PE CMS AMENDMENT 1.PDF

Maricopa County — Formal (2024-08-21)

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CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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AMENDMENT TO 
CONTRACT  
Between 
MARICOPA COUNTY  
by and through 
DEPARTMENT OF PUBLIC HEALTH 
and 
Community Medical Services Arizona-State, LLC 
 
I. 
The above-named contract is hereby amended as specified below: 
 
A. Section 1.0 CONTRACT TERM shall be updated to reflect a new expiration date of August 
31, 2025.  
 
B. An additional $250,000 shall be added for the additional year as outlined in Exhibit A, Year 2 
Budget & Budget Narrative, beginning on page 2 of this amendment. The revised not to 
exceed (NTE) amount shall be updated to $450,000.   
 
C. Exhibit B, Scope of work, shall be replaced with the Revised Scope of Work, Year 2 Project 
Narrative, and Year 2 Project Timeline beginning on page 5 of this amendment.   
  
II. 
All other terms and conditions of the original contract shall remain in full force and effect. 
 
IN WITNESS WHEREOF, the parties agree to the changes indicated herein: 
 
      
FOR AND ON BEHALF OF                            
MARICOPA COUNTY 
 
FOR AND ON BEHALF OF 
COMMUNITY MEDICAL SERVICES ARIZONA-
STATE, LLC                                
 
By:  
 
 
By: 
 
Chairman, Board of Supervisors 
 
 
 
Community Medical Services Arizona-State, LLC     
 
 
Date 
 
 
Date 
ATTEST 
 
 
 
 
Clerk of the Board 
 
 
 
 
 
Date 
 
 
 
APPROVED AS TO FORM 
 
 
 
 
 
Attorney for Maricopa County 
 
 
 
 
 
Date 
 
 
 
7/11/2024

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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EXHIBIT A 
YEAR 2 BUDGET & BUDGET NARRATIVE   
 
 
YEAR TWO BUDGET SHEET 
TOTAL  
 
Personnel 
 
 
Salaries 
 
 
Program Manager  
$47,500 
 
24/7 Criminal Justice Liaison 1  
$48,000 
 
24/7 Criminal Justice Liaison 2  
$44,000 
 
Total Salaries 
$139,500 
 
Fringe Benefits (ERE rate: 21.9%) 
$30,550.50 
 
Personnel Subtotal 
$170,050.50 
 
Operating 
 
 
Travel 
$6,734 
 
Outreach 
$43,200 
 
Staff Education and Training 
$360 
 
Equipment 
$1,800 
 
Other 
$5,292.86 
 
Operating Subtotal 
$57,384.86 
 
DIRECT COSTS (personnel + operating) 
$227,436.36 
 
INDIRECT COSTS (10%, excludes equipment) 
$22,563.64 
 
TOTAL BUDGET (Direct + Indirect) 
$250,000 
  
 
Year 2 Budget Narrative 
Program Personnel: $170,050.50 
Program Manager 
This role will be responsible for a comprehensive programmatic overview. Duties will include strategic 
planning, outreach to key stakeholders, facilitating communication among the cross-functional team 
(including the development of a deflection committee for Maricopa County), development of training 
materials, conducting training for law enforcement and first responders, outreach at community events, 
evaluation of program outcomes, continuous quality improvement, and the preparation and submission 
of narrative reports to the MCDPH. 
 
0.50 FTE Program Manager Salary = $47,500.00 
0.50 FTE Program Manager ERE (21.9%) = $10,402.50 
0.50 FTE Program Manager Salary and ERE Subtotal = $57,902.50 
 
24/7 Criminal Justice Liaison 1  
This role will provide member support and be assigned to any member with opioid use disorder and 
criminal justice involvement. Duties will include assisting members with the process regarding any open

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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or ongoing court proceedings or court hearings, coordination of care for members who are incarcerated 
while receiving services, engaging the client to resume treatment upon release as well as being involved 
in the release planning for the incarcerated member, and a liaison for any community supervision entities 
that the member may be involved with, including complying with terms and conditions of probation and 
parole. 
 
0.80 FTE CJ Liaison 1 Salary = $48,000.00 
0.80 FTE CJ Liaison 1 ERE (21.9%) = $10,512.00 
0.80 FTE CJ Liaison 1 Salary and ERE Subtotal = $58,512.00 
 
24/7 Criminal Justice Liaison 2 
This role will provide member support and be assigned to any member with opioid use disorder and 
criminal justice involvement. Duties will include assisting members with the process regarding any open 
or ongoing court proceedings or court hearings, coordination of care for members who are incarcerated 
while receiving services, engaging the client to resume treatment upon release as well as being involved 
in the release planning for the incarcerated member, and a liaison for any community supervision entities 
that the member may be involved with, including complying with terms and conditions of probation and 
parole. 
 
0.80 FTE CJ Liaison 2 Salary = $44,000.00 
0.80 FTE CJ Liaison 2 ERE (21.9%) = $9,636.00 
0.80 FTE CJ Liaison 2 Salary and ERE Subtotal = $53,636.00 
Travel: 
Local Travel and Deliveries 
CMS is requesting funds to support local travel and deliveries. Staff will be responsible for attending 
deflection committee and stakeholder meetings related to the ongoing referrals with law enforcement, 
fire departments, hospitals, correctional health facilities, and other stakeholders that engage and support 
patients with opioid use disorder. Miles may also be used for delivering medication to skilled nursing 
facilities and other rehabilitative settings.  
 
$0.665 per mile x 350 miles per month x 12 months = $2,793.00 
 
PAARI National Law Enforcement Summit (Location TBD, rates based on BOS) 
CMS is requesting funds to support attendance by program staff at the PAARI National Law Enforcement 
Summit. This summit provides a unique opportunity for staff to engage with national experts, learn about 
innovative practices in law enforcement-assisted recovery initiatives, and network with peers from across 
the country. Attendance at this summit will enhance the knowledge and skills of our team, enabling them 
to implement cutting-edge strategies in our own deflection and recovery programs. 
 
Airfare: $300 per round trip flight x 3 key personnel = $900.00 
Lodging: $197 per night x 3 nights x 3 key personnel = $1,773.00 
M&IE: $79 per day x 4 days x 3 key personnel = $948.00 
Car Rental: $80 per day x 4 days shared between 3 key personnel = $320.00 
Education and Outreach:  
Naloxone (injectable) 
CMS is requesting funds for naloxone (injectable) kits to distribute to local law enforcement, first 
responders, and other co-responders at training sessions, during service provision, on-site, and in the 
community to support harm reduction efforts. Narcan is a safe medication that is widely used to prevent 
opioid overdose deaths.

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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$18 per injectable naloxone kit x 30 kits per month x 12 months = $6,480.00 
 
Naloxone (nasal) 
CMS is requesting funds for naloxone (nasal) kits to distribute to local law enforcement, first responders, 
and other co-responders at training sessions, during service provision, on-site, and in the community to 
support harm reduction efforts. Narcan is a safe medication that is widely used to prevent opioid 
overdose deaths. 
 
$36 per nasal naloxone kit x 75 kits per month x 12 months = $36,720.00 
Staff Education and Training: 
Registration for PAARI National Law Enforcement Summit 
CMS is requesting funds to support attendance by program staff at the PAARI National Law Enforcement 
Summit. This summit provides a unique opportunity for staff to engage with national experts, learn about 
innovative practices in law enforcement-assisted recovery initiatives, and network with peers from across 
the country. Attendance at this summit will enhance the knowledge and skills of our team, enabling them 
to implement cutting-edge strategies in our own deflection and recovery programs. 
 
$120 per registration x 3 key personnel to attend = $360.00 
Equipment: 
Enterprise Vehicle Lease 
CMS is requesting funds to support transportation and ancillary services provided by staff through an 
Enterprise Fleet Management vehicle lease. Transportation utilized by staff will focus on engaging 
individuals, providing access and information to treatment, and promoting the integration of services, 
particularly for under and uninsured populations. Leased vehicles will also be used to deliver medication 
to individuals on MAT that are residing in skilled nursing facilities or other rehabilitative settings who 
cannot come to the clinic for their medication, and for local travel between clinics. The vehicle will be 
shared between the 24/7 Criminal Justice Liaisons. 
$150 per vehicle per month x 1 vehicle x 12 months = $1,800.00 
Other:  
Cell Phone Service 
CMS is requesting funds for cell phones for staff to support daily work duties and provide resources and 
referrals for positions that need to be mobile. 
 
$50 per month x 12 months x 0.50 FTE for Program Manager = $300.00 
$50 per month x 12 months x 0.80 FTE for CJ Liaison 1 = $480.00 
$50 per month x 12 months x 0.80 FTE for CJ Liaison 2 = $480.00 
Cell Phone Service Subtotal = $1,260.00 
 
Leased Vehicle Fuel, Registration, and Repairs and Maintenance 
CMS is requesting funds for several vehicle-related expenses essential to maintaining compliance and 
supporting program activities. This includes the registration renewal of vehicles leased through 
Enterprise Rental, an annual expense necessary to ensure vehicle compliance. Additionally, CMS is 
requesting funds for fuel, provided through Wright Express, to transport patients referred from various 
settings and deliver medication as needed. Lastly, funds are needed for regular, ongoing repairs and 
maintenance of leased vehicles to ensure their reliability and safety. 
Leased Vehicle Fuel: $200 per vehicle per month x 1 vehicle x 12 months = $2,400.00

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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Leased Vehicle Registration: $250 annually 
Leased Vehicle Repairs and Maintenance: $1,381.86 annually 
Indirect Costs: 
CMS is electing a 10 percent de minimis rate based on the modified total direct cost of this grant budget, 
in compliance with the 2 CFR §200.403 factors that affect allowability of cost. CMS does not currently 
have a negotiated indirect cost rate and will be using the de minimis rate indefinitely and consistently for 
all federal awards until such a time CMS chooses to negotiate a rate. CMS is not a state, local 
government, or Indian tribe and is not receiving more than $35M in direct federal funding and is eligible 
for de minimis according to 2 CFR §200 Appendix VII D(1)(b). 
Modified Total Indirect Cost Calculation 
Total Direct Costs 
$227,436.36 
Less: Equipment 
$1,800.00 
Less: Subawards 
$0.00 
Plus: First $25,000 
$0.00 
MTDC Base: 
$225,636.36 
Rate Applied: 
10% 
Indirect Costs: 
$22,563.64 
 
Exhibit B 
REVISED SCOPE OF WORK, YEAR 2 PROJECT NARRATIVE, YEAR 2 PROJECT TIMELINE 
 
REVISED SCOPE OF WORK 
Contractor shall: 
3.1 
Provide training to public safety professionals. Activities/topics should include, but are 
not limited to: 
3.1.1 
Deflection programs 
3.1.2 
Opioid reversal medication administration and distribution 
3.2 
Participate in the Maricopa County Deflection Committee and use feedback to inform 
deflection trainings. 
3.3 
Engage in community outreach to disseminate substance use prevention and education 
resources as well as distribute harm reduction supplies.  
3.4 
Distribute opioid reversal medications and provide training on its administration. 
3.5 
Provide referrals and warm hand-offs for those in need of additional services. 
3.6 
Submit any training or educational materials to MCDPH for review and approval prior to 
implementation/dissemination. Any material with the Maricopa County brand is also 
subject to review and approval prior to use.  
3.7 
Evaluation 
3.7.1 
Collaborate with MCDPH on an evaluation plan that includes metrics for how 
success will be measured and opportunities for improvement. 
3.7.2 
Complete quarterly and annual reports using template(s) provided by MCDPH, to 
include: 
• 
Narrative description of project activities achieved during the specified 
timeframe 
• 
Accomplishments (“success stories”) and challenges 
• 
Staffing changes 
• 
Current budget and description of over or underspending 
• 
Evaluation metrics

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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3.7.3 
Complete any additional reporting requirements that may be requested. 
3.8 
Participate in, at minimum, one monthly meeting with MCDPH. 
3.9 
Submit invoices and supporting documentation for work completed during the month by 
the 15th of the following month. 
3.10 
Maintain client confidentiality in alignment with applicable state and federal laws that 
protect client confidentiality of medical, behavioral health, and drug treatment 
information. 
3.11 
Provide documentation that any staff working with minors has secured and maintained 
an Arizona Department of Public Safety Level 1 Clearance Card and completed a 
background check. 
3.12 
Allowable expenses: 
Direct, operational, and indirect costs associated with the provision of activities and 
services as detailed and accepted in the Scope of Work, Budget, and/or Budget Narrative. 
Indirect expenses may not exceed ten percent (10%). 
 
MCDPH shall: 
 
3.13 
Provide technical assistance in developing an evaluation plan and support for ongoing 
evaluation. 
3.14 
Ongoing review of the establishment and implementation of activities and measures for 
accomplishing the goals of this agreement. 
3.15 
Participating, as appropriate, in conference calls and meetings that are conducted during 
the project period. 
3.16 
Review training and education materials prior to implementation/dissemination.  
3.17 
Review and approve the use of any materials or items with the Maricopa County 
branding.  
 
YEAR 2 PROJECT NARRATIVE 
2.1.3 Prevent overdose deaths and other harms (harm reduction) 
 
ACTIVITIES/DELIVERABLES 
To prevent overdose deaths and other harms (harm reduction), several key activities will be expanded 
upon in the second year of funding. 
 
The Program will focus on continued engagement in a credentialed curriculum for harm reduction and 
naloxone administration. Key program staff, including the Program Manager and two Criminal Justice 
Liaisons, have been trained to conduct these sessions. This will enable the continuation of monthly harm 
reduction and naloxone administration training sessions specifically designed for law enforcement 
officers and first responders. The outcome that will be measured is the number of harm reduction and 
naloxone administration training sessions conducted. 
 
Community outreach and education will be a significant component of the harm reduction efforts. 
Educational materials such as flyers, brochures, and fact sheets will be developed and distributed to 
increase awareness and understanding, as well as naloxone and Narcan for community. Additionally, 
participation in community events will provide opportunities to educate the public about the Criminal 
Justice Liaison and Deflection Program, further supporting harm reduction goals. The outcome that will 
be measured is the number of community outreach events attended and supplies distributed. 
 
Evaluation and reporting will ensure the effectiveness of these activities. Pre- and post-surveys will be 
conducted at each training session to assess their impact. Quarterly narrative progress reports will be 
prepared and submitted to the MCDPH Substance Abuse Prevention program to provide ongoing

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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evaluation and accountability. The outcome that will be measured are the results from pre- and post-
surveys assessing training effectiveness and submission of quarterly narrative progress reports and a 
comprehensive annual report at the end of the grant term. 
 
ACTIVITIES 
 
 
Activity 
 
Activity Type 
Projected # of individuals to be 
served during year 2 
Harm reduction and naloxone 
administration training sessions 
Naloxone Training 
120 
Community outreach events to 
distribute harm reduction 
supplies 
Naloxone Distribution 
1,200 
 
TARGET POPULATION & SERVICE AREA 
The target population remains unchanged from Year One. CMS is committed to reducing barriers to 
treatment for individuals who are experiencing opioid use disorder, including reducing stigma and 
educating the community on effective treatments regardless of race, ethnicity, nationality, religion or 
spirituality, gender identity or expression, sexual orientation, socioeconomic status, physical or cognitive 
ability, language, beliefs, values, behavior patterns, or customs.  
 
OUTCOMES 
• 
Increase knowledge on how to use Naloxone for a suspected overdose (measure number of 
sessions and change in knowledge via survey) 
• 
Harm reduction supplies are distributed at community outreach events (measure number of 
events and number of supplies distributed) 
 
2.1.4 Support connections to care and warm hand-off services 
 
ACTIVITIES/DELIVERABLES 
To support connections to care and warm hand-off services, the program will focus on the enhancement 
of the Deflection Committee and framework, as well as the Deflection Program and warm hand-off 
services. 
The program will continue to gather stakeholder interest and invite key community members to 
participate in the Maricopa County Deflection Committee. Collaboration with the Deflection Committee 
and the Maricopa County Department of Public Health (MCDPH) will be essential to develop effective 
deflection training materials. The outcome to be measured will be the number of committee meetings 
held. 
The Deflection Program will involve quarterly and as-needed training sessions that will be conducted for 
law enforcement officers and first responders to ensure they are well-versed in deflection strategies. The 
outcome to be measured will be the number of deflection training sessions conducted. 
Warm Hand-Off Services Enhancement will be a key focus area in the second year of funding, with 
activities aimed at improving the referral and service uptake processes for individuals with OUD. Efforts 
will be made to increase the number of individuals referred to recovery services through enhanced 
outreach and collaboration with relevant facilities and organizations. Strengthening these partnerships 
will help identify more individuals in need and connect them with essential support services. This will 
involve reducing barriers to access and encouraging greater participation in recovery programs, ensuring 
that individuals can fully benefit from the services available.

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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The program will also work to offer tailored services to a diverse group of individuals, ensuring that 
interventions meet the specific needs of different demographic groups. By addressing the unique needs 
of various populations, the program aims to provide more effective and equitable support to those at risk. 
The outcome to be measured will be the number of individuals referred to CMS and receiving recovery 
services. 
 
 
ACTIVITIES 
 
 
Activity 
 
Activity Type 
Projected # of individuals to be 
served during year 2 
Participate in the Maricopa 
County Deflection Committee 
Training on Substance Use 
Disorder Screening and Warm 
Hand Off 
Monthly meeting, attendance 
count is approx. 5 
 
Provide deflection program 
training sessions 
Training on Substance Use 
Disorder Screening and Referral 
25 
Enhance warm hand-off 
services 
Substance Use Disorder Referral 
1,200 
 
TARGET POPULATION & SERVICE AREA 
The target population remains unchanged from Year One. The target population for this project are any 
members who are at risk of becoming criminal justice involved, who are criminal justice involved, and who 
have – or are at risk of developing – opioid use disorder and any co-occurring substance use disorder or 
mental health conditions. Our wide range of medication assisted treatment (MAT) and wrap-around 
services are offered to all individuals regardless of race, ethnicity, nationality, religion or spirituality, 
gender identity or expression, sexual orientation, socioeconomic status, physical or cognitive ability, 
language, beliefs, values, behavior patterns, or customs. 
 
OUTCOMES 
• 
Increased knowledge about deflection strategies (measure number of sessions held) 
• 
Increase enrollment in recovery programs (measure number of referrals)

CONTRACT NO:  C-86-24-007-X-00 / PH RFP 230190                                     AMENDMENT NO:         1        
 
 
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