ADHS NFP MIECH A1 (07) FOR SIGNATURE.PDF

Maricopa County — Formal (2020-10-21)

Extracted text (via pymupdf) 42734 characters

INTERGOVERNMENTAL AGREEMENT (IGA)
Amendment
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave. Suite 530
Phoenix, Arizona 85007
Contract No.: ADHS17-155910
IGA Amendment No.: 1
Procurement Officer:
Anthony Beckum

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Nurse Family Partnership For MIECHV

Effective upon signature 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 made under this Amendment One (1):

1.1
The Scope of Work is revised and replaced with the Scope of Work of this Amendment One (1); and

1.2
The Price Sheet is revised to include the Price Sheet of this Amendment One (1).

**All other provisions of this Agreement shall remain in their entirety.**

Contractor Name: MARICOPA COUNTY DEPARTMENT OF PUBLIC
HEALTH

Authorized Signature

Address: 4041 NORTH CENTRAL, 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.: ADHS17-155910, 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

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SCOPE OF WORK

1. DEFINITIONS:

1.1. “ADE” refers to the Arizona Department of Education.

1.2. “ADES” refers to Arizona Department of Economic Security.

1.3. “ADHS” refers to the Arizona Department of Health Services.

1.4. “ADHS Evaluators” refers to the internal and external evaluators working for ADHS on the Maternal, Infant, and
Early Childhood Home Visiting Program (MIECHV).

1.5. “At Risk Communities” are the communities outlined in this Agreement for receiving services, previously called
Community Health Analysis Areas.

1.6. “AZETO” refers to the Arizona Efforts to Outcomes; Efforts to Outcomes is the Arizona Coordinated Home
Visitation Data Management System.

1.7. "ACA" refers to Affordable Care Act.

1.8. "BWCH" refers Bureau of Women's and Children's Health.

1.9. "Benchmark" for the purpose of this document means the Benchmarks laid out by Health Resources Service
Administration (HRSA) in the Supplemental Information Request and further clarified in the Updated Plan. This
definition includes any updates HRSA makes to these Benchmarks. This includes all the constructs which are
parts of the Benchmarks.

1.10. "Capacity" for the purpose of this Agreement is defined by the federal funder as the total number of families that
can be served at any point and time by a Local Implementing Agency and is determined by the number of
contracted Family Support Specialists or Home Visitors.

1.11. "CQI" refers to Continuous Quality Improvement.

1.12. "DHHS" refers to Department of Health and Human Services.

1.13. "FTE" refers to Full Time Equivalent staffing positions.

1.14. "HRSA" refers to Health Resources and Services Administration.

1.15. "IALT" refers to lnteragency Leadership Team.

1.16. ''ITCA" refers to Inter Tribal Council of Arizona.

1.17. "LIA" refers to the Local Implementing Agency(ies) in which the Maricopa County Department of Public Health
contracts to for the implementation and delivery of services of the Nurse Family Partnership program with
Maternal, Infant and Early Childhood Home Visiting grant funding.

1.18. "MCDPH" refers to Maricopa County Department of Public Health.

1.19. "MIECHV" refers to Maternal, Infant and Early Childhood Home Visiting.

1.20. "Model" refers to the Nurse Family Partnership model as outlined by Nurse Family Partnership.

1.21. "NFP" refers to Nurse Family Partnership.

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1.22. "Program Manager" refers to the ADHS Maternal, Infant, and Early Childhood Home Visiting Program Manager.

1.23. "Site" refers to a location offering Nurse Family Partnership under this Agreement.

1.24. "Updated Plan" refers to the State Updated Plan and any of its updates.

2. BACKGROUND:

2.1. ADHS BWCH supports efforts to improve the health of Arizona women and children. Within BWCH, the Office
of Children's Health supports the increased focus within the state and nation on the importance of early
childhood programs. It also supports enhanced integration of existing children's programs both within ADHS
and among other state and federal agencies and our outside partners. The Office of Children's Health within
the Bureau administers the ACA MIECHV federal grant funded by HRSA. The MIECHV program is funded
entirely through federal funds.

2.2. The goal of the MIECHV Program is to deliver evidence based home visiting models to communities identified
to be at risk through the Needs Assessment developed as a requirement for the grant. HRSA commissioned a
study by Mathematic to determine which models of home visiting were considered evidence based. Based on
these findings, HRSA determined which models would be eligible for funding. It was then up to the states to
determine which of the evidence based models fit their needs.

2.3. In October 2009, the Arizona Early Childhood Development and Health Board, also known as First Things
First, along with ADHS, ADES, and ADE and community providers of home visiting services convened an
Early Childhood Home Visiting Task Force (Task Force).

2.4. The purpose of the Task Force was to define a system-wide strategy for the future development and delivery
of quality home visiting services throughout Arizona. After several focused meetings, the Task Force produced
a plan, titled The Vision for Early Childhood Home Visiting Services in Arizona. The Plan hoped to provide a
pathway for delivery of consistent, high quality home visiting services in the context of Arizona's statewide early
childhood development and health system.

2.5. While the Task Force was a start for Arizona; when the ACA MIECHV statute was passed, the ADHS called
together the state agencies that provide early childhood home visiting to begin work on the grant opportunity.
This group includes representation from the Title V agency and the state's Single State Agency for Substance
Abuse, which are housed within ADHS; the state's Head Start Collaboration Director, the ADE; the state's Title
II agency, ADES; which serves as the state's child care and child welfare agency; ITCA and senior
management from Arizona's Early Childhood Development and Health Board. This group is now referred to as
the IALT. These agencies are Early Childhood Comprehensive System stakeholders as well and several
members serve on Project LAUNCH's State Advisory Council.

2.6. The IALT committed to work together on the process of developing a statewide system of evidence based
home visiting. This collaborative decision making guided the needs assessment process, the development of
the Updated Plan and built on the earlier plan for early childhood home visiting in a concerted effort to best
serve the most at risk families of Arizona. This agreement seeks to implement the actions and measures
discussed in the Updated Plan and subsequent grant applications.

2.7. The evidence based models chosen for implementation as part of this plan were Healthy Families and NFP.
Once a community is selected by the IALT to receive evidence based home visiting, a meeting is held in the
local community, At the meeting the community has input and in fact makes the decision on which model will
be implemented based on the their needs and resources. In the target At Risk Communities in Maricopa, the
local communities chose to implement Healthy Families and NFP.

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3. OBJECTIVE:

3.1. To provide evidence based home visiting services through the NFP model to eligible women in target areas of
Maricopa County, and to evaluate the process and outcome of implementation of the model.

4. SCOPE OF SERVICES:

The Contractor shall:

4.1.1.
Provide a quality, evidence home visitation program delivering the NFP model to pregnant women and
young children in identified At Risk Communities and provide data on program participants; program
fidelity; and required benchmark data measures and participate in program evaluation; monitoring; and
CQI.

5. TASKS:

The Contractor shall:

5.1. Develop and update the implementation plan annually. The plan shall include, but not limited to, activities or
strategies and schedules for:

5.1.1.
Working with the national model developer and a description of the technical assistance and support to
be provided through the national model,

5.1.2.
Recruiting, hiring, and retaining appropriate staff for all positions including the number of positions to be
hired,
I

5.1.3.
Ensuring quality clinical supervision and reflective practice for all home visitors and supervisors,

5.1.4.
Obtaining the curriculum or other materials needed to implement the NFP with fidelity,

5.1.5.
Providing initial and ongoing training and professional development activities including a description of
how and what type of training will be provided by or through the Contractor and/or the model developer,

5.1.6.
Identifying, screening, and recruiting participants,

5.1.7.
Conducting individualized assessments of participant families including a description of what
assessments will be used and how services will be provided in accordance with those individual
assessments,

5.1.8.
Assuring that client's participation in the services is voluntary,

5.1.9.
Assuring that priority will be given to serve eligible participants who fall under one of the following
categories:

5.1.9.1.
Have low incomes;

5.1.9.2.
Are pregnant women who have not attained age twenty-one (21);

5.1.9.3.
Have a history of child abuse or neglect or have had interactions with child welfare services;

5.1.9.4.
Have a history of substance abuse or need substance abuse treatment;

5.1.9.5.
Are users of tobacco products in the homes;

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5.1.9.6.
Have, or have children with low student achievement;

5.1.9.7.
Have children with developmental delays or disabilities; or

5.1.9.8.
Are in families that include individuals who are serving or have formerly served in the armed
forces, including families that have members of the armed forces who have had multiple
deployments outside of the United States.

5.1.10. Estimating and tracking the number of families served monthly and annually,

5.1.11. Minimizing the attrition rates for participants enrolled in the program by maintaining no more than thirty-
five percent (35%) attrition,

5.1.12. Estimating a timeline to reach maximum caseload in each location and maintaining program capacity no
less than eight-five percent (85%),

5.1.13. Operationalizing the coordination between the proposed home visiting program(s) and other existing
programs and resources in those communities, especially regarding health, mental health, early
childhood development, substance abuse, domestic violence prevention, child maltreatment prevention,
child welfare, education, and other social and health services,

5.1.14. Estimate a system of referrals for families with identified needs, including follow up to ensure referred
services were received,

5.1.15. Developing, maintaining and updating a list of collaborative public and private partners,

5.1.16. Monitoring data for quality,

5.1.17. Measuring family satisfaction with visits,

5.1.18. Participating in the MIECHV CQI committee,

5.1.19. Anticipating challenges to maintaining quality and fidelity, and responding to the issues identified,

5.1.20. Describing data collection instruments, data entry, management of case notes, and data quality
assurance process, and

5.1.21. Working with ADHS evaluation team in the external evaluation of the MIECHV program in Arizona.

5.2. Implement, conduct and oversee the NFP Model to fidelity in the funded areas which include the following At
Risk Community areas:

5.2.1.
85014, 85016, 85018, 85028, 85251, 85008, 85020, 85012, 85013, 85015, 85017, 85019, 85021,
85051, 85003, 85004, 85006, 85007, 85034, 85066, 85281, 85301, 85302, 85120, 85145, 85207,
85209, 85212, 85201,085202,085210, 85323, 85391, 85043, 85343, 85381, 85382, 85308, 85303,
85309, 85340, 85345, 85353, 85363, 85374, 85379, 85387, 85388, 85378,

5.2.2.
Additional At Risk Communities can be served under this agreement in partnership with other NFP
programs and with approval from the ADHS to mitigate the need for clients to be placed on a wait list
for services,

5.2.3.
Caseload Capacity for these communities requires 300 enrolled clients at any point and time. This
caseload capacity includes 187 clients for MCDPH and 113 clients for a subcontracted LIA,

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5.2.4.
Work with the national model developer(s) to receive program specific information, trainings,
professional development and technical assistance to ensure fidelity to the model,

5.2.5.
Notify ADHS within fourteen (14) days of any NFP data collection changes impacting the data collection
of MIECHV funded participants,

5.2.6.
Maintain NFP affiliation through the NFP National Service Office,

5.2.7.
Recruit, hire, train, and retain appropriate staff for all funded positions and ensure all hired staff meet the
requirements for employment,

5.2.8.
Ensure high quality clinical supervision and reflective practice for all home visitors and supervisors,

5.2.9.
Maintain the use of an approved evidenced based curriculum, and

5.2.10. Provide initial and ongoing training and professional development activities to the local implementing
agencies, or obtained from the national model developer.

5.3. Ensure that the following components are included, implemented and reported as required by the MIECHV
federal grant:

5.3.1.
Identify and recruit participants, maintaining program goal of no less than eighty-five percent (85%)
capacity,

5.3.2.
Give priority to serve eligible participants who fall under one of the following categories:

5.3.2.1.
Have low incomes;

5.3.2.2.
Are pregnant women who have not attained age twenty-one (21);

5.3.2.3.
Have a history of child abuse or neglect or have had interactions with child welfare services;

5.3.2.4.
Have a history of substance abuse or need substance abuse treatment;

5.3.2.5.
Are users of tobacco products in the home;

5.3.2.6.
Have, or have children with, low student achievement;

5.3.2.7.
Have children with developmental delays or disabilities; or

5.3.2.8.
Are in families that include individuals who are serving or have formerly served in the armed
forces, including such families that have members of the armed forces who have had multiple
deployments outside of the United States.

5.3.3.
Minimize the attrition rates for participants enrolled in the program by maintaining no more than thirty-
five percent (35%) attrition,

5.3.4.
Develop partnerships and coordinate with the proposed home visiting program(s) and other existing
programs and resources in those communities, especially regarding health, mental health, early
childhood development, substance abuse, domestic violence prevention, child maltreatment prevention,
child welfare, education, and other social and health services:

5.3.4.1.
Establish a list of collaborative public and private partners; and

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5.3.4.2.
Provide referrals to community resources for families with identified need(s).

5.3.5.
Ensure participation in statewide CQI by:

5.3.5.1.
Participating in monthly meetings remotely via video conference platform;

5.3.5.2.
Participate in CQI processes and activities and report monthly on progress;

5.3.5.3.
Participate in the annual CQI Presentation Session during the Strong Families AZ Home
Visiting Conference; and

5.3.5.4.
Request Technical Assistance from ADHS to ensure CQI participation and progress as
needed.

5.3.6.
Collecting all data as required by ADHS for this program as per the Updated State Plan and any revised
plans (including data and evaluation plans developed for the MIECHV program) to include but is not
limited to:

5.3.6.1.
Participant Demographic Data:

5.3.6.1.1.
Gender,

5.3.6.1.2.
Age,

5.3.6.1.3.
Ethnicity,

5.3.6.1.4.
Race,

5.3.6.1.5.
Marital Status,

5.3.6.1.6.
Education Attainment,

5.3.6.1.7.
Employee Status,

5.3.6.1.8.
Housing and homelessness,

5.3.6.1.9.
Primary Language,

5.3.6.1.10. Income, and

5.3.6.1.11. Identified Priority Population Category.

5.3.6.2.
Benchmark Data:

5.3.6.2.1.
Maternal and Child Health,

5.3.6.2.2.
Preterm Birth,

5.3.6.2.3.
Breastfeeding Rates,

5.3.6.2.4.
Depression Screening and Referrals,

5.3.6.2.5.
Well Child Visits,

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5.3.6.2.6.
Postpartum care for mothers, and

5.3.6.2.7.
Tobacco Use.

5.3.6.3.
Child Injuries, Abuse, Neglect and Maltreatment:

5.3.6.3.1.
Safe Sleep Practices,

5.3.6.3.2.
Trips to Emergency Departments, and

5.3.6.3.3.
Child Maltreatment.

5.3.6.4.
School Readiness and Achievement:

5.3.6.4.1.
Parent Child Interaction,

5.3.6.4.2.
Early Language and Literacy,

5.3.6.4.3.
Developmental Screenings, and

5.3.6.4.4.
Child Development, behavior and learning.

5.3.6.5.
Domestic Violence:

5.3.6.5.1.
Intimate Partner Violence Screening and Referral.

5.3.6.6.
Family Economic Self Sufficiency:

5.3.6.6.1.
Primary Caregiver Education, and

5.3.6.6.2.
Continuity of Health Insurance Coverage.

5.3.6.7.
Coordination and Referral to Other Community Resources and Supports:

5.3.6.7.1.
Referral to services related to postpartum depression,

5.3.6.7.2.
Referral to services related to child developmental delays, and

5.3.6.7.3.
Referrals to services related to intimate partner violence.

5.3.6.8.
Program Service Utilization Data:

5.3.6.8.1.
Number of newly enrolled participants,

5.3.6.8.2.
Number of participants to disengage in the program,

5.3.6.8.3.
Number of participants who graduated or completed the program,

5.3.6.8.4.
Number of participants to transfer in or out of the program to another
MIECHV funded site,

5.3.6.8.5.
Number of participants currently enrolled but not currently engaging in
services,

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5.3.6.8.6.
Number of home visits completed,

5.3.6.8.7.
Number of referrals provided to community resources, and

5.3.6.8.8.
Reason for disengagement from the program.

5.3.6.9.
Funded Staff Status:

5.3.6.9.1.
Number of funded home visitors continuing employment; newly hired;
number of vacancies,

5.3.6.9.2.
Number of funded supervisors continuing employment; newly hired;
number of vacancies, and

5.3.6.9.3.
Number of funded supporting or other staff continuing, newly hired,
number of vacancies.

5.3.7.
Ensure all demographic, benchmark, service utilization data is entered and reviewed for quality
assurance in an ADHS identified and approved data management and reporting system within two (2)
weeks of data collection,

5.3.8.
Ensure all funded staff statuses are accurate and updated in the ADHS identified and approve data
management and reporting system with in two (2) weeks of any staff status initiation or change,

5.3.9.
Provide narrative updates on programmatic concerns impacting the quality of the program and/or
maintaining fidelity to the model; impacting the ability to reach and maintain capacity and retention; and
staffing concerns into the specified data collection template monthly, and

5.3.10. Working with ADHS Evaluators to modify data collection forms or provide additional information to
capture all required data including benchmarks and demographics required for MIECHV program.

5.3.10.1. Ensuring that all of the Program forms and visit notes are kept in a locked location
and are transported in a locked file.

5.4. Meet additional program and report requirements including, but not limited to:

5.4.1.
Be responsive and ensure timely response to ADHS Program Managers and Evaluators to any request
for clarification, documentation, reports and/or any questions regarding program implementation and
evaluation and provide all requested information the format and medium requested,

5.4.2.
Ensure that all required staff attend ADHS sponsored meetings and trainings in the format that is
required. Meetings and trainings may be required in-person in various places throughout the state; via
conference call or via video conferencing Required meetings include but are not limited to:

5.4.2.1. Monthly CQI;

5.4.2.2. Quarterly Contractor Meetings;

5.4.2.3. MIECHV Funded Agency Meetings;

5.4.2.4. Annual Site Visits; and

5.4.2.5. Data Collection and Reporting Training.

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5.4.3.
Develop and implement collaborations with the other home visiting providers in the community to
prevent duel enrollment and ensure that clients are enrolled in the program that best meets their needs
and ensure that there are selection criteria and standardized processes for referring families from one
(1) program to another, and

5.4.4.
Provide a detailed description of the funded programs, if Contractor/subcontractor has another
Contract, Grant, or Subcontract that administers and/or provides a similar home visiting program in the
targeted service area or adjoining service areas, including staffing, funding source and clearly identify
how the program(s) will not duplicate services and/or home visiting services to the targeted
communities that are being proposed through the ADHS Home Visiting Program. It shall also state how
the two (2) separate funding sources will be tracked.

5.5. Complete sub-contract monitoring of each LIA bi-annually, notifying ADHS MIECHV Program Manager at least
90 days in advance of scheduled meetings which includes the following components:

5.5.1.
Programmatic Quality Assurance:

5.5.1.1.
Submit completed and accurate monthly reports;

5.5.1.2.
Provide high quality clinical supervision and reflective practice for home visitors and
supervisors in accordance with model requirements;

5.5.1.3.
Ensure all LIA sites are utilizing a model approved curriculum;

5.5.1.4.
Ensure home visitors are receiving model-specific initial and ongoing training as required by
the national model developers;

5.5.1.5.
Ensure enrolled clients are appropriately identified, screened, and consent forms, if
applicable, are signed and on file;

5.5.1.6.
Participate in monthly CQI calls and reporting by LIA site supervisors and/or an
individual identified by the site supervisors; and

5.5.1.7.
Ensure all LIA sites maintain fidelity to the model.

5.5.2.
Administrative Quality Assurance:

5.5.2.1.
Complete annual inventory with items reported to ADHS;

5.5.2.2.
Save I-9 forms on file for all program staff;

5.5.2.3.
Enter and clean data in accordance with this Agreement;

5.5.2.4.
Obtain pre- approval from ADHS for trainings that paid with MIECHV funds;

5.5.2.5.
Obtain approval from ADHS prior to production of materials created utilizing MIECHV funding
and they shall include ADHS and Strong Families AZ Logos, and funded language
accordingly; and

5.5.2.6.
Provide pandemic plan in writing.

5.5.3.
Fiscal Quality Assurance:

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5.5.3.1.
Audit expenditures incurred during a quarter of the federal fiscal year to ensure all purchases
are allowable in accordance to the MIECHV grant;

5.5.3.2.
Submit a copy of the report to MIECHV Program Manager on an annual basis;

5.5.3.3.
Submit back up documentations for invoices provided; and

5.5.3.4.
Submit invoices timely.

5.6. Develop, implement, update and/or provide a copy of policies and procedures for:

5.6.1.
Sub-contractor Agreement monitoring,

5.6.2.
Participant enrollment including:

5.6.2.1.
How participants are identified, screened and recruited;

5.6.2.2.
How participants are informed of and enrolled on a voluntary basis;

5.6.2.3.
How the agency ensures participants are not dually enrolled in home visitation programs; and

5.6.2.4.
Assurance of enrollment of the identified priority populations which include:

5.6.2.4.1.
Low income,

5.6.2.4.2.
Pregnant women who have not attained age twenty-one (21),

5.6.2.4.3.
Have a history of child abuse or neglect or have had interactions with
child welfare services,

5.6.2.4.4.
Have a history of substance abuse or need substance abuse treatment,

5.6.2.4.5.
Are users of tobacco products in the home,

5.6.2.4.6.
Have children with developmental delays or disabilities, or

5.6.2.4.7.
Families that include individuals who are serving or have formally
served in the armed forces, including such families that have members
of the armed forces who have had multiple deployments outside of the
United States.

5.6.3.
Fiscal Management Oversight

6. DELIVERABLES

The Contractor shall deliver the following to ADHS:

6.1. Monthly invoices are due within twenty-one (21) days following the end of the service month including all
supporting documentation which includes but is not limited to:

6.1.1.
Completed Expenditure Report (CER) utilizing the most recent CER form provided by ADHS,

6.1.2.
Time sheets; labor distribution reports; percentage of time; pay stubs,

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6.1.3.
Proof of enrollment and payment of employee fringe benefits,

6.1.4.
Approvals; quotes; purchase orders; invoices; copies of checks/deposits for professional and outside
services,

6.1.5.
Approvals; justification; receipts; documentation of conference/training attendance; proof of payment for
all in state and out of state travel expenses,

6.1.6.
Calculation of occupancy rent/lease amount and/or an agreement of lease terms including expenses
from MIECHV funds; proof of payment for rent/lease based on rent/lease terms,

6.1.7.
Approvals, quotes, Purchase Orders; receipts and proof of payment for supplies and operating
expenses,

6.1.8.
Any expenses in which there is a shared cost with another program should outline how the amount was
calculated for the MIECHV funded program,

6.1.9.
Calculation and description of uses for indirect costs, and

6.1.10. Any additional information as requested by ADHS and/or HRSA to determine expenses were allowable
and allocable.

6.2. For staff training beyond what is required by the model, documentation of attendance shall be provided
including a Certificate of Attendance and written pre-approval from ADHS;

6.3. Monthly Progress:

6.3.1.
Monthly Progress Reports are due within twenty-one (21) calendar days following the end of each
month using the ADHS provided Google Form Template Monthly progress reports include:

6.3.1.1.
MIECHV Funded Staff Status including current, new and vacant positions; including a
narrative on staff recruitment and retention success and challenges and staff trainings;

6.3.1.2.
Referrals to community organizations and resources including narrative on community
collaboration and outreach success and barriers;

6.3.1.3.
Disengagement Reasons including narrative on family retention strategies; and

6.3.1.4.
Narrative on Service Utilization that includes key achievements and challenges in meeting
service utilization requirements.

6.3.2.
Data is required to be accurate and available through the ADHS identified data management and
reporting system within fourteen (14) days of data collection for the following data points to be reported
on a monthly basis:

6.3.2.1.
Current number of active clients;

6.3.2.2.
Current number of outreach clients;

6.3.2.3.
Number of new clients enrolled during the reporting month;

6.3.2.4.
Number of clients to disengage in service during the reporting month;

6.3.2.5.
Number of clients to graduate or complete the program during the reporting month;

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6.3.2.6.
Number of clients to transfer in or out of the program from another MIECHV funded site;

6.3.2.7.
Total number of home visits completed;

6.3.2.8.
MIECHV required demographic data as outlined in the data collection plan; and

6.3.2.9.
MIECHV required benchmark data as outlined in the data collection plan.
6.3.3.
Complete data quality assurance in accordance with the data cleaning schedule. The name, phone
numbers, and resume of MIECHV Funded program staff if replaced, within twenty-one (21) days of hire
and a training/onboarding schedule for hired staff that includes MIECHV specific training,

6.3.4.
Provide copies of Policy and Procedures on an annual basis, or within thirty (30) days of any Policy and
Procedure updates and changes pertaining to:

6.3.4.1.
Sub-Contract Monitoring;

6.3.4.2.
Participant Enrollment; and

6.3.4.3.
Fiscal Management.

6.4. Annual Submissions:

6.4.1.
Verification of receipt of annual site visit report which tracks the quarterly progress of:

6.4.1.1.
Update on work-to-date with national model developer(s) and a description of the technical
assistance and support provided to-date through the national model(s);

6.4.1.2.
Maintain curriculum and other materials needed for the home visiting program;

6.4.1.3.
Update on training and professional development activities obtained from the national model
developer, or provided by the State or the implementing local agencies;

6.4.1.4.
Update on staff recruitment, hiring, training, and retention for all positions including
subcontracts;

6.4.1.5.
Update on participant recruitment and retention efforts;

6.4.1.6.
Family satisfaction with visit information;

6.4.1.7.
Status of home visiting program caseload within each at-risk community, Update on the
coordination between home visiting program(s) and other existing programs and resources in
those communities;

6.4.1.8.
Fiscal Management;

6.4.1.9.
Subcontract Monitoring;

6.4.1.10. CQI Attendance and Participation;

6.4.1.11. Meeting Attendance and Participation;

6.4.1.12. Other items pertaining to program progress, implementation, barriers and successes; and

6.4.1.13. A discussion of challenges, both experienced and anticipated, to maintaining quality and

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fidelity of each home visiting program, and the response to the issues identified.

6.5. Annual copy of the NSO NFP Fidelity Report. This item can typically be received directly from NSO but in the
event that ADHS is not able to obtain it, the site would be responsible for ensuring that we have received it;

6.6. Copy of established list of collaborative public and private partners. Submit data model/program specific data
collection changes that impact the data collection of MIECHV funded participants within fourteen (14) days of
changes;

6.7. A copy of all sub-recipient contracts for MIECHV funded NFP sites within thirty (30) days of Agreement
execution;

6.8. A copy of all annual site reviews for MIECHV funded NFP sites within sixty (60) days of completion of site
review;

6.9. A copy of bi-annual Agreement monitoring summaries within sixty (60) days upon completion; and

6.10. Annual submission of the Federal Funding Accountability and Transparency Act of 2006 (FFATA) report within
forty-five (45) days of purchase order execution.

7. REQUIREMENTS

7.1. The Contractor shall maintain NFP accreditation;

7.2. The Contractor shall meet all requirements of NFP to implement the model with fidelity and maintain fidelity to
the model;

7.3. If the Contractor/subcontractor has another Contract, Grant, or Subcontract that administers and/or provides a
similar home visiting program in the targeted service area or adjoining service areas, provide a detailed
description of the other funded programs including staffing, funding, Source and clearly identify how the
program(s) will not duplicate services and/or home visiting services to the targeted communities that are being
proposed through the ADHS Home Visiting Program.

7.3.1.
State how the two (2) separate funding sources will be tracked, and

7.3.2.
Provide a written plan to ADHS as how the Contractor will divide work with the Sub-Contractors, and
which entity will be serving which areas.

7.4. This program is fully funded by Federal funds so the DHHS Appropriation Act requirements shall be followed.
The DHHS Appropriations Act requires that when issuing statements, press releases, requests for proposals,
bid solicitations, and other documents describing projects or programs funded in whole or in part with Federal
money, all grantees receiving Federal funds including, but not limited to, State and local governments, shall
clearly state the percentage of the total costs of the program or project which will be financed with Federal
money, the dollar amount of Federal funds for the project or program, and percentage and a dollar amount of
the total costs of the project or program that will be financed by nor-governmental sources.

7.4.1.
Marketing and published materials that are created utilizing MIECHV funds require the following
statement:

7.4.1.1.
This [ENTER PROJECT/ PUBLICATIONI WEBSITE/ PRODUCT/ PROGRAM/ ETC NAME]
[IS/WAS] supported by the Health Resources and Services Administration (HRSA) of the
U.S. Department of Health and Human Services (HHS) as part of an award totaling
$11,204,224.00
with
[ENTER
PERCENTAGE
OF
NON-GOVERNMENTAL
CONTRIBUTIONS] percentage financed with nongovernmental sources. The contents are

Page 15 of 17

those of the author(s) and do not necessarily represent the official views of, nor an
endorsement, by HRSA, HHS or the U.S. Government.

7.4.1.2.
The award total is subject to change annually.

7.5. Utilize and reference the ADHS Guidance for Federal Grant Award Management and the Arizona MIECHV
Program Fiscal Policy Management.

8. APPROVALS

The following items require review and approval by ADHS:

8.1. Monthly Contractor's Expenditure Report (invoice/GER) prior to payment;

8.2. Written approvals must be received prior to utilizing funds for travel; trainings; equipment; marketing or
education materials; food; program incentives; and other items determined by ADHS in accordance with the
fiscal policy manuals;

8.3. Families receiving NFP services under this Contract cannot be transferred from a non-funded MIECHV site to
a funded MIECHV site without review and approval from ADHS;

8.4. All marketing or educational materials, and promotional items, media or forms including, but not limited to,
brochures, posters, publications or journal articles developed using funds awarded under this Agreement shall
be approved by ADHS Program Manager prior to production by submitting:

8.4.1.
Draft of the materials prior to production, and

8.4.2.
a copy of the final printed versions for each item created.

8.5. Before expansion to any new service areas under this contracts or expansion of existing sites; and

8.6. Prior approval to move up to ten percent (10%) of the total budget amount between line items is required.
Transfers of funds are only allowed between funded line items. Transfers exceeding ten percent (10%) or to a
non-funded line item shall require an amendment.

9. REFERENCE DOCUMENTS

The following documents are available from ADHS:

9.1. Arizona's Maternal, Infant and Early Childhood Updated Plan;

9.2. Data Collection and Benchmark Analysis Plan;

9.3. CQI Plan; and

9.4. Data Collection Forms.

The following items will be submitted to the contactor from ADHS upon Agreement execution:

9.5. CER Template;

9.6. Monthly Report Template;

9.7. Data Cleaning Schedule; and

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9.8. Quarterly Meeting and Annual Site Visit Tracking Document, and other templates required for data
collection and reporting as identified.

10. NOTICES, CORRESPONDENCE, REPORTS, AND INVOICES

10.1. Notices, correspondence, reports and invoices/CERs from the Contractor to ADHS shall be sent to:

Arizona Department of Health Services
MIECHV Program Manager
150 North 18th Avenue, Suite 320
Phoenix, Arizona. 85007-3242
Phone: 602-364-1441
Email: peggy.peixoto@azdhs.gov

10.2. Invoices shall be emailed to: invoices@azdhs.qov. Contractor's invoice shall be submitted no later than twenty-
one (21) days following the end of the service month, following the month of service. The Contractor Manager,
or Designee, shall approve the invoice. Approved invoices shall be paid by ADHS within thirty (30) days of
receipt

10.3. Notices, correspondence, and reports (and payments if sent to same address) from ADHS to the
Contractor shall be sent to:

Maricopa County Department of Public Health
Denise Voiles, Nurse Manager,
4041 N Central Ave, Suite 700
Phoenix, Arizona 85012
Phone: 602-506-6782
Fax: 602-506-6896
Email:denise.voiles@maricopa.gov

With a copy to:
Maricopa County Department of Public Health
Katherine Mason, Grant/Contract Specialist
4041 N Central Ave, Suite 700
Phoenix Arizona 85012
Phone: 602-372-0674
Fax: 602-506-6885
Email:katherinemason@mail.maricopa.gov

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PRICE SHEET

HOME VISITING SERVICES FOR MIECHV

ACCOUNT CLASSIFICATION
LINE ITEM TOTALS
PERSONNEL COSTS/SALARY EXPENSES
$622,546.00
EMPLOYEE RELATED EXPENSES
$234,782.00
PROFESSIONAL & OUTSIDE EXPENSES
$531,500.00
TRAVEL EXPENSES
$18,834.00
OCCUPANCY EXPENSES
$25,755.00
OTHER OPERATING EXPENSES
$18,422.00
CAPITAL OUTLAY EXPENSES
$500.00
INDIRECT COST EXPENSES (IF AUTHORIZED)
$179,184.00
TOTAL $1,631,523.00