AMD NO 1 ADHS16-102232 RE HEALTHY PHC WITH ADHS.PDF

Chairman, Maricopa County Board of Supervisors
ATTEST:
___________________________________________
Clerk of the Board Date

ARIZONA DEPARTMENT OF
HEALTH SERVICES
,fliid1111114, INTERGOVERNMENTAL AGREEMENT(IGA) 1740W Adams, Room 303
AMENDMENT Phoenix, Arizona 85007
_..,\ ,,Az4,:e., •,f,,:: (602) 542-1040
(602) 542-1741 Fax
540;rif# Contract No: ADHS16-102232 Amendment No 1 Procurement Tracey Thomas Officer:
MARICOPA COUNTY
PRICE SHEET PHASE ONE (1)
PHASE 1: JULY 1,2015 - JUNE 30, 2016
PHASE ONE (1) ACTION PLAN (Tobacco and Chronic Disease)
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
Phase 1 Action Plan Tobacco and Chronic EA 1 $110,561,00 $110,561 00
Disease
TOTAL 1 $110,561.00 $110,561.00
TOBACCO
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service
Strategies (i e Prevention, QTR 4 $488,404.38 $1,953,617 52
Cessation, Secondhand Smoke,
Enforcement)
TOTAL 4 $488,404.38 $1,953,617.52
CHRONIC DISEASE
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service
Strategies (i.e. Alzheimer's,
Chronic Pulmonary Disease, QTR 4 $38761.82 $147,046 48
Hypertension, Self-Management,
School Health)
TOTAL 4 $36,761.62 $147,046.48
PHASE ONE ) ACTION PLAN (HAPI)
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
Phase 1 Action Plan HAPI EA 1 $9,200.00 $9,200.00
TOTAL 1 $9,200.00 $9,200.00
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ARIZONA DEPARTMENT OF
iiisIfflei HEALTH SERVICES
60,1— ,4PAIIMIC0/, 0 INTERGOVERNMENTAL AGREEMENT(IGA) 1740W Adams, Room 303
AMENDMENT AMENDMENT Phoenix, Arizona 65007
(602) 542-1040
%. • , ,,,,,,_ • (602)542.1741 Fax
Contract No. Amendment No. 1 Procurement Tracey Thomas Officer:
HEALTH IN ARIZONA POLICY INITIATIVE
ITEMISERVICE DESCRIPTION UNIT OF NUMBER r UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service
Strategies (i.e. Procurement,
Healthy Community Design, QTR 4 $97,425 00 $389,700 00
School Health, Worksite
Wellness, Clinical Care, and
Special Health Care Needs)
TOTAL 4 $97,425.00 $389,700.00
PHASE ONE (1) ACTION PLAN HEALTHY ARIZONA WORKSITE PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
Phase 1 Action Plan HAWP EA 1 $16,962.00 $16,962.00
TOTAL 1 $16,962.00 $16,962.00
HEALTHY ARIZONA WORKSITE PROGRAM
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service QTR 4 $80,572.00 $322,288.00
Strategies
TOTAL 4 $80,572.00 $322,288.00
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ARIZONA DEPARTMENT OF
iMef INTERGOVERNMENTAL AGREEMENT(IGA) 1740 HEALTH W. Adams, SERVICES Ftoom 303
• — . AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
. (602) 542-1741 Fax
Contract No: ADHS16-102232 Amendment No. 1 Pr ocurernent Tracey Thomas Officer:
MARICOPA COUNTY
PRICE SHEET PHASE (2)
PHASE 2: OCTOBER 1, 2016 —JUNE 30, 2016
PHASE TWO (2) ACTION PLAN
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
Phase 2 Action Plan EA 1 $7,000.00 $7000.00
TOTAL 1 $7,000.00 $7,000.00
PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service
Strategies (I e. Fees for
Accreditation, Quality Improvement
Projects, Workforce Development QTR 3 $80,000 00 $240,000.00
Implementation, Performance
Management Documentation,
Progress Toward County Health
Improvement Plan)
TOTAL 3 $80,000.00 $240,000.00
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ARIZONA DEPARTMENT OF
, ,4+),AiiIet, iN INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
1740w Adams. Room 303
ft ' — Ili AMENDMENT AMENDMENT Phoenix, Arizona 65007
(602) 542-1040
(602) 542-1741 Fax
Contract No: Amendment No. 1 Procurement Tracey Thomas Officer:
MARICOPA COUNTY
PRICE SHEET PHASE THREE (3)
PHASE 3: JANUARY 1, 2016 - JUNE 30, 2016
PHASE THREE (3) ACTION PLAN (Maternal Child Health)
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
Phase 3 — Action Plan — Maternal EA 1 $50,000.00 $50,000.00
Child Health
TOTAL 1 $50,000.00 $50,000.00
MATERNAL CHILD HEALTH
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service QTR 2 $50 1000.00 $10000000
Strategies (i.e. Exhibit G 1.1.1)
TOTAL 2 $50,000.00 $100,000.00
ACTION PLAN (Teen Pregnancy Prevention)
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
Phase 3 — Action Plan — Teen EA 1 $38,30600 $3830600
Pregnancy Prevention
TOTAL 1 $38,306.00 $38,306.00
TEEN PREGNANCY PREVENTION
ITEM/SERVICE DESCRIPTION UNIT OF NUMBER UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service QTR 2 $38,306.25 $76,612 50
Strategies (i.e. Exhibit E 1.1 1)
TOTAL 2 $38„306.25 $76,612.50
PHASE ONE (1), PHASE TWO (2) AND PHASE THREE (3) GRAND TOTAL
ITEM/SERVICE DESCRIPTION TOTAL
GRAND TOTAL $3A61,293.50
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