DIGNITY ORAL HEALTH SERVICES CONTRACT 1048858 AMD 4 YR 5.PDF

C-86-19-014-3-04   
 
                                                          AMENDMENT NO: 4          
 
                                                                        
1
AMENDMENT TO CONTRACT BETWEEN 
MARICOPA COUNTY BY AND THROUGH THE 
DEPARTMENT OF PUBLIC HEALTH AND 
DIGNITY COMMUNITY CARE DBA 
 CHANDLER REGIONAL MEDICAL CENTER 
 
I. 
The above-named contract is hereby amended as specified below: 
 
A. Cover Page 
3. Contract Amount: $414,700 
5. Start Date: 07/01/2022 
6. Expiration Date: 06/30/2023 
 
B. Work Statement 
MCOOH FTF shall: 
9.   Will be responsible for 250 of the Contracted Service Units (CSU) in the 
East Region 
10. Will be responsible for collecting all Dignity Health client forms on a 
weekly basis. 
 
DHF shall: 
7.  Meet the CSU for children, expectant mothers, and oral health 
presentations in the East and Southeast Regions designated in the 
RFGA. 
 
 
East Region: Children = 1750, Expectant Mothers = 300, Oral 
Health Presentations = 15 
 
Southeast Region: Children = 2000, Expectant Mothers = 300, Oral 
Health Presentations = 15 
11. After data entry all consent forms and treatment records will be stored 
according to HIPAA standards until MCOOH FTF staff collects the 
forms. 
15. Attend the three MCOOH FTF All Staff Meetings and one Registered 
Dental Hygienist (RDH) Calibration Meeting. 
 
All Staff Meetings: 
• 
September 9, 2022 
• 
January 20, 2023 
• 
May 5, 2023 
RDH Calibration Meeting 
• 
March 3, 2023 
 
II. 
All other terms and conditions of the original contract and its amendments shall 
remain in full force and effect.

C-86-19-014-3-04   
 
                                                          AMENDMENT NO: 4          
 
                                                                        
2
 
IN WITNESS WHEREOF, THE PARTIES AGREE TO THE CHANGES INDICATED HEREIN: 
      
FOR AND ON BEHALF OF DIGNITY COMMUNITY CARE  
DBA CHANDLER REGIONAL MEDICAL CENTER: 
 
 
________________________ 
 
 
Mark Slyter, President & CEO 
 
_____________ 
 
 
Date 
 
 
FOR AND ON BEHALF OF 
 
MARICOPA COUNTY: 
 
 
 
 
 
________________________ 
 
 
Bill Gates, Chairman, Board of Supervisors 
 
_____________ 
 
 
Date 
 
 
 
 
ATTEST: 
 
 
 
 
 
 
 
 
 
________________________ 
 
 
Juanita Garza, Clerk of the Board 
 
 
_____________ 
 
 
Date 
 
 
 
 
APPROVED AS TO FORM: 
 
 
 
________________________ 
 
 
Anne Longo, Attorney for Maricopa County 
 
 
_____________ 
 
 
Date