MCDPH MEDICAL SCREENING IGA EXECUTION READY.PDF

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
Intergovernmental Agreement between the Arizona Department of Economic Security ("ADES") and the
Maricopa County Department of Public Health ("Contractor").
WHEREAS ADES is duly authorized to execute and administer contracts under A.R.S § 41-1954 and,
The Contractor is duly authorized to execute and administer contracts under A.R.S § 11-201 and,
ADES and the Contractor are authorized by A.R.S. § 11-952 et seq. to enter into agreements for joint or
cooperative action to contract for the services specified in this Agreement.
The term of this Agreement shall begin on 10/1/2023 and shall end on 09/30/2028, unless otherwise amended.
THEREFORE, ADES and Contractor (the “Parties”) agree to abide by all the terms and conditions set forth in this
Agreement.
BY SIGNING THIS FORM ON BEHALF OF A PARTY, THE SIGNATORY CERTIFIES POSSESSING THE AUTHORITY TO BIND THE
PARTY TO THIS AGREEMENT.
FOR AND ON BEHALF OF THE ARIZONA
DEPARTMENT OF ECONOMIC SECURITY:
FOR AND ON BEHALF OF THE MARICOPA
COUNTY DEPARTMENT OF PUBLIC HEALTH
Procurement Officer Signature
Signature
Printed Name
Printed Name
Title
Title
Date
Date
ADES Contract Number
Contractor’s Contract Number (If applicable)
IN ACCORDANCE WITH A.R.S. § 11-952, THIS AGREEMENT IS IN APPROPRIATE FORM AND WITHIN THE POWERS
AND AUTHORITY GRANTED TO EACH RESPECTIVE PUBLIC BODY.
ARIZONA ATTORNEY GENERAL’S OFFICE
By: ___________________________________
By:
_________________________________________
Assistant Attorney General
Public Agency Legal Counsel
Date: __________________________________
Date: ________________________________________
12/05/2023 Intergovernmental Agreement Page 1 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
1.0
ADES VISION AND MISSION STATEMENTS
1.1
ADES Mission: To strengthen individuals, families, and communities for a better quality of
life.
1.2
ADES Vision: A thriving Arizona.
2.0
PURPOSE OF AGREEMENT
2.1
The purpose of this agreement is to maintain the coordination of a comprehensive
medical screening to be referred to as the Domestic Medical Examination for Newly
Arrived Refugees (DME) Program for refugees and other eligible beneficiaries resettling
in Maricopa County. The purpose of the DME Program is to follow up on medical issues
identified in the overseas medical screening, identify persons with communicable
diseases of potential public health significance, enable refugees to successfully resettle
by identifying health conditions that threaten their well-being, and refer clients to primary
care providers or specialists for ongoing health care.
3.0
DEFINITIONS
3.1
The Arizona Refugee Resettlement Online Data System (ARRPODS): RRP’s online
Client database and service reporting portal.
3.2
Class A Health Conditions: Illnesses of public health importance that, without a grant of
waiver, prohibit a person from entering the U.S. Examples of Class A health conditions
are tuberculosis, Hansen's disease, and severe acute respiratory syndrome (SARS).
3.3
Client: A term used to describe anyone who meets the service eligibility criteria described
in section 5.1.1.
3.4
Domestic Medical Examination for Newly Arrived Refugees (DME): The DME is a
comprehensive medical screening for all newly-arrived refugees and other ORR-eligible
beneficiaries in the United States.
3.5
Limited English Proficiency (LEP): Individuals who do not speak English as their primary
language and who have a limited ability to read, speak, write, or understand English.
3.6
Local Resettlement Agency (LRA): A local affiliate of a domestic National Resettlement
Agency (RAs) that operates under a cooperative agreement with the U.S. Department of
State to provide reception and placement services (R&P) to the refugees.
3.7
Office of Refugee Resettlement (ORR): The U.S. Department of Health and Human
Services (DHHS), Office of Refugee Resettlement, within the Administration for Children
and Families, with responsibility for the broad domestic program of refugee resettlement
programs and services, such as Refugee Cash and medical assistance and a broad
range of time-limited employment and social services for refugees and other eligible
beneficiaries in the U.S.
12/05/2023 Intergovernmental Agreement Page 2 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
3.8
Arizona Refugee Resettlement Program (RRP): RRP is the state’s administration within
ADES, Division of Aging and Adult Services (DAAS), with the statutory responsibility and
authority to coordinate public and private resources for refugee and other eligible
beneficiary resettlement in the state. This responsibility, authority, and associated
programs and services are reflected in the Arizona State Plan for Refugee Resettlement.
RRP supports individuals and families who have fled their countries of origin or the
countries in which they last habitually resided due to persecution, violence, or other
threats to their safety and well-being to support their successful rebuilding of lives in
Arizona.
3.9
Private Sponsor Group (PSG): A group of 5 (five) or more individuals who commit to
providing reception and placement-type services to support refugee(s), including but not
limited to financial, logistical, and emotional support during the first 90 days of
resettlement.
4.0
SERVICE DESCRIPTION
4.1
ADES is contracting with the Contractor to provide the coordination of the DME in
Maricopa County. Services include, but are not limited to, the coordination of physical
health assessments and preventative screening, counseling, initial laboratory tests,
behavioral health assessment, immunizations, and referrals for treatment. All medical
and diagnostic procedures shall be provided by the same organization that provides for
coordination of these services.
5.0
PROGRAM ELIGIBILITY
5.1
Eligibility for the DME Program includes those individuals who have been authorized by
the RRP to receive services. Proof of authorization is provided through validation in the
RRP online database or Contractor verification of immigration documentation.
5.1.1
Eligible Clients include:
5.1.1.1
Refugees admitted under INA § 207
5.1.1.2
Asylees granted asylum under INS § 208
5.1.1.3
Cuban and Haitian Entrants as defined under 45 CFR § 401.2
5.1.1.4
Certain Amerasians
5.1.1.5
Adult Foreign Victims of Trafficking certified by the U.S. Department
of Health and Human Services (DHHS) and Minor Victims of
Trafficking
5.1.1.6
Permanent Residents who had held one of the above statuses in the
past
5.1.1.7
Special Immigrant Juvenile Status Cases
5.1.1.8
Special Immigrant Visa holders
12/05/2023 Intergovernmental Agreement Page 3 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
5.1.1.9
Others as indicated by RRP
6.0
RESPONSIBILITIES
6.1
ADES and the Contractor agree as follows:
6.2
The Contractor shall:
6.2.1
Provide all services in a culturally responsive and linguistically compatible
manner for the population to be served.
6.2.2
Provide interpretation and translation services for individuals with Limited English
Proficiency (LEP).
6.2.3
Coordinate the scheduling for and completion of the DME within the following
time frames:
6.2.3.1
Ensure DME visits are scheduled within two (2) business days from
the date of referral for the next available time interval.
6.2.3.2
Ensure completion of the DME within twenty-one (21) calendar days
of referral, unless another mutually agreed upon timeframe is
approved by RRP in writing.
6.2.3.3
When coordinating DMEs, be cognizant of Clients’ schedules and
time restrictions.
6.2.3.4
When coordinating DMEs for Clients arriving with Class A Health
Conditions, as documented by the U.S. Department of Health and
Human Services/Centers for Disease Control and Prevention (CDC),
Division of Global Migration and Quarantine, ensure the completion
of the DME within five (5) business days of referral in the Arizona
Refugee Resettlement Program Online Data System (ARRPODS).
6.2.4
Coordinate the DME in conjunction with the Local Resettlement Agencies (LRA)
and Private Sponsor Groups (PSG) that sponsor Clients to ensure that the LRA
or PSG can assist Clients with attending their DME appointments and to
minimize the time and disruption to Clients. Coordinate directly with Clients when
they are not affiliated with an LRA or PSG.
6.2.5
Coordinate for a physician, physician assistant, and/or nurse to conduct the
recommended health assessment activities found in ORR’s Domestic Medical
Screening Guidelines Checklist (available here), as may be amended in writing
by RRP. For best practices and recommendations on how to provide these
services, the CDC has created Guidance for the U.S. Domestic Medical
Examination for Newly Arriving Refugees (See
https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic-guidelines.html
).
12/05/2023 Intergovernmental Agreement Page 4 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
6.2.6
Maintain the ability to bill the Arizona Health Care Cost Containment System
(AHCCCS) through the AHCCCS Health Plans for services provided during the
DME.
6.2.7
Bill AHCCCS Health Plans for the cost of all medical assessment procedures for
AHCCCS members.
6.2.8
Bill Refugee Medical Assistance (RMA) for the services provided during the DME
for those Clients who were not eligible for AHCCCS or who did not have
AHCCCS coverage on the DME dates of service.
6.2.9
Wait thirty (30) calendar days after administering the DME to charge RMA for
DME services if the Client is not found within the AHCCCS system at the time of
the screening, due to the occasional delay in Clients appearing within the
AHCCCS system. If RMA receives a claim for services for a Client who is found
to have had AHCCCS at the time of the screening, RMA will deny the claim.
6.2.10
For those Clients deemed eligible for RMA reimbursement, RMA shall reimburse
the Contractor for DME services utilizing the AHCCCS fee for service rates
available online at:
https://www.azahcccs.gov/PlansProviders/RatesAndBilling/FFS/Physicianrates/F
FSCodes.aspx?schedule=2021OctoberPhysicianRates
6.2.11
Ensure that all DME services are documented accurately in ARRRPODS with
correct dates of service. RRP shall only reimburse DME medical assessment bills
for Clients with DME services documented in ARRPODS by the Contractor.
Applicable service options in ARRPODS are “Screening Completed” for the
appointment where a provider performs a physical, medical history, and reviews
lab results, and “Lab Completed” for the appointment where labs are drawn.
6.2.12
Ensure that the cost of the DME medical services is not billed to RMA for Clients
covered by AHCCCS on the date(s) of service.
6.2.13
Ensure that those DME services provided are reimbursable by the AHCCCS
Health Plan and that all medical providers employed by the contractor and
performing DME medical services may be reimbursed by the plans for the
activities performed during the DME. RMA shall not reimburse DME providers or
the contractor for any DME services billed to RMA because a provider is not
registered, certified, or contracted with an AHCCCS Health Plan or is registered
incorrectly.
6.2.14
Ensure that Clients are not billed for any part of the DME at any time.Should a
Client be found not to be enrolled in any AHCCCS Health Plan thirty (30)
calendar days after the DME is completed, RMA may be billed for DME services.
An Explanation of Benefits from AHCCCS billing must be included with any
claims sent to RMA, except where a Client was not found to be enrolled in
AHCCCS on the dates of service at the time of billing. RMA may not be billed
where a Client is enrolled in an AHCCCS Plan on the DME dates of service.
12/05/2023 Intergovernmental Agreement Page 5 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
6.2.15
Do not delay the screening due to the Client not having AHCCCS coverage. After
thirty (30) calendar days, all Clients who did not have AHCCCS at the time of the
DME will have their DME services paid for under RMA per 45 CFR § 400.107.
6.2.16
The Contractor shall not bill RMA for services paid by other funding sources; i.e.,
the Contractor may not bill RMA for vaccines paid by the Vaccines for Children's
Program, testing paid for by AHCCCS Health Plans, etc.
6.2.17
Record the Client’s alien number in each Client’s medical chart .
6.2.18
Document DME results, immunizations, and referrals for treatment in each
Client’s medical chart.
6.2.19
Refer Clients with adverse health conditions to appropriate health care providers
for treatment and document referral in the Client's medical records.
6.2.20
Confer with designated staff at the Client’s LRA when they must help coordinate
Client health care. This process shall only take place if the Client has signed a
release of information form stating that their LRA is eligible to receive their
medical information and coordinate follow-up medical appointments.
6.2.21
Provide coordination of care for Clients requiring Tuberculosis (TB) testing and
refer those testing positive for treatment. Document coordination and referrals in
Client medical records.
6.2.22
All required clinical facilities, including laboratory facilities, should be located in
one (1) medical campus. Alternatively, the Contractor may send laboratory
samples for testing; however, the Contractor must have the ability to collect all
necessary laboratory samples at their primary location.
6.2.23
Prepare and provide copies of all Client medical records as requested by RRP
within five (5) business days.
6.2.24
Attend all RRP meetings and present on numbers of Clients screened, Clients
screening timelines, trends, challenges, and DME program successes.
6.2.25
Develop a procedural manual and document training that details the coordination
of the DME and the billing process. This manual and training process will be
routinely reviewed during programmatic monitoring.
6.2.26
Ensure that access to RRP systems and databases are restricted to health care
professionals who either coordinate or provide assessment procedures required
to complete the DME.
6.2.27
Ensure that coordination of DME services is not interrupted (ie., scheduling
DMEs is delayed or unavailable).
6.2.28
Identify and train staff to assume the responsibilities of the DME, thus ensuring
uninterrupted DME coordination, should primary staff responsible for DME
coordination become unavailable.
12/05/2023 Intergovernmental Agreement Page 6 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
6.2.29
Immediately notify RRP should there be a coordination or medical staffing
vacancy or change that impedes or could potentially impede the delivery of
services.
6.2.30
Record the date of the laboratory visit (“Lab Completed”) and the date of the
examination visit (“Screening Completed”) in ARRPODS within fourteen (14)
business days from the date of the respective visit.
6.2.31
Comply with Arizona Administrative Code (A.AC. R-9-6-202) Communicable
Disease and Infestation Reporting as may be amended. (See
https://apps.azsos.gov/public_services/title_09/9-06.pdf.)
6.2.32
Gain access to the CDC’s Electronic Disease Notification (EDN) system and
review Clients’ overseas medical examination results before performing the
DME. Most Clients receive a limited overseas health screening before departure
for the United States. The EDN is an online portal and accessible through an
internet browser.
6.2.33
Ensure that all staff providing direct services (i.e front office staff, support staff,
and health care providers) attend a Refugee 101 training (1 hour and 30 minute
session) provided by RRP annuallyis.
6.2.34
Ensure all staff providing direct services have applicable accreditations, licenses
or certifications related to their profession. Ensure licenses are without sanctions,
according to Arizona State laws.
7.0
MANNER OF FINANCING
7.1
Reimbursement to the Contractor is in accordance with actual allowable costs incurred,
not to exceed the service reimbursement ceiling as stated in the Itemized Service Budget
(Exhibit A, as may be amended).
7.1.1
If the subrecipient elects to use the ten (10) percent de Minimis rate for indirect
costs, they must complete and submit the Certification of de Minimis Indirect
Cost Rate Form (Exhibit B, as may be amended).
7.1.2
If the subrecipient elects to use a federally negotiated indirect cost rate, they
must provide a copy of the rate agreement with the Itemized Service Budget. If
the federally approved indirect cost rate changes, or is allowed to expire within
the contract period, the subrecipient must notify ADES of the changes.
7.2
Costs for DME medical screenings and diagnostic services shall be billed at current
AHCCCS rates as specified in Section 6.2.10.
7.3
In addition to the amount in the Itemized Service Budget, as part of the reimbursement
for coordination of the DME, RRP shall pay the Contractor an amount of $150.00 per
Client with both a Screening Completed and Lab Completed service documented in
ARRPODS as demonstrated in ARRPODS on the 15th day after the end of the month of
service. The Contractor shall be reimbursed $150.00 only once per Client.
12/05/2023 Intergovernmental Agreement Page 7 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
8.0
REPORTING REQUIREMENTS
The Contractor shall:
8.1
Submit all notices/correspondence relevant to this contract electronically to the assigned
DAAS Contract Specialist, or as directed by ADES.
8.2
Submit the following items electronically to: DAAS-RRP-Reports@azdes.gov:
8.2.1
Complete the Refugee Health Screening Monthly Report (Exhibit C as may be
amended), which is due the 15th day following the end of each calendar month.
Indicate in the email subject line the Contractor name, service month, and year.
(e.g., ABC Agency-April 2022).
8.3
Reporting requirements may change during the Contract term. The Contractor will be
notified in writing about any change in reporting forms.
8.3.1
ADES reserves the right to request that the Contractor submit additional or
revised reports related to the service provision and contract performance
8.4
Submit financial billing information every month directly to the Division of Aging and Adult
Reporting System (DAARS), which is due the 25th day following the end of each
calendar month.
8.5
Contractor's Equipment List with instructions, Form FES-1000AFORFF
https://des.az.gov/sites/default/files/FES-1000aforff.doc quarterly, for all equipment
purchases costing $5,000 or more purchased by the Contractor and Subcontractor{s), in
whole or in part with ADES funds.
8.6
Current Certificate of Insurance within ten (10) calendar days of award and as required in
the Special Terms and Conditions and maintain a valid Certificate of Insurance on file
with the ADES.
9.0
PAYMENT REQUIREMENTS
9.1
Invoices shall be submitted by the 15th day of the month following the month services
were provided.
9.2
Directly enter financial billing information monthly into the (DAARS in accordance with the
system Guide, as may be amended.
10.0
NOTICES
10.1
All notices to the Contractor regarding this agreement shall be sent to the following
address:
Maricopa County Department of Public Health
ATTN: Grants and Contracts
4041 N. Central Ave, Suite 1400
12/05/2023 Intergovernmental Agreement Page 8 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
Phoenix, AZ 85012
10.2
All notices, reporting, funding, and correspondence to ADES regarding this agreement
shall be sent to the following address:
Department of Economic Security
Division of Aging and Adult Services
ATTN: Contract Unit – Mail Drop 6271
P.O. Box 6123
Phoenix, AZ 85005
11.0
DISPOSITION OF PROPERTY
11.1
None
12.0
OTHER MATTERS
12.1
None
13.0
EXTENSION
13.1
This agreement may be extended through a mutual written agreement.
14.0
TERMINATION
14.1
This agreement may be terminated by mutual agreement of the parties at any time during
the term of this agreement.
14.2
Each Party shall have the right to terminate this agreement by personal delivery or by
certified mail, return receipt requested, to the other Party. Written notice of termination at
least thirty (30) days prior to the effective date of said termination.
15.0
AMENDMENTS
15.1
This agreement may be amended only by mutual written amendment. No agent,
employee, or other representative of either Party is empowered to alter any of the terms
of the agreement unless amended in writing and signed by the authorized representative
of the respective Parties.
15.2
Either Party shall give written notice to the other Party of any non-material alteration that
affects the provisions of this agreement. Non-material alterations that do not require a
written amendment are as follows:
15.2.1
Change of telephone number;
15.2.2
Change in authorized signatory; and/or
15.2.3
Change in the name and/or address of the person to whom notices are to be
sent.
12/05/2023 Intergovernmental Agreement Page 9 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
16.0
APPLICABLE LAW
16.1
This agreement shall be governed and interpreted by the laws of the State of Arizona.
The materials and services supplied under this agreement shall comply with all applicable
Federal, State, and local laws, and the Contractor shall maintain all applicable licenses
and permit requirements.
17.0
ARBITRATION
17.1
The Parties to this agreement agree to resolve all disputes arising out of or relating to this
agreement through arbitration, after exhausting applicable administrative review, to the
extent required by A.R.S.§§ 12-1518(B) and 12-133, except as may be required by other
applicable statutes.
18.0
AUDIT
18.1
In accordance with A.R.S. § 35-214, ADES shall retain and shall contractually require
each subcontractor to retain all data, books, and other records (“records”) relating to this
agreement for a period of five (5) years after the completion of the agreement except if
subject to Health Insurance Portability & Accountability Act which is six (6) years from the
date of final payment. All records shall be subject to inspection and audit at reasonable
times. Upon request, ADES shall produce the original of any or all such records.
19.0
CONFLICT OF INTEREST
19.1
In accordance with A.R.S. § 38-511, the State may within three years after execution
terminate the agreement, without penalty or further obligation, if any person significantly
involved in initiating, negotiating, securing, drafting, or creating the agreement on behalf
of either party, at any time while the agreement is in effect, becomes an employee or
agent of any other party to the Agreement in any capacity or a consultant to any other
party to the agreement with respect to the matter of the agreement.
20.0
NON-DISCRIMINATION
20.1
In accordance with ARS § 41-1461, et seq, the Contractor shall provide equal
employment opportunities for all persons, regardless of race, color, creed, religion, sex,
age, national origin, disability, or political affiliation. The contractor shall comply with the
Americans with Disabilities Act.
21.0
E-VERIFY
21.1
In accordance with A.R.S. § 41-4401, the Contractor warrants compliance with all
Federal immigration laws and regulations relating to employees and warrants its
compliance with A.R.S. § 23-214, Subsection A.
22.0
FEDERAL IMMIGRATION AND NATIONALITY ACT
22.1
By entering into the agreement, the Contractor warrants compliance with the Federal
Immigration and Nationality Act. (FINA) and all other Federal immigration laws and
12/05/2023 Intergovernmental Agreement Page 10 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
regulations related to the immigration status of its employees. The Contractor shall
obtain statements from its subcontractors certifying compliance and shall furnish the
statements to the Procurement Officer upon request. These warranties shall remain in
effect through the term of the agreement. The Contractor and its subcontractors shall
also maintain Employment Eligibility Verification forms (I-9) as required by the U.S.
Department of Labor’s Immigration and Control Act, for all employees performing work
under the Agreement. I-9 forms are available for download at USCIS.GOV.
22.2
The State may request verification of compliance for any Contractor or subcontractor
performing work under the agreement. Should the State suspect or find that the
Contractor or any of its subcontractors are not in compliance, the State may pursue any
and all remedies allowed by law, including, but not limited to suspension of work,
termination of the agreement for default, and suspension and/or debarment of the
Contractor. All costs necessary to verify compliance are the responsibility of the
Contractor.
23.0
INDEMNIFICATION:
23.1
Each party (as "Indemnitor") agrees to defend, indemnify, and hold harmless the other
party (as "Indemnitee") from and against any and all claims, losses, liability, costs, or
expenses (including reasonable attorney's fees) (hereinafter collectively referred to as
"Claims") arising out of bodily injury of any person (including death) or property damage,
but only to the extent that such Claims which result in vicarious/derivative liability to the
Indemnitee are caused by the act, omission, negligence, misconduct, or other fault of the
Indemnitor, its officers, officials, agents, employees, or volunteers. The State of Arizona,
Department of Economic Security is self-insured per A.R.S. 41-621.
23.2
In addition, should the Contractor utilize a contractor(s) and subcontractor(s) the
indemnification clause between the Contractor and its contractor(s) and subcontractor(s)
shall include the following:
23.3
To the fullest extent permitted by law, Contractor shall defend, indemnify, and hold
harmless the Contractor and the State of Arizona, and any jurisdiction or agency issuing
any permits for any work arising out of this agreement, and its departments, agencies,
boards, commissions, universities, , officers, officials, agents, and employees (hereinafter
referred to as “Indemnitee”) from and against any and all claims, actions, liabilities,
damages, losses, or expenses (including court costs, attorneys’ fees, and costs of claim
processing, investigation and litigation) (hereinafter referred to as “Claims”) for bodily
injury or personal injury (including death), or loss or damage to tangible or intangible
property caused, or alleged to be caused, in whole or in part, by the negligent or willful
acts or omissions of the contractor or any of the directors, officers, agents, or employees
or subcontractors of such contractor. This indemnity includes any claim or amount
arising out of or recovered under the Workers’ Compensation Law or arising out of the
failure of such contractor to conform to any federal, state, or local law, statute, ordinance,
rule, regulation, or court decree. It is the specific intention of the parties that the
Indemnitee shall, in all instances, except for Claims arising solely from the negligent or
willful acts or omissions of the Indemnitee, be indemnified by such contractor from and
against all claims. It is agreed that such a contractor will be responsible for primary loss
investigation, defense, and judgment costs where this indemnification is applicable.
Additionally, on all applicable insurance policies, the contractor and its subcontractors
12/05/2023 Intergovernmental Agreement Page 11 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
shall name the State of Arizona, and its departments, agencies, boards, commissions,
universities, officers, officials, agents, and employees as additional insured and also
include a waiver of subrogation in favor of the State.
24.0
NON-AVAILABILITY OF FUNDS
24.1
In accordance with A.R.S. § 35-154, every payment obligation of the State under the
agreement is conditioned upon the availability of funds appropriated or allocated for
payment of such obligation. If funds are not allocated and available for the continuance
of this agreement, this agreement may be terminated by the State at the end of the
period for which funds are available. No liability shall accrue to the State in the event this
provision is exercised, and the State shall not be obligated or liable for any future
payments or for any damages as a result of termination under this paragraph.
25.0
OFFSHORE PERFORMANCE OF WORK PROHIBITED
25.1
Due to security and identity protection concerns, direct services under this agreement
shall be performed within the borders of the United States. Any services that are
described in the specifications or scope of work that directly serve the State of Arizona or
its clients and may involve access to secure or sensitive data or personal client data or
development or modification of software for the State shall be performed within the
borders of the United States. Unless specifically stated otherwise in the specifications,
this definition does not apply to indirect or 'overhead' services, redundant back-up
services, or services that are incidental to the performance of the Agreement. This
provision applies to work performed by subcontractors at all tiers.
26.0
PARTICIPATION IN BOYCOTT OF ISRAEL
26.1
Contractor warrants it is not engaged in a boycott of Israel as defined by A.R.S. §
35-393.01.
27.0
PRIOR SERVICES
27.1
The Parties agree that if services were performed before the start date of this agreement
those services will be compensated as though having been performed under this
agreement.
28.0
RIGHT OF OFFSET
28.1
ADES shall be entitled to offset against any sums due the Contractor, any expenses or
costs incurred by ADES, or damages assessed by ADES concerning the Contractor's
non-conforming performance or failure to perform the agreement. The right to offset may
include but is not limited to, a deduction from an unpaid balance and a collection against
the bid and/or performance bonds. Any offset taken for damages assessed by the ADES
shall represent a fair and reasonable amount for the actual damages and shall not be a
penalty for non-performance.
29.0
SIGNATURES IN COUNTERPART
12/05/2023 Intergovernmental Agreement Page 12 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
29.1
This agreement may be executed in any number of counterparts, each of which when
executed and delivered shall constitute a duplicate original, but all counterparts together
shall constitute a single agreement.
30.0
ATTACHMENTS
30.1
The following list of attachments constitutes an integral part of subject agreement:
30.1.1
Attachment 1: Data Sharing Agreement
31.0
DATA SHARING AGREEMENT
31.1
When determined by ADES that sharing of confidential data will occur with the
Contractor, the Contractor shall complete ADES Data Sharing Request Agreement and
submit the completed Agreement to ADES Program Designated Staff prior to any work
commencing or data shared. A separate Data Sharing Request Agreement shall be
required between the Contractor and each ADES Program sharing confidential data. The
Data Sharing Agreement is located at: http:??des.az.gov/documents-center.
31.2
In the "Search" field type "Data Sharing" and click "Search". The search will produce the
following results:
31.3
Document Number J-119-Single - Data Sharing Request/Agreement (Single Division)
12/05/2023 Intergovernmental Agreement Page 13 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
.Exhibit A - Itemized Service Budget
12/05/2023 Intergovernmental Agreement Page 14 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
Exhibit B. Certification of de Minimis Indirect Cost Rate Form
12/05/2023 Intergovernmental Agreement Page 15 of 16

Intergovernmental Agreement (IGA)
Agreement No.:
Description: Coordination - Health Assessment
Exhibit C. Refugee Health Screening Monthly Report
12/05/2023 Intergovernmental Agreement Page 16 of 16