AMD RE PUBLIC HEALTH IN ACTION WITH ADHS.PDF

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Avenue Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Officer:
Agreement No: ADHS16-114422 Amendment No. 1
Russell Coplen
Public Health in Action: Advancing Strategies to Sustain Healthy Communities
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 and replaced with the Scope of Services 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 Price Sheet is revised and replaced with the Price Sheet of this Amendment One (1).
All other provisions shall remain in their entirety.
CONTRACTOR SIGNATURE
Maricopa County by and through its,
Maricopa County Department of Public Health
Contractor Name Contractor Authorized Signature
4041 N. Central Ave. Clint L. Hickman
Address Printed Name
Phoenix AZ 85012 Chairman, Maricopa County Board of upervisors
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
has determined that this Intergovernmental Agreement is in proper form commence any billable work or provide any material, service or
and is within the powers and authority granted under the laws of the construction under this IGA until the IGA has been executed by an
State of Arizona. authorized ADHS 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 Date Page 1 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Avenue Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS16-114422 Amendment No. 1 Procurement Officer:
Russell Coplen
1. BACKGROUND
1.1. The Arizona Department of Health Services (ADHS) Division of Prevention Services (DPS) received
the CDC-RFA-DP13-1305 State Public Health Actions to Prevent and Control Diabetes, Heart Disease,
Obesity and Associated Risk Factors and Promote School Health Cooperative Agreement (Grant
Number: 1 U58 DP004793.01), a 5 year project that is contingent upon federal appropriations. The
overall purpose of the Centers for Disease Control and Prevention (CDC) Cooperative Agreement is to
support State Health Departments which implement targeted strategies resulting in measureable
impacts addressing school health, nutrition and physical activity, obesity, diabetes and heart disease
and stroke prevention. The long term outcome of the program is to “improve prevention and control of
hypertension, diabetes, and overweight and obesity.” The enhanced component of the CDC
Cooperative Agreement addresses the following three (3) areas of CDC’s Four (4) Chronic Disease
Prevention and Health Promotion Domains:
1.1.1. Domain 2 (Environmental Approaches that Promote Health): Environmental approaches that
promote health and support and reinforce healthful behaviors (statewide in schools, worksites,
and communities):
1.1.2. Domain 3 (Health Systems Interventions): Health Systems interventions to improve the
effective delivery and use of clinical and other preventive services in order to prevent disease,
detect diseases early, and reduce or eliminate risk factors and mitigate or manage
complications; and
1.1.3. Domain 4 (Community Clinical Linkages): Strategies to improve community-clinical linkages
ensuring that communities support and clinics refer patients to programs that improve the
management of chronic conditions and meeting the management and emergency care needs
of students with chronic conditions.
1.2. The Public Health in Action Inter-Governmental Agreement (IGA) will fund a one-year collaborative
effort at the Local Health Department level that will result in “improved prevention and control of
hypertension, diabetes, and overweight and obesity.” Renewal for Years 4 through 5 of the IGA is
contingent upon federal appropriations.
2. SCOPE OF WORK
2.1. The IGA will address a variety of school health, nutrition and physical activity, obesity, diabetes and
heart disease and stroke prevention evidence-based strategies designed to impact performance
measures, and to promote county-wide health changes so that public health impact will be maximized.
Local Health Departments are expected to develop and implement a scope of work with strategies that
are in accordance with local community needs, and should emphasize complementary policy,
environmental, programmatic, and infrastructure activities that integrate and build on each other to
optimize health improvements. Strategies that influence policy, systems, or environmental change
practices (aka Public Health Approaches) are highly recommended. The Local Health Department will
select at a minimum one (1) of the strategies to be addressed (based on the strategies within the
enhanced component of Public Health in Action-1305 Work Plan):
2.1.1. Domain 2 (Environmental Approaches that Promote Health):
2.1.1.1. Strategy: Increase access to healthy food and beverages.
2.1.1.1.1. Intervention: Provide access to Farmers Markets.
2.1.1.2. Strategy: Increase access to breastfeeding friendly environments.
Page 2 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Avenue Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS16-114422 Amendment No. 1 Procurement Officer:
Russell Coplen
2.1.1.2.1. Intervention: Ensure workplace compliance with federal lactation
accommodation law.
2.1.1.3. Strategies: Create supportive nutrition environments in schools and implement
quality physical education and physical activity in K-12 schools. Interventions:
Implement policies and practices that create a supportive nutrition environment,
including establish standards (including sodium) for all competitive foods; prohibit
advertising of unhealthy foods; and promote healthy foods in schools, including those
sold and served within school meal programs and other venues. Develop, implement
and evaluate comprehensive school physical activity programs (CSPAP). CSPAP
includes quality physical education and physical activity programming before, during,
and after school, such as recess, classroom activity breaks, walk/bicycle to school,
physical activity clubs.
2.1.2. Domain 3 (Health Systems Interventions):
2.1.2.1. Strategy: Increase implementation of quality improvement processes in health systems
2.1.2.1.1. Intervention: Increase Electronic Health Record (EHR) adoption and the use
of health Information Technology (IT) to improve performance
2.1.2.1.2. Intervention: Increase the institutionalization and monitoring of
aggregated/standardized quality measures at the provider and systems level
2.1.3. Domain 4 (Community Clinical Linkages):
2.1.3.1. Strategy: Implement policies, processes, and protocols in schools to meet the
management and care needs of students with chronic conditions
2.1.3.1.1. Intervention: Identify and track students with chronic conditions that may
require daily or emergency management, e.g. asthma and food allergies
2.1.3.1.2. Intervention: Develop protocols that ensure students identified with a chronic
condition that may require daily or emergency management are enrolled into
private, state, or federally funded insurance programs, if eligible
2.1.3.1.3. Intervention: Provide assessment, counseling, and referrals to community
based medical care providers for students on activity, diet, and weight-
related chronic conditions
2.2. Maricopa County has selected the following target strategy(ies) for completion under this Agreement:
2.2.1. Domain 2 (Environmental Approaches that Promote Health):
2.2.1.1. Strategy: Increase access to healthy food and beverages
2.2.1.1.1. Intervention: Provide access to farmers Markets
2.2.1.2. Strategy: Increase access to breastfeeding friendly environments
2.2.1.2.1. Intervention: Ensure workplace compliance with federal lactation
accommodation law
Page 3 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Avenue Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS16-114422 Amendment No. 1 Procurement Officer:
Russell Coplen
3. TASK AND REQUIREMENTS
3.1. Minimum Staffing Competency. The Contractor shall:
3.1.1. Designate or dedicate staff with previous policy and/or public health experience to manage
and/or administer the program, and food policy and/or food access experience specific to an
understanding of Arizona farmers markets; worksite wellness experience through the Healthy
Arizona Worksite Program (HAWP); and school health index training. It is recommended that
the staff have an undergraduate degree from an accredited institution in related areas,
including, but not limited to nutrition, public health or a related field such as public policy or
public health administration.
3.2. Administrative Services. The Contractor shall:
3.2.1. Complete a brief narrative of the overall scope of the Farmers’ Market project including goals
and objectives relative to the identified strategy (ies) selected. Complete Attachment A by
listing activities, lead personnel, key partners, and timeframe to accomplish them building on
scope of project defined in narrative. (Performance measures will be listed by ADHS in
Attachment A)
3.2.2. Complete a logic model that includes outlining an evaluation design that will incorporate
performance measures for each strategy selected, including but not limited to those listed in
Attachment A if requested. The performance measures will be collected and reported at the
local health department level. Assistance in methodology, design, and planning will be
provided by ADHS, as needed.
3.2.3. Develop and submit a proposed budget for the funding cycle and/or any subsequent funding
years.
3.2.4. Submit biannual Contractor’s Expenditure Reports (CER).
3.2.5. Submit a mid-year and annual report based on evaluation of outcomes and objectives that
includes reporting of performance measures in Attachment A, cumulative year to date data of
strategy(ies) impacts for the funding cycle and/or any subsequent funding.
3.3. Breastfeeding Friendly Environments: Workplace Lactation Accommodation:
3.3.1. Collaborate with ADHS Contracted Breastfeeding Specialist to market the Making it Work:
Breastfeeding Accommodation Toolkit through providing presentations, toolkits, technical
assistance, and follow-up to businesses interested in working on workplace lactation
accommodation (ADHS will provide marketing materials to contractor).
3.3.2. Review requests for the Toolkit from an on-line survey (survey monkey) and fill orders within
two (2) weeks . (ADHS will supply the toolkits to contractor).
3.3.3. Contact businesses at the following intervals after providing toolkit: one (1) months, three (3)
months, six (6) months and one (1) year to collect data, answer questions, and offer technical
assistance provided by ADHS.
3.3.4. Document contact made and progress with businesses on the established Collection Form.
3.3.5. Work with ADHS to identify targeted populations and/or communities with the highest
documented burden of chronic disease.
Page 4 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Avenue Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS16-114422 Amendment No. 1 Procurement Officer:
Russell Coplen
3.3.6. Work and develop partnerships with State and community partners, such as: Arizona
Department of Economic Security, Arizona Department of Agriculture, ADHS tobacco/chronic
disease contractors, Women, Infant and Children (WIC) Local Agencies, tribal communities,
ADE’s Health & Nutrition team, local educational agencies, community health centers and
community based organizations, including those supporting students with chronic conditions,
present in the Local Health Departments, in order to fulfill developed action plan.
3.3.7. Implement strategy(ies) approved by ADHS.
3.3.8. Participate in conference calls and in–person meetings with ADHS, when scheduled.
3.3.9. Work in collaboration with the Arizona State University (ASU) School of Nutrition and Health
Promotion to leverage current research activities around the expansion of access to farmers
markets in Arizona.
3.3.10. Disseminate pilot study findings statewide for replication of services and approach throughout
Arizona.
3.3.11. The Contractor may:
3.3.11.1. Leverage program or policy activities with other currently funded initiatives and
3.3.11.2. Partner with other Local Health University(ies) on program or policy activities.
4. DELIVERABLES
4.1. The Contractor shall submit to ADHS:
4.1.1. Prepare and submit an annual action plan, no later than thirty (30) days following the contract
award.
4.1.2. Prepare and submit a logic model, no later than thirty (30) days following the contract award if
requested
4.1.3. Prepare and submit an evaluation design and methodology, no later than thirty (30) days
following the contract award to ADHS Program Manager for review and approval, prior to the
report of performance measures if requested.
4.1.4. Prepare and submit a proposed budget for the funding year and/or subsequent funding years
thirty (30) days following the contract award.
4.1.5. Complete monthly and quarterly report templates located in Dropbox for Farmers’ Market
Strategy according to instructions tab: monthly within ten (10) business days following the end
of the month; quarterly reports due October 2015, January 2016, April 2016, and July 2016
within ten (10) business days of the beginning of the month.
4.1.6. Prepare and submit a monthly report on the status of businesses that have requested and
received a Breastfeeding Accommodation Toolkit.
4.1.7. Prepare and submit a mid-year program report, no later than thirty (30) days following the end
of the contract mid-year.
Page 5 of 7

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Avenue Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS16-114422 Amendment No. 1 Procurement Officer:
Russell Coplen
4.1.8. Prepare and submit an annual program report, no later than forty-five (45) days following the
end of the contract.
4.1.9. Prepare and submit an individually signed electronic CER invoice, no later than thirty (30) days
following the contract mid-year;
4.1.10. Submit a final CER invoice for the program, no later than forty-five (45) days following the end
of each contract year.
4.1.11. Copies of all printed or broadcast media or any other educational and/or marketing materials
developed using funds awarded under this Intergovernmental Agreement (IGA) to the ADHS
Program Manager for review and approval.
4.1.12. The name, phone numbers, and resume of all program staff funded under this IGA are due
within thirty (30) days of hire, and should be sent to the ADHS Program Manager.
5. NOTICES, CORRESPONDENCE, AND REPORTS
5.1. Notices, Correspondence and Program Reports from the Contractor to ADHS shall be sent to:
Arizona Department of Health Services
Bureau of Health Systems Development
ATTN: Program Manager of the CDC Public Health in Actions Grant
Street Address: 150 North 18th Avenue, Suite 300
City, State, and Zip Code: Phoenix, Arizona 85007
Telephone: (602) 542-1219
Facsimile: (602) 542-2011
5.2. CER Invoices shall be sent to: Teresa.manygoats@azdhs.gov.
5.3. Notices, Correspondence and Reports from the ADHS to the Contractor shall be sent to:
Organization: Maricopa County Dept. of Public Health
Attention: Matthew Juan
Street Address: 4041 N. Central Ave. Suite 1400
City, State and Zip Code: Phoenix, AZ 85012
Telephone: 602-372-0674
Email: mattjuan@mail.maricopa.gov
5.4. 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 N. 18th Avenue Suite 280
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS16-114422 Amendment No. 1 Procurement Officer:
Russell Coplen
PRICE SHEET
Fixed Price beginning June 30, 2016 through June 29, 2017
Account Classification Number per Budget Unit Rate Total Cost
Period
Domain 2; Strategy 1.1;
Intervention 1.1.1 2 $25,000.00 $50,000.00
Domain 2; Strategy 1.2;
Intervention 1.2.1 2 $5,000.00 $10,000.00
TOTAL $60,000.00
Page 7 of 7