AMENDMENT 1 RE SPONSORED PROJECT SERVICES WITH UOFA.PDF

AGREEMENT NO: C-86-13-089-3-01 AMENDMENT NO: 1
AMENDMENT TO
CONTRACT
Between
MAR1COPA COUNTY
By and Through
DEPARTMENT OF PUBLIC HEALTH
4041 N Central Avenue, Suite 1400, Phoenix, Arizona 85012
and
ARIZONA BOARD OF REGENTS FOR AND ON BEHALF OF
THE UNIVERSITY OF ARIZONA
The above named contract is hereby amended as specified below:
A. Section III, Work Statement is replaced in its entirety pursuant to Section III, Paragraph 6 —
Amendments and Extension.
B. The budget for this period is in the not-to-exceed amount of $134,000 from July 1, 2014 through
June 30, 2015.
C. Add Attachment A — Salmonella Investigation Protocol.
All other terms and conditions of the original contract shall remain in full force and effect.
IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF UNIVERSITY
MARICOPA COUNTY OF ARIZONA
By:
Chairman, Board of Supervisors
Date Date Le is BrzfV4i, Director
ATTEST ATTEST Office of Research and Contr..ct Analysis
Clerk of the Board
Date Date
APPROVED AS TO FORM APPROVE
Attorney for Maricopa County
Date Date
1

Section III Work Statement
1. PURPOSE
Maricopa County Department of Public Health contracts with The University of Arizona's Mel and
Enid Zuckerman College of Public Health (MEZCOPH) Student Aid for Field Epidemiology Response
(SAFER) Team for epidemiology, investigation, and response capacity. The goals of this team are to
provide public health and epidemiology students with experimental learning opportunities within
health departments and simultaneously accomplish core surveillance and disease investigation
activities of the MCDPH Office of Epidemiology (OE).
2. RESPONSIBILITIES OFTHE CONTRACTOR
A. The Faculty Principal Investigator (PI)/Director for the SAFER Team will be responsible for
the supervision, tracking and maintenance of all activities pertaining to the IntErgovemmental
Agreement (IGA).
B. The two (2) Graduate Research Assistants (GRAS) for the SAFER Team shall each work
a maximum of ten (10) hours per week o n activities pertaining to this Agreement.
C. The University of Arizona shall have students available to MCDPH when requested during
the academic calendar. Students should be available to MCDPH within one (1) business
day from the date of the request. In the event that students are not available, the Faculty
Director and/or Graduate Research Assistant(s) will respond.
D. The SAFER annual report will be available to MCDPH for evaluation at the end of each calendar
year.
3. EXPECTATIONS AND METHODOLOGY
A. During Events and Exercises
The University of Arizona's Mel and Enid Zuckerman College of Public Health (MEZCOPH)
Student Aid for Field Epidemiology Response (SAFER) Team will provide response aid to
Maricopa County Department of Public Health (MCDPH) during events, outbreaks and
emergencies. The SAFER Students will function under the direction of OE in coordination
with the Office of Preparedness and Response (OPR). SAFER students serve on the field
epidemiology team during various large events in Maricopa County including sporting events,
Annual Fiesta College Bowls, Phoenix International Raceway (PIR) events and other situations
when the decision is made by OE to activate the team.
B. To assist with outbreaks and enteric disease investigations, data collection and analysis.
During routine enteric disease investigations, pandemics, and other large outbreaks, the
students will function under the direction MCDPH OE for any number of supportive functions
including, but not limited to: survey creation, phone interviews, medical record requests and
chart extraction, email and web-based interview distribution and collection, descriptive
and/or complex data analysis.
In order to increase timeliness and efficiency on reports, it is understood by MCDPH, the
students will enter data into an online database and the faculty PI/Director, GRAs, or other
student workers will be responsible for transfer of the data into MEDSIS (Medical Electronic
Disease Surveillance Intelligence System) on behalf of MCDPH. Priority of data collection and
data entry will be determined by MCDPH.

Section III Work Statement
For outbreaks and single case investigations, the data should be collected from the
clients/cases using MCDPH supplied forms. Any additional data collected which is not
included on the original MCDPH form shall be included in the online database only with the
express permission of MCDPH. MCDPH shall have full access to and the right to examine,
copy, and make use of any and all such data. For large outbreak investigations, an optimal
response rate of 33% or pre-designated sample sized to adequately .represent the population.
To achieve an optimal response rate during routine disease case investigations the following
contact methodology will be attempted.
1. For cases with contact phone numbers and address:
a. A maximum of up to three attempted phone calls
b. An MCDPH standardized contact letter sent to address if phone contact
unsuccessful after three attempts.
2. For cases with contact phone numbers, but no contact address
a. A maximum of up to three attempted phone calls
3. For cases with contact address, but no contact phone number
a. A MCDPH standardized contact letter sent to address
4. For cases with no contact information
a. Contact provider to retrieve contact address and/or phone number
4. RIGHTS IN DATA
A. Confidential Information
1. SAFER shall not use, or disclose to any third party, identifiable data in any manner
whatsoever and will require its employees and agents who have access to such
information maintain the same in strict confidence; provided that SAFER's obligations
hereunder shall not apply to information which was already known to the receiving
party prior to the time of first disclosure, as demonstrated by contemporaneous,
written documentation; or
2. At the time of disclosure is in the public domain, or after the date of the disclosure,
lawfully becomes a part of the public domain other than through breach of this
Agreement by the receiving party; or
3. Is received without any obligation of confidentiality from a third party having a legal
right to disclose the same; or
4. Is independently developed by the receiving party by individuals without access to
such information, as demonstrated by contemporaneous, written documentation; or
5. Is required to be disclosed by the receiving party pursuant to a legally enforceable
order, subpoena, or other regulation (Order), provided, however, the receiving party
promptly notifies the disclosing party in advance of such disclosure and discloses only
the information necessary to comply with said order.
B. The Parties agree to:
1. Carefully restrict use and access of information to those designated by the MCDPH.
2. Prohibit identifying information about a person which was supplied under the terms
of this Agreement, from being released to anyone not working on MCDPH/SAFER data
collection and analysis.
3. Require all officers, agents, and employees to keep all such shared information
strictly confidential.

Section III Work Statement
4. Communicate the requirements for this section to all officers, agents, and employees;
discipline all persons who may violate the requirements of this section; and notify the
originating party in writing within forty-eight (48) hours of any violation and
corrective actions to be taken.
5. All parties who have access to the data will participate in any training which shall be
required or shall sign any documents which are reasonably necessary to keep both
parties in compliance with HIPAA, including but not limited to, Business Associate
Agreement, User Confidentiality Affirmation Statement, HiPAA Training Certification
or other HIPAA related compliance documents.
6. The data shall only be accessed at locations which are considered physically secure
for data access and use including, specified SAFER call center or MCDPH office. The
data shall not be accessed at any public venue.
7. Notification to MCDPH OE shall occur prior to the research or publication using
MCDPH data.
5. AMENDMENTS
All Amendments to this Agreement must be in writing and signed by authorized persons for both parties.

ATTACHMENT A
SAFER Salmonella investigation Protocol
MCDPH will facilitate getting access to MEDSIS for Kristin Pogreba-Brown and SAFER TAs (Teaching
Assistants) and will provide MEDSIS training and user manuals. If students are to have access to MEDSIS,
Kristin Pogreba-Brown or designee should submit student names and signed user agreements at the
beginning of each semester for each student needing access to MEDSIS. Aurlmar Ayala is a MEDSIS
liaison who will be responsible for deactivating student MEDSIS accounts at the end of their rotation.
Students who are staying on as members of SAFER for more than one semester should have that noted
as soon as possible to prevent account deactivation.
MCDPH will provide salmonella specific investigation training for SAFER students every semester. This
can be incorporated into the training session normally given at the start of the semester.
New Salmonella cases will be assigned by MCDPH triage to Kristen Pogreba-Brown, Steven Hadeed, and
Jonathan Schouest (except for those cases indicating the case is a food handler, childcare worker or
attendee, or healthcare worker, these will be handled by MCDPH staff) which will then be distributed to
SAFER students for investigation. Kristin, Steven, and Jonathan will be responsible for cross checking
each other's MEDSIS queue to assure if one or more of them are absent, Salmonella cases will continue
to be investigated in a timely manner.
MCDPH will provide SAFER with an abbreviated Salmonella investigation form to be used during case
interviews, students will attempt to interview the case within three (3) days of receipt of a case and
complete the investigation form.
If during the case investigation, the student determines the case is a food handler, childcare worker or
attendee and/ or is a healthcare worker, SAFER will contact MCDPH EPI (602) 506-6767 (ask to speak
with a surveillance nurse) and the case will be assigned to a MCDPH staff member.
If during the case investigation, the student(s) discover similarities between two unrelated cases (not
members of the same household), SAFER will contact MCDPH EPI (602) 506-6767 (ask to speak with a
surveillance nurse) and the cases will be assigned to a MCDPH staff member. Similarities between cases
could include:
• Consuming food or drink from the same establishment (excluding common venues such
as Taco Bell, McDonalds, Jack in the Box, etc., unless the unrelated cases mention the
same location).
• Visits to the same zoo, farm, pet shop, fair, water park, lake, river, social gathering,
sporting event, etc.
• Cases which have similar travel related exposures.
• Cases which reside in the same facility (assisted living, halfway house, etc. or attend the
same adult daycare facility.

ATTACHMENT A
Upon completion of the form, Kristin Pogreba-Brown or a TA will enter information contained in the
form into corresponding MEDSIS fields within one day. Note: students will be using an abbreviated
investigation form, more fields are available in the MEDSIS DSO (disease specific observation), and fields
not captured during the case Interview using the abbreviated form will be left blank. "Key" critical
IVIEDSIS fields will be addressed during training; these fields should be filled if at all possible. Any
information/data collected during case interviews which does not have a corresponding data entry field
on the DSO shall be entered in the MEDSIS case notes section.
After completion of the investigation and entry into MEDSIS, students will close their case and submit to
ADHS per MEDSIS training and protocol.
MCDPH will provide SAFER with an informational packet on Salmonella which can be emailed to the
person interviewed after obtaining their email addresses. For those cases who do not have an email,
SAFER will mail packets via USPS.
The informational packet includes instructions and a seven (7) day food history to be completed by the
case and returned to ADHS via email or USPS. SAFER will request the person not to reveal their
salmonella diagnosis when sending via email, simply complete the history and send to ADHS as
indicated. ADHS will enter information gained from the returned seven (7) day food history into
MEDSIS.