execution of this Amendment One (1).
CONTINUED ON NEXT PAGE
CONTRACTOR SIGNATURE
Maricopa County by and through its
Maricopa County Department of Public Health
Community Wellness And Health Promotion
Contractor Name Authorized Signature
4041 North Central Avenue, Suite 600 Clint Hickman
Address Printed Name
Phoenix Arizona 85012 Chairman, Board of Supervisors
City State Zip Title
CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be effective the
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney date indicated. The Public Agency is hereby cautioned not to commence
has determined that this Intergovernmental Agreement is in proper form any billable work or provide any material, service or construction under
and is within the powers and authority granted under the laws of the this IGA until the IGA has been executed by an authorized ADHS
State of Arizona. signatory.
State of Arizona
Signed this ______ day of _______________________ 20___ 16
Signature Date
Printed Name Procurement Officer
Attorney General Contract No. P0012014000078, which is an RESERVED FOR USE BY THE SECRETARY OF STATE
Agreement between public agencies, has been reviewed pursuant to
A.R.S. § 11-952 by the undersigned Assistant Attorney General, who Under House Bill 2011, A.R.S. § 11-952
has determined that it is in proper form and is within the powers and
authority granted under the laws of the State of Arizona. was amended to remove the requirement
that Intergovernmental Agreements be filed
with the Secretary of State.
Signature Date
Assistant Attorney General
Printed Name:
ATTEST:_________________________________
Clerk of the Board

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) 150 N. 18th Avenue, Suite #280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
CONTRACT No.: ADHS16-108068 AMENDMENT No.: 1 Jacqueline PROCUREMENT S. Ortega-Avila OFFICER
1. Background.
1.1 The Arizona Department of Health Services (ADHS), Bureau of Nutrition and Physical Activity’s (BNPA) Empower
Program has the responsibility for directing the Childhood and Adolescent Obesity Prevention Program contract
with funding provided by the State Attorney General’s Office. This initiative will target children birth through age
twelve (12) by means of training and technical assistance services provided to over three-hundred (300) licensed
Child Care Group Homes (CCGH) through a Contract with the Maricopa County Department of Public Health
(Contractor).
2. Objective.
2.1 Facilitate targeted training to CCGH providers throughout Arizona during face-to-face trainings and through
technical assistance and distribution of physical activity and family style meal and nutrition education resource kits;
and
2.2 Facilitate impactful, sustainable policy and practice improvements in CCGH programs for the purpose of childhood
obesity prevention.
3. Scope of Services.
The Contractor shall:
3.1 Distribute physical activity and family style meal and nutrition education resource kits and targeted training to
CCGH providers during face-to-face trainings over the two (2) year period (May 1, 2015 to April 30, 2017); and
3.2 Provide technical assistance in person or through electronic or telephonic means for providers that will be unable
to attend the regional trainings, either due to travel, staffing, or other limitations.
4. Tasks.
The Contractor shall:
4.1 Attend stakeholder and planning meetings with ADHS on an as needed basis;
4.2 Implement a communications plan to engage with key informants through in-person or phone interviews to
understand the CCGH providers’ capacity for implementing obesity prevention strategies leading to policy and
system changes;
4.3 Attend training from ADHS on the implementation of the nutrition and physical activity strategies consistent with the
Empower standards;
4.4 Implement a communications plan to inform the CCGH providers of specialized regional trainings and technical
assistance opportunities. Communications may include newsletters, success stories, professional development
opportunities, and other meaningful content identified by key informants;
4.5 Facilitate face-to-face trainings over a two (2) year period;
4.6 Provide local community resource referral lists to CCGH providers and families seeking services that the
Contractor is unable to provide, and that will promote sustainability once the Contractor is no longer available;
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) 150 N. 18th Avenue, Suite #280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
CONTRACT No.: ADHS16-108068 AMENDMENT No.: 1 Jacqueline PROCUREMENT S. Ortega-Avila OFFICER
4.7 Provide targeted technical assistance (in English or Spanish) to CCGHs as follow-up to training and for those that
do not attend a face-to-face training;
4.8 Distribute resource kits to support family style meals/healthy eating promotion and physical activity to each
participating CCGH and provide training on use of the kits;
4.9 Write and provide monthly status reports on or by the 15th of each month, beginning November 15, 2015 through
April 15, 2017; and
4.10 Write and provide an Annual Report on or by April 15, 2016 and April 15, 2017.
5. State Provided Tasks.
ADHS will:
5.1 Conduct stakeholder meetings to identify opportunities for applications of lessons learned with CCGH targeted
Empower model into DES Certified family child care homes;
5.2 Develop content for and order resource kits to support family style meals/healthy eating promotion and physical
activity;
5.3 Provide training and technical assistance to the Contractor on the implementation of the nutrition and physical
activity strategies consistent with the Empower standards;
5.4 Develop, with input from the evaluator and the Contractor, a communications plan to engage with key informant
interviews (phone or in person) to explore the CCGH participants’ capacity for implementing strategies, barriers
and lessons learned;
5.5 Develop and contribute to the communications plan to inform the CCGH providers of specialized face-to-face
trainings and technical assistance opportunities. Communications may include newsletters, success stories,
professional development opportunities, and other meaningful content identified by key informants;
5.6 Attend at least one (1) of the face-to-face trainings each year; and
5.7 Review the Contractor’s progress reports and provides feedback and guidance electronically or in-person.
6. Requirements.
The Contractor shall:
6.1 Provide one (1) bilingual child care health specialist to provide oversight of the delivery of the goals, objectives and
outcomes of the program during outreach activities;
6.1.1 Attend and facilitate all CCGH trainings;
6.1.2 Provide technical assistance to CCGH, as needed, prioritizing those that do not attend in-person training,
including site visits, email, and phone calls; and
6.1.3 Perform in-state travel which is required to provide training and attend training sessions and program
related meetings.
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) 150 N. 18th Avenue, Suite #280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
CONTRACT No.: ADHS16-108068 AMENDMENT No.: 1 Jacqueline PROCUREMENT S. Ortega-Avila OFFICER
7. Deliverables.
The Contractor shall submit to ADHS:
7.1 CCGH Providers’ Key Informant Interview Communication Log for year one of the contract
7.2 Training Communication Log
7.2.1 Attendance Logs and Evaluations for face-to-face Trainings of all CCGHs over a two (2) year period;
7.3 State Community Resource Referral List(s) Distribution Log;
7.4 Technical Assistance Log;
7.5 Resource Kit Distribution Log;
7.6 Monthly Status Reports (including updated logs listed above and lessons learned); and
7.7 Annual Reports.
8. Delivery Schedule and Timeline.
8.1 Monthly, by the 15th of each month, beginning November 15, 2015 through April 15, 2017
8.1.1 CCGH Providers’ Key Informant Interview Communication Log for year one of the contract; and
8.1.2 Training Communication Log;
8.1.3 Face-to-face Trainings, Attendance Logs and Evaluations;
8.1.4 State Community Resource Referral List(s) Distribution Log;
8.1.5 Technical Assistance Log; and
8.1.6 Resource Kit Distribution Log.
8.2 Annual Reports, due April 15, 2016 and April 15, 2017
Status Report Totals;
8.2.1 Summary of overall strengths and suggested improvements to the model; and
8.2.2 Opportunities for applications of lessons learned with CCGH targeted Empower model into DES Certified
family child care homes.
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) 150 N. 18th Avenue, Suite #280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
CONTRACT No.: ADHS16-108068 AMENDMENT No.: 1 Jacqueline PROCUREMENT S. Ortega-Avila OFFICER
REVISED PRICE SHEET
YEAR TWO (2)
PROCUREAZ SERVICE DESCRIPTION QUANTITY UOM UNIT ANNUAL
LINE ITEM COST TOTAL
1.0 FACE-TO-FACE TRAININGS OF A CCGH (WITH 130 EACH $782.38 $101,710.00
AV AND REFRESHMENTS FOR GROUPS)
TOTAL $101,710.00
ALL OTHER PROVISIONS OF THIS AGREEMENT SHALL REMAIN IN THEIR ENTIRETY.
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