AMENDMENT 10 RE EMERGENCY PREPAREDNESS PROGRAM WITH ADHS.PDF

ARIZONA DEPARTMENT OF
X-- Agig---„c HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA)
- 1740W. Adams, Room 303
Phoenix, Arizona 85007
AMENDMENT (602) 542-1040
(602) 542-1741 Fax
Contract No: ADI-15 12-007891 Amendment No. 10 Procurement Officer:
Lorraine Ball-Schwarzwald
Emergency Preparedness Program
Effective April 1, 2015, it is mutually agreed that the Intergovernmental Agreement (IGA) referenced above is
amended as follows:
1. Attachment C is added to address activities related to Ebola virus disease (EVD) and Infectious Disease
Preparedness and Response.
2. The current Price Sheet is deleted and replaced with the Price Sheet of this Amendment. This Price Sheet
reflects added funding to cover the addition of EVD and Infectious Disease Preparedness and Response.
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. Suite 1400
Address Printed Name
Phoenix AZ 85012
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 any billable work or provide any material, service or construction under
form and is within the powers and authority granted under the laws of this IGA until the IGA has been executed by an authorized ADHS
the State of Arizona. signatory.
State of Arizona
Signed this day of 20
Sig nature Date
Printed Name Procurement Officer
Attorney General Contract No. P00120143000078, 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
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
Signature Date
Assistant Attorney General with the Secretary of State.
Printed Name:
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ARIZONA DEPARTMENT OF
05 "1444:4A INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
r.. MTN, OPUS AMENDMENT 1740 W. Adams, Room 303
Phoenix, Arizona 85007
ATTACHMENT C (602) 542-1040
(602) 542-1741 Fax
Contract No: ADHS12-007891 Amendment No. 10 Procurement Officer:
Lorraine Ball -Schwarzwald
Ebola and Infectious Disease Preparedness and Response
Sub-Awardee Requirements and Deliverables
Effective: April 1,2015
1. INTRODUCTION
1.1. The threat of the EVD is a top national public health priority. This supplemental PHEP grant will support and
improve Arizona's preparedness capabilities to ensure operational readiness, effective health response efforts
and continued collaboration within Arizona's healthcare system.
1.2. PHEP developed this Sub-Awardees Requirements and Deliverables document based on information
and guidance set forth by the Center for Disease Control (CDC).
1.3. This Attachment outlines the requirements of the supplemental grant and provides guidance for
successful achievement of the expected goals, objectives and outcomes.
1,4. Measuring the successful accomplishment of the deliverables and requirement will require frequent
communication and established reporting practices.
2. PROGRAM REQUIREMENTS for Ebola and Infectious Disease Supplemental Grant: The Contractor shall
adhere to all federal and State grant requirements:
2.1. FINANCIAL REQUIREMENTS
2.1.1. Budget Allocation
2.1.1.1, The Contractor shall complete the Budget Tool and Work Plan provided by ADHS and
return to ADHS for review and approval no later than March 27, 2015. ADHS will not
release funding until the Work Plan and Budget Tool has been submitted and approved.
2.1.1.2. All activities and procurements funded through this grant must align with the budget tool
and work plan designed to ensure the successful accomplishment of the goals and
objectives outlined in this Attachment.
2.1.1.2.1. Any items and/or activities that are not specifically identified within the
budget tool require prior approval by ADHS before the funds are spent on
those activities or items.
2.1.1,3. Applicable Office of Management and Budget (OMB) Circulars and Cost Principles must
be followed when developing the budget and throughout the period of performance.
2.1.2. Grant Activity Oversight
2.1.2.1. A Coordinator shall identified and:
2,1,2.1.1. Will be the main point of contact for ADHS;
2.1.2.1,2. Will work closely with ADHS to ensure all deliverables and requirements are
met; and
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
AMENDMENT 1740 W. Adams, Room 303
Phoenix, Arizona 85007
ATTACHMENT C (602) 542-1040
(602) 542-1741 Fax
Contract No: ADHS12-001891 Amendment No. 10 Procurement Officer:
Lorraine Ball-Schwarzwald
2.1.21.3. Will direct all activities related to on-site monitoring visits, requested by
ADHS.
2,1.3. Performance
2.1.3.1. Failure to meet the sub-awardee program requirements, deliverables and performance
measures described in this Attachment may result in the reimbursement of funds back to
ADHS by the sub-awardee.
2.1.3.2. At the end of the performance period, August 30, 2016, any unexpended funds that
were awarded to sub-awardees for approved activities, are subject to be returned to
ADHS.
2.2. EMERGENCY OPERATION PARTICIPATION
2.2.1. The Contractor shall participate in all emergency management ADHS sponsored joint exercises,
trainings, table-top exercises or other activities.
2.2.2. The Contractor shall maintain documentation of all collaborative efforts with local, tribal and state
emergency management partners and provide documentation to ADHS upon request.
2.3. REPORTING
2.3.1. The Contractor shall report progress on deliverables, performance measures and activities
funded through this grant in a timely manner, to ensure ADHS has adequate time to compile the
information and submit to the CDC to meet required reporting timeframes.
2.3.2. Progress Report
2.3.2.1. ADHS will distribute a Progress Report template in advance of the semi-annual due
date.
2.3.2.2. ADHS will provide the CDC Performance Measures templates (if applicable) in
advance of the semi-annual due date.
2.3.3. Final Performance Period Report
2.3.3.1. ADHS will distribute a Final Performance Period Report template in advance of the
semi-annual due date.
2.3.4. The Contractor shall submit a AAR/IP within forty-five (45) days of exercise(s).
3. DELIVERABLES:
The activities listed below are summarized from the ADHS work plan submitted to the CDC for the supplemental
PHEP grant and relate to the deliverables required for the county and tribal sub-awardees.
31. ACTIVITY 1: Community Preparedness Sub-Awardee output requirements:
3.1.1. The Sub-awardee shall collaborate with state and local partners to evaluate and clarify elements
from the state Ebola response plan.
3.1.2. Develop an Ebola specific AAR/IP that addresses the Sub-awardee's respective jurisdiction.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (ICA) HEALTH SERVICES
40'
AMENDMENT 1740 W. Adams, Room 303
Phoenix, Arizona 85007
ATTACHMENT C (602) 542-1040
(602) 542-1741 Fax
Contract No: ADHS12-007891 Amendment No. 10 Lorraine Procurement Bali-Schwarzwald Officer:
3.2. ACTIVITY 2: Public Health Surveillance and Epidemiological Investigation Sub-Awardee output
requirements:
3.2.1. Create and/or update surveillance and investigation protocols to include Ebola and other
emerging/exotic disease monitoring and surveillance for review with ADHS.
3.2.2. Monitor updates to the State's Contact/Exposed Persons tracking database found on the ADHS
Health Services Portal (HSP),
3.2.3. Identify personnel who are capable of conducting health surveillance and epidemiological
investigations for Ebola and other emerging/exotic diseases.
3.2.4. Attend ADHS sponsored "How To" trainings and Infectious Disease Training and Exercises that
address epidemiology, disease surveillance, investigation and control measures and emerging
public health issues.
3.3. ACTIVITY 3: Public Health Laboratory Testing Sub-Awardee output requirements:
No Requirements
3.4. ACTIVITY 4: Non-Pharmaceutical Interventions Sub-Awardee outputs requirements:
3.4.1, Review and utilize the statewide NPI Plan for Ebola disseminated by ADHS to review and
assess local Ebola NPI plans for gap assessment. The local Ebola NPI Plan will include a
component to address environmental cleaning and waste management. Participate in ADHS
organized subject matter workgroups/webinars for environmental cleaning and waste
management.
3.4.2. Participate in scheduled workshop/table top exercises; i.e. Arizona Infectious Disease Training
and Exercise, and provide a local Ebola NPI plan for ADHS review at the scheduled
workshop/table top exercise. Address any gaps identified in a subsequent After-Action Report
(AAR)/Improvement Plan (IP).
3.4,3. Review the local Ebola NPI Implementation Plan for, and address, any barriers to
implementation.
3.5. ACTIVITY 5: Responder Safety and Health Sub-Awardee output requirement:
3.5,1. Support the engagement of local EMS communities to accomplish training that will increase the
safety of first responders and strengthen the State Ebola Response and All Hazards Plan.
3.6. ACTIVITY 6: Emergency Public Information and Warning/Information Sharing Sub-Awardee output
requirements:
3.6.1. Participate in the development of Ebola messaging (e.g. talking points and message maps.); and
3.6.2, Participate in ADHS offered spokesperson training to address public and media inquiries related
to Ebola cases.
3.7. ACTIVITY 6a: Emergency Public Information and Warning/Information Sharing (WEBEOC) Sub-Awardee
output requirements:
3.7.1. Utilize mobile technology to allow for easy access to disease information and the ability to
receive alert messaging on hand held devices.
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liciotauk, ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
AMENDMENT 1740 W. Adams, Room 303
Phoenix, Arizona 85007
ATTACHMENT C (602) 542-1040
(602) 542-1741 Fax
Contract No: ADHS12-007891 Amendment No. 10 Procurement Officer:
Lorraine Ball-Schwarzwald
3.8. ACTIVITY 7: Medical Surge Sub-Awardee output requirements:
3.8.1. Participate and 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.
3.8.2. Apply the statewide communication plan developed by ADHS to increase Ebola messaging
effectiveness.
3.8.3. Implement a process to utilize the ADHS messaging map for collaboration and coordination of
responses to ensure the health and safety of Arizona residents in the event of an infectious
disease threat of public significance.
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ARIZONA DEPARTMENT OF
4V-1%1I9 INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
AMENDMENT 1740 W. Adams, Room 303
... 0,• Phoenix, Arizona 85007
PRICE SHEET (602) 542-1040
.. (602) 542-1741 Fax
* Contract No: ADHS12-007891 Amendment No. 10 Procurement Officer:
Lorraine Ball-Schwarzwald
PRICE SHEET
July 1, 2014 June 30, 2015
Fixed Price
No. Description UOM Amount
1 CDC Deliverables for Public Health Emergency YR $1,937,925.21
Preparedness - PHEP
2 Less charges for CEFO YR $203,000.00
3 Cities Response Initiative (CRI) YR $1,002,226.00
Total $2,737,151.21
EVD PRICE SHEET
Effective Date: March 26, 2015
Phase 1
Fixed Price
No. Description UOM Amount
1 Ebola Virus Disease Investigation Guidelines and an Ebola EA $50,912.60
Response Plan
Total $50,912.60
EVD PRICE SHEET
April 1, 2015— August 30, 2016
Phase 2
Fixed Price
No. Description UOM Amount
1 Ebola and Infectious Disease Preparedness and Response EA $700,000,00
Total $700,000.00
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