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INTERGOVERNMENTAL AGREEMENT
MARICOPA COUNTY
by and through the
DEPARTMENT OF PUBLIC HEALTH
4041 N. Central Avenue, #1400, Phoenix, Arizona 85012
1.
Agreement No: RGA2022-001
2. Agreement Type: Fixed Price
3.
Agreement Amount: $115,000 (Year 1)
4. Purpose: BRFSS Survey
5.
Start Date:
January 1, 2022
6. Expiration Date: July 31, 2023
This Agreement is entered into by and between the Arizona Department of Health Services (ADHS)
(referred to herein as “Contractor”), and Maricopa County, by and through its Department of Public Health
(MCDPH) (referred to hereinafter 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: Office Chief, Arizona Health Disparities Center, ADHS
Phone 602-542-2849
Address:
150 N. 18th Avenue, Phoenix, AZ 85007
Notice to Department: MCDPH Grants/Contract Unit
Phone: (602) 372-0674
Address: 4041 North Central Avenue, Suite #1400, Phoenix, Arizona 85012
SECTION I GENERAL PROVISIONS
2
IN WITNESS WHEREOF, the parties enter into this Agreement:
ARIZONA DEPARTMENT OF HEALTH SERVICES
MARICOPA COUNTY BOARD OF SUPERVISORS
Signature
Signature
Name
Christopher Balderrama
Name
Bill Gates
Title
Procurement Services Supervisor
Title
Chairman, Board of Supervisors
Date
Date
ATTEST:
Signature
ADHS Contract # RGA2022-001
Date
Juanita Garza, Clerk of the Board
Pursuant to A.R.S. § 11-952, the undersigned public agency
attorney has determined that this Intergovernmental
Agreement is in proper form and is within the powers and
authority granted under the laws of the State of Arizona.
Pursuant to A.R.S. § 11-952, the Attorney for the Board of
Supervisors has determined that this Intergovernmental
Agreement is within the powers and authority granted under the
laws of the State of Arizona.
Signature
Signature
Date
Date
Anne Longo, Attorney for Maricopa County
SECTION I GENERAL PROVISIONS
3
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.
F. Contractor Staff, Employee or Faculty means a person or persons employed
by, contracted with, or retained by the Contractor for the purpose of providing the
services and responsibilities contained in this Contract.
G. HIPAA means the Health Insurance Portability and Accountability Act of 1996 (PL
104-191) and the United States Department of Health and Human Services
(DHHS) final regulations on “Privacy Standards for Individually Identifiable Health
Information”, as amended and clarified from time to time.
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
SECTION I GENERAL PROVISIONS
4
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
A. This provision applies to all financial and programmatic records, supporting
documents, statistical records, and other records of the County and Contractor that
relate to this Agreement.
B. The County and 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 and
Contractor.
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.
B. 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.
C. The County shall, upon review and agreement of the Parties, remit to the
Contractor any payments determined to have been insufficiently paid, in the
amount of the payment shortfall, as well as court costs and attorney fees the
Contractor incurs to pursue legal action relating to such short payment.
SECTION I GENERAL PROVISIONS
5
9. AGREEMENT COMPLIANCE MONITORING
County may 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. The County shall refer no clients to Contractor for periods of
time for which funding is not available unless at the discretion of both parties, an
alternate source of funds is made available to continue the medical service.
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, 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
SECTION I GENERAL PROVISIONS
6
resolved pursuant to the "Disputes'' clause section contained herein.
12. DEFAULT
For material breach of contractual obligations, or upon the happening of any event
which would jeopardize the ability of the Contractor to perform its contractual
obligations, the County may suspend, modify, or terminate this Agreement
immediately upon giving written notice to the Contractor in the event of non-
performance of any stated objectives. Unless expressly stated otherwise in this
Agreement, such determination will not be made until such time as the disputes
process has been exhausted.
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) hour 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.
D. Either Party has the right to terminate this Agreement for cause upon fourteen (14)
working days written notice for any of the following reasons:
(1) Breach of this Contract which is not corrected within fourteen (14) working days
after written notice thereof or registered mail, return receipt requested.
(2) Inability to discharge the duties and responsibility under this Contract for a
continual period of 30 days or more.
E. This contract is subject to cancellation in accordance with the provision of A.R.S.
§ 38-511.
14. SEVERABILITY
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
SECTION I GENERAL PROVISIONS
7
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
A. 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.
B. The Contractor and its officers, representatives, agents, and employees shall not
be liable for any act or omission by the County or any County subcontractor,
employee, officer, agent, or representative of the County or any County
subcontractor occurring in the performance of this Agreement, nor shall they be
liable for purchases or contracts made by the County or any County 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.
County and Contractor shall safeguard confidential and privileged client and patient
information i.e., medical, financial and patient specific information, and shall only
disclose such information in accordance with all applicable federal, state and local
laws, rules, and/or regulations, including HIPAA. The use or disclosure by any party of
any information concerning a client or patient served under this Agreement or any
other applicable payer contract is directly limited to services under this Agreement
subject to applicable federal, state and local laws, rules and/or regulations.
Contractor’s obligation to maintain the confidentiality of all medical, financial and
patient specific information shall exist after termination or expiration of this Contract.
SECTION I GENERAL PROVISIONS
8
County shall assist Contractor with regard to Contractors’ obligation to comply with
HIPAA.
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. OWNERSHIP OF INFORMATION
Subject to applicable state and federal laws, rules and regulations, including, without
limitation, those concerning confidentiality of patient records, the Contractor shall have
full and complete ownership rights to and the sole and exclusive right to inspect,
reproduce, duplicate, adapt, distribute, display, disclose and otherwise use all reports,
information, data and material prepared by the Contractor in performance of the
Agreement. County may examine and may receive copies of such information
necessary for County's performance of this Agreement.
22. NON-DISCRIMINATION
The Contractor, in connection with any service or other activity under this Agreement,
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 its subcontracts related to this Agreement.
23. 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 ensure 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.).
24. RIGHT OF PARTIAL CANCELLATION
SECTION I GENERAL PROVISIONS
9
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.
25. 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 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 (i.e., transactions with subcontractors) and in all solicitations
for lower tier covered transactions related to this Agreement.
27. E-VERIFICATION OF EMPLOYEES
The Contractor warrants that it is in compliance with A.R.S. § 41-4401 and further
SECTION I GENERAL PROVISIONS
10
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.
28. DISPOSITION OF PROPERTY
All property acquired with funds provided for in this agreement shall become the
property of the funding source.
SECTION II
SPECIAL PROVISIONS
11
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:
A. 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.
B. The person administering this Agreement or the Procurement Officer, as
applicable, shall respond in writing to the dispute within fourteen (14) days.
C. The Contractor may abide by the decision or may appeal the decision to the
Director of the Department within seven (7) days.
D. Any claim or controversy arising out of or in connection with this Agreement not
resolved in accordance with paragraphs 2.A. through 2.C. above shall be resolved
through binding arbitration conducted by a single arbitrator in accordance with the
American Arbitration Association (AAA) Commercial Arbitration Rules, then in
effect, in Phoenix, Arizona; provided, however, matters that primarily involve
Provider's professional competence or conduct shall not be eligible for arbitration.
If possible the arbitrator shall be an attorney with at least fifteen {15) years of
experience, including at least five (5) years' experience in managed health care.
The parties shall conduct a mandatory settlement conference at the initiation of
arbitration, to be administered by AAA. The arbitrator shall have no authority to
provide a remedy or award damages that would not be available to such prevailing
party in a court of law, nor shall the arbitrator have the authority to award punitive
damages. Each party shall bear its own costs and expenses, including its own
attorneys' fees, and shall bear an equal share of the arbitrator's and administrative
fees of arbitration. The parties agree to accept any decision by the arbitrator as a
final determination of the matter in dispute, and judgment on the award rendered
by the arbitrator may be entered in any court having jurisdiction. Arbitration must
be initiated within one year of the earlier of the date the claim or controversy arose,
was discovered or should have been discovered with reasonable diligence;
otherwise it shall be deemed waived. The use of binding arbitration shall not
preclude a request for equitable and injunctive relief made to a court of appropriate
jurisdiction.
This Paragraph shall not apply to claims arising from bodily injury, death, or property
damage.
SECTION II
SPECIAL PROVISIONS
12
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
A. If the Contractor expends $750,000 or more in a year in federal awards, the Contractor
shall have a single audit conducted for that year according to the Office Management and
Budget, Title 2, Subtitle A, Chapter II, PART 200—UNIFORM ADMINISTRATIVE
REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL
AWARDS contained in Title 2 C.F.R. § 200. 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.
SECTION II
SPECIAL PROVISIONS
13
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:
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 and
such allegations arise under the services or terms of this Agreement, 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.
SECTION II
SPECIAL PROVISIONS
14
G. In the event the Contractor(s) is/are a public entity, then the Insurance Requirements shall
not apply. Such a public entity shall provide a Certificate of Self-Insurance. If the
Contractor(s) is/are a State of Arizona agency, board, commission, or university, none of
the above shall apply.
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 upon written request.
7. REPORTING REQUIREMENTS
If requested by the County, the Contractor shall submit annual progress reports on or before
the third (3rd) day of the month following the end of the reporting period.
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 relating to this
Agreement shall include the following statement, “Sponsored by Maricopa County Department
of Public Health.”
SECTION III
WORK STATEMENT
15
1. BACKGROUND:
The Arizona Behavioral Risk Factor Surveillance System (BRFSS) telephone survey has been
in existence since 1984 and is partially funded by the Center of Disease Control and
Prevention (CDC). This surveillance collects and summarizes the data on health-related
topics as reported by Arizona adults aged 18 and over living at home.
2. PURPOSE:
Using a scientifically selected telephone sample, the BRFSS Survey is given to residents of
Maricopa County, completed annually by ADHS. This data is then used to supplement our
community health assessment activities by providing social context to our health indicator
data. Collection of this data will be used to reduce health disparities for all race/ethnicity
groups, income levels, and geographic areas.
In addition to the Centers for Disease Control (CDC) survey questions, this agreement
includes State added questions regarding: Place of Flu Vaccination, (split 2) COVID
Vaccination, (split 2), Reaction to Race, (split 2), and Social Determinants and Health Equity
(split 1 & 2) into the BRFSS 2022 survey.
A. The Arizona BRFSS 2022 is a split survey consisting of 8,000 partial and completed
interviews each. Maricopa County questions will be in Split 2 of the AZ BRFSS 2022
survey. The Arizona Department of Health Services with CDC agreed to absorb the cost
of the Social Determinant & Health Equity Modules which includes the Food Assistance
questions) which will be in Split 1 and 2. There is a sample expansion of 1,000 of 8,000
interviews for Maricopa County which includes Hispanic oversample.
B. Place of Flu question is to develop understanding about contextual effects on individual
and community health, to quantify these effects, and to use this information to develop
more effective strategies and interventions to improve health and to reduce or eliminate
disparities in health. The Place of Flu consists of 1 question; Flu vaccination coverage has
increased for adults over the past three flu seasons and has also been increasing for
children. The racial/ethnic disparities in flu vaccination coverage persist.
C. The COVID-19 Vaccination questions can help raise awareness of health disparities
through understanding and intervening on individual-level risk factors for major causes of
morbidity and mortality. Understanding coronavirus disease (COVID-19) surveillance can
be enhanced by collecting population-level data on individual prevention measures. We
described the use of a state-based, population-level surveillance system on COVID-19
prevention and information-seeking behaviors in Arizona.
D. Reaction to Race questions will help establish a baseline for socially-assigned
race/ethnicity and other race reaction questions to help understand health equity and how
race and health interact. Health disparities commonly exist between racial/ethnic groups.
It is important to understand how one’s self-identified race/ethnicity and socially assigned
race/ethnicity impact their perceived healthcare quality and health status.
E. Sexual Orientation & Health Equity - Many health care providers do not routinely discuss
sexual orientation or gender identity (SO/GI) with patients, and many health care facilities
have not developed systems to collect structured SO/GI data from all patients. Without
SECTION III
WORK STATEMENT
16
this information, lesbian, gay, bisexual, and transgender (LGBT) patients and their specific
health care needs cannot be identified, the health disparities they experience cannot be
addressed, and important health care services may not be delivered. Such services
include appropriate preventive screenings, assessments of risk for sexually transmitted
diseases and HIV, discussions about parenting, and effective interventions for behavioral
health concerns that can be related to the experiences of anti-LGBT stigma.1
3. RESPONSIBILITIES OF CONTRACTOR (ADHS)
A. Assign Arizona BRFSS Program Manager/Coordinator, Bureau of Public Health Statistics,
to serve as a project liaison.
B. Regularly communicate with Maricopa County, as needed, through the duration of the
project to ensure project goals are achieved.
C. Work in collaboration with MCDPH to conduct public relations activities about the project
and findings from the survey.
D. Include the following list of questions in the Arizona BRFSS 2022 questionnaire: CDC’s
Place of Flu Vaccination Module (1 question) in survey split 2; CDC’s partial COVID
Vaccination Module (2 questions) in survey split 2; CDC’s partial Reaction to Race Module
(5 questions) in survey split 2; and CDC’s partial Sexual Orientation Module (2 questions)
in survey split 1 & 2.
E. Survey residents of Arizona in accordance with standard BRFSS survey processes and
use the 9 questions of the CDC’s partial Modules as State-Added questions and one CDC
Module in accordance with the policies and practices set forth by CDC and ADHS.
F. Notify Maricopa County when the data from the BRFSS 2022 survey is ready to export
from the AZ BRFSS website.
G. Receive and accept a contribution of $115,000 from Maricopa County as restricted
earmarked funds designated specifically toward the costs of the 10 questions as State-
Added and one CDC module in the 2022 BRFSS survey.
H. Any notice or other communication to be given shall be in writing and may be personally
served, sent by a recognized overnight courier or sent by U.S. mail, and shall be deemed
to have been delivered or, if delivery is refused, when tendered for delivery properly
addressed as directed below or to such other address later designated by a party in writing
to the other party.
4. RESPONSIBILITIES OF COUNTY
A. Payment for the acquisition of the BRFSS 10 question(s) consisting of 9 State-Added
questions and 1 CDC module.
B. Effectively utilize the survey questions to design programs and allocate resources.
SECTION III
WORK STATEMENT
17
5. SCOPE OF WORK:
A. ADHS agrees to include the attached questions. See Attachment A.
B. The IGA shall commence on January 1, 2022 and will expire on July 31, 2023.
SECTION IV
COMPENSATION
18
1. COMPENSATION
A. The Contractor shall submit a detailed monthly invoice by the 25th of the following month.
B. The Department shall, within thirty (30) working days from the date of receipt of
Contractor’s invoice, process and remit to the Contractor a warrant for payment. Should
the Department make disallowance in the claim, the claim shall be processed to the
reduced amount. The Contractor shall be notified at the address below in writing of the
amount and reasons for any disallowances and shall be afforded the opportunity to
document the appropriateness of the disallowed costs and to resubmit an invoice for
payment.
C. Each Party assumes sole and exclusive responsibility for payment of any federal and state
income taxes, federal social security taxes, workers’ compensation, and unemployment
insurance benefits for its physicians, staff, agents, and employees, as well as any and all
other mandatory governmental deductions or obligations.
D. The Agreement amount is not-to-exceed $115,000 for the budget period of January 1,
2022 through July 31, 2023.
2. METHOD OF PAYMENT
A. The Contractor shall submit one (1) legible copy of their detailed invoice before payment(s)
can be made. At a minimum, the invoice must provide the following information:
● Company name, address, and contact
● County bill-to name and contact information
● Contract Serial Number
● County purchase order number
● Invoice number and date
● Payment terms
● Date of service or delivery
● Quantity
● Contract Item number(s)
● Description of Purchase (services)
● Pricing per unit of service
● Extended price
● Total Amount Due
B. Problems regarding billing or invoicing shall be directed to the using agency as listed on
the Purchase Order
C. The Contractor must maintain and have available upon request supporting documents for
each monthly reimbursement request, including invoices of costs incurred and expenditure
reports.
D. Subject to the availability of funds, the County will, within thirty (30) working days from the
date of receipt of documents enumerated herein, process and remit to the Contractor a
warrant for payment up to the maximum total allowable for services provided. Should the
County make a disallowance in the claim, the claim shall be processed for the reduced
SECTION IV
COMPENSATION
19
amount. If the Contractor protests the amount or the reason for a disallowance, the protest
shall be construed as a dispute concerning a question of fact within the meaning of the
“Disputes” clause of the Special Provisions of this Agreement.
E. 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 (45) days after the expiration date without
approval of the County.
F. Payments made by the County to the Contractor are conditioned upon the timely receipt
of applicable, accurate, and complete invoices submitted by the Contractor. The
Contractor forfeits the right to reimbursement for costs incurred in any month for which it
fails to meet the deadline for submitting the monthly reports, except if such failure is
beyond the reasonable control of the Contractor.
G. The Contractor shall submit one invoice to:
Maricopa County Department of Public Health
Program Operations Administrator
4041 N Central Ave, Suite #1400
Phoenix, AZ 85006
602-506-4926
4. PRICE SHEET
BRFSS 2022 SURVEY
ITEM
# of Questions
RATE/ question
TOTAL
Place of Flu
Vaccination
1
$11,500
$11,500.00
COVID Vaccination
2
$11,500
$23,000.00
Reaction to Race
5
$11,500
$57,500.00
Sexual Orientation
and Gender Identity
2
$11,500
$23,000.00
Grand Total
10
$115,000.00
SECTION IV
COMPENSATION
20
5. NOTICE
Any notice given under this Agreement shall be sent to the attention of the following:
Department
Contractor
Maricopa County Department
Of Public Health
Program Operations Administrator
4041 N Central Ave, Suite #1400
Phoenix, AZ 85006
602-506-4926
Office Chief, Arizona Health Disparities
Center, ADHS
150 N. 18th Avenue
Phoenix, AZ 85007
602-542-2849
Public Health
Grants and Contracts Unit
Attn: Grants Administrator
4041 N Central Ave, Suite 1400
Phoenix, AZ 85012
ATTACHMENT A
21
Module 4: Place of Flu Vaccination (Split 2)
Questio
n
Number
Question
text
Variable
names
Responses
(DO NOT
READ
UNLESS
OTHERWISE
NOTED)
SKIP
INFO/
CATI Note
Interviewer Note
(s)
Column(
s)
Ask if
CIMM= 1
This
question
may be
inserted in
core after
CIMM.02
MFP.01
At what kind
of place did
you get
your last flu
shot or
vaccine?
IMFVPLA1
Read if
necessary:
01 A doctor’s
office or health
maintenance
organization
(HMO)
02 A health
department
03 Another
type of clinic or
health center
(a community
health center)
04 A senior,
recreation, or
community
center
05 A store
(supermarket,
drug store)
06 A hospital
(inpatient or
outpatient)
Read if
necessary: How
would you
describe the
place where you
went to get your
most recent flu
vaccine?
If the respondent
indicates that it
was a drive
through
immunization
site, ask the
location of the
site. If the
respondent
remembers only
that it was drive
through and
cannot identify
the location,
code “11”
348-349
ATTACHMENT A
22
07 An
emergency
room
08 Workplace
09 Some other
kind of place
10 A school
11 A drive
though location
at some other
place than
listed above
Do not read:
77 Don’t know
/ Not sure
99 Refused
AZ State-Added 5: COVID Vaccination (Split 2)
Questio
n
Number
Question text
Variable
names
Responses
(DO NOT
READ
UNLESS
OTHERWISE
NOTED)
SKIP INFO/
CATI Note
Interviewer Note
(s)
Column(s)
MCOV.0
1
Have you
received at
least one dose
of a COVID-
19
vaccination?
¿Ha recibido
al menos una
dosis de la
vacuna contra
el COVID-19?
***NEW***
1 Yes
Go to next
section
2 No
Go to
MCOV.02
(COVACGET
)
7 Don’t know /
Not sure
9 Refused
Go to next
section
MCOV.0
2
Would you say
you will
definitely get a
COVACGE
T
1 = Will
definitely get a
vaccine
Go to next
section
ATTACHMENT A
23
vaccine, will
probably get a
vaccine, will
probably not
get a vaccine,
will definitely
not get a
vaccine, or are
you not sure?
¿Diría que,
seguramente
se vacunará,
probablement
e se vacunará,
probablement
e no se
vacunará,
definitivament
e no se
vacunará, o
no está
seguro?
2 = Will
probably get a
vaccine
3 = Will
probably not
get a vaccine
4 = Will
definitely not
get a vaccine
7 = Don’t
know/Not sure
9 = Refused
1 =
Seguramente
se vacunará
2 =
Probablemente
se vacunará
3 =
Probablemente
no se vacunará
4 =
Seguramente
no se vacunará
AZ State-Added 8: Reactions to Race (Split 2)
Question Number
Question
text
Variable
names
Responses
(DO NOT
READ
UNLESS
OTHERWIS
E NOTED)
SKIP INFO/
CATI Note
Interviewer
Note (s)
Column(
s)
AZRTR.05
Earlier I
asked you to
self-identify
your race.
Now I will ask
you how other
people
identify you
and treat you.
Within the
past 12
months, when
seeking
health care,
do you feel
your
experiences
were worse
than, the
same as, or
better than for
1 Worse
than other
races
2 The same
as other
races
3 Better than
other races
4 Worse
than some
races, better
than others
5 Only
encountered
people of the
same race
7 Don’t know
/ Not sure
9 Refused
If the
respondent
indicates that
they do not
know about
other people’s
experiences
when seeking
health care,
say: “This
question is
asking about
your
perceptions
when seeking
health care. It
does not
require
specific
knowledge
about other
ATTACHMENT A
24
people of
other races?
people’s
experiences
AZRTR.01
How do other
people
usually
classify you in
this country?
Would you
say: White,
Black or
African
American,
Hispanic or
Latino, Asian,
Native
Hawaiian or
Other Pacific
Islander,
American
Indian or
Alaska
Native, or
some other
group?
01 White
02 Black or
African
American
03 Hispanic
or Latino
04 Asian
05 Native
Hawaiian or
Other Pacific
Islander
06 American
Indian or
Alaska
Native
07 Mixed
Race
08 Some
other group
77 Don’t
know / Not
sure
99 Refused
If the
respondent
requests
clarification of
this question,
say: “We want
to know how
OTHER
people
usually
classify you in
this country,
which might
be different
from how you
classify
yourself.”
Interviewer
note: do not
offer “mixed
race” as a
category but
use as a code
if respondent
offers it.
AZRTR.02
How often do
you think
about your
race? Would
you say
never, once a
year, once a
month, once
a week, once
a day, once
an hour, or
constantly?
1 Never
2 Once a
year
3 Once a
month
4 Once a
week
5 Once a
day
6 Once an
hour
8 Constantly
7 Don’t know
/ Not sure
9 Refused
The
responses
can be
interpreted as
meaning “at
least” the
indicated time
frequency. If a
respondent
cannot decide
between two
categories,
check the
response for
the lower
frequency.
For example,
if a
ATTACHMENT A
25
respondent
says that they
think about
their race
between once
a week and
once a month,
check “once a
month” as the
response.
AZRTR.03
Within the
past 12
months, on
average,
were you
treated worse
than, the
same as, or
better than
people of
other races?
1 Worse
than other
races
2 The same
as other
races
3 Better than
other races
4 Worse
than some
races, better
than others
5 Only
encountered
people of the
same race
7 Don’t know
/ Not sure
9 Refused
If
EMPLOY1=
3, 5, 6, 7, 8,
9 GOTO
NEXT
MODULE
[CATI skip
pattern: This
question
should only
be asked of
those who
are
“employed
for wages,”
“self-
employed,”
or “out of
work for less
than one
year.”]
AZRTR.04
Within the
past 12
months at
work, do you
feel you were
1 Worse
than other
races
ATTACHMENT A
26
treated worse
than, the
same as, or
better than
people of
other races?
2 The same
as other
races
3 Better than
other races
4 Worse
than some
races, better
than others
5 Only
encountered
people of the
same race
7 Don’t know
/ Not sure
9 Refused
ATTACHMENT A
27
AZ State Added 7: Sexual Orientation and Gender Identity (SOGI)
(Split 1 and 2)
Question
Number
Question text
Variable
names
Responses
(DO NOT
READ UNLESS
OTHERWISE
NOTED)
SKIP INFO/
CATI Note
Interviewer
Note (s)
Column(
s)
Prologue
The next two questions are about sexual orientation and gender identity
If sex= male
(using
BIRTHSEX,
CELLSEX,
LANDSEX )
continue,
otherwise go
to
MSOGI.01b.
MSOGI.01
a
Which of the
following best
represents
how you think
of yourself?
SOMALE
1 = Gay
2 = Straight,
that is, not gay
3 = Bisexual
4 = Something
else
7 = I don't know
the answer
9 = Refused
Read if
necessary: We
ask this
question in
order to better
understand the
health and
health care
needs of people
with different
sexual
orientations.
Please say the
number before
the text
response.
Respondent can
answer with
either the
number or the
text/word.
551
ATTACHMENT A
28
MSOGI.02
a
Do you
consider
yourself to be
transgender?
TRNSGND
R
1 Yes,
Transgender,
male-to-female
2 Yes,
Transgender,
female to male
3 Yes,
Transgender,
gender
nonconforming
4 No
7 Don’t
know/not sure
9 Refused
Read if
necessary:
Some people
describe
themselves as
transgender
when they
experience a
different gender
identity from
their sex at
birth. For
example, a
person born into
a male body,
but who feels
female or lives
as a woman
would be
transgender.
Some
transgender
people change
their physical
appearance so
that it matches
their internal
gender identity.
Some
transgender
people take
hormones and
some have
surgery. A
transgender
person may be
of any sexual
orientation –
straight, gay,
lesbian, or
bisexual.
If asked about
definition of
gender non-
553
ATTACHMENT A
29
conforming:
Some people
think of
themselves as
gender non-
conforming
when they do
not identify only
as a man or
only as a
woman.
If yes, ask Do
you consider
yourself to be 1.
male-to-female,
2. female-to-
male, or 3.
gender non-
conforming?
Please say the
number before
the text
response.
Respondent can
answer with
either the
number or the
text/word.