CONTRACT AMENDMENT RE HEALTH CENTER CLUSTERS WITH US DEPT OF HEALTH AND HUMAN SERVICES.PDF

. DATE ISSUED: 2. PROGRAM CFDA: 93.224 • • ir.z. ndprima-fd pliti..im.p.fie-,:irams.rotto . :
09112/2013
RSA
3. SUPERSEDES AWARD NOTICE dated: 07/05/2013
except that any additions Cr restrictions previousty imposed remain in effect uniess specifically rescinded_ . Health Eimenca, and Sordgaikhriniefingien
4a. AWARD NO.: 411. GRANT NO.: 5. FORMER NOTICE OF AWARD
6 H81JC500044-12-03 H80CS00044 GRANT NO.: AUTHORIZATION (Legislation/Regulation)
H66CS00459 Public Health Service Act, Title III, Section 330
Public Health Service Act, Section 330, 42 U.S.C. 254b
Affordable Care Act, Section 10503
6. PROJECT PERIOD: Public Health Service Act, Section 330,42 U.S.C. 254, as amended.
FROM: 11/01/2001 THROUGH: 10/31/2017 Authority: Public Health Service Act, Section 330, 42 U.S.C, 254b, as
7. BUDGET PERIOD: amended
Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended
FROM: 11/01/2012 THROUGH: 10/31/2013
8. TITLE OF PROJECT (OR PROGRAM): HEALTH CENTER CLUSTER
9. GRANTEE NAME AND ADDRESS: 10. DIRECTOR: (PROGRAM DIRECTOR/PRINCIPALINVESTIGATOR)
MARICOPA COUNTY PUBLIC HLTH SERVS DEPT Tress Floyd
220 S 12th Ave MARICOPA COUNTY PUBLIC HLTH SERVS DEPT
Phoenix, AZ 85007-3101 Division Line: Maricopa County Dept. Public Health, Health Care for the
DUNS NUMBER: Homeless
145454000 220S 12th Ave
BHCMIS #090750 Phoenix, AZ 85007-3101
11.APPROVED BUDGET:(Excludes Direct Assistance) 12. AWARD COMPUTATION FOR FINANCIAL ASSISTANCE:
[ I Grant Funds Only a. Authorized Financial Assistance This Period $2,687,897.00
[X] Total project costs including grant funds and all other financial b. Less Unobligated Balance from Prior Budget Periods
participation . .... . ... i. Additional Authority $0.00
a. Salaries and Wages : $1,299,739.00 ii. Offset $0.00
b. Fringe Benefits : $480,806.00 c. Unawarded Balance of Current Year's Funds $0.00
c. Total Personnel Costs : $1,780,545.00 d. Less Cumulative Prior Awards(s) This Budget Period $2,557,730.00
d. Consultant Costs : $0.00 e. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION $30,167.00
e. Equipment : $0.00
f. Supplies : $198,500.00
g . Travel : $7,490.00 13. RECOMMENDED FUTURE SUPPORT: (Subject to the availabilityof
funds and satisfactoryprogress . . of nroiect)
h . Construction/Alteration and Renovation : $0,00 '''l'YEP41: ..i .••.... -..:..:.: ; - :...:.:::.::.•:.:.:.:.::..:.:.. . . ,:74174.:PgaTS::
I. Other : $204,828.00 13 $2,580,229.00
' . Consortium/Contractual Costs : $345,000.00 14 $2,682,897.00
. Trainee Related Expenses : $0.00 15 $2682,897.00
16 $2,682,897.00
I. Trainee Stipends : $0.00
m . Trainee Tuition and Fees : $0.00
n. Trainee Travel : $0 .00 14. APPROVED DIRECT ASSISTANCE BU GET:(In lieu of cash)
o. TOTAL DIRECT COSTS: $2,536,363.00 a. Amount of Direct Assistance $0.00
p. INDIRECT COSTS (Rate: % of S&VV/TADC) i $351.534.00 b. Less Unawarded Balance of Current Year's Funds $0.00
. TOTAL APPROVED BUDGET: $2,887,897,00 c. Less Cumulative Prior Awards(s) This Budget Period $0.00
I. Less Non-Federal Share: $200.000.00 d. AMOUNT OF DIRECT ASSISTANCE THIS ACTION $0.00
ii. Federal Share: $2,687,897.00
15. PROGRAM INCOME SUBJECT TO 45 CFR Part 74.24 OR 45 CFR 92.25 SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING
ALTERNATIVES:
A=Addition 13=Deduction C=Cost Sharing or Matching D=Other (D]
Estimated Program Income: $200,000.00
16. THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY HRSA, IS ON THE ABOVE TITLED PROJECT
AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY OR BY REFERENCE IN THE FOLLOWING:
a. The great program legislation cited above. b. The grant program regolatlon cited above_ c_ This award hotica including terms and conditions, if any, noted below under REMARKS. ol, 45CFR Part 74 or 45 .
SFR Part 92 as applicable, In the event there are conflicting or otherwise inconsistent policies applicable to the grant, the abOve order of precedence shall prevail, Acceptance of the grant terms and conditions is
CS.nowiedged by the grantee when funds are drawn or otherwise obtained from the grant payment systerh_
REMARKS: (Other Terms and Conditions Attached [ . X ]Yes ]No)
Electronically signed by Helen Harpold , Grants Management Officer on : 09/12/2013
17. OBJ. CLASS: 41.51 '18. CRS-EIN: 19. FUTURE RECOMMENDED FUNDING: $0.00
1866000472A2
• • • • SUB PROGRAM ...::... 'S11:5 - ::: : ...:. • •
FY:PAN::::.. • CFPA:: DOCUMENT NO AMT...FOL 'AS$T.: .:. AMT 17 0 .:.........•..:......... .• .. •.. ACCQUNT:..:
• .":...:COOF•:•.:::
...:.::000 . - .
13 -3988790 93.527 H80CS0004400 $30,167.00 $0.00 HCK N/A J
Page I

NOTICE OF AWARD (Continuation Sheet) Date Issued: 9/12/2013 11:51:08 AM
Award Number: 6 1180CS00044-12-03
HRSA Electronic Handbooks (EHBs) Registration Requirements
The Project Director of the grant (listed on this NoA) and the Authorizing Official of the grantee organization are required to register (if not
already registered) within HRSA's Electronic Handbooks (EHBs). Registration within HRSA EHBs is required only once for each user for each
organization they represent. To complete the registration quickly and efficiently we recommend that you note the 10-digit grant number from box
4b of this NoA. After you have completed the initial registration steps (i.e.,created an individual account and associated it with the correct
grantee organization record), be sure to add this grant to your portfolio. This registration in HRSA EHBs is required for submission of
noncompetng continuation applications. In addition, you can also use HRSA EHBs to perform other activities such as updating addresses,
updating email addresses and submitting certain deliverables electronically. Visit https://grants.hrsa.gov/webexternai/login.asp to use the
system. Additional help is available online and/or from the HRSA Call Center at 877-Go4-HRSA/877-464-4772.
Terms and Conditions
Failure to comply with the special remarks and condition(s) may result in a draw down restriction being placed on your Payment
Management System account or denial of future funding.
Grant Specific Term(s)
1. This Notice of Award (NoA) provides an ongoing base adjustment to your Health Center Program funding level and establishes a new target
level of support for FY 2014. Under the FY 2013 base adjustment formula, all section 330 grantees will receive the base amount of $22,750
with an additional $1.00 per health center patient as exhibited on their Calendar Year (CY) 2012 Uniform Data System (UDS) submission,
All prior terms and conditions remain in effect unless specifically removed.
Contacts
i
NoA Email Address(es):
...,..,........
ikente-::...!.:::•.:•: ........... ....... ..... ::::::"::.1..:.:•.":•:...•.,::.::.:.::.::.... ..... .. . . ..... . . Role .. Entail .............. .:•::••:.:::' .- ...:. ...
Jane E Cochrane Official janecochrane@mail.maricopa.gov
Tresa Floyd Program Director tresafloyd@rnail.rnaricopa.goy
Note: NoA emaied to these address(es)
Program Contact:
For assistance on programmatic issues, please contact Stephanie McCoy at:
MallStop Code: 16C-26
HRSA/BPHC
5600 Fishers Ln
Rockville, MD, 20857-1750
Email: smccoy@hrsa.gov
Phone: (301) 443-1848
Fax: (301) 594-0161
Division of Grants Management Operations:
For assistance on grant administration issues, please contact Clare Oscar at:
MailStop Code: 11-03
OFAM/DGMO/HCB
5600 Fishers Ln
Rockville, MD, 20852-1750
Email: coscar@hrsa.gov
Phone: (301) 443-8862
Fax: (301) 443-9810
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C-86-02-073-2-31 Amendment No. 32
IN WITNESS WHEREOF, the parties agree to enter into this Agreement:
FOR AND ON BEHALF OF
MAR1COPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Deputy Attorney for Maricopa County
Date