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INTERGOVERNMENTAL AGREEMENT (IGA)
Amendment
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave Suite 530
Phoenix, Arizona 85007
Contract No.: CTR046145
IGA Amendment No.: 3
Procurement Officer
Anthony Beckum
Page 1 of 6
Dietetic Internship
Effective upon signatures of both parties, it is mutually agreed that the Intergovernmental Agreement referenced is amended
as follows:
1.
Pursuant to the Terms and Conditions, Provision Six (6), Contract Changes, Section 6.1, Amendments, Purchase Orders
and Change Orders, the following changes are hereby made under this Amendment Three (3):
1.1
The Scope of Work is revised and replaced by the Scope of work in this Amendment Three (3), and
1.2
The Price Sheet is revised and replaced by the Price Sheet of this Amendment Three (3).
All other provisions of this Agreement remain unchanged.
Contractor Name: MARICOPA COUNTY DEPARTMENT OF PUBLIC
HEALTH
Authorized Signature
Address: 4041 N. CENTERAL AVE., SUITE 1400
Print Name
PHOENIX
ARIZONA
85012
City
State
Zip
Title
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 Arizona
This Intergovernmental Agreement Amendment shall be effective
the date indicated. The Public Agency is hereby cautioned not to
commence any billable work or provide any material, service or
construction under this IGA until the IGA has been executed by an
authorized ADHS signatory.
State of Arizona
Signature
Date
Signed this
day of
20___.
Print Name
Procurement Officer
Contract No.: CTR046145, which is an Agreement between public agencies, has been
reviewed pursuant to A.R.S. § 11-952 by the undersigned Assistant Attorney, who has
determined that it is in proper form and is within the powers and authority granted under
the laws of the State of Arizona.
Signature
Date
Assistant Attorney General
Print Name
ATTEST:
___________________________
Clerk of the Board Date
Anne Longo /s/
INTERGOVERNMENTAL AGREEMENT (IGA)
Amendment
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave Suite 530
Phoenix, Arizona 85007
Contract No.: CTR046145
IGA Amendment No.: 3
Procurement Officer
Anthony Beckum
Page 2 of 6
1.
Background
The availability of dietetic internships nationally is very limited resulting in few nutrition graduates working in Arizona
Women, Infants, and Children (WIC) local agencies being accepted each year. Acceptance for dietetic internships
is not determined by the Arizona Department of Health Services (ADHS) but by the Accreditation Council for
Education in Nutrition and Dietetics (ACEND). In Arizona, there are about forty-eight (48) internship slots and about
ninety-five (95) graduates every year. This situation is impacting the ability of WIC local agencies to recruit for
registered dietitian nutritionists statewide to provide training and mentoring of paraprofessional staff as well as
provide high-risk nutrition counseling to WIC clients. The United States Department of Agriculture provides for
reimbursement of reasonable and necessary costs using federal Special Supplemental Nutrition Program for WIC
grant funds for dietetic supervised practice programs or other out-of-service training programs for WIC and eligible
in-kind staff. To support local infrastructure development for nutrition personnel in the WIC program, the ADHS WIC
Program is proposing to provide financial support for the administration of a part-time WIC Dietetic Internship as an
additional track in the Maricopa County Public Health Dietetic Internship.
2.
Objective
To annually increase by no more than six (6) the number of Registered Dietitian Nutritionists in Arizona WIC clinics
specifically for eligible Arizona WIC Staff in the Maricopa County Public Health Dietetic Internship and supporting
enough staff in the Maricopa County Dietetic Internship to operate the WIC-track dietetic internship program.
3.
Tasks
3.1.
The Contractor may submit reimbursement requests for internship coordinator(s) serving the Arizona WIC
Part-Time Dietetic Internship.
3.2.
The Contractor shall:
3.2.1.
Manage fiscal resources and ensure program operates within budget,
3.2.2.
Establish contractual agreements with multiple sites to serve as affiliate agencies for internship
rotations,
3.2.3.
Establish practicum sites and coordinate activities to ensure that competencies are met,
3.2.4.
Establish the overall program goals, strategies, and priorities of the program including programmatic
evaluation and outcomes,
3.2.5.
Develop and implement policies and procedures for the effective management and operation of the
dietetic internship program,
3.2.6.
Complete all necessary correspondence with ACEND/AND, including any annual or requested
reports, and program Self Study as required,
3.2.7.
Integrate learning experiences in administrative, clinical, and community dietetics into the didactic
and clinical components of the internship program,
3.2.8.
Coordinate and direct the efforts of staff participating as preceptors and/or instructors in the
internship program,
3.2.9.
Plan and coordinate the master rotation schedules with staff, affiliation sites and other local dietetic
internship programs as necessary,
INTERGOVERNMENTAL AGREEMENT (IGA)
Amendment
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave Suite 530
Phoenix, Arizona 85007
Contract No.: CTR046145
IGA Amendment No.: 3
Procurement Officer
Anthony Beckum
Page 3 of 6
3.2.10. Establish and maintain a continuous and systematic process of curriculum development,
assessment, evaluation, and implementation,
3.2.11. Review and analyze dietetic intern performance evaluations and take appropriate action to provide
support when minimum standards of performance are not being met,
3.2.12. Prepare and deliver presentations, grade projects and assignments as necessary,
3.2.13. Ensure the internship program remains current with standards established by the ACEND of the
AND,
3.2.14. Provide verification statements for graduates,
3.2.15. Develop recruitment information materials for qualified WIC candidates and establish procedures
for the dissemination of program information to WIC agencies and individual WIC staff requesting
information,
3.2.16. Establish selection criteria for acceptance into internship program, and establish an executive
committee for selection of candidates with representation from Maricopa County Public Health and
ADHS,
3.2.17. Review and evaluate all application packets for presentation to selection committee,
3.2.18. Obtain Letters of agreement from each accepted WIC Employee/Intern and their Local WIC Agency
that they will be working for during their internship,
3.2.19. Coordinate the evaluation process of the selection committee and informs applicants of decisions,
3.2.20. Maintain professional currency in areas relevant to directing the dietetic internship, dietetic
registration and continuing education requirements,
3.2.21. Develop and implement individualized plan for professional growth including participation in
professional organizations and activities,
3.2.22. Guide and mentor the intern graduates to be successful in their dietetic registration exams,
3.2.23. Participate as an active member of the Arizona Dietetic Practicum Advisory Committee, and
3.2.24. Provide monthly and as needed status updates to ADHS including information such as intern
progress and performance, and interns’ registration exam status.
4.
Qualifications
Internship Assistant Director Qualifications:
4.1.
Minimum education and/or experience:
4.1.1.
Master’s degree in nutrition, dietetics, food management or health related field, granted by a US
regionally accredited college of university,
4.1.2.
Completion of a didactic program in dietetics and supervised practice program approved the
ACEND of the AND.
4.1.3.
Must have the Registered Dietitian Nutritionist credential, and
INTERGOVERNMENTAL AGREEMENT (IGA)
Amendment
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave Suite 530
Phoenix, Arizona 85007
Contract No.: CTR046145
IGA Amendment No.: 3
Procurement Officer
Anthony Beckum
Page 4 of 6
4.1.4.
Minimum of three (3) years experience in staff management and/or as dietetics practitioner
required.
4.2.
Preferred education and/or experience:
4.2.1.
Teaching experience as a dietetic preceptor, and
4.2.2.
Community nutrition/WIC experience.
4.3.
Knowledge, Skills, and Abilities:
4.3.1.
Knowledge of ACEND standards of education and broad knowledge of clinical and administrative
dietetics,
4.3.2.
Knowledge of human nutrition, physiology, food science, biochemistry, education theory and
techniques,
4.3.3.
Ability to integrate food and nutrition services with other services in the practice setting,
4.3.4.
Ability to promote effective professional relationships in the practice of dietetics,
4.3.5.
Ability to communicate clearly and effectively in both written and verbal forms,
4.3.6.
Ability to solve problems, generate ideas, and think creatively,
4.3.7.
Ability to organize and coordinate multiple projects,
4.3.8.
Skills in organizing and directing the work effort of others,
4.3.9.
Skill in problem-solving, strategic thinking, negotiation, and sound judgment,
4.3.10. Skill in planning and executing projects and programs,
4.3.11. Ability to work in a multi-task environment and meet tight deadlines,
4.3.12. Strong organizational and computer skills,
4.3.13. Knowledge of food and nutrition policy regulation and governance,
4.3.14. Ability to motivate and mentor students and staff, and
4.3.15. Skills in time management, fiscal planning and marketing.
4.4.
Special working conditions:
4.4.1.
Travel to affiliate sites throughout the state of Arizona required.
5.
Requirements
5.1.
Grant provided to contractor will be based on the costs needed to support enough staff to operate the WIC-
track dietetic internship.
5.2.
Allowable costs for the grant include:
INTERGOVERNMENTAL AGREEMENT (IGA)
Amendment
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave Suite 530
Phoenix, Arizona 85007
Contract No.: CTR046145
IGA Amendment No.: 3
Procurement Officer
Anthony Beckum
Page 5 of 6
5.2.1.
Employee Salary and Benefits,
5.2.2.
Mileage,
5.2.3.
Office Supplies,
5.2.4.
Training costs, and
5.2.5.
Indirect costs.
6.
Deliverables
The Contractor shall submit to ADHS:
6.1.
All application materials which will be used by interested applicants;
6.2.
Selection criteria to be used to rate applicants;
6.3.
Acceptance letters to each employee accepted to the Arizona WIC Part-Time Dietetic Internship accredited
by the Accreditation Council for Education in Nutrition and Dietetics (ACEND), the Academy of Nutrition and
Dietetics ’s accrediting agency for education programs preparing students for careers as Registered Dietitian
Nutritionists;
6.4.
Documentation of allowable Arizona WIC Part-Time Dietetic Internship costs included in monthly Contractor
Expenditure Report by the thirtieth (30th day of the month following the reporting month); and
6.5.
Provide an overview of clinical nutrition training for interns before they begin their clinical rotations.
7.
Notices, Correspondence, Reports and Invoices
7.1.
Notices, correspondence, reports and invoices from the Contractor to ADHS shall be sent to:
Arizona Department of Health Services
Attn: Gladys Lovera, Operations Coordinator
Bureau of Nutrition and Physical Activity
150 N. 18th Ave, Suite 310
Phoenix AZ 85007
Phone: 602-364-1649
Email: Gladys.Lovera@azdhs.gov
7.2.
Notices and Correspondence from ADHS to the Contractor shall be sent to:
Maricopa County Department of Health Services
Diana Kinsfather, MS, RDN
4041 N. Central Avenue Suite 1400
Phoenix, Arizona 85012
Phone: 480-612-4144
Email: Diana.Kinsfather@maricopa.gov
INTERGOVERNMENTAL AGREEMENT (IGA)
Amendment
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave Suite 530
Phoenix, Arizona 85007
Contract No.: CTR046145
IGA Amendment No.: 3
Procurement Officer
Anthony Beckum
Page 6 of 6
PRICE SHEET
WIC Services
Account Classification
Amount
1. Personnel Expenses
$84,699.00
2. Employee Related Expenses
$37,439.00
3. Professional & Outside Services
$0.00
4. Travel Expense
$2,250.00
5. Occupancy Expenses
$4,844.00
6. Other Operating Expenses
$12,707.00
7. Capital Expenditures
$0.00
8. Indirect Cost
$25,974.00
Total (Not to Exceed)
$167,913.00