IGA AMENDMENT 4 RE COMMUNITY ACTION PROGRAM WITH CITY OF BUCKEYE.PDF

Maricopa County — Formal (2026-06-24)

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Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 1 of 16 
AMENDMENT NO. 4 TO THE 
INTERGOVERNMENTAL AGREEMENT 
BETWEEN 
MARICOPA COUNTY 
ADMINISTERED BY ITS 
HUMAN SERVICES DEPARTMENT 
AND 
CITY OF BUCKEYE 
 
I. 
Maricopa County (“County”), administered by its Human Services Department, and the 
City of Buckeye, (“Subrecipient”) entered into a financial Intergovernmental Agreement 
(“Agreement”), on or about July 15, 2022. The purpose of the Agreement is for the 
Subrecipient to provide Community Action Program (CAP) services to include crisis case 
management, coordination of services to assist low-income households in crisis situations, 
and assistance to move closer to economic self-sufficiency in Buckeye. The current 
Agreement term is July 1, 2025, through June 30, 2026. 
 
The County provided the Subrecipient with $165,000 Fiscal Year 2026 funding for CAP 
Services through an Intergovernmental Agreement (IGA) with Arizona Department of 
Economic Security (DES) under IGA DI25-002428/C-22-26-011-X-00. The total 
Agreement funding is $165,000. The funding period of availability is July 1, 2025, through 
June 30, 2026.The County and the Subrecipient collectively are referred to as the 
“Parties.”  
 
II. 
The Parties agree to enter into this Amendment No. 4 to amend the Agreement as follows: 
 
A. 
Extend the Agreement expiration date shown on page 1 of the Agreement from 
June 30, 2026, through June 30, 2027. 
 
B. 
Revise Maricopa County Representative on Page 1 of the Agreement as follows: 
 
Maricopa County Representative: 
Chela Schuster, Assistant Director 
Senior Services and Community Resilience Division 
234 N. Central Avenue, 3rd Floor 
Phoenix, AZ 85004 
602-283-8981 
chela.schuster@maricopa.gov 
 
C. 
The County shall provide the Subrecipient with $66,000 for the budget period July 
1,2026 through December 31, 2026 (Fiscal Year 2027).  
 
a. The funding sources for this Amendment may include but are not limited to 
the following: 
 
93.569 Community Services Block Grant (CSBG) 
93.667 Social Services Block Grant (SSBG) 
93.558 Temporary Assistance for Needy Families (TANF) 
93.568 Low Income Home Energy Assistance Program (LIHEAP) 
21.027 American Rescue Plan Act State and Local Fiscal Recovery Funds 
(ARPA-SLFRF)

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 2 of 16 
b. The County shall provide the Subrecipient with additional funding for the 
Agreement term, through an amendment to the Agreement, as outlined in 
Section 1 (GENERAL PROVISIONS) PARAGRAPH 4.0 (AMENDMENTS) 
of the Agreement, subject to County’s receipt of funding. 
 
c. In accordance with 2 CFR 200.332(b)(1)(xii), the County shall provide the 
Subrecipient with FY2026 and FY2027 final expenditure dollar amounts 
made available under each federal award program, according to 
Assistance Listing Number (ALN), within 60 days after the applicable fiscal 
year end by formal amendment in accordance with Section 1 (General 
provisions), 
Paragraph 
4.0 
(Amendments) 
(https://www.ecfr.gov/current/title-2/part-200/subpart-D#p-
200.332(b)(1)(xii)). 
 
d. In accordance with Section 4 (Budget and Compensation), subparagraph 
1.1 of the Agreement, the Subrecipient is required to leverage a minimum 
25% cash match of the total Agreement award to support administration 
and operating costs in the delivery of program services, which shall be 
identified in the Itemized Service Budget (ISB). Subrecipient shall provide 
County an ISB within 30 days of execution of the Agreement, subject to 
final approval by Human Services Department Assistant Director, identified 
on page 1 of the Agreement. The final approved budget for the first six 
months of Fiscal Year 2027 shall be incorporated into the Agreement by 
Addendum, as provided in the Sample Addendum. 
 
D. 
Revise Section 1 (General provisions), Paragraph 5.0 (Termination) by adding 
subparagraph 5.6 to the Agreement as follows: 
 
5.6 
Upon termination or cancellation of this Agreement, all property, if 
any, shall be returned to or retained by the purchasing Party. 
 
E. 
Revise Section 3 (Work Statement), by removing it in its entirety and replacing it 
with the following: 
 
1.0 
PROGRAM GOALS 
Maricopa County is a designated Community Action Agency, authorized 
under the federal Community Services Block Grant (CSBG) Act to address 
the causes and conditions of poverty in local areas. The Maricopa County 
Human Services Department/Senior Services and Community Resilience 
Division (MCHSD/SSCRD) administers Community Action Program 
activities, the primary purpose of SSCRD is to provide a range of programs 
or services that are intended to: 
• 
pursue the reduction of poverty,  
• 
the revitalization of low-income communities; and  
• 
the empowerment of low-income families and individuals to 
become fully self-supportive.  
Through partnerships with local municipalities or private, non-profit 
organizations, community action programs and services are provided to 
residents in the local area.

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 3 of 16 
2.0 
SCOPE OF WORK 
Community Action Program Services shall include the delivery of crisis 
services, internal/ external program navigation, and program referrals 
intended to assist in the stabilization of immediate/ emergent needs for 
families that are facing eviction, disruption in utilities, experiencing 
insufficient food and/or nutrition, and/or are unemployed/ underemployed.  
Services shall be delivered in a wrap around, comprehensive manner to 
address the needs of the household and to move families closer to 
economic stability. 
 
2.1 
MCHSD Crisis Financial Assistance Services  
Eligibility for financial assistance is determined and benefit 
payments made on behalf of program participants, these include 
but are not limited to, emergency rent, move-in assistance, utility 
payments or deposits, and emergency utility payments. 
2.1.1 MCHSD Crisis Financial Assistance Services shall be 
coordinated with other local or grant financial assistance 
services to maximize benefits to the household.  
2.1.2 Eligibility criteria for financial assistance funds are defined 
in the MCHSD/SSCRD Policy and Procedure Program 
Handbook. 
2.1.3 Financial assistance funds are managed and allocated by 
MCHSD. Funds will be made available to the Subrecipient 
through HSD Dynamics or another comparable platform. 
2.1.4 MCHSD/SSCRD will make payments directly to vendors 
upon authorization by the County). 
2.1.5 Available Financial Assistance Services shall include the 
following: 
2.1.5.1 Utility Assistance 
2.1.5.1.1 Utility payments and deposits for heating 
and cooling; 
2.1.5.1.2 Rental assistance where utility payment 
is included in rent. 
2.1.5.2 Rental Assistance  
2.1.5.2.1 Rental assistance to prevent eviction; 
and 
2.1.5.2.2 Move in assistance to include rental 
deposits and first month rent. 
2.1.6 MCHSD Crisis Financial Assistance Service Requirements:  
2.1.6.1 Subrecipient shall conduct application intake for 
MCHSD Crisis Financial Assistance Services to 
clients who apply in person with a paper application 
or need assistance applying online. 
2.1.6.2 On-site application process shall include the 
following: 
2.1.6.2.1 Provide paper applications, or assist 
clients 
with 
completing 
the 
online 
application process; 
2.1.6.2.2 Collect client eligibility documents for 
identified services, as required in the

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 4 of 16 
MCHSD/SSCRD Policy and Procedure 
Program Handbook;  
2.1.6.2.3 Information from the paper application 
shall be entered into HSD Dynamics or 
another comparable platform within 24 
hours of receipt;  
2.1.6.2.4 Upload a copy of the paper application in 
HSD Dynamics SharePoint or another 
comparable platform; 
2.1.6.2.5 Create an application in HSD Dynamics 
or another comparable platform, as well 
as the program application (s) which the 
client applied for; 
2.1.6.2.6 Upload eligibility documents in HSD 
Dynamics 
or 
another 
comparable 
platform; 
2.1.6.2.7 Research each household member to 
determine if they have received previous 
assistance; and  
2.1.6.2.8 Research and enter vendor/provider 
information in Dynamics.  
2.1.6.3 The Subrecipient will also process applications 
submitted through the HSD Dynamics client portal or 
another comparable platform per MCHSD/ SSCRD 
Policy and Procedure Handbook following the 
process outlined below: 
2.1.6.3.1 Subrecipient will assign and disposition 
program applications to Client Services 
Specialists; 
2.1.6.3.2 Upload eligibility documents in HSD 
Dynamics 
or 
another 
comparable 
platform; and 
2.1.6.3.3 Research provider profile and submit 
vendor information related to the County 
vendor 
registration 
process, 
within 
twenty-four (24 hours), if applicable; 
2.1.6.3.4 Document all services provided and 
supported by County funds in HSD 
Dynamics 
or 
another 
comparable 
platform, in addition to local/ grant 
financial assistance services; 
2.1.6.3.5 Manage and monitor application queue in 
HSD Dynamics or another comparable 
platform based on program application 
submission date;  
2.1.6.3.6 The Service Provider shall adhere to the 
queue mitigation protocols set forth in the 
Policy and Procedure Handbook to 
maintain wait times and queue volumes 
within the parameters defined therein

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 5 of 16 
2.1.6.3.7 All 
client 
communication 
must 
be 
documented as well as make relevant 
‘case notes’ on the client’s current 
application timeline in HSD Dynamics or 
another comparable platform.  
2.1.6.3.8 Conduct quality assurance review and 
ensure quality controls on each program 
application 
case 
and 
subsequent 
completed service authorization (s); 
Subrecipient shall document site QA 
procedures and designate an owner of 
the QA process by role and name which 
must remain updated throughout the 
program year. Submit to MCHSD upon 
request. 
2.1.6.3.9 Resolve rejected service authorizations 
and data entry errors within two (2) 
business days from the rejection date. 
2.1.6.3.10 Subcontractor shall comply with the 
requirements of Arizona Confidentiality 
Program A.R.S.§41-161 and procedures 
outlined in the MCHSD-SSCRD Policy 
and Procedure Manual. 
 
2.2 
Navigation Services 
Navigation services are offered to clients following the completion 
of the HSD Dynamics application or another comparable platform 
application, and program application. Navigation is a staff assisted 
function that includes the collection of eligibility documents and 
completion/ 
submission 
of 
program 
application 
for 
both 
Subrecipient’s internal programs (non-County funded) along with 
external program services. 
2.2.1 Navigation to Low-Income Energy Assistance Program 
(LIHEAP) Services:  
2.2.1.1 Subrecipient shall provide application assistance 
which may include the following:  
2.2.1.1.1 Answering questions about program 
eligibility and the application process.  
2.2.1.1.2 Entering application data directly into the 
DES portal on behalf of the Client, 
including LIHEAP application signature 
page. 
2.2.1.1.3 Scanning 
and 
uploading 
required 
documents, as needed. 
2.2.1.1.4 Provide paper applications to clients, 
upon request. Enter and upload required 
documentation into the DES portal on the 
Client’s behalf.  
2.2.1.1.5 Upon request, provide assistance in 
completing the ID.me identity verification 
process to include scanning required

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 6 of 16 
documents and uploading to the ID.me 
website (www.ID.me.com). 
2.2.1.1.6 Screen for crisis circumstances to ensure 
priority will be given to a Life Threatening 
Crisis Assistance Application.  
2.2.1.1.7 Conduct initial screening and reporting of 
potential Welfare Fraud. 
2.2.1.1.8 All 
LIHEAP 
Navigations 
that 
are 
completed must be documented in HSD 
Dynamics 
or 
another 
comparable 
platform.  A case note must be made on 
the utility program application timeline 
and monitory navigations fields must be 
completed.  
2.2.1.2 Navigation to Internal Program Services 
2.2.1.2.1 Subrecipient shall identify a minimum of 
two (2) internal programs based on the 
most recent MCHSD Community Needs 
Assessment, to complete a logic model 
and 
provide 
additional 
outcome 
reporting. Subrecipient will submit a logic 
model (Exhibit 1) by July 31st of the 
current program year, to be approved by 
MCHSD. The logic model shall provide 
the 
following 
information 
for 
each 
program service: 
2.2.1.2.1.1 Community need; 
2.2.1.2.1.2 Anticipated 
program 
outcome(s); 
2.2.1.2.1.3 Description 
of 
program 
service; 
2.2.1.2.1.4 Projected 
number 
of 
individuals/ households to be 
served; and 
2.2.1.2.1.5 Projected 
number 
of 
individuals/ households who 
will 
achieve 
anticipated 
program outcome(s). 
2.2.1.2.1.6 Data collection methodology  
2.2.1.2.2 Subrecipient shall conduct follow up 
contact with clients to assess for 
additional needs and to track program 
outcomes as it relates to the outcomes 
identified in the Subrecipient’s logic 
model.   
2.2.1.2.2.1 Follow up contact shall be 
conducted at intervals of 3 
months, 6 months, and 9 
months following the receipt 
of program services.

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 7 of 16 
2.2.1.3 Navigation Service Requirements 
2.2.1.3.1 Clients 
shall 
have 
a 
completed 
application and program application(s) in 
HSD Dynamics or another comparable 
platform prior to receiving navigation 
services to DES portal for LIHEAP 
services or internal program services.  
2.2.1.3.2 Subrecipient shall ensure that all income 
eligible clients will be navigated to the 
Arizona Department Economic Security 
(DES) portal for LIHEAP services. 
2.2.1.4 Subrecipient shall provide navigation services as it 
relates to internal program services to clients that 
have been dispositioned in the HSD Dynamic 
queue.  
2.2.1.5 Navigation 
services 
shall 
be 
provided 
and 
documented, 
in 
accordance 
with 
the 
MCHSD/SSCRD Policy and Procedure Manual. 
2.2.1.6 Navigation 
services 
shall 
be 
reported 
in 
MCHSD/SSCRD quarterly ROMA reports. 
2.2.1.7 Subrecipient shall use the MCHSD approved logic 
model template for internal program navigation. 
 
2.3 
Information and Referrals  
2.3.1 Subrecipient shall provide information and referrals to 
include but not limited to the following:  
2.3.1.1 Community Legal Services (CLS) for households 
who are facing immediate eviction for non-payment 
of rent or who receive assistance and have a 
judgement that is not satisfied. 
2.3.1.2 DES Child support enforcement services for clients 
who are custodial parents in single parent 
households. 
2.3.1.3 Assistance completing applications for SNAP, 
AHCCCS, and Unemployment Insurance. 
2.3.1.4 Food and nutrition services to counteract the 
impacts of starvation or malnutrition. 
2.3.2 Information and Referrals Service Requirements 
2.3.2.1 Clients shall have a completed program application 
in HSD Dynamics or another comparable platform 
prior to the delivery of information and referral 
services.   
2.3.2.2 Subrecipient shall document all referrals in HSD 
Dynamics or another comparable platform and 
follow referral procedures in accordance with the 
MCHSD/SSCRD Policy and Procedure Manual. 
2.3.2.3 Information regarding program referrals shall be 
reported in the MCHSD/SSCRD quarterly ROMA 
reports.

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 8 of 16 
2.4 
Facility Requirements 
2.4.1 Subrecipient shall ensure staff on-site are able to navigate 
to websites and provide generalized assistance to clients. 
Staff shall provide access through self-maintaining or 
partnership agreements, a computer lab to include multiple 
computers with internet access, fax machines, copier, 
phones, and basic office supplies to allow individuals 
access to the following: 
2.4.1.1 AZDES LIHEAP Application Portal; 
2.4.1.2 HSD Client Portal; 
2.4.1.3 Online applications for AZDES Unemployment 
Insurance, 
Supplemental 
Nutrition 
Assistance 
Program (SNAP), and AHCCCS Health Insurance; 
2.4.1.4 Online job search and submission of application/ 
resume; and/or 
2.4.1.5 Information regarding scholarships and federal 
financial aid. 
2.4.2 Subrecipient shall ensure adequate space for the following: 
2.4.2.1 On-site workshops and training classes; 
2.4.2.2 Local job/career fairs; and 
2.4.2.3 Eligibility 
determination 
where 
confidential 
information cannot be overheard. 
 
2.5 
Reporting Requirements 
2.5.1 Subrecipient shall submit programmatic and financial 
reports to MCHSD as listed below: 
2.5.1.1 Results Oriented Management and Accountability 
(ROMA/ROMA Next Gen) data and/or reports no 
later than the 10th business day after the end of each 
quarter of the fiscal year. 
2.5.1.2 Monthly 
invoices/claims 
with 
supporting 
documentation no later than the 10th business day, 
following the end of the month. 
2.5.1.3 The County reserves the right to add, remove, or 
revise reporting requirements to meet program 
goals. 
2.5.1.4 Failure to submit required reports in the designated 
timeframe listed may result: 
2.5.1.4.1 in a forfeiture of payment, if not submitted 
by the forty-fifth (45th) calendar days 
following the end of a month. 
2.5.1.4.2 in a forfeiture of final payment, if final 
program and fiscal reports are not 
submitted within the designated time 
period, determined by MCHSD following 
the Contract term. 
 
2.6 
HSD Dynamics (Or Another Comparable Platform) Access 
2.6.1 Access to HSD Dynamics or another comparable platform 
will be provided by MCHSD/SSCRD upon request by the 
Subrecipient.

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 9 of 16 
2.6.2 Subrecipient shall provide MCHSD/SSCRD information 
regarding staffs’ name, position title, contact information, 
and evidence of successful completion of all required 
background checks, to include Fingerprint and Central 
Registry Submission/Clearances. Subrecipient will submit 
CAP personnel Fingerprint renewals and annual Central 
Registry renewals to CAPSupport@maricopa.gov.   
2.6.3 MCHSD reserves the right to immediately remove access if 
it is determined Subrecipient’s personnel (employed or as 
volunteer) is a risk to County operations for any of the 
following reasons but not limited to: 
2.6.3.1 Approving clients for services they are not eligible for; 
2.6.3.2 Denying eligible clients services; and 
Accessing the HSD Dynamics or another comparable 
platform for any purpose other than areas of 
responsibility. 
2.6.4 MCHSD will provide Subrecipient programmatic ad hoc 
reports, as requested. 
 
2.7 
Staff Requirements 
2.7.1 Subrecipient shall: 
2.7.1.1 Ensure staff and/or volunteers do not provide direct 
services to clients until all appropriate Background 
Checks, Fingerprint Clearances (applicable to ARS 
§§36-594.01, 36-3008, 41-1964, and 46-141) and 
Central Registry clearances (compliant with Central 
Registry provisions of ARS §8-804 in its entirety) 
have been completed with satisfactory results and 
procedures are in place if results are unsatisfactory. 
Subrecipient shall have a documented procedure for 
CAP 
personnel 
who 
as 
a 
condition 
of 
employment/volunteer or upon renewal (annual 
review for Central Registry) is deemed disqualified 
through 
the 
Fingerprint 
or 
Central 
Registry 
Clearance process. Documented procedure is 
provided to MCHSD-SSCRD upon request. 
2.7.1.2 Maintain documentation that key staff have received 
appropriate 
training 
or 
hold 
appropriate 
certification/licensure in accordance with roles, 
responsibilities and job descriptions; 
2.7.1.3 Ensure that staff and volunteers do not have any 
conflicts of interest in the provision of services and 
management of programs; 
2.7.1.4 Provide staff and volunteers with supervision, 
equipment, materials and supplies necessary to 
perform contracted services; 
2.7.1.5 Provide training to all new employees and 
volunteers providing services under this Agreement, 
to include but not limited to the following: 
2.7.1.5.1 An overview of the MCHSD/SSCRD 
Policy and Procedure Manual; and

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 10 of 16 
2.7.1.5.2 Requirements of ARS §46-140.01 and 
ARS §1-501 and ARS § 1-502 regarding 
eligibility for state and local benefits. 
2.7.1.6 Maintain 
documentation 
that 
verifies 
case 
management staff have received relevant training 
and provide documentation upon request to 
MCHSD-SSCRD; 
2.7.1.7 The Subrecipient shall be required to notify MCHSD-
SSCRD of staff changes and vacant positions within 
two (2) business days of staff changes through 
CAPSupport@maricopa.gov. The Subrecipient shall 
open the recruitment to fill case worker vacancies, 
no later than thirty (30) days after the vacancy 
occurs, to ensure service availability and clients are 
not turned away due to lack of staff.  
 
2.7.2 Code of Conduct: 
2.7.2.1 The Subrecipient shall avoid any action that might 
create or result in the appearance of: 
2.7.2.1.1 Inappropriate 
use 
or 
divulging 
of 
information 
gathered 
or 
discovered 
pursuant to the performance of its duties 
under the Contract. 
2.7.2.1.2 Actions on behalf of the County without 
appropriate authorization. 
2.7.2.1.3 Providing 
favorable 
or 
unfavorable 
treatment to anyone. 
2.7.2.1.4 Making a decision on behalf of the 
County that exceeds their authority, 
displaying 
preferential 
treatment 
or 
actions that would have unfavorable 
consequences for the County. 
2.7.2.1.5 Misrepresenting or otherwise impede the 
efficiency, authority, actions, policies, or 
adversely affect the confidence of the 
public or integrity of the County. 
2.7.2.1.6 Loss of impartiality when advising the 
County. 
 
2.8 
Community Action Program Meetings 
2.8.1 MCHSD will facilitate meetings that will be held on a 
quarterly basis, at a minimum with CAP Subrecipients to 
communicate new developments, discuss problems, 
address barriers to services, share ideas for improvements, 
and to address other identified topic areas. 
2.8.2 Subrecipient shall ensure that a designated member of 
leadership staff participates in all CAP meetings, as 
scheduled.

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 11 of 16 
2.9 
Cooperation in Strategic Planning and Community Needs 
Assessment: 
2.9.1 Subrecipient shall participate in strategic planning initiatives 
which lead to the development of the five (5) year strategic 
plan and the annual Community Action Plan and provide 
information regarding the causes/condition of poverty within 
the designated geographic service area. 
 
2.10 
Training and Technical Assistance 
2.10.1 To ensure successful program service delivery, MCHSD will 
provide/conduct training and technical assistance, if 
applicable, on the following: 
2.10.1.1 
MCHSD/SSCRD Policy and Procedure Program 
Manual; 
2.10.1.2 
MCHSD funded financial assistance services; 
2.10.1.3 
Use of HSD Dynamics or another comparable 
platform; 
2.10.1.4 
Reports and forms, as required; 
2.10.1.5 
Results 
Oriented 
Management 
and 
Accountability (ROMA)/ROMA Next Gen; 
2.10.1.6 
Review of all applicable federal, state, and 
county regulations, laws, and rules related to 
specific funding sources used; 
2.10.1.7 
Review of program monitoring findings; and 
2.10.1.8 
Other training and technical assistance as 
needed/required. 
 
2.11 
Limited English Proficiency 
2.11.1 The Subrecipient shall ensure that all services provided are 
culturally relevant and linguistically appropriate to the 
population to be served. To ensure compliance, reference 
DES 1-01-34 at: https://des.az.gov/digital-library/limited-
english-proficiency  
2.11.2 Applicable Program Rules and Regulations: 
2.11.2.1 
Subrecipient shall comply with all applicable 
federal, state, and county regulations, laws, and 
rules as amended, including but not limited to the 
following: 
2.11.2.2 
COATS Human Services Reauthorization Act of 
1998; 
2.11.2.3 
2 
CFR 
200 
Uniform 
Administrative 
Requirements; 
2.11.2.4 
Personal Responsibilities and Work Opportunity 
Reconciliation Act of 1996; 
2.11.2.5 
Stewart B. McKinney Homeless Assistance Act; 
2.11.2.6 
ARS §46-241-State Short Term Crisis Services; 
2.11.2.7 
ARS §46-731–Utility Assistance; 
2.11.2.8 
ARS §46-741–Neighbors Helping Neighbors; 
2.11.2.9 
ARS §46-140.01-Verifying applicants for public 
benefits; violation; classification; citizen suits

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 12 of 16 
2.11.2.10 ARS§1-501-§1-502, Eligibility for federal, state, 
or local public benefits; documentation; violation; 
classification; citizen suites; court costs and 
attorney fees; 
2.11.2.11 The requirements related to reporting to a peace 
officer or child protective services incidents of 
crimes against children as specified in A.R.S. 
§13-3620 as may be amended. 
2.11.2.12 P.L. 101-121, Section 319 (31 U.S.C. section 
1352) as may be amended, and 29 C.F.R. Part 
93 as may be amended which prohibit the use of 
federal funds for lobbying and which state, in 
part: Except with the express authorization of 
Congress, the Subrecipient, its employees or 
agents, shall not utilize any federal funds under 
the terms of this contract to solicit or influence, 
or to attempt to solicit or influence, directly or 
indirectly, any member of Congress regarding 
pending or prospective legislation. Indian tribes, 
tribal organizations and any other Indian 
organizations are exempt from these lobbying 
restrictions with respect to expenditures that are 
specifically permitted by other federal law. 
2.11.2.13 A.R.S. § 23-722.01 as may be amended relating 
to new hire reporting, 
2.11.2.14 A.R.S. § 23-722.02 as may be amended relating 
to wage assignment orders to provide child 
support, and A.R.S. § 25-535 as may be 
amended relating to administrative or court-
ordered health insurance coverage for children. 
2.11.3 Administrative Simplification rules in Title II of the Health 
Insurance Portability and Accountability Act of 1996 (Public 
Law 104-191) and all Federal regulations that are applicable 
to the operations of the Subrecipient by the dates required 
by the implementing Federal regulations as well as all 
subsequent requirements and regulations as published. 
 
2.12 
Appeal/Grievance Procedures 
2.12.1 Subrecipient shall establish a process to review and 
address client appeals and grievances. Subrecipient shall 
submit an appeal/grievance process to MCHSD/SSCRD 
annually, and as requested. The grievance/appeal 
procedure shall be accessible to applicants at the time of 
application submission. 
2.12.2 Subrecipient shall advise all applicants of their right to 
present to the Subrecipient any appeal/grievances arising 
from the delivery of contract services, including, but not 
limited to, ineligibility determination, award amount, 
reduction of services, suspension or termination of services, 
or quality of services.

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 13 of 16 
2.12.3 Subrecipient shall address grievances for individuals 
seeking/receiving County funded assistance who feel that 
they have not been treated fairly.  
2.12.4 Subrecipient shall act as first reviewer of grievances for their 
respective site following their prescribed written process. All 
grievance requests generated by clients must be 
documented in HSD Dynamics or another comparable 
platform. All communication and documentation requests 
regarding the grievance must be documented in HSD 
Dynamics or another comparable platform on the 
Application timeline. MCHSD acts as second review for all 
escalated CAP grievances. Follow grievance procedures as 
outlined in the MCHSD/SSCRD Policy and Procedure 
Program Manual.  
 
2.13 
Community Action Tripartite Board Recruitment 
2.13.1 Subrecipient shall recruit local community members to 
serve in the role of the Public Official or Consumer 
Representative sectors for the MCHSD Community Action 
Commission, as requested by MCHSD.  Subrecipients shall 
perform the following outreach activities: 
2.13.1.1 
Post flyers at location(s) and community 
events; 
2.13.1.2 
Share information and distribute flyers to 
clients; 
2.13.1.3 
Direct community members to the following 
MCHSD 
website 
page 
to 
obtain 
additional 
information 
and 
Commission 
application: 
CACCommission@maricopa.gov; 
2.13.1.4 
Assist clients or with the Democratic 
Selection Process; 
2.13.1.5 
Coordinate outreach efforts to city council 
members.  
 
2.14 
Pandemic Award Performance 
2.14.1 The Subrecipient shall establish a written plan that 
illustrates how the services and contract performance 
standards will be met in the event of a pandemic 
occurrence. 
2.14.2 The pandemic performance plan shall include: 
2.14.2.1 
Key succession and performance planning if a 
sudden significant decrease in Subrecipient’s 
workforce should occur. 
2.14.2.2 
Alternative methods to ensure services are 
available. 
2.14.2.3 
An up-to-date list of Subrecipient contacts and 
organizational chart. 
2.14.2.4 
In the event of a pandemic, as declared by the 
Governor of Arizona, U.S. Government, or the 
World 
Health 
Organization, 
which makes 
performance of any term under this Award

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 14 of 16 
impossible or impracticable, the MCHSD shall 
have the following rights: 
2.14.2.5 
After the official declaration of a pandemic, 
MCHSD may temporarily void the Award in 
whole or specific sections if the Awardee cannot 
perform to the standards agreed upon in the 
initial terms. 
2.14.2.6 
MCHSD shall not incur any liability if a pandemic 
is declared, and emergency procurements are 
authorized by the Director of the Arizona 
Department of Administration per A.R.S. § 41-
2537 as may be amended by the Arizona 
Procurement Code. 
2.14.2.7 
Once the pandemic is officially declared over 
and/or the Subrecipient can demonstrate the 
ability to perform, MCHSD, at its sole discretion, 
may reinstate the temporarily voided Award. 
 
III. 
Section II above contains all the changes to the Agreement made by this Amendment 
No. 4. The Agreement is amended to incorporate the changes contained in this 
Amendment No. 4. All other terms and conditions of the Agreement remain in full force 
and effect as executed by the Parties. This Amendment No. 4 is subject to and 
incorporates the provisions of A.R.S. §38-511. 
 
IV. 
The Parties have authorized the undersigned to execute this Amendment No. 4, and it 
shall be effective upon approval and signature by both Parties. 
 
[signatures contained on following page]

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 15 of 16 
 
IN WITNESS, the Parties have approved and signed this Amendment No. 4: 
 
APPROVED BY: 
CITY OF BUCKEYE 
 
APPROVED BY:  
MARICOPA COUNTY 
 
 
 
___________________________________ 
Eric Orsborn                                           Date 
Mayor 
 
 
 
 
____________________________________ 
Kate Brophy McGee                                Date 
Chair, Board of Supervisors 
Attested To: 
 
 
 
___________________________________ 
Lucinda Aja                                            Date 
City Clerk 
 
Attested To: 
 
 
 
____________________________________ 
Juanita Garza                                          Date 
Clerk of the Board 
IN ACCORDANCE WITH A.R.S. §§ 9-240, 9-
500.11, 11-952, AND 46-241, ET SEQ., THIS 
AMENDMENT NO. 4 HAS BEEN REVIEWED 
BY THE UNDERSIGNED ATTORNEY WHO 
HAS DETERMINED IT IS PROPER IN FORM 
AND 
WITHIN 
THE 
POWERS 
AND 
AUTHORITY GRANTED TO THE CITY OF 
BUCKEYE UNDER THE LAWS OF THE 
STATE OF ARIZONA. 
 
APPROVED AS TO FORM: 
 
 
 
BY: ________________________________ 
Attorney for the City                        Date 
 
IN ACCORDANCE WITH A.R.S. §§ 11-201, 
11-251, AND 11-952, THIS AMENDMENT 
NO. 4 HAS BEEN REVIEWED BY THE 
UNDERSIGNED ATTORNEY WHO HAS 
DETERMINED IT IS PROPER IN FORM AND 
WITHIN THE POWERS AND AUTHORITY 
GRANTED TO MARICOPA COUNTY UNDER 
THE LAWS OF THE STATE OF ARIZONA. 
 
APPROVED AS TO FORM: 
 
 
 
BY: _________________________________ 
Deputy County Attorney                    Date

Contract No. C-22-22-111-X-04 
 
Amendment No. 4 
City of Buckeye 
 
Page 16 of 16 
Addendum Sample 
 
Fiscal Year 2027 Operating Budget  
  
  
City of Buckeye Operating Budget – CAP Services  
Contract Budget Period 
July 1st, 2026, through December 31, 2026  
  
  
  
Funding 
  
County Funds 
$  
  
Cash Match Contributions 
$  
  
  
$  
  
  
  
Budget Category 
Direct Cost 
Administration Cost 
Total 
Cost 
Personnel 
$  
$  
$  
ERE 
$  
$  
$  
P & O Services 
$  
$  
$  
Travel 
$  
$  
$  
Space 
$  
$  
$  
Materials & Supplies 
$  
$  
$  
Operating Services 
$  
$  
$  
  
  
Total Expenses 
$  
$  
$