Extracted text (via pymupdf)
60480 characters
INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 1 WIC and BFPC Services It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: 1. Pursuant to Terms and Conditions, Page Seven (7), Provision Six (6), Contract Changes; the Intergovernmental Agreement is amended to revise the following: 1.1 The Scope of Work is revised and replaced by the Scope of Work of this Amendment Four (4); and 1.2 The Price Sheet is revised and replaced by the Price Sheet of this Amendment Four (4). All other provisions of this agreement remain unchanged. Contractor Name: MARICOPA COUNTY Authorized Signature Address: 4041 N. CENTRAL 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.: CTR040876, 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 Clint Hickman Chairman, Board of Supervisors Anne Longo ATTEST: _______________________________ Office of the Clerk of the Board _______________________________ Date INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 2 SCOPE OF WORK 1. BACKGROUND The Arizona Department of Health Services (ADHS) Bureau of Nutrition and Physical Activity (BNPA) administers funds provided by the United States Department of Agriculture (USDA) for the operation of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and Breastfeeding Peer Counseling Program (BFPC) for the State of Arizona. The USDA nutrition programs are discretionary, and each provides a specific service to women, infants, and children who are low income and at nutrition risk. The overall goal of all the USDA Nutrition Programs is to improve the health status of eligible participants through adoption of healthy behavioral lifestyle changes and to help prevent the occurrence of health problems. 1.1. WIC Nutrition Services 1.1.1. The WIC Program accomplishes this goal by providing participant-centered services (PCS) including nutrition and breastfeeding information and support, specific supplemental healthy foods through the issuance of food benefits that can be used at ADHS-approved grocery stores and farmers’ markets, and referrals to other health and human services as an adjunct to good health care during critical times of growth and development. Service population eligibility for the WIC Program is based upon federal regulations such as participant category (pregnant and breastfeeding woman, infant or child under five years of age), a household income at or below 185% of federal poverty guidelines, residence within the service area, and nutrition risks. 1.1.2. To be considered as a WIC Local Agency, the organization must be a local public or private non- profit organization, County health department, or tribal entity under contract with ADHS to provide WIC services according to the WIC Program federal regulations and state policies and procedures. The State awards a WIC Contract based on the ability of the organization to provide WIC services, potentially eligible population, need, response to the Scope of Work, information technology capacity, and available funds. The State determines and awards the WIC contract amount based on a funding formula using several factors such as a base level for a program to function, the amount of caseload negotiated with each Local Agency, and quality of performance. 1.1.1.1 Specific objectives for nutrition services (based on Healthy People 2020 goals) are: 1.1.1.1.1 To increase the incidence of breastfeeding to eighty-two percent (82%) of women initiating breastfeeding; 1.1.1.1.2 To increase the duration of breastfeeding to sixty-one percent (61%) of women breastfeeding for the first six (6) months of their baby’s life; 1.1.1.1.3 To increase the duration of breastfeeding to thirty-four percent (34%) of women breastfeeding for the first year of their baby’s life; 1.1.1.1.4 To increase the rate infants are exclusively breastfed to forty-four percent (44%) at three (3) months and twenty-four percent (24%) at six months; 1.1.1.1.5 To reduce the proportion of adults who are considered obese to thirty-one percent (31%); 1.1.1.1.6 To reduce the proportion of children ages two (2) to five (5) who are considered obese to ten percent (10%); 1.1.1.1.7 To increase the consumption and variety of fruits and vegetables by those two (2) and older; INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 3 1.1.1.1.8 To increase the consumption of whole grains by those two (2) and older; and 1.1.1.1.9 To increase the proportion of children ages zero (0) to two (2) who view no television or videos on an average day to forty-five percent (45%). 1.2. Breastfeeding Peer Counseling (BFPC) 1.2.1. In 2003, the USDA Food and Nutrition Service (FNS) entered into a cooperative agreement with Best Start Social Marketing (Best Start) to gather information to obtain a clear understanding of the components that are necessary to sustain effective peer counseling programs and how to structure these programs so they are cost effective and manageable. They developed the program "Using Loving Support to Implement Best Practices in Peer Counseling", which is a training and technical assistance project that will be used as a model to aid WIC in designing, building, maintaining, and sustaining peer counseling programs that will improve breastfeeding initiation and duration rates. Arizona will be using this program to guide and develop the state peer counseling program. 1.2.2. The discretionary peer counseling services are considered an adjunct support to WIC breastfeeding services to help achieve the WIC Nutrition Services objectives regarding breastfeeding. 1.2.3. Peer counseling has been a significant factor in improving initiation and duration rates of breastfeeding among women in a variety of settings, including disadvantaged and WIC populations representing diverse cultural backgrounds and geographical locations. Peer counselors are especially effective in communities where role models for breastfeeding behaviors, knowledgeable health care providers, and cultural practices that include breastfeeding as the norm, are scarce. Combining peer counseling with the ongoing WIC breastfeeding promotion and support efforts has the potential to significantly impact breastfeeding rates among WIC participants, and most significantly, increase the harder to achieve breastfeeding duration rates. WIC Local Agencies are strongly encouraged to provide peer counseling services in addition to the ongoing breastfeeding support to their WIC participants. Contractors must provide a breastfeeding friendly environment and have policies to accommodate participants and staff who are breastfeeding. 2. OBJECTIVE At a minimum, to provide WIC services while allowing each Local Agency to provide, at their discretion, Breastfeeding Peer Counseling Services. 3. SCOPE OF WORK 3.1. WIC Services The WIC Program Contractor shall perform all the work required to administer and provide WIC services to eligible participants according to the Arizona WIC Program Policies and Procedures Manual (WIC PPM). These include, but are not limited to the following activities: 3.1.1 Perform WIC certification procedures such as categorical and income screening and health and nutrition assessments, 3.1.2 Provide participant centered nutrition and breastfeeding support services to WIC participants, 3.1.3 Provide the mandatory and appropriate additional referrals reflecting the needs of the individual WIC participants, 3.1.4 Issue WIC food benefits tailored to meet the needs of the participants, INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 4 3.1.5 Ensure the collection and recording of accurate information, 3.1.6 Provide professional training, mentoring and monitoring of WIC staff competencies necessary for delivery of required services, 3.1.7 Provide administrative functions for operation of the WIC Program, and 3.1.8 Prepare and submit all required plans/reports in accordance with this contract and the WIC PPM. 3.2. Breastfeeding Peer Counseling (BFPC) WIC BFPC Contractors shall perform all the work required to administer and provide additional breastfeeding support services to WIC mothers following the Loving Support best practice guidelines for peer counseling services and according to the Contractor's proposal in order to increase the breastfeeding rate and duration of breastfeeding. 3.3. WIC Special Projects: Monies are provided for WIC Special Projects that will include the following: 3.3.1 To cover occupancy, security, and cleaning services costs for an ADHS WIC computer lab training room housing up to forty (40) computers located at 2737 W Southern Ave, Suite 10, Tempe, AZ 85282: 3.3.1.1 The WIC computer lab training room will be for the priority use of the Arizona State WIC Program and be made available to other Arizona WIC local agencies. ADHS Information Technology staff will be responsible for installation and maintenance of computer and networking hardware and software. The training room computers will not be connected to the Maricopa County internal network, but the training room will share the same internet line as the adjacent WIC clinic. 3.3.2 Additional monies have been added to the Registered Dietitian (RD) line item for Maricopa County WIC Program to provide RD services to other local WIC agencies as agreed upon in the Scope of Work documents between Maricopa and each local WIC program that services are provided, 3.3.3 Additional monies have been added to the Personnel Services, Employee Related Expenses, Occupancy and Indirect Cost line items to support the Thunderbird Clinic’s Supervisor and rent costs, and 3.3.4 Additional monies have been added to the Personnel, Employee Related Expenses, and Indirect Cost line items to the Maricopa County WIC Special Projects Budget to provide State-wide secondary nutrition education for families enrolled with local agencies utilizing the WIC Your Way virtual services approach by providing staff to support this program at the state office full time: 3.3.4.1 The staff provided will assist the ADHS team with outreach and retention campaigns involving text messaging and/or virtual services, provide virtual secondary nutrition education and high-risk services through this project, support local agencies with their training needs related to this service, and support local agency services state-wide by facilitating group education classes and completing administrative work related to providing these services; and 3.3.4.2 The staff will also work with the ADHS WIC Evaluator to evaluate measurable outcomes from the services including data on nutrition related attitudes and behaviors, ease and satisfaction of technology use, increasing attendance at the nutrition education sessions and then implement a process to improve the services. INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 5 4. TASKS AND REQUIREMENTS 4.1. WIC Services Outreach, Retention, and Referrals: 4.1.1 Conduct outreach activities targeting underserved populations by developing written and verbal presentations or utilizing available materials to inform potentially WIC eligible individuals of the availability of the WIC Program and to explain the benefits of participation in accordance with the WIC PPM, 4.1.2 Conduct retention activities to maintain and increase the participation of current WIC enrollees, 4.1.3 Establish community partnerships with, at a minimum, the mandatory referral agencies, local hospitals, OB/GYN and pediatricians offices, and provide regular contacts in accordance with the WIC PPM, 4.1.4 Establish community partnerships with community organizations such as food banks, community organizations, human and social services, school districts, etc. in accordance with the WIC PPM, and 4.1.5 Establish a referral system with breastfeeding/lactation specialists, including but not limited to, International Board Certified Lactation Consultants (IBCLC), Certified Lactation Counselors (CLC), Certified Breastfeeding Counselors (CBC), and Certified Lactation Educators (CLE) in accordance with the WIC PPM. 4.2. Additional BFPC Outreach Tasks: Develop and document an internal referral link between WIC Program and WIC Peer Counseling Program when applicable. Interaction between WIC Program and WIC Peer Counseling Program shall occur at least monthly and may be in the form of site visits from Peer Counselors, participation of Peer Counselors in WIC clinic meetings, and/or additional training for WIC clinic staff and Peer Counselors. 4.3. Participant Records: 4.3.1 Follow and maintain documentation of participant centered certification and administrative procedures as described in the WIC PPM, including but not limited to: 4.3.1.1 Eligibility and ineligibility determinations; 4.3.1.2 Nutrition assessments; 4.3.1.3 Nutrition and breastfeeding education and support; 4.3.1.4 Nutrition and breastfeeding counseling; 4.3.1.5 Facilitate behavioral goal setting; 4.3.1.6 Appropriate referrals; 4.3.1.7 Program fraud; and 4.3.1.8 Food Benefit issuances. 4.3.2 Maintain inventory and accountability records, as set forth in the WIC PPM for eWIC cards, INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 6 4.3.3 Assure participant confidentiality by obtaining written permission from affected program participant(s) prior to the release of participant information to any agency. The Contractor shall have a written agreement, completed in accordance with 7 CFR (Code of Federal Regulations) 246.26 (h)(3), and the Arizona WIC Policy and Procedure Manual, with any agency or program that will share participant information. The above federal regulation details the implementation of a written agreement and state plan to regulate use and disclosure of confidential applicant and participant information, 4.3.4 Staff shall only access the WIC Computer Data System and client files for business related reason(s), 4.3.5 Ensure paper files containing confidential participant information are stored in a secure location in the clinic, archived when appropriate, and destroyed according to the retention schedule. All files should be destroyed in an appropriate manner, 4.3.6 The Local Agency shall notify the State Agency immediately by telephone call and email upon the discovery of a breach of a participant’s confidentiality, 4.3.7 The Local Agency shall immediately investigate such security incident, breach, or unauthorized use or disclosure of participant information, including: 4.3.7.1 What data elements were involved and the extent of the data involved in the breach; 4.3.7.2 A description of the unauthorized person(s) known or reasonably believed to have improperly used or disclosed the protected information; 4.3.7.3 A description of where the protected information is believed to have been improperly transmitted, sent, or utilized; 4.3.7.4 A description of the probable causes of the improper use or disclosure; and 4.3.7.5 Whether Arizona Revised Statutes (A.R.S) § 18-545 or any other federal or state laws requiring individual notifications of breaches are triggered. 4.3.8 The Local Agency shall provide a written report of the investigation to the Chief of the Bureau of Nutrition and Physical Activity (BNPA)/WIC Director and Program Integrity Manager within ten (10) working days of the discovery of the breach or unauthorized use or disclosure. The report shall include the information specified above, as well as a full, detailed corrective action plan, including information on measures that were taken to halt and/or contain the improper use or disclosure, and 4.3.9 The Local Agency shall notify individuals of the breach or unauthorized use or disclosure when notification is required under state or federal law and shall pay any costs of such notifications, as well as any costs associated with the breach using non WIC funds. The BNPA Chief/WIC Director, Program Integrity Manager, and Assistant Attorney General shall approve the time, manner and content of any such notifications. The Local Agency will arrange and pay for any mitigation (e.g. LifeLock) for participants at risk for identity theft because of breach of security of information. 4.4. Service Delivery and Program Rules The Contractor shall: 4.4.1 Determine eligibility of persons requesting WIC services by screening individuals in accordance with procedures set forth in the WIC PPM; Eligible program participants shall include the following categories whose household income does not exceed 185% of the current designated federal INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 7 poverty guidelines, who have a nutritional risk as defined in the WIC PPM, and reside in Arizona as defined by the WIC PPM: 4.4.1.1 Pregnant women, breastfeeding women up to twelve (12) months post-partum, and non- breastfeeding women up to six (6) months following the end of a pregnancy; 4.4.1.2 Infants from birth to age one (1); and 4.4.1.3 Children from age one (1) year up to five (5) years of age. 4.4.2 Provide complete nutrition assessment and document results and follow-up in accordance with Value Enhanced Nutrition Assessment (VENA) initiative as outlined in Chapter two (2) and seven (7) of the Arizona WIC Policy and Procedure Manual, 4.4.3 Provide participant-centered nutrition education to participants and appropriately utilize materials provided by the State, 4.4.4 Facilitate goal setting for behavioral change and follow-up on goals set, 4.4.5 Promote breastfeeding to WIC participants and provide breastfeeding education and support, and refer to and promote the Breastfeeding Peer Counseling Program, when appropriate, 4.4.6 Prescribe and tailor a food package appropriate to the participant's nutritional risk(s), category, and cultural preferences and issue food benefits as set forth in the WIC PPM, 4.4.7 Provide program participants with information about available health and social services to which the participant could be referred. The participant shall be provided with written information regarding community services and referrals in accordance with the WIC PPM and Local Agency referral procedures, 4.4.8 Coordinate WIC Services with other health and social services available within the service area, including but not limited to immunizations, voter registration, and breastfeeding support, 4.4.9 Provide information, check for understanding, and document training to participants on program rules, regulations, WIC approved foods, use of eWIC cards, and food benefit use and redemption. The training shall be documented in the participant's record as set forth in the WIC PPM, 4.4.10 Consider the impact of scheduling practices, hours of operation, and clinic closures on caseload and WIC applicants’ access to services, and 4.4.11 Additional BFPC Service Delivery tasks: 4.4.11.1 Accept referrals generated from calls to the ADHS Pregnancy and Breastfeeding Hotline into the Peer Counseling Program; 4.4.11.2 Provide peer counseling services, when appropriate. Services shall be made available outside of usual clinic hours and outside of the WIC clinic, but may also be available during usual clinic hours and in the WIC clinic; and 4.4.11.3 Provide supervision, mentoring, monitoring, and evaluation of peer counselors, when appropriate. 4.5. Participant-Centered Nutrition Education The Contractor shall: INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 8 4.5.1 Prepare a one (1) year Nutrition Services and Training Plan for participants to include, but not be limited to: 4.5.1.1 Adoption and Implementation of ADHS goals for nutrition services. In addition, Local Agencies will identify their own goals for nutrition services in this plan; and 4.5.1.2 Adoption and implementation of the State objectives for staff training and client interventions related to the goals for nutrition services. In addition, Local Agencies are required to provide at least one additional objective for each goal. 4.5.2 Provide and document participant-centered nutrition education to all WIC adult participants, and to parents or caretakers of participants according to the guidelines of the State Nutrition Services Plans. A minimum of two (2) nutrition education contacts in each six (6) month certification period shall be made and documented in the participant's record. Breastfeeding women, children, infants and migrants from any eligibility category are certified for one (1) year and will receive one (1) nutrition education contact for each three (3) month period. Pregnant women certified through six (6) weeks postpartum will receive one (1) nutrition education contact for each three (3) month period, 4.5.3 Provide and document professional supervision, mentoring and monitoring of staff at the clinic level on a regular basis, in accordance with Local Agency Self-Assessment requirements and as often as necessary, to ensure competence, 4.5.4 Offer, as often as necessary, high- and medium-risk nutrition education/counseling by a Registered Dietitian (RD) to all participants deemed high-risk upon assessment. As defined in the WIC PPM Local Agencies may designate a Bachelor's degree nutritionist or Dietetic Technician Registered to provide medium-risk counseling to participants under the supervision of the RD, 4.5.5 Expend for nutrition education activities an aggregate amount that is not less than the sum of one- sixth (1/6) of the amount the Contractor receives for provision of WIC services each contract year. If the one- sixth (1/6) amount is not expended for nutrition education activities, ADHS may request the Contractor to return an amount equal to the difference between the one-sixth (1/6) requirement and the actual amount expended IF ADHS must pay a penalty to the Federal Government. Costs that can be applied to meet the one-sixth (1/6) requirement for nutrition education include: 4.5.5.1 Salary and other costs for time spent on nutrition education, whether with an individual or group; 4.5.5.2 The cost of procuring and producing nutrition education materials; 4.5.5.3 The cost of training nutrition educators, including costs related to conducting training sessions and purchasing and producing training materials; 4.5.5.4 The cost of conducting participant evaluations of nutrition education, nutrition assessments and observations; 4.5.5.5 The salary and other costs incurred in developing the nutrition education plan; and 4.5.5.6 Other ADHS-approved costs. 4.5.6 Coordinate nutrition education activities and messages. Wherever possible, the Contractor shall utilize USDA and/or AZ Health Zone materials and messages to ensure common nutrition messages, and INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 9 4.5.7 Provide documentation that a minimum of four percent (4%) of their annual WIC expenditures have been used to support breastfeeding promotion and education. If the four percent (4%) is not expended for breastfeeding promotion and education activities, ADHS may request the Contractor to return an equal to the difference between the four percent (4%) and the actual amount expended if ADHS must pay a penalty to the Federal Government. 4.6. Staffing The Contractor shall: 4.6.1 Designate a WIC Program Director/Manager who is an RD, with previous WIC and/or community health experience to manage and administer the WIC Program and may provide high-risk nutrition counseling and/or formula authorization to WIC participants. If an RD is on staff to provide the WIC RD services and with prior approval from ADHS, the Contractor shall designate a Director with a minimum of an undergraduate degree from an accredited institution in nutrition (community nutrition, public health nutrition, nutrition education, human nutrition or nutrition science) or a related field such as home economics or biochemistry with an emphasis in nutritional science or public health administration. With prior approval from ADHS, number of years working in a WIC Program Director/Manager capacity may substitute for some years of education, 4.6.2 Identify an RD to serve as the Local Agency Nutrition Coordinator as defined in the WIC PPM. The Nutrition Coordinator will oversee all WIC nutrition services for the Local Agency. If a Local Agency has barriers to this staffing standard, they must be submitted in writing to ADHS with their plan for coordination of nutrition services within the Local Agency to be approved by ADHS, 4.6.3 Based on the assigned caseload, provide an appropriate number of RDs to perform high-risk and medium-risk counseling, formula authorization, and as necessary, certification of participants. The Contractor shall provide the RD services in a number proportional to the agency's high-risk caseload in accordance with the WIC PPM, The Contractor may hire graduates with a minimum of an undergraduate degree from an accredited institution, in nutrition (community nutrition, public health nutrition, nutrition education, human nutrition or nutrition science) or a related field such as home economics or biochemistry, with an emphasis in nutritional science or Registered Dietetic Technicians, to do medium-risk counseling, formula authorization, and as necessary participant certification under the direction of an RD. If a Local Agency has a barrier to having an RD on staff, the agency must submit in writing to ADHS with their plan for providing high risk nutrition counseling to participants, 4.6.4 When applicable, necessary and based on the assigned caseload, provide an appropriate number of adequately trained certification specialists to provide categorical and financial eligibility screening, pre-certification and record required documentation, in accordance with the WIC PPM, as well as administrative support services when necessary. Such individuals shall have the minimum of a high school degree or equivalent and must complete the state training requirements and be certified by the Contractor as competent according to the competencies for the position. Previous nutrition or health related job experience is desirable. These individuals shall meet individual ADHS competencies as set forth in the WIC PPM prior to providing each service such as certifying applicants for participation and/or providing health assessments in the Arizona WIC Program Staff should be observed and certified by the supervising authority to be competent in an activity before being allowed to perform on their own without supervision, 4.6.5 Based on the assigned caseload, provide an appropriate number of adequately trained nutrition education specialists to provide certification and nutrition education services to participants in accordance with the WIC PPM. Such individuals will have the minimum of a high school diploma with nutrition experience, education, and training that have been certified by local or state agencies to be competent for the position. An Associate or Bachelor's degree is highly preferred. These individuals shall meet the ADHS competencies for Nutrition Education Specialists as set forth in the INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 10 WIC PPM prior to certifying applicants for participation and/or providing nutrition education in the Arizona WIC Program. Staff should be observed and certified by the supervising authority to be competent in an activity before being allowed to perform on their own without supervision, 4.6.6 Identify an International Board Certified Lactation Consultant (IBCLC) to serve as the local agency Breastfeeding Coordinator as defined in the WIC PPM. The Breastfeeding Coordinator will oversee all WIC breastfeeding services for the local agency to ensure all participants have access to breastfeeding promotion and support services. If a local agency has barriers to this staffing standard, they must be submitted in writing to ADHS with their plan for coordination of breastfeeding services within the local agency to be approved by ADHS, 4.6.7 Identify a Training Coordinator as defined in the WIC PPM. The Training Coordinator will oversee and facilitate both new employee and ongoing WIC training for the Local Agency including certifying that staff has met competencies prior to providing services without supervision. If a Local Agency has barriers to this staffing standard, they must submit in writing to ADHS their plan for coordination of training services within the Local Agency to be approved by ADHS, 4.6.8 Identify an Outreach Coordinator who will oversee and facilitate activities and efforts to retain current WIC enrollees and outreach to potentially eligible population not currently enrolled in WIC, and participate in outreach-related workgroups. If a Local Agency has barriers to this staffing standard, they must submit in writing to ADHS their plan for coordination of outreach activities within the Local Agency to be approved by ADHS, 4.6.9 Provide staff to conduct outreach activities targeting high risk and underserved populations, including but not limited to homeless and migrants, by developing written and verbal presentations or utilizing available materials to inform the potentially eligible individuals of the availability of WIC Program and explain the benefits of participation, and 4.6.10 When applicable and necessary, provide WIC Clerks to perform administrative support within WIC clinics at the option of the Contractor. Such individuals shall have the minimum of a high school degree or equivalent. They must meet WIC Program competencies. Previous clerical or work experience is desirable. 4.7. Additional BFPC Service Staffing 4.7.1 Employ a BFPC Program Manager to plan, direct and coordinate general operation of Peer Counseling Program. Ideal candidate will be an International Board Certified Lactation Consultant (IBCLC), have WIC experience, and be familiar with community resources, 4.7.2 Develop a support referral system for peer counselors with community Lactation Consultants, including IBCLCs, if the BFPC Program Manager is not an IBCLC or is unable to fulfill consultation duties for any reason, and 4.7.3 Employ Breastfeeding Peer Counselors to provide services. Qualifications for peer counselors shall be previous personal experience with breastfeeding, enthusiasm for helping others to succeed at breastfeeding, and similarities with the WIC population the program serves (including similar age, ethnic background, and language spoken). Exemptions to the peer counselor qualifications must be approved by ADHS before hire. When possible, peer counselors should be current or previous WIC participants. 4.8. Staff Training The Contractor shall: 4.8.1 Train new staff as outlined in the ADHS developed new employee training plan, INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 11 4.8.2 Register and ensure all WIC staff complete all ADHS required WIC on-line courses according to the time requirements set forth by the State through ADHS LMS at az.train.org, or state-assigned LMS System in accordance with the ADHS WIC PPM, 4.8.3 In addition to state requirements for competency trainings, Local Agencies must implement and adopt the state training standards as reflected in the Nutrition Education Plan and the ADHS WIC PPM. In addition, Local Agencies must participate in any mandatory training provided by ADHS due to changes in policy, procedures, and / or federal regulations, 4.8.4 Provide training for all new staff members regarding Civil Rights, Americans with Disabilities Act (ADA), and Voter Registration during their orientation and, annually, provide all staff with training on Civil Rights, ADA, and Voter Registration issues by completing the ADHS LMS courses on Civil Rights and Voter Registration or other courses or trainings that will be required by ADHS, 4.8.5 Provide one (1) representative for a maximum of six (6) mandatory, in-person WIC Partners’ two (2) day meetings or trainings session in Phoenix, as scheduled by ADHS on a yearly basis. These meetings will be opportunities for the Local Agency to discuss issues with regards to WIC policies and procedures, federal rules and regulations, and nutrition standards, 4.8.6 Provide one (1) representative for a maximum of 12 GoToMeeting WIC Director teleconference meetings to receive information updates on WIC operations, policies and procedures, and other relevant materials being held in lieu of face to face meetings. This may include urgent meetings to discuss current events (e.g. government shutdown) and plan on managing the continuity of operations plan (COOP), 4.8.7 Provide one (1) representative to attend a two (2) day trainer conference in Phoenix during each fiscal year for skill and knowledge building, and 4.8.8 Maintain a record of training provided, monitoring and observation results of staff competencies in each staff file and/or the State LMS. 4.9. Additional BFPC Staff Training: 4.9.1 Send the WIC Director or designee and the Breastfeeding Peer Counselor Program Manager to a two (2) day training at the ADHS office in Phoenix during each Peer Counseling Program contract term, 4.9.2 Provide training of Breastfeeding Peer Counselors using the Loving Support through Peer Counseling curriculum within one (1) month of employment, 4.9.3 Provide continual education and adequate resources to peer counselors. Continual education shall include basic and continuing breastfeeding training, and may include opportunities to shadow lactation consultants, opportunities to meet with other peer counselors, and related training such as counseling skills, adult learning styles, and others, and 4.9.4 Provide all WIC clinic staff the PowerPoint presentation "Peer Counseling: Making a Difference for WIC Families" through the Loving Support curriculum at least once during each Peer Counseling Program contract term. INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 12 4.10. Data Collection The Contractor shall: 4.10.1 Utilize the hardware, software, and training provided by the Arizona WIC Program to operate the Contractor's portion of the WIC Computer Data System, 4.10.2 Complete all data elements required on the WIC Computer Data System as outlined in the WIC PPM, 4.10.3 WIC Computer Data System users are required to maintain integrity by keeping their username and password secure. Users shall not share their login information with others, and 4.10.4 When applicable and necessary to fulfill WIC business functions, local WIC IT shall coordinate with ADHS WIC IT to ensure immediate restoration of technical equipment (i.e. ADHS owned equipment) to include but not limited to providing a temporary administrative account. 4.11. Administrative Services The Contractor shall: 4.11.1 In addition to complying with the Guidance for Federal Grant Award Management (Blue Book) and State of Arizona Accounting Manual (SAAM) for Contractors of ADHS Funded programs, Chapter twelve (12) and thirteen (13) of the WIC PPM: 4.11.1.1 Maintain a formal inventory listing or subsidiary record of all equipment owned by the Contractor in an organized manner as a part of the official accounting system. Ensure the non-capital and capital equipment listing includes the following: Tag or ID number, Description, Purchase cost or fair market value on date of donation, Purchase or donation date, Location, Disposal Date, Funding Source, Serial Number, Manufacturer, Model Number, RAM size (if applicable), Specifications (if applicable), and Receipt/Invoice (proof of purchase); 4.11.1.2 Provide maintenance and upkeep for all equipment purchased with WIC funds. Maintenance may be provided through the Contractor's own organization or the Contractor may participate in State maintenance contracts where available; 4.11.1.3 Obtain written permission from ADHS prior to expending WIC funds to purchase equipment with a value of $5,000 or more; 4.11.1.4 For all asset-related items, a request shall be submitted to ADHS utilizing the process specified in the WIC PPM: hardware (e.g. computers, tablets, scanners, printers, card readers, pin pads, webcams, and headsets) and certain telecommunications equipment necessary to access the web based WIC Computer Data System (e.g. routers, MiFi’s). New technology will be evaluated for inclusion based on program needs. Software may not be purchased with local agency WIC funds: 4.11.1.4.1 Notification to ADHS must be provided for any asset-related resource items that need to be transferred or disposed. Contractors shall not directly dispose of any asset. 4.11.1.5 Transfer and disposals must follow procedures outline in WIC PPM; and INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 13 4.11.1.6 Destroyed/Missing/Stolen asset resources must be reported upon discovery no later than ten (10) business days from the time of incident to the assigned ADHS WIC Nutrition Consultant. 4.11.2 If applicable, submit to ADHS for approval in writing any policy or procedure that deviates from those set forth in the Arizona WIC PPM, 4.11.3 Update the Local Agency information on a timely basis on the WIC Clinic Search administrative website including but not limited to names of CEO/Health Officer, WIC Director, Clinic Supervisors, Nutrition Coordinator, Breastfeeding Coordinator, Training Coordinator, IT lead(s), clinic names, addresses, phone numbers, days and hours of operations, closure days, and other pertinent information for the public to know, 4.11.4 Provide at least ten (10) weeks written notice when planning on opening, moving, or suspending WIC services at any location, 4.11.5 Read, timely, all ADHS provided documents and provide requested response, if applicable, 4.11.6 The Local Agency Director shall ensure the State Agency has their most recent contact information in an effort to maintain current and accurate information in the Arizona Health Alert Network (AzHAN) account, 4.11.7 Maintain records of WIC services in WIC Computer Data System and electronic files of other WIC- related operations and trainings, if applicable, according to the WIC PPM, including but not limited to: 4.11.7.1 Signed consent for hemoglobin screening and anthropometrics; 4.11.7.2 Signed Rights and Obligations for enrolled participant files (active and inactive); 4.11.7.3 Eligible participant files (active and inactive); 4.11.7.4 Ineligible applicant signatures; 4.11.7.5 Monthly Participation Reports by Category and Ethnicity; 4.11.7.6 Outreach files; 4.11.7.7 Medical documentation; 4.11.7.8 Staff files: Trainings attended, skill observations, and Local Agency Self Assessments; 4.11.7.9 Documentation of dual participation actions; 4.11.7.10 Waiting lists (when applicable); 4.11.7.11 Reconciliation of eWIC cards; 4.11.7.12 Civil rights file to include documentation and resolution of all civil rights complaints; 4.11.7.13 Documentation of annual civil rights and voter registration training of all employees; and 4.11.7.14 Documentation of WIC Confidentiality and Conflict of Interest forms. INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 14 4.11.8 Correct and resolve inappropriate or missing participant information, improbable assessment values, duplicate participation, and other quality assurance WIC Computer Data System issues identified in the report provided to the Contractor by ADHS within the timeframes specified in the WIC PPM, 4.11.9 Correct any regulatory deficiency or discrepancy noted during any of the three program Management Evaluations, Audits, Local Agency Compliance Investigations or Program Financial Reviews within sixty (60) calendar days of the date of the audit report unless an extension date is granted by the auditing/reviewing agency and documented, 4.11.10 Adhere to the SAAM travel rates. Travel rates reimbursed by the Local Agency cannot exceed the current Arizona State Reimbursement Rates, located here: https://gao.az.gov/travel/welcome-gao- travel, 4.11.11 Prepare individual electronic copies of the Contractor's Expenditure Reports (CER) for each contracted program according to the instructions and requirements of the WIC PPM, 4.11.12 Retain all evidentiary documentation (i.e. meal receipts) and submit to ADHS upon request for all expenses charged towards the WIC grant, 4.11.13 Prepare Final Closeout CER invoice for each contracted program reflecting the cumulative expenditures for a contract year, 4.11.14 Prepare WIC Local Agency Quarterly Cost Summary Reports that matches the amount of each quarter’s expenditures respectively in accordance with the requirements in the WIC PPM, 4.11.15 Prepare an annual evaluation on the annual Contractor's Outreach Plan and a progress report on activities accomplished during the year, 4.11.16 Prepare an annual evaluation on the One (1) Year Nutrition Services and Training Plan and a progress report on activities accomplished during the year, 4.11.17 Prepare an annual Amendment Application in accordance with the individual program requirements that will include budget breakdown of line items and budget justifications of any budget changes, 4.11.18 Prepare a Summary of Local Agency Annual Self Assessments. Local Agency self-assessments must be done annually in the year that the Local Agency has a Management Evaluation, and semi- annually in the year that they do not have a Management Evaluation, and 4.11.19 Prepare all required plans, reports, and documents in accordance with the requirements in the WIC PPM. In the event the Arizona WIC Program funding is depleted (e.g. government shutdown) the Contractor may request permission to continue operating their program utilizing local funds. The Contractor will contact the Arizona WIC Director to discuss the feasibility of sustaining clinic operations and participant food redemption at authorized vendor locations. The Contractor may transfer funds to ADHS to ensure continued operation. Additional monies may be awarded under this contract for WIC Special Projects related to, but not limited to general infrastructure, breastfeeding promotion, nutrition services, information system enhancement efforts and client retention efforts. 4.12. Additional Peer Counseling Administrative Services 4.12.1. Prepare and submit a Quarterly Report for the Peer Counseling services in the format provided by ADHS, and INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 15 4.12.2. Training and resources to assist the local agency in establishing and maintaining competency for new and existing staff. 5. REFERENCE DOCUMENTS 5.1. Arizona WIC Program Policies and Procedures Manual: Refer to http://azdhs.gov/azwic/local_agencies_policyManual.htm 5.2. Guidance for Federal Grant Award Management (Blue Book): https://www.azdhs.gov/documents/prevention/womens-childrens-health/childrens- health/homevisiting/guidance-for-federal-grant-award-management.pdf 5.3. State of Arizona Accounting Manual (SAAM): https://gao.az.gov/publications/SAAM/ 5.4. Federal Regulations: Refer to https://www.ecfr.gov/cgi-bin/text- idx?SID=a42889f84f99d56ec18d77c9b463c613&node=7:4.1.1.1.10&rgn=div5 5.5. 7 CFR 246.14: Program costs 5.6. 7 CFR 246.26 (h)(2): Notice to applicants and participants about the use and disclosure of confidential applicant and participant information 5.7. 7 CFR 246.26 (h)(3): Implementation of a written agreement and state plan to regulate use and disclosure of confidential applicant and participant information. 6. STATE PROVIDED ITEMS ADHS shall provide the following: 6.1. Paper copies of the Arizona WIC Program Policies and Procedures Manual, upon request; 6.2. Hardware and software necessary for operation of the WIC Computer Database System; 6.3. Training and resources to assist local agencies in establishing staff competency for new and existing staff; 6.4. Blank eWIC Cards; 6.5. Method for submitting expenditures. The ADHS WIC Program Manager or designee will accept and approve the expenditures prior to payment; 6.6. Nutrition Education Materials for participants; 6.7. Quarterly Report template (electronic) for Peer Counseling Program; 6.8. Technical assistance and support; 6.9. Breastfeeding material and supplies for participants and resources for staff; 6.10. Assistance with International Board Certified Lactation Consultant (IBCLC) career track or advanced lactation consultant education, when appropriate; 6.11. Loving Support through Peer Counseling curriculum, which includes the PowerPoint presentation "Peer Counseling: Making a Difference for WIC Families," when appropriate; INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 16 6.12. Monitoring of WIC Authorized Vendors for compliance with regulations and coordination with tribal and county officials when doing compliance buys for markets on a reservation; 6.13. Periodic redemption reports for issued benefits; and 6.14. Formats for required reports. 7. DELIVERABLES If applicable, any work plan or other documentation submitted to and accepted by ADHS regarding participation in WIC or BFPC shall be incorporated into this Agreement. Furthermore, any policy or procedure that deviates from those set forth in the Arizona WIC Program Policies and Procedures Manuals requires approval from ADHS prior to implementation. The Contractor shall submit to ADHS: 7.1. Updated copies of Local Agency Policies and Procedures as required per the WIC PPM; 7.2. Individual electronic CER invoice for each program, no later than thirty (30) days following the end of each report month of the program year; 7.3. WIC Local Agency Quarterly Cost Summary matching the WIC Contractor's CER expenses no later than thirty (30) days following the end of each quarter report of the program year; 7.4. Final CER invoice for each program no later than forty-five (45) days following the end of each Contract year; 7.5. WIC Local Agency fourth (4th) Quarterly Final Cost Summary matching the WIC Contractor's CER expenses, not later than forty-five (45) days following the end of each Contract year; 7.6. Updated Nutrition Services and Training Plan for the upcoming FFY and evaluation of the previous years activities; 7.7. Annual Summary of Local Agency Self Assessments; 7.8. Each Contracted Program's amendment application by the specified deadline for the following contract year which contains the following information: 7.8.1. Request for Caseload to be served, 7.8.2. Request for budget and budget justification, 7.8.3. Updated Outreach Plan for the upcoming FFY and an evaluation of previous years activities, and 7.8.4. Any additional services and other documents specified. 7.9. All required responses to federal and state audits and reviews submitted in a timely manner; 7.10. Additional Peer Counseling Deliverables 7.10.1. Quarterly reports for the Peer Counseling Program to be submitted 15 days after each quarter of the Contract year. INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 17 8. PERFORMANCE STANDARDS AND AWARDS 8.1. Upon Contract finalization, ADHS shall notify the Contractor by email of the assigned caseload, and throughout the term of the Contract, of any changes to the assigned caseload. The Contractor shall maintain an average monthly participation level in accordance with the following table: Caseload Assignment % Maintained <10,000 participants/month 97% 10,000 to <49,999 participants/month 98% >50,000 participants/month 99% 8.2. If, after each quarter of the Federal Fiscal Year (October through September), the Contractor has not attained the required participation level, ADHS will have the option of reducing the assigned caseload and resources to the Contractor's current service level. ADHS may also then move the unused caseload and corresponding resources to other WIC Local Agencies in order to fully utilize the resources; and 8.3. Local Agencies shall be eligible for one (1) or more of the following awards: 8.3.1. Any local agency which meets 100% or more of its caseload assignment for three (3) consecutive months during the previous FFY may receive an award of $10,000 added to that agency's following fiscal year WIC funding formula award if the Contract is extended and additional expenditures can be identified, 8.3.2. Utilizing the “Nutrition Discussion Contact” report ran in the first quarter of the FFY preceding time of application (October through December), any Local Agency meeting 95% of its nutrition education documentation requirement for each participation time period may receive an award of $10,000 added to that agency's following fiscal year WIC funding formula award if the Contract is extended and additional expenditures can be identified, 8.3.3. The agency with the highest percentage of IENs in the first quarter (Oct 1 through Dec 31) of each fiscal year within their Assigned Caseload Cohort may be eligible to receive an award added to the following fiscal year WIC funding formula award if the Contract is extended and additional expenditures can be identified. Assigned Caseload Cohorts and award amounts will be determined as follows: Assigned Caseload Cohort Award Amount Less than 2000 $5,000 2000 - 8000 $10,000 More than 8000 $15,000 8.3.4. Pursuant to 7 CFR 246. 14, which allows the WIC program to fund nutrition services and administrative expenses, the Performance Awards may be part of the annual funding formula and awarded to the Contractor in the next contract year, and 8.3.5. USDA has the option to award breastfeeding performance awards to State Agencies who exceed the national average. If funds are awarded to Arizona, each Local Agency program will receive a proration of the amount based upon the number of exclusively nursing women in their Local Agency. It will be a set amount, and may only be used for purposes outlined in the current federal guidelines. INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 18 9. NOTICES, CORRESPONDENCE AND REPORTS 9.1. Notices, correspondence, reports and invoices from the Contractor to ADHS shall be sent to: Arizona Department of Health Services 150 N. 18th Avenue, Suite 310 Phoenix, Arizona 85007 Attention: WIC Program Manager 9.2. Notice, correspondence and reports from ADHS to the Contractor shall be sent to: (Contractor to complete) Contractor: Attention: Address: Address: City, State, ZIP: Phone: Fax: Email: INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 19 PRICE SHEET October 1, 2020 to September 30, 2021 Cost Reimbursement Line Item Budget Agency Name: Maricopa County WIC Services Federal Award Date: October 1, 2019 CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children WIC Services Account Classification Amount Personnel $3,872,527.00 Employee Related Expenses $2,022,012.00 Professional & Outside Services $105,000.00 Travel Expense $10,550.00 Occupancy Expenses $397,086.00 Other Operating Expenses $88,531.00 Capital Expenditures $1.00 Indirect Cost $1,221,193.00 RD Supplement $1,038,016.00 Total $8,754,916.00 Breastfeeding Peer Counseling Services Federal Award Date: October 1, 2019 CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children Breastfeeding Peer Counseling Services Account Classification Amount Personnel $275,028.00 Employee Related Expenses $142,747.00 Professional & Outside Services $1.00 Travel Expense $2,500.00 Occupancy Expenses $1.00 Other Operating Expenses $9,016.00 Capital Expenditures $0.00 Indirect Costs $80,707.00 Total $510,000.00 INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR040876 IGA Amendment No: 4 Procurement Officer Kristine Newton 20 WIC Special Projects Federal Award Date: October 1, 2019 CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children WIC Special Projects Account Classification Amount Personnel $179,234.00 Employee Related Expenses $106,728.00 Professional & Outside Services $1.00 Travel Expense $1.00 Occupancy Expenses $113,110.00 Other Operating Expenses $1.00 Capital Expenditures $0.00 Indirect Costs $81,908.00 RD Supplement $36,608.00 Total $517,591.00 Additional Terms and Conditions: With prior written approval from the Program Manager, the Contractor is authorized to transfer up to a maximum of ten percent (10%) of the total budget amount between funded line items except for Registered Dietitian Expenses. 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. The Registered Dietitian line item may only be used to fund additional Registered Dietitian position(s) to meet high risk counseling requirements. Authorization for purchase of services under this Contract shall be made only upon ADHS issuance of a Purchase Order that is signed by an authorized agent. The Purchase Order will indicate the Contract number and the dollar amount of funds authorized. The Contractor shall only be authorized to perform services up to the amount on the Purchase Order. ADHS shall not have any legal obligation to pay for services in excess of the amount indicated on the Purchase Order. No further obligation for payment shall exist on behalf of ADHS unless a.) The Purchase Order is modified with an official ADHS Procurement Change Order, and/or b.) An additional Purchase Order is issued for purchase of services under this Contract. ADHS reserves the right to adjust awards given to local agencies depending on federal dollars received. Adjustments will be at the discretion of ADHS. Additional WIC Program: Should additional administrative monies become available through state or federal grants, ADHS may increase the purchase order to increase the number of participants served and increase the total of this contract. The assigned caseload for FFY 2020 is: 48,000 Additional Breastfeeding Peer Counseling Program: Allowable costs for the Peer Counseling Program include compensation for peer counselors and designated peer counselor managers/coordinators, and related costs such as training and training materials; telephone expenses for participant contacts (including pager, cell phones and answering machines); travel for training and home and hospital visits; recruitment of peer counseling staff; and the purchase of demonstration materials (e.g., breast pumps for demonstration purposes, videos). Out of state travel must be pre-approved by ADHS. Items and materials for distribution to WIC participants (e.g. breast pumps, breastfeeding aids) are not allowable costs.