DES SFY14 MID-YR AMENDMENT 9.DOCX

Intergovernmental Agreement
CONTRACT AMENDMENT
1. CONTRACTOR (Name and address) 2. CONTRACT ID NUMBER
DE111071001
Maricopa County Administered by its Human Services Department
234 N. Central Ave., Suite 3000
Phoenix, Arizona 85004
3. AMENDMENT NUMBER
Nine (9)
4. THE PARTIES AGREE TO THE FOLLOWING AMENDMENT
Pursuant to the Terms and Conditions, Amendments or Modifications section, the purpose of this amendment is to:
Funding for the contract period July 1, 2013 through June 30, 2014:
The reimbursement ceiling for the service Case Management is increased from $4,053,289 to $4,132,926. This is an
increase of $79,637.
The reimbursement ceiling for the service Community Services is increased from $798,043 to $1,075,286. This is an
increase of $277,243. Carry forward funding in the amount of $333,683 is not added to the cumulative reimbursement
ceiling.
The cumulative reimbursement ceiling for the contract period July 1, 2010 through June 30, 2015 is $20,522,596.
Therefore, the Itemized Service Budget for the services of Case Management (Attachment A) and Community Services
(Attachment B) are revised and attached.
Delete and Replace:
The Background Checks for Employment through Central Registry section located in the DES Special Terms and
Conditions is replaced in its entirety with the following, effective immediately.
5. EXCEPT AS PROVIDED HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT AS HERETOFORE CHANGED AND/OR
AMENDED REMAIN UNCHANGED AND IN FULL FORCE AND EFFECT. THE AMENDMENT SHALL BECOME EFFECTIVE ON THE DATE
OF LAST SIGNATURE UNLESS OTHERWISE SPECIFIED HEREIN. BY SIGNING THIS FORM ON BEHALF OF THE CONTRACTOR, THE
SIGNATORY CERTIFIES HE/SHE HAS THE AUTHORITY TO BIND THE CONTRACTOR TO THIS CONTRACT.
6. 7. NAME OF CONTRACTOR
ARIZONA DEPARTMENT OF ECONOMIC SECURITY Maricopa County Administered by its Human Services
Department
SIGNATURE OF AUTHORIZED INDIVIDUAL SIGNATURE OF AUTHORIZED INDIVIDUAL
TYPED NAME TYPED NAME
Francine Whittington Andrew Kunasek
TITLE TITLE
Manager – Contract Administration Unit Chairman, Board of Supervisors
DATE DATE
IN ACCORDANCE WITH ARS §11-952 THIS CONTRACT AMENDMENT HAS BEEN REVIEWED BY THE UNDERSIGNED WHO HAVE DETERMINED THAT THIS
CONTRACT AMENDMENT IS IN APPROPRIATE FORM AND WITHIN THE POWERS AND AUTHORITY GRANTED TO EACH RESPECTIVE PUBLIC BODY.
ARIZONA ATTORNEY GENERAL’S OFFICE
BY: BY:
ASSISTANT ATTORNEY GENERAL DEPUTY COUNTY ATTORNEY
DATE: DATE:
Revised: 8/22/13

DE111071001
Amendment # 9, page 2
16.0 Background Checks for Employment through the Central Registry
If providing direct services to children or vulnerable adults, the following shall apply:
16.1 The provision of A.R.S 8-804 (as may be amended) are hereby incorporated in its entirety as provisions of this
Contract.
16.2 The Department will conduct Central Registry Background Checks and will use the information contained in the
Central Registry as a factor to determine qualifications for positions that provide direct service to children or
vulnerable adults for:
1. Any person who applies for a contract with this State and that person’s employees;
2. All employees of a contractor;
3. A subcontractor of a contractor and the subcontractor’s employees; and
4. Prospective employees of the contractor or subcontractor at the request of the prospective employer.
16.3 Volunteers who provide direct services to children or vulnerable adults shall have a Central Registry Background
Check which is to be used as a factor to determine qualifications for volunteer positions.
16.4 1. A person who is disqualified because of a Central Registry Background Check may apply to the Board of
Fingerprinting for a Central Registry exception pursuant to A.R.S. § 41-619.57. A person who is granted a
Central Registry exception pursuant to A.R.S. § 41-619.57 is not entitled to a contract, employment, licensure,
certification or other benefit because the person has been granted a Central Registry exception.
2. Before being employed or volunteering in a position that provides direct services to children or vulnerable
adults, persons shall certify on forms that are provided by the Department whether an allegation of abuse or
neglect was made against them and was substantiated. The completed forms are to be maintained as
confidential.
16.5 A person awaiting receipt of the Central Registry Background Check may provide direct services to ADES clients
after completion and submittal of the Direct Service Position certification form if the certification states:
1. The person is not currently the subject of an investigation of child abuse or neglect in Arizona or another state
or jurisdiction; and
2. The person has not been the subject of an investigation of child abuse or neglect in Arizona, or another state or
jurisdiction, which resulted in a substantiated finding.
The Certification for Direct Service Position is located at:
https://www.azdes.gov/InternetFiles/InternetProgrammaticForms/doc/ACY-1287AFORFF.doc
16.6 If the Central Registry Background Check specifies any disqualifying act and the person does not have a Central
Registry exception, the person shall be prohibited from providing direct services to ADES clients.
16.7 The Contractor shall maintain the Central Registry Background Check results and any related forms or documents
in a confidential file for five (5) years after termination of the Contract. The Request for Search of Central Registry
for Background is located at: https://www.azdes.gov/opac
Revised: 8/22/13

DE111071001
Amendment # 9, page 3
Scope of Work, section 10.3.7, is replaced in its entirety with the following, effective October 1, 2013, complete the Self-
Sufficiency Matrix for all case managed households in which a member of the household is 18 to 59 years of age, not
disabled and not a full-time student, and is:
- Unemployed and seeking earned income; or
- Employed and seeking to reduce barriers to maintain earned income; or
- Employed and seeking increased earned income and/or employment benefits.
The results of the Self-Sufficiency Matrix shall be reported in Results Oriented Management and Accountability (ROMA),
National Performance Indicators (NPI’s), goal one.
Revised: 8/22/13