IGA AMD RE WIC BFPC AND FMNP WITH ADHS.PDF
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ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT (IGA) 1740 West Adams, Room 303 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 FAX Contract No.: ADHS14-053007 Amendment No.: 3 Procurement Officer: Jacqueline Ortega-Avila WIC, BFPC and FMNP SERVICES Effective October 1, 2015, it is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: 1. The WIC Price Sheet in Amendment Two (2) is hereby amended with the revised WIC Price Sheet of this Amendment Three (3). The total of the revised WIC Price Sheet budget amount is $10,489,246.00 with the following changes: 1.1. Personnel Costs Salary decreased by $199,424.00 due to a decrease in the caseload assigned and personnel. 1.2. Employee Related Expenses increased by $74,138.00 due to the increased of county costs of health benefits. 1.3. Professional and Outside Services increased by $4,000.00 to provide an outside presenter/facilitator for a customer service training for all personnel. 1.4. Travel Expenses increased by $2,100.00 due to mileage reimbursement. 1.5. Occupancy Expenses increased by $56,183.00 in rent due to moving one (1) clinic, added costs for printer use and maintenance. 1.6. Other Operating Expenses decreased by $158.00 due to adjusted operating expenses to stay within the budget. 1.7. Indirect increased by $56,768.00 due to increase in overall funding. 1.8. Registered Dietitian increased by $120,854.00 due to one (1) additional FTE in RD supplement. CONTINUED ON NEXT PAGE MARICOPA COUNTY by and through its, CONTRACTOR SIGNATURE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH Contractor Name Contractor Authorized Signature 4041 NORTH CENTRAL AVENUE, SUITE 1400 Steve Chucri Address Printed Name PHOENIX ARIZONA 85012 Chairman, Maricopa County 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 has date indicated. The Public Agency is hereby cautioned not to commence determined that this Intergovernmental Agreement is in proper form and is any billable work or provide any material, service or construction under within the powers and authority granted under the laws of Arizona. this IGA until the IGA has been executed by an authorized ADHS signatory. State of Arizona Signed this day of 2015 Signature Date Print Name Title Procurement Officer Attorney General Contract No.:P0012014000078, which is an Agreement RESERVED FOR USE BY THE SECRETARY OF STATE between public agencies, has been reviewed pursuant to A.R.S. § 11-952 by the undersigned Assistant Attorney, 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. Under House Bill 2011, A.R.S. § 11-952 was amended to remove the requirement that Intergovernmental Agreements be filed with the Secretary of State. Signature Date Assistant Attorney General Print Name Title ATTEST: ________________________________________ Page 1 of 5 Clerk of the Board Date ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT (IGA) 1740 West Adams, Room 303 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 FAX Contract No.: ADHS14-053007 Amendment No.: 3 Procurement Officer: Jacqueline Ortega-Avila 2. The BFPC Price Sheet in Amendment Two (2) is hereby amended with the revised BFPC Price Sheet of this Amendment Three (3). The total of the revised BFPC Price Sheet budget amount is $475,000.00 with the following changes: 2.1. Personnel Costs Salary decreased by $3,122.00 due to a decrease in the caseload assigned and personnel. 2.2. Employee Related Expenses decreased by $745.00 due to the increased of county costs of health benefits. 2.3. Travel Expenses decreased by $3,456.00 due to mileage costs allocated. 2.4. Other Operating Expenses increased by $3,750.00 due to additional air cards for internet access. 2.5. Indirect increased by $3,573.00 due to increase in overall funding. 3. The ONEDS Price Sheet in Amendment Two (2) is hereby amended with the revised ONEDS Price Sheet of this Amendment Three (3). The total of the revised ONEDS Price Sheet budget amount is $42,000.00 with the following changes: 3.1. Personnel Costs Salary increased by $10,600.00 due to increase in overall funding. 3.2. Employee Related Expenses increased by $3,622.00 due to increase in overall funding. 3.3. Travel Expenses remains the same at $1,300.00. 3.4. Indirect increased by $1,792.00 due to increase in overall funding. 4. In ProcureAZ the Contract pricing “Items” tab will be updated upon execution of this Amendment Three (3). Page 2 of 5 ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT (IGA) 1740 West Adams, Room 303 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 FAX Contract No.: ADHS14-053007 Amendment No.: 3 Procurement Officer: Jacqueline Ortega-Avila WIC, BFPC and FMNP SERVICES REVISED PRICE SHEET EFFECTIVE: OCTOBER 1, 2015 TO SEPTEMBER 30, 2016 WIC SERVICES LINE ITEM BUDGET AMOUNT 1.1 PERSONNEL SERVICES $4,893,987.00 1.2 EMPLOYEE RELATED EXPENSES $2,322,043.00 1.3 PROFESSIONAL & OUTSIDE SERVICES $36,000.00 1.4 TRAVEL EXPENSES $38,000.00 1.5 OCCUPANCY EXPENSES $730,776.00 1.6 OTHER OPERATING EXPENSES $140,877.00 1.7 CAPITAL OUTLAY EXPENSES $1.00 1.8 INDIRECT (IF AUTHORIZED) $1,289,546.00 1.9 RD SUPPLEMENT $1,038,016.00 TOTAL $10,489,246.00 EFFECTIVE: OCTOBER 1, 2015 TO SEPTEMBER 30, 2016 BREASTFEEDING PEER COUNSELING SERVICES (BFPC) LINE ITEM BUDGET AMOUNT 2.1 PERSONNEL SERVICES $261,738.00 2.2 EMPLOYEE RELATED EXPENSES $130,536.00 2.3 PROFESSIONAL & OUTSIDE SERVICES $1.00 2.4 TRAVEL EXPENSES $8,364.00 2.5 OCCUPANCY EXPENSES $0.00 2.6 OTHER OPERATING EXPENSES $9,550.00 2.7 CAPITAL OUTLAY EXPENSES $1.00 2.8 INDIRECT (IF AUTHORIZED) $64,810.00 TOTAL $475,000.00 EFFECTIVE: MARCH 1, 2016 TO SEPTEMBER 30, 2016 FARMER’S MARKET NUTRITION PROGRAM (FMNP) UNIT OF ESTIMATED TYPE OF SERVICE UNIT RATE MEASURE NUMBER OF PARTICIPANTS WIC FMNP CHECK ISSUANCE $1.25 WIC Participant AS NEEDED Page 3 of 5 ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT (IGA) 1740 West Adams, Room 303 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 FAX Contract No.: ADHS14-053007 Amendment No.: 3 Procurement Officer: Jacqueline Ortega-Avila Effective: October 1, 2015 to September 30, 2016 ONLINE NUTRITION EDUCATION DISCUSSION SESSIONS (ONEDS) LINE ITEM BUDGET AMOUNT 3.1 PERSONNEL SERVICES $26,050.00 3.2 EMPLOYEE RELATED EXPENSES $9,478.00 3.3 PROFESSIONAL & OUTSIDE SERVICES $0.00 3.4 TRAVEL EXPENSES $1,330.00 3.5 OCCUPANCY EXPENSES $0.00 3.6 OTHER OPERATING EXPENSES $0.00 3.7 CAPITAL OUTLAY EXPENSES $0.00 3.8 INDIRECT (IF AUTHORIZED) $5,142.00 TOTAL $42,000.00 ADDITIONAL TERMS AND CONDITIONS: With prior written approval from the Program Manager, the Contractor is authorized to transfer up to a maximum of ten percent (10%) of the total budget amount between funded line items except for Registered Dietitian Expenses. Transfers of funds are only allowed between funded line items. Transfers exceeding ten percent (10%) or to a non- funded line item shall require an amendment. The Registered Dietitian line item is meant to fund additional Registered Dietitian position(s) to meet high risk counseling requirements. Authorization for purchase of services under this Contract shall be made only upon ADHS issuance of a Purchase Order that is signed by an authorized agent. The Purchase Order will indicate the Contract number and the dollar amount of funds authorized. The Contractor shall only be authorized to perform services up to the amount on the Purchase Order. ADHS shall not have any legal obligation to pay for services in excess of the amount indicated on the Purchase Order. No further obligation for payment shall exist on behalf of ADHS unless a.) the Purchase Order is modified with an official ADHS Procurement Change Order, and/or b.) an additional Purchase Order is issued for purchase of services under this Contract. ADHS reserves the right to adjust awards given to local agencies depending on federal dollars received. Adjustments will be at the discretion of ADHS. ADDITIONAL WIC PROGRAM: Should additional administrative monies become available through state or federal grants, ADHS may increase the purchase order to increase the number of participants served and increase the total of this contract. The assigned caseload for FFY 2016 is: 68,500 Additional administrative monies are provided to the Contractor to assist in their participation in the Online Nutrition Education Discussion Sessions (ONEDS). The Contractor shall perform all work required to support the WIC Special Grant ONEDS project ensuring that all ONEDS-related activities required of the intervention and control clinics are performed on a timely basis. These activities include but are not limited to staff attendance in required trainings, recruitment of participants to the study, and ensure completion of evaluation and questionnaires by both participants and staff. Page 4 of 5 ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT (IGA) 1740 West Adams, Room 303 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 FAX Contract No.: ADHS14-053007 Amendment No.: 3 Procurement Officer: Jacqueline Ortega-Avila ADDITIONAL BREASTFEEDING PEER COUNSELING PROGRAM: Allowable costs for the Peer Counseling Program include compensation for peer counselors and designated peer counselor managers/coordinators, and related costs such as training and training materials; telephone expenses for participant contacts (including pager, cell phones and answering machines); travel for training and home and hospital visits; recruitment of peer counseling staff; and the purchase of demonstration materials (e.g., breast pumps for demonstration purposes, videos). Out of state travel must be pre-approved by ADHS. Items and materials for distribution to WIC participants (e.g. breast pumps, breastfeeding aids, written materials) are not allowable costs. FARMER’S MARKET NUTRITION PROGRAM: If funding for additional FMNP checks becomes available and the contract budget (as shown on the Contract Price Sheet) has been fully expended, Contractor may choose whether or not to distribute the additional checks with no increase in the contract budget. ALL OTHER PROVISIONS OF THIS AGREEMENT SHALL REMAIN IN THEIR ENTIRETY. Page 5 of 5