IGA RE TOBACCO USE PREVENTION WITH CAVE CREEK UNIFIED SCHOOL DISTRICT.PDF

INTERGOVERNMENTAL AGREEMENT
MARICOPA COUNTY
by and through the
DEPARTMENT OF PUBLIC HEALTH
4041 N. Central Avenue, #1400, Phoenix, Arizona 85012
1. Agreement No: C-86-15 2. Agreement Type: Fee for Service
3. Agreement Amount: $2,000 4. Purpose: SHIP
5. Start Date: August 1, 2014 6. Expiration Date: May 31, 2015
This Agreement is entered into by and between the Cave Creek Unified School District (referred to herein as "Contractor"), and
Maricopa County, by arid through its Department of Public Health (referred to herein after as "County"). Contractor and the
County are collectively referred to herein as the "Parties" and individually as a "Party." Contractor, for and in consideration of
the covenants and conditions set forth herein, shall provide and perform the services as set forth below. All rights and
obligations of the Parties shall be governed by the terms of this Agreement, its exhibits, attachments, and appendices, including
any subcontracts or amendments as set forth herein and in:
Section I General Provisions Section III Work Statement
Section II Special Provisions Section IV Compensation
This Agreement contains all the terms and conditions agreed to by the Parties. No other understanding, oral or otherwise,
regarding the subject matter of this Agreement shall be deemed to exist or to bind the Parties. Nothing in this Agreement shall
be construed as consent to any lawsuit or waiver of any defense in a lawsuit brought against the County or the Contractor in any
State or federal Court.
Legal Notice under this Agreement shall be given by personal delivery or by registered or certified mail, postage prepaid, return
receipt requested, to the addresses set forth below and shall be effective upon receipt by the Party to whom addressed unless
otherwise indicated in the notice.
Notice to Contractor: Cave Creek Unified School District Phone 480-575-2026
Address: Gina Durbin, Director of Student Support, PO Box 426, Cave Creek, AZ 85327
Notice to Department: MCDPH Grants/Contract Unit Phone: (602) 506-1829
Address: 4041 North Central Avenue, Ste #1400, Phoenix, Arizona 85012
IN WITNESS WHEREOF, the parties enter into this Agreement:
MARICOPA COUNTY BOARD OF SUPERVISORS
Signature Signature
Name 8ardick Name
Title Sttp-erin-terideeii- Title Chairman, Board of Supervisors
Date Y113/fti Date
ATTEST:
Signature
Clerk of the Board
Date
Pursuant to A.R.S. § 11-952, the undersigned public agency Pursuant to A.R.S. § 11-952, the Attorney for the Board of
attorney has determined that this Intergovernmental Agreement Supervisors has determined that this Intergovernmental
is in proper form and is within the powers and authority granted Agreement is within the powers and authority granted under the
under the laws of the State of Arizona. laws of the State of Arizona.
Signature Signature
Attorney for Maricopa County
Date Date
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SECTION I GENERAL PROVISIONS
1. EFFECT
To the extent the Special Provisions are in conflict with the General Provisions, the
Special Provisions shall control. To the extent the Work Statement(s) and the Special or
General Provisions are in conflict, the Work Statement(s) shall control.
2. DEFINITIONS
As used throughout this Agreement, the following terms shall have the following
meanings:
A. Agreement means this document and all attachments and amendments hereto.
B. Contractor means the person, firm or organization listed on the Cover Page of
this Agreement.
C. County means Maricopa County, Arizona.
D. Department means the Maricopa County Department of Public Health.
E. Funding Source means any federal, State, or private agency funding source,
which may impose conditions on the funding that will be passed on to the
Contractor.
3. GENERAL REQUIREMENTS
A. The terms of this Agreement shall be construed in accordance with Arizona law,
Any lawsuit arising out of this Agreement shall be brought in the appropriate
court in Maricopa County.
B. The Contractor shall, without limitation, obtain and maintain all licenses, permits,
and authority necessary to do business, render services, and perform work under
this Agreement, and shall comply with all laws regarding unemployment
insurance, disability, and workers' compensation.
C. The Contractor is an independent contractor in the performance of work and the
provision of services under this Agreement and is not to be considered an officer,
employee, or agent of the County.
4. AMENDMENTS
All Amendments to this Agreement must be in writing and signed by authorized persons
for both Parties. All amendments shall clearly state the effective date of the action.
5. ADEQUACY OF RECORDS
If the Contractor's books, records and other documents related to this Agreement are not
sufficient to support and document that allowable services were provided to eligible
clients, the Contractor shall reimburse the County for the services not adequately
supported and documented.
6. RETENTION OF RECORDS
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SECTION I GENERAL PROVISIONS
A. This provision applies to all financial and programmatic records, supporting
documents, statistical records, and other records of the Contractor that relate to
this Agreement.
The Contractor shall retain all financial books, records, and other documents
related to this Agreement for five (5) years after final payment or until after the
resolution of any audit questions, which could be more than five (5) years,
whichever is longer. County, federal, or State auditors, and any other persons
duly authorized by the County, shall have full access to and the right to examine,
copy and make use of any and all such financial books, records and other
documents.
7. ASSIGNMENT AND SUBCONTRACTING
No rights, liability, obligations or duties under this Agreement may be assigned,
delegated, or subcontracted without the prior written approval of the County.
8. AUDIT DISALLOWANCES
A. The Contractor shall, upon written demand therefore, reimburse the County for
any payments made under this Agreement that are disallowed, by a federal,
State or County audit in the amount of the disallowance, as well as court costs
and attorney fees the County incurs to pursue legal action relating to a
disallowance.
If the County determines that a cost for which payment has been made is a
disallowed cost, the County shall notify the Contractor in writing of the
disallowance and the required course of action, which shall be at the option of
the County either to adjust any future claim submitted by the Contractor by the
amount of the disallowance or to require immediate repayment of the disallowed
amount by the Contractor.
9. AGREEMENT COMPLIANCE MONITORING
County shall monitor the Contractor's compliance with, and performance under, the
terms and conditions of this Agreement. On-site visits for compliance monitoring may be
made by the County and/or its grantor agencies at any time during the Contractor's
normal business hours, announced or unannounced. During an on-site visit, the
Contractor shall make its records and documents related to work performed or services
provided under this Agreement available to the County for inspection and copying.
10. AVAILABILITY OF FUNDS
A. The provisions of this Agreement relating to the payment for services shall
become effective when funds assigned for the purpose of compensating the
Contractor, as provided herein, are actually available to the County for
disbursement. The Department shall be the sole authority in determining the
availability of funds under this Agreement and the County shall keep the
Contractor fully informed as to the availability of funds.
B. If any action is taken by any State agency, federal department, or any other
agency or instrumentality to suspend, decrease, or terminate its fiscal obligations
under or in connection with this Agreement, the County may amend, suspend,
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SECTION I GENERAL PROVISIONS
decrease, or terminate its obligations under or in connection with this Agreement.
If this Agreement is terminated, the County shall be liable for payment only for
services rendered prior to the effective date of the termination, provided that such
services are performed in accordance with the provisions of this Agreement. The
County shall give written notice of the effective date of any suspension,
amendment, or termination under this section at least ten (10) days in advance.
11. CONTINGENCY RELATING TO OTHER CONTRACTS AND GRANTS
A. The Contractor shall, during the term of this Agreement, immediately inform the
County in writing of the award of any other contract or grant where the award of
such contract or grant may affect either the direct or indirect costs being paid or
reimbursed under this Agreement. Failure by the Contractor to notify the County
of such award shall be considered a material breach of this Agreement and the
County may immediately terminate this Agreement without liability.
B. County may request, and the Contractor shall provide within a reasonable time,
not exceeding ten (10) working days, a copy of such other contract or grant,
when, in the opinion of the Department, the award of the contract or grant may
affect the costs being paid or reimbursed under this Agreement.
C. If the County determines that the award to the Contractor of such other contract
or grant has affected the costs being paid or reimbursed under this Agreement,
the County shall prepare an amendment to this Agreement effecting a cost
adjustment. If the Contractor disputes the proposed cost adjustment, the dispute
shall be resolved pursuant to the "Disputes" clause section contained herein.
12. DEFAULT
The County may suspend, modify, or terminate this Agreement immediately upon giving
written notice to the Contractor if the Contractor fails to perform under or otherwise
breaches any obligation under this Agreement, or upon the occurrence of any event that
may jeopardize the ability of the Contractor to perform any of its obligations under this
Agreement.
13. TERMINATION
A. Either Party may terminate this Agreement at any time by giving the other Party
at least thirty (30) calendar days prior written notice. The notice shall be given by
personal delivery or by registered or certified mail, postage prepaid, return
receipt requested.
B. This Agreement may be terminated by mutual written agreement of the Parties
specifying the termination date therein.
C. The County may terminate this Agreement upon twenty-four (24) hours notice
when the County deems the health or welfare of a patient is endangered or the
Contractor's non-compliance jeopardizes funding source financial participation. If
not terminated by one of the above methods, this Agreement will terminate upon
the expiration date of this Agreement as stated on the Cover Page of this
Agreement,
14. SEVERABILITY
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SECTION I GENERAL PROVISIONS
Any provision of this Agreement that is determined to be invalid, void, or illegal by a
court shall in no way affect, impair, or invalidate any other provision hereof, and the
remaining provisions shall remain in full force and effect.
15. STRICT COMPLIANCE
Acceptance by the County of performance that is not in strict compliance with the terms
of this Agreement shall not be deemed to waive the requirement of strict compliance for
all future performance. All changes in performance obligations under this Agreement
must be in writing and signed by the Parties.
16. NON-LIABILITY
The County and its officers, representatives, agents, and employees shall not be liable
for any act or omission by the Contractor or any subcontractor, employee, officer, agent,
or representative of the Contractor or any subcontractor occurring in the performance of
this Agreement, nor shall they be liable for purchases or contracts made by the
Contractor or any subcontractor in connection with this Agreement.
17. INDEMNITY
Each Party (as "Indemnitor") agrees to indemnify, defend, and hold harmless the other
Party (as "Indemnitee") from and against all claims, losses, liability, costs, and expenses
(including reasonable attorneys' fees) (hereinafter collectively referred to as "Claims")
arising out of bodily injury of any person (including death) or property damage, but only
to the extent that such Claims, which result in vicarious liability to Indemnitee, are
caused by the act, omission, negligence, misconduct, or other fault of Indemnitor, its
officers, agents, employees, or volunteers.
18. COVENANT AGAINST CONTINGENT FEES
The Contractor warrants that no person or entity has been employed or retained to solicit
or secure this Agreement upon an agreement or understanding for a commission,
percentage, brokerage, or contingent fee. For breach or violation of this warranty, the
County may immediately terminate this Agreement without liability.
19. SAFEGUARDING CLIENT INFORMATION
The use or disclosure by any Party of any information concerning an eligible individual
served under this Agreement is directly limited to the performance of this Agreement.
20. RIGHTS IN DATA
The Parties shall have the use of data and reports resulting from this Agreement without
cost or other restriction, except as otherwise provided herein or by law. Each Party shall
supply to the other Party, upon request, any available information known to the
supplying Party that is relevant to this Agreement and to the performance hereunder,
21. NON-DISCRIMINATION
The Contractor, in connection with any service or other activity under this Agreement,
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SECTION 1 GENERAL PROVISIONS
shall not in any way discriminate against any person on the grounds of race, color,
religion, sex, national origin, age, disability, affiliation or belief. The Contractor shall
include this clause in all of its subcontracts related to this Agreement.
22. EQUAL EMPLOYMENT OPPORTUNITY
The Contractor shall not discriminate against any employee or applicant for employment
because of race, age, disability, color, religion, sex, or national origin, The Contractor
shall take affirmative action to insure that applicants are employed and that employees
are treated during employment without regard to their race, age, disability, color, religion,
sex, or national origin. Such action shall include, but is not limited to, the following:
employment, upgrading, demotion or transfer, recruitment or recruitment advertising, lay-
off or termination, rates of pay or other forms of compensation, and selection for training,
including apprenticeship. The Contractor shall, to the extent such provisions apply,
comply with Titles VI and VII of the Civil Rights Act of 1964, as amended (42 U.S.C. §§
2000a, et seq.); the Rehabilitation Act of 1973, as amended (29 U.S.C. §§ 701, et seq.);
the Age Discrimination in Employment Act of 1967, as amended (29 U.S.C. §§ 621, et
seq.); the Immigration Reform and Control Act of 1986 (Pub. L. No. 99-603) ("IRCA");
and Arizona Executive Order 2009-09, which mandates that all persons shall have equal
access to employment opportunities. The Contractor shall also comply with all
applicable provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. §§ 12101,
et seq.).
23. RIGHT OF PARTIAL CANCELLATION
If more than one activity is funded by this Agreement, the County reserves the right to
terminate this Agreement or any part thereof based on the Contractor's failure to perform
any part of this Agreement without impairing, invalidating or canceling the remaining
Work Statement obligations.
24. RIGHT TO EXTEND AGREEMENT
Subject to the availability of funds and acceptable Contractor performance, the
Contractor hereby acknowledges and agrees that the County shall have the right to
extend this Agreement for additional one-year periods, not to exceed a total extended
term of five (5) years, except that the cost will be subject to renegotiation. Any extension
of this Agreement shall be in writing mutually acceptable to the Department and the
Contractor and signed by both Parties,
26. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
A. The undersigned, an authorized representative of the Contractor, certifies, to the
best of his or her knowledge and belief, that the Contractor, defined as the
primary participant in accordance with 45 C.F.R. Part 76, and its principals:
1) are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any federal
department or agency;
2) have not within the 3-year period preceding this Agreement been convicted of
or had a civil judgment entered against them for the commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing
a public (federal, State or local) transaction or contract under a public
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SECTION 1 GENERAL PROVISIONS
transaction; violation of federal or State antitrust statues or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3) are not presently indicted or otherwise criminally or civilly charged by a
government entity (federal, State or local) with the commission of any of the
offenses enumerated in paragraph (2) of this certification; and
4) have not within the 3-year period preceding this Agreement had one or more
public transactions (federal, State or local) terminated for cause or default.
B. if the Contractor is not able to provide this certification, an explanation as to why
shall be attached to this Agreement.
C. The Contractor shall include, without modification, this Paragraph in all lower tier
covered transactions (La, transactions with subcontractors) and in all
solicitations for lower tier covered transactions related to this Agreement.
26. ENERIFICATION OF EMPLOYEES
The Contractor warrants that it is in compliance with A.R.S. § 41-4401 and further
acknowledges:
A. That the Contractor and its subcontractors, if any, warrant their compliance with
all federal immigration laws and regulations that relate to their employees and
their compliance with A.R.S. § 23-214;
B. That a breach of the warranty under subsection A above shall be deemed a
material breach of this Agreement that entitles the County to, among other
things, immediately terminate this Agreement without liability;
C. That the County and any contracting government entity retains the legal right to
inspect the papers of any contractor or subcontractor employee who works on
this Agreement to ensure that the contractor or subcontractor is complying with
the warranty provided under subsection A above and that the contractor agrees
to make all papers and employment records of said employee(s) available during
normal working hours in order to facilitate such an inspection;
D. That nothing herein shall make any contractor or subcontractor an agent or
employee of the County or contracting government entity.
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SECTION II SPECIAL PROVISIONS
1. EFFECT
To the extent that the Special Provisions are in conflict with the General Provisions, the
Special Provisions shall control. To the extent that the Work Statement(s) are in conflict
with the Special or General Provisions, the Work Statement(s) shall control,
2. DISPUTES
Except as otherwise provided by law, or otherwise specifically agreed to by the Parties,
any dispute not involving a question of law arising out of this Agreement that is not
resolved between the Parties within a reasonable time, which shall not exceed 120 days,
shall be resolved as follows:
1, Disputes must be filed with the person administering this Agreement
for the County, if one has been appointed, or, if not, with the Procurement
Officer, within ten (10) days from the date the Contractor knew or should
have known the basis of the dispute.
2. The person administering this Agreement or the Procurement Officer,
as applicable, shall respond in writing to the dispute within fourteen (14)
days,
3. The Contractor may abide by the decision or may appeal the decision
to the Director of the Department within seven (7) days.
This Paragraph shall not apply to claims arising from bodily injury, death, or property
damage.
3. CHANGES
A. The Department may, at any time, by written order, make changes within the
general scope of this Agreement in any one or more of the following areas:
1 Work Statement activities reflecting changes in funding source or County
regulations, policies, or requirements.
2. Administrative requirements, such as changes in reporting periods,
frequency of reports, or report formats, required by funding source or
County regulations, policies, or requirements.
3. Contractor reimbursement schedules and/or program budgets.
B. The order will not increase or decrease the maximum reimbursable amount to be
paid the Contractor. Additionally, the order will not direct substantive changes in
services to be rendered by the Contractor.
C. Any dispute or disagreement caused by such order shall constitute a "Dispute"
within the meaning of the Disputes Clause of the Special Provisions of this
Agreement and shall be administered accordingly.
4, AUDIT REQUIREMENT
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SECTION II SPECIAL PROVISIONS
A. If the Contractor expends $500,000 or more in a year in federal awards, the
Contractor shall have a single audit conducted for that year according to the
Single Audit Act of 1984 (Pub. L. No. 98-502) (codified at 31 U.S.C. §§ 7501, et
seq.), and the Single Audit Act Amendments of 1996 (Pub. L. No. 104-156). The
Contractor shall comply with OMB Circulars A-133, A-87, A-102, and A-110, as
applicable. The audit report shall be submitted to the County for review within
nine (9) months following the close of the fiscal year. The Contractor shall take
any necessary corrective action to remedy any material weaknesses and/or
reportable conditions identified in the audit report within six (6) months after the
release date of the report. The County may consider sanctions as described in §
.225 of OMB Circular A-133 for contractors not in compliance with the audit
requirements. All books and records shall be maintained in accordance with
Generally Accepted Accounting Principles (GAAP).
B. The Contractor shall schedule an annual financial audit to be submitted to the
County for review within twelve (12) months following the close of the program's
fiscal year. Contractor understands that its failure to meet this requirement may
result in the loss of current funding and disqualification from consideration for
future County-administered funding.
C. Comply with the requirement of the Federal Office of Management and Budget
("OMB'') Circular A-133. The Contractor is responsible for having an audit
performed in accordance with, and when required, by OMB Circular A-133, and
for sending a copy of the report issued as a result of the audit to the County
within thirty (30) days of issuance. The County reserves the right to engage an
auditor, at the Contractor's expense, to perform an OMB Circular A-133 audit of
the Contractor in the event that the Contractor fails to engage an auditor or the
County rejects or disapproves of the auditor engaged by the Contractor.
5. INSURANCE
A. The Contractor shall have in effect at all times during the term of this Agreement
insurance or comparable self-insurance that is adequate to protect the County,
its officers, employees, property, and equipment against the losses set forth
below. The Contractor shall provide the County with a certificate of insurance or
a certified copy of the insurance policy naming the County as an additional
insured, or, if the Contractor is self-insured, shall provide the County with a letter
indicating that it is self-insured.
B. The following types and amounts of insurance are required as minimums:
1. Workers' compensation and unemployment insurance as required by law.
2. Unemployment insurance as required by Arizona law.
3. Public liability, bodily injury, and property damage policies that insure
against claims for liability for the Contractor's negligence or maintenance
of unsafe vehicles, facilities, or equipment brought by clients receiving
services pursuant to this Agreement and by lawful visitors of such clients.
The limits of the policies shall not be less than $2,000,000 per occurrence
and $4,000,000 aggregate.
C. Automobile and Truck Liability, Bodily Injury and Property Damages:
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SECTION II SPECIAL PROVISIONS
1. General liability, each occurrence; $1,000,000
2. Property damage; $1,000,000
3. Combined single limit; $1,000,000
D. Standard minimum deductible amounts are allowable. Any losses applied
against insurance deductible are the sole responsibility of the Contractor.
E. Professional Liability:
1 Insurance for the Contractor and its agents, employees, and other staff
shall be maintained with coverage limits of one million dollars
($1,000,000) per person, three million dollars ($3,000,000) per
occurrence.
2 The Contractor agrees that in the event it, or any of its agents,
employees, and other staff working under this Agreement, is named as a
defendant in litigation, or is identified in a written notice of claim, wherein
professional misconduct is alleged, the Contractor will promptly notify the
Department in writing. The duty to notify under this paragraph applies
whether or not the County is alleged to be involved, is named as a party
to the matter, or could be potentially liable as a party.
F. The Contractor shall immediately inform the Department of any cancellation of its
insurance or any decrease in its lines of coverage at least thirty (30) days before
such action takes place.
6. SPECIAL REQUIREMENTS
A. If the use of subcontractors is approved by the County, the Contractor agrees to
use written subcontracts or consultant agreements that conform to federal and
State laws and regulations and the requirements of this Agreement appropriate
to the service or activity covered by the subcontract. These provisions apply with
equal force to the subcontract as if the subcontractor were the Contractor. The
Contractor is responsible for performance under this Agreement whether or not
any subcontractors are used. The Contractor shall submit a copy of each
subcontract to the County within fifteen (15) days of its effective date.
B. The Contractor shall include in any subcontracts a provision to the effect that the
subcontractor agrees that the County shall have access to the subcontractor's
facilities and the right to examine any books, documents, and records of the
subcontractor involving transactions related to the subcontract, and that such
books, documents, and records shall not be disposed of except as provided
herein.
7. REPORTING REQUIREMENTS
If requested by the County, the Contractor shall submit monthly, quarterly, and annual
progress reports on or before the third (3rd) day of the month following the end of the
reporting period. In addition, a quarterly expenditure report will be submitted with the
quarterly progress report.
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SECTION II SPECIAL PROVISIONS
8. STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST
Pursuant to A.R.S. § 38-511, the County may cancel this Agreement without penalty or
further obligation, within three years after execution of this Agreement, if any person
significantly involved in initiating, negotiating, securing, drafting, or creating this
Agreement on behalf of the County is, at any time while this Agreement or any extension
of this Agreement is in effect, an employee or agent of any other Party to this Agreement
in any capacity or is a consultant to any other Party to this Agreement with respect to the
subject matter of this Agreement In addition, the County may recoup any fee or
commission paid or due to any person significantly involved in initiating, negotiating,
securing, drafting, or creating this Agreement on behalf of the County from any other
Party to this Agreement arising as the result of this Agreement.
9. POLICY ON CONFIDENTIALITY
The Contractor and the County understand and agree that this Agreement is subject to
all State and federal laws protecting client confidentiality of medical, behavioral health
and drug treatment information.
10. LAWS, RULES AND REGULATIONS
The Contractor and the County understand and agree that this Agreement is subject to
all State and federal laws, rules, and regulations that pertain hereto.
11. SPONSORSHIP ACKNOWLEDGMENT
All promotional materials, brochures, and flyers prepared by the Contractor shall include
the following statement, "Sponsored by Maricopa County Department of Public Health."
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SECTION III WORKSTATENIENT
1. DEFINITIONS
A. DEPARTMENT refers to the Maricopa County Department of Public Health (MCDPH)
and includes the Maricopa County Office of Tobacco & Chronic Disease Prevention.
B. CONTRACTOR refers to the School District listed on the front page of this Agreement.
C. COUNTY refers to Maricopa County, Arizona.
D. MCTCDP is an acronym for the Maricopa County Tobacco & Chronic Disease
Prevention.
E. CDC refers to the Centers for Disease Control and Prevention.
F. STIPEND refers to the funds allocated to the school Tobacco Prevention Site
Coordinator.
G. MATERIAL refers to non-stipend related expenses.
2. (SHI) SERVICE GOALS
Contractor agrees to act as a pay agent and pass through funds to each school based
on the following categories:
A. A stipend will be provided per school listed in Attachment A to be paid to the
school district or charter upon successful completion of the School Health Index.
B. Technical assistance, training, and other prevention related material, will be
provided by MCTCDP.
3. (SHI) SERVICE OBJECTIVES/ACTIVITIES
The school agrees to provide the following required services;
A. School Health Index (SHI) school coordinator will attend a MCTCDP sponsored
SHI Training.
B. Coordinated School Health Program
SHI coordinator will recruit SHAG (School Health Advisory Council)
members, following CDC recommendations to attain multi-disciplinary
participation.
SHI Coordinator will schedule a meeting with the SHAG for an orientation
with the MCTCDP Representative in regards to the purpose, completion,
and their role in participating on the SHAG team.
SHI coordinator will assign and distribute the module completion forms to
members and collect module discussion questions and score cards for all
SHAG team meeting(s).
iv. SH1 coordinator will schedule meeting date(s) and time(s) with the SHAC
team and MCTCDP representative, to complete the SHI and Planning for
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SECTION III WORKSTATEMENT
Improvement Instrument.
v. SHI Coordinator will complete and submit a Program Completion Report
to MCTCDP when the SHI deliverables are completed. Program
Completion Reports can be sent via email to the assigned IVICTCDP
representative. All SHI program deliverables must be completed by the
end of the contract period listed on the cover page of this Agreement.
vi. Upon satisfactory completion of SHI deliverables and receipt of Program
Completion Report, the School Health Improvement Plan Implementation
(SHIP) must be submitted to the assigned MCTCDP representative for
approval. Upon approval, each school is eligible for the advance payment
and to proceed with the SHIP Implementation Plan. The SHIP Service
Goals and Service Objectives/Activities stated below. Only a school that
completes the SHI is elioible to participate in the SHIP.
4. (SHI) OTHER REQUIREMENTS
A. Written monthly reports will be submitted by the 3' 1 of each month. Reports may
be submitted via email to the assigned MCTCDP representative.
B. Payment requests must be submitted on school letterhead and include the
following information from Attachment A (completing school, amount per school)
and the total amount requested. Submit payment requests via email to the
assigned MCTCDP representative.
C. Contractor shall respond to all additional requests for information solicited by
MCTCDP when they are submitted in writing and allow for a minimum of 72
hours to respond.
D. Final invoices must be submitted within 60 days of the expiration of the contract
period.
E. Contractor agrees to participate in randomly generated site visits in accordance
with the fiduciary responsibility delegated to us by State grantor, the Arizona
Department of Health Services. During the site visits, we will check for supporting
documentation for submitted charges.
5. (SHIP) SERVICE GOALS
Contractor agrees to act as a pay agent and pass through funds to each school based
on the following categories:
A. A one-time advance payment will be provided to each school listed in Attachment A
to be paid to the school district or charter.
B. Each school wanting to participate in the School Health Improvement Plan (SHIP)
will begin by submitting a plan, for review and approval, to the designated MCTCDP
representative. Upon approval, the school may begin the implementation of the plan
and submit their request for reimbursement.
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SECTION III WORKSTATEIVIENT
6. (SHIP) SERVICE OBJECTIVES/ACTIVITIES
The school agrees to provide the following required services:
A. Each school agrees to submit a SHIP Implementation and Evaluation Plan to
MCTCDP and to perform the activities and/or outcomes designated in the
approved plan. The SHIP Implementation and Evaluation Plan must be approved
by the assigned MCTCDP representative prior to performing the activities and
submitting the request for advance payment.
B. A SHIP Coordinator at each school will submit a Mid-Year SHIP Implementation
Report three months after receiving implementation funds and a SHIP
Completion Report to MCTCDP upon completion of activities. Program
Completion Reports should be emailed to the assigned MCTCDP representative.
All SHIP program deliverables must be completed by the end of the contract
period listed on the cover page of this Agreement.
7. (SHIP) OTHER REQUIREMENTS
A. Each district must submit a request for advance payment on school letterhead,
The request must identify each participating school, amount per school and total
amount requested. Payment requests should be emailed to the assigned
MCTCDP representative.
B. Contractor shall respond to all additional requests for information solicited by
MCTCDP when they are submitted in writing and allow for a minimum of 72
hours to respond.
C. All payment requests must be submitted within 60 days of the expiration of the
contract period.
D. Contractor agrees to participate in randomly generated site visits in accordance
with the fiduciary responsibility delegated to us by State grantor, the Arizona
Department of Health Services.
8. COMPENSATION
Subject to the availability of funds, County shall pay the Contractor for the services
described herein for a sum not-to-exceed the Contract Amount listed on the cover page
of this Agreement. The request for advance payment must be submitted by the
Contractor. The payment request/invoice will also include the following information from
Attachment A (participating school, amount per school and total amount requested).
SHI and SHIP payment request must be requested separately. The district must submit
the invoice on behalf of the schools that have completed the SHI prior to the school(s)
entering into the SHIP implementation. Upon MCTCDP approval of the SHIP
Implementation Plans, the district may submit the invoice for participating schools.
9. METHOD OF PAYMENT
14

SECTION III WORKSTATEMENT
A. Contractor shall submit a payment request. This payment request must be on school
letterhead and contain a signature authorizing the request.
B. Subject to the availability of funds, the County will, within thirty (30) working days
from the date of receipt of the fully executed IGA, process and remit, to the
Contractor, a warrant for payment up to the maximum total allowable for services
provided.
C. The Contractor understands and agrees that the County will not honor any claim for
payment submitted six (6) months after the date of service. The Contractor
understands and agrees that the County will not process any claim for payment for
services rendered prior to the expiration date that is submitted sixty (60) days after
the expiration date without approval of the County.
10. NOTICE
Any notice given under this Contract shall be sent to the attention of the following:
Maricopa County Department of Public Health Maricopa County Department of Public Health
Office of Tobacco & Chronic Disease Grants and Contracts Unit
Alaina Rinne, Contract Coordinator Grants and Contracts Administrator
4041 N. Central Avenue, Suite 1400 4041 N. Central Avenue, Suite 1400
Phoenix, Arizona 85012 Phoenix, Arizona 85012
15

SECTION IV ATTACHMENT A
School Health Implementation Program
School District or Charter: Cave Creek Unified School District
Gina Durbin
Director of Student Support Services
GDurbin@ccusd93.orq
.School(s)
:Name of School(s) Address
Cactus Shadows High 5802 E Dove Valley Road Scottsdale AZ 85331 $2,000
Total $2,000
16

blood be will if
weight 2013 provide charts educational control, low provider,
free 2013 heart, year
When promote Aug.-Sept. students weekly Aug. provide weight healthy healthcare school
and pressure/weight will proper 2013
implement. completed. Whom will monitoring nursing monitoring agency SHC pressure, Fall medical 2013-2014
to be By staff aide, blood outside and example: blood to
agreed will office pressure health by SRI, for sodium/cholesterol staff during
has Action. work Health /blood RN, pressure/weight Individual supplied CDC, materials, monitoring Refer needed,
Plan team the a. b. c. d. e.
Index each when via 1 Page
and weight healthy if
INDEX Improvement Health implement Step monitoring week/more of provider, wellness page
to each pressure/ record implement SHC. next IMPROVEMENT—
HEALTH School taken for pressure/weight blood a once to and healthcare and on
SCHOOL the be Steps charting staff for tools videos/ CDC, health Continued FOR
Health that to responsible posters provide office SFR, medical staffs
Actions need blood and to health needed confidential pressure provide via PLANNEVG
that be free time in if and staff through outside ensure
School the Steps will flyers, for to to
order, who Promote e-mail, Schedule monitoring frequently Provide weight/blood Instruct changes pamphlets Refer needed,
specific a. b. c. d. e.
priority people
in the list the and assess, wellness
list, list tools
column: column: with implement, and
column: Actions staff health
first second third to proper
Instructions the the the Provide knowledge
In In In 1. ensure
1_ 2. 3. 1.

will staff
Health free Healthcare for with September above September
When CSHS screening healthcare after needed,
and staff/community Scottsdale counseling offered medical care if
Whom screening cardiovascular free be will their up completed,
By August/September2013, promote 2013, screening, RN to follow is
will September free community. or staff for
Office cardiovascular provide and After physician 2013 Refer provider monitoring 2013
a. b. c. d.
c- as 2
posters, scheduled Healthcare process Page
INDEX scheduled through self-schedule their of Scottsdale screening IMPROVEMENT
HEALTH of date announcements website phone per
Steps date screening up staff/community and cardiovascular FOR
SCHOOL confirm and sign staff/community computer screening
to screening confirmed mailers, to for with PLANNING
SHC computer for reminders via rooms SHC
Contact cardiovascular Promote flyers, Create appointment Send appointment up Set recommendations Assist
a. b. mails, c. d. e. f. needed
health staff
for
Actions cardiovascular awareness
community
Provide screening/
2. and

3
Page
—
INDEX
HEALTH IMPROVEMENT
SCHOOL FOR
PLANNING

High 100% 96% 81%
-
where 81%
column 80% box
- 74% 64% each
one 61% in
the falls* scores
in X Score 60%
an Medium - 51% module
School write Module 41% the
(row), the 40% write 5
Middle/High Index module - 30% to like Page —
Card 21%
- Score each schools IMPROVEMENT
Index Health For
Low 0-20% Some
Health Overall FOR
School - 1 2 3 4 5 6 7 8 PLANNING
School Module Module Activity Module Module Module Social Module Module Module
Environment - - - - and - -
and Education Physical Programs Services Services Psychological, Services Staff- for Involvement
Policies Other Health
Health and Nutrition Promotion
Health School Counseling, Community
Education Health
School School and
Physical Family