CTR055260 AMENDMENT 4.PDF

Maricopa County — Formal (2023-08-09)

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INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
Title V Maternal and Child Health Healthy Arizona Families 
 
1. Effective upon signature by all parties and pursuant to the Terms and Conditions, Provision Six (6), Contract Changes, 
Section 6.1, Amendments, Purchases Orders and Change Orders, it is mutually agreed that the Intergovernmental 
Agreement referenced is amended as follows under this Amendment Four (4): 
 
1.1 
The Terms and Conditions are revised and replaced;  
 
1.2 
The Scope of Work is revised and replaced; and 
 
1.3 
The Price Sheet is revised and replaced. 
 
ALL CHANGES ARE REFLECTED IN RED. 
 
All Other Provisions of This Agreement Remain Unchanged. 
MARICOPA COUNTY ATTN: CHERYL BUCALO 
 
 
Contractor Name:  
 
Authorized Signature 
4041 N. CENTRAL AVENUE #1400 
 
 
Address:  
 
Print Name 
Phoenix 
AZ 
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 2023.                           
 
 
Print Name 
 
Procurement Officer 
Contract No.: CTR055260, 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

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
TERMS AND CONDITIONS 
 
1. 
Definition of Terms.  As used in this Contract, the terms listed below are defined as follows: 
 
1.1 
“Attachment” means any document attached to the Contract and incorporated into the Contract.  
 
1.2 
“ADHS” means Arizona Department of Health Services.  
1.3 
“Budget Term” means the period of time for which the contract budget has been created and during 
which funds should be expended.   
1.4 
“Change Order” means a written order that is signed by a Procurement Officer and that directs the 
Contractor to make changes authorized by the Uniform Terms and Conditions of the Contract.   
1.5 
“Contract” means the combination of the Uniform and Special Terms and Conditions, the Specifications 
and Statement or Scope of Work, Attachments, Referenced Documents, any Contract Amendments 
and any terms applied by law.   
1.6 
“Contract Amendment” means a written document signed by the Procurement Officer and the 
Contractor that is issued for the purpose of making changes in the Contract.   
1.7 
“Contractor” means any person who has a Contract with the Arizona Department of Health Services.  
1.8 
“Cost Reimbursement” means a contract under which a contractor is reimbursed for costs, which are 
reasonable, allowable and allocable in accordance with the contract terms and approved by ADHS.  
1.9 
“Days” means calendar days unless otherwise specified.   
1.10 
“Family Advisor” means a Family Member, parent, grandparent, foster parent, aunt, uncle, adult sibling, 
adult cousin, or other adult, who is considered family by a child who has first-hand, lived experience 
with systems of care, for the purpose of having direct and meaningful input into the systems, policies, 
programs, and/or practices that impact care, health, well-being, and the lives of children, youth, and 
families, who are recruited, trained, and managed through the Engaging Families and Young Adults 
Program (EFYAP).   
 
1.11 
“Fixed Price” establishes a set price per unit of service.  The set price shall be based on costs, which 
are reasonable, allowable and allocable.   
1.12 
“Gratuity” means a payment, loan, subscription, advance, deposit of money, services, or anything of 
more than nominal value, present or promised, unless consideration of substantially equal or greater 
value is received.   
1.13 
“Materials” unless otherwise stated herein, means all property, including but not limited to equipment, 
supplies, printing, insurance and leases of property.   
1.14 
“Procurement Officer” means the person duly authorized by the State to enter into and administer 
Contracts and make written determinations with respect to the Contract.   
1.15 
“Purchase Order” means a written document that is signed by a Procurement Officer, that requests a 
vendor to deliver described goods or services at a specific price and that, on delivery and acceptance 
of the goods or services by ADHS, becomes an obligation of the State.   
1.16 
“Services” means the furnishing of labor, time or effort by a Contractor or Subcontractor.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
1.17 
“Subcontract” means any contract, express or implied, between the Contractor and another party or 
between a subcontractor and another party delegating or assigning, in whole or in part, the making 
or furnishing of any material or any service required for the performance of this Contract.   
1.18 
“State” means the State of Arizona and/or the ADHS.  For purposes of this Contract, the term “State” 
shall not include the Contractor. 
 
1.19 
“Young Adult Advisor” means individuals ages eighteen through twenty-six (18-26), including those 
who have disabilities, ongoing healthcare considerations, and a variety of diversities, who are 
recruited, trained, and managed through the Engaging Families and Young Adults Program (EFYAP). 
 
2. 
Contract Type. 
 
This Contract shall be:  
 
  
X 
 Cost Reimbursement 
 
3. 
Contract Interpretation. 
 
3.1. Arizona Law. The law of Arizona applies to this Contract including, where applicable, the Uniform 
Commercial Code as adopted by the State of Arizona. 
 
3.2. Implied Contract Terms.  Each provision of law and any terms required by law to be in this Contract are a 
part of this Contract as if fully stated in it. 
 
3.3. Contract Order of Precedence.  In the event of a conflict in the provisions of the Contract, as accepted by 
the State and as they may be amended, the following shall prevail in the order set forth below: 
 
3.3.1. 
Terms and Conditions; 
 
3.3.2. 
Statement or Scope of Work; 
 
3.3.3. 
Attachments; and 
 
3.3.4. 
Referenced Documents. 
 
3.4. Relationship of Parties.  The Contractor under this Contract is an independent Contractor.  Neither party 
to this Contract shall be deemed to be the employee or agent of the other party to the Contract. 
 
3.5. Severability.  The provisions of this Contract are severable.  Any term or condition deemed illegal or invalid 
shall not affect any other term or condition of the Contract. 
 
3.6. No Parole Evidence.  This Contract is intended by the parties as a final and complete expression of their 
agreement.  No course of prior dealings between the parties and no usage of the trade shall supplement 
or explain any terms used in this document. 
 
3.7. No Waiver.  Either party’s failure to insist on strict performance of any term or condition of the Contract 
shall not be deemed a waiver of that term or condition even if the party accepting or acquiescing in the 
nonconforming performance knows of the nature of the performance and fails to object to it. 
 
3.8. Headings.  Headings are for organizational purposes only and shall not be interpreted as having legal 
significance or meaning.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
4. 
Contract Administration and Operation. 
 
4.1. Term.  As indicated on the signature page of the Contract, the Contract shall be effective as of the Begin 
Date and shall remain effective until the Termination Date.  
 
4.2. Contract Renewal.  This Contract shall not bind, nor purport to bind, the State for any contractual 
commitment in excess of the original Contract period.  The term of the Contract shall not exceed five years.  
However, if the original Contract period is for less than five years, the State shall have the right, at its sole 
option, to renew the Contract, so long as the original Contract period together with the renewal periods 
does not exceed five years.  If the State exercises such rights, all terms, conditions and provisions of the 
original Contract shall remain the same and apply during the renewal period with the exception of price 
and Scope of Work, which may be renegotiated.   
 
4.3. New Budget Term.   If a budget term has been completed in a multi-term Contract, the parties may agree 
to change the amount and type of funding to accommodate new circumstances in the next budget term. 
Any increase or decrease in funding at the time of the new budget term shall coincide with a change in the 
Scope of Work or change in cost of services as approved by the Arizona Department of Health Services. 
 
4.4. Non-Discrimination.  The Contractor shall comply with State Executive Order No. 2023-09, 2023-01, 2009-
09 and any and all other applicable Federal and State laws, rules and regulations, including the Americans 
with Disabilities Act. Contractor shall include these provisions in contracts with Subcontractors when 
required by Federal or State law. 
 
4.5. Records and Audit.  Under A.R.S. § 35-214 and A.R.S. § 35-215, the Contractor shall retain and shall 
contractually require each subcontractor to retain all data and other records (“records”) relating to the 
acquisition and performance of the Contract for a period of five years after the completion of the Contract.  
All records shall be subject to inspection and audit by the State and where applicable the Federal 
Government at reasonable times.  Upon request, the Contractor shall produce a legible copy of any or all 
such records. 
 
4.6. Financial Management.  For all contracts, the practices, procedures, and standards specified in and 
required by the Accounting and Auditing Procedures Manual for the ADHS funded programs shall be used 
by the Contractor in the management of Contract funds and by the State when performing a Contract 
audit.  Funds collected by the Contractor in the form of fees, donations and/or charges for the delivery of 
these Contract services shall be accounted for in a separate fund.   
 
4.6.1. 
Federal Funding. Contractors receiving federal funds under this Contract shall comply with the 
certified finance and compliance audit provision of the Office of Management and Budget (OMB) 
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards 
(2 CFR 200), if applicable.  The federal financial assistance information shall be stated in a Change 
Order or Purchase Order. 
 
4.6.2. 
State Funding.  Contractors receiving state funds under this Contract shall comply with the certified 
compliance provisions of A.R.S. § 35-181.03. 
 
4.7. Inspection and Testing.  The Contractor agrees to permit access, at reasonable times, to its facilities. 
 
4.8. Notices.  Notices to the Contractor required by this Contract shall be made by the State to the person 
indicated on the signature page by the Contractor, unless otherwise stated in the Contract.  Notices to the 
State required by the Contract shall be made by the Contractor to an ADHS Procurement Officer, unless 
otherwise stated in the Contract.  An authorized ADHS Procurement Officer and an authorized Contractor 
representative may change their respective person to whom notice shall be given by written notice, and 
an amendment to the Contract shall not be necessary.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
4.9. Advertising and Promotion of Contract.  The Contractor shall not advertise or publish information for 
commercial benefit concerning this Contract without the prior written approval of an ADHS Procurement 
Officer. 
 
4.10. Property of the State.   
 
4.10.1. Equipment.  Except as provided below or otherwise agreed to by the parties, the title to any and 
all equipment acquired through the expenditure of funds received from the State shall remain the 
property of the State by and through the ADHS and, as such, shall remain under the sole 
direction, management and control of the ADHS.  When this Contract is terminated, the 
disposition of all such property shall be determined by the ADHS.  For Fixed Price contracts, 
when the Contractor provides the services/materials required by the Contract, any and all 
equipment purchased by the Contractor remains the property of the Contractor.  All purchases of 
equipment need to be reported to the ADHS Office of Inventory Control.  
 
4.10.2. Title and Rights to Materials.  As used in this section, the term “Materials” means all products 
created or produced by the Contractor under this Contract, including, but not limited to: written 
and electronic information, recordings, reports, research, research findings, conclusions, 
abstracts, results, software, data and any other intellectual property or deliverables created, 
prepared, or received by the Contractor in performance of this Contract.  Contractor 
acknowledges that all Materials are the property of the State by and through the ADHS and, as 
such, shall remain under the sole direction, management and control of the ADHS.  The 
Contractor is not entitled to a patent or copyright on these Materials and may not transfer a patent 
or copyright on them to any other person or entity.  To the extent any copyright in any Materials 
may originally vest in the Contractor, the Contractor hereby irrevocably transfers to the ADHS, 
for and on behalf of the State, all copyright ownership.  The ADHS shall have full, complete and 
exclusive rights to reproduce, duplicate, adapt, distribute, display, disclose, publish, release and 
otherwise use all Materials.  The Contractor shall not use or release these Materials without the 
prior written consent of the ADHS.  When this Contract is terminated, the disposition of all such 
Materials shall be determined by the ADHS.  Further, the Contractor agrees to give recognition 
to the ADHS for its support of any program when releasing or publishing program Materials. 
 
4.10.3. Notwithstanding the above, if the Contractor is a State agency, the following shall apply instead:  
It is the intention of ADHS and Contractor that all material and intellectual property developed 
under this Agreement be used and controlled in ways to produce the greatest  benefit to the 
parties to this Contract and the citizens of the State of Arizona.  As used in this paragraph, 
“Material” means all written and electronic information, recordings, reports, findings, research 
information, abstracts, results, software, data, discoveries, inventions, procedures and processes 
of services developed by the Contractor and any other materials created, prepared or received 
by the Contractor and subcontractors in performance of this Agreement.  “Material” as used 
herein shall not include any pre-existing data, information, materials, discoveries, inventions or 
any form of intellectual property invented, created, developed or devised by Contractor (or its 
employees, subcontractors or agents) prior to the commencement of the services funded by this 
Agreement or that may result from Contractor’s involvement in other service activities that are 
not funded by the Agreement. 
 
4.10.4. Title and exclusive copyright to all Material shall vest in the State of Arizona, subject to any rights 
reserved on behalf of the federal government.  As State agencies and instrumentalities, both 
ADHS and Contractor shall have full, complete, perpetual, irrevocable and non-transferable rights 
to reproduce, duplicate, adapt, make derivative works, distribute, display, disclose, publish and 
otherwise use any and all Material.  The Contractor’s right to use Material shall include the 
following rights:   the right to use the Material in connection with its internal, non-profit research 
and educational activities, the right to present at academic or professional meetings or symposia 
and the right to publish in journals, theses, dissertations or otherwise of Contractor’s own

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
choosing.  Contractor agrees to provide ADHS with a right of review prior to any publication or 
public presentation of the Material, and ADHS shall be entitled to request the removal of its 
confidential information or any other content the disclosure of which would be contrary to the best 
interest of the State of Arizona.  Neither party shall release confidential information to the public 
without the prior expressly written permission of the other, unless required by the State public 
records statutes or other law, including a court order.  Each party agrees to give recognition to 
the other party in all public presentations or publications of any Material, when releasing or 
publishing them.  
 
4.10.5. In addition, ADHS and Contractor agree that any and all Material shall be made freely available 
to the public to the extent it is in the best interest of the State.  However, if either party wants to 
license or assign an intellectual property interest in the material to a third-party for monetary 
compensation, ADHS and Contractor agree to convene to determine the relevant issues of title, 
copyright, patent and distribution of revenue.  In the event of a controversy as to whether the 
Material is being used for monetary compensation or in a way that interferes with the best interest 
of the state or ADHS, then the Arizona Department of Administration shall make the final decision.  
Notwithstanding the above, “monetary compensation’ does not include compensation paid to an 
individual creator for traditional publications in academia (the copyrights to which are Employee-
Excluded Works under ABOR Intellectual Property Policy Section 6-908C.4.), an honorarium or 
other reimbursement of expenses for an academic or professional presentation, or an 
unprofitable distribution of Material.  
 
4.11. E-Verify Requirements   In accordance with A.R.S. § 41-4401, Contractor warrants compliance with all 
Federal immigration laws and regulations relating to employees and warrants its compliance with Section 
A.R.S. § 23-214, Subsection A. 
 
4.12. Federal Immigration and Nationality Act   The Contractor shall comply with all federal, state and local 
immigration laws and regulations relating to the immigration status of their employees during the term of 
the Contract. Further, the Contractor shall flow down this requirement to all subcontractors utilized during 
the term of the Contract. The State shall retain the right to perform random audits of Contractor and 
subcontractor records or to inspect papers of any employee thereof to ensure compliance. Should the 
State determine that the Contractor and/or any subcontractors be found noncompliant, the State may 
pursue all remedies allowed by law, including, but not limited to; suspension of work, termination of the 
Contract for default and suspension and/or debarment of the Contractor. 
 
4.13. Protection of State Cybersecurity Interests. The Contractor shall comply with State Executive Order No. 
2023-10, which includes, but is not limited to, a prohibition against (a) downloading and installing of TikTok 
on all State-owned and State-leased information technology; and (b) accessing TikTok through State 
information technology. 
    
5. 
Costs and Payments  
 
5.1. Payments.  Payments shall comply with the requirements of A.R.S. Titles 35 and 41, net 30 days. Upon 
receipt and acceptance of goods or services, the Contractor shall submit a complete and accurate 
Contractor’s Expenditure Report for payment from the State within thirty (30) days, as provided in the 
Accounting and Auditing Procedures Manual for the ADHS. 
 
5.2. Recoupment of Contract Payments.  
 
5.2.1. 
Unearned Advanced Funds.  Any unearned State funds that have been advanced to the 
Contractor and remain in its possession at the end of each budget term, or at the time of 
termination of the Contract, shall be refunded to the ADHS within forty-five (45) days of the end 
of a budget term or of the time of termination.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
5.2.2. 
Contracted Services.  In a fixed price contract, if the number of services provided is less than the 
number of services for which the Contractor received compensation, funds to be returned to the 
ADHS shall be determined by the Contract price.  Where the price is determined by cost per unit 
of service or material, the funds to be returned shall be determined by multiplying the unit of 
service cost by the number of services the Contractor did not provide during the Contract term.  
Where the price for a deliverable is fixed, but the deliverable has not been completed, the 
Contractor shall be paid a pro rata portion of the completed deliverable.  In a cost reimbursement 
contract, the ADHS shall pay for any costs that the Contractor can document as having been 
paid by the Contractor and approved by ADHS.  In addition, the Contractor will be paid its 
reasonable actual costs for work in progress as determined by Generally Accepted Accounting 
Procedures up to the date of contract termination.   
 
5.2.3. 
Refunds.  Within forty-five (45) days after the end of each budget term or of the time of termination 
of the Contract, the Contractor shall refund the greater of:  i) the amount refundable in accordance 
with paragraph 4.2.1, Unearned Advanced Funds; or ii) the amount refundable in accordance 
with paragraph 5.2.2, Contracted Services.   
 
5.2.4. 
Unacceptable Expenditures.  The Contractor agrees to reimburse the ADHS for all Contract funds 
expended, which are determined by the ADHS not to have been disbursed by the Contractor in 
accordance with the terms of this Contract.  The Contractor shall reimburse ADHS within 45 days 
of the determination of unacceptability. 
 
5.3. Unit Costs/Rates or Fees.  Unit costs/rates or fees shall be based on costs, which are determined by 
ADHS to be reasonable, allowable and allocable as outlined in the Accounting and Auditing Procedures 
Manual for the ADHS. 
 
5.4. Applicable Taxes. 
 
5.4.1. 
State and Local Transaction Privilege Taxes.  The State of Arizona is subject to all applicable 
state and local transaction privilege taxes.  Transaction privilege taxes apply to the sale and are 
the responsibility of the seller to remit.  Failure to collect taxes from the buyer does not relieve 
the seller from its obligation to remit taxes. 
 
5.4.2. 
Tax Indemnification.  The Contractor and all subcontractors shall pay all federal, state and local 
taxes applicable to its operation and any persons employed by the Contractor.  Contractor shall 
require all subcontractors to hold the State harmless from any responsibility for taxes, damages 
and interest, if applicable, contributions required under Federal, and/or state and local laws and 
regulations and any other costs, including transaction privilege taxes, unemployment 
compensation insurance, Social Security and Worker’s Compensation. 
 
5.4.3. 
I.R.S. W9 Form.  In order to receive payment under any resulting Contract, the Contractor shall 
have a current I.R.S. W9 Form on file with the State of Arizona.   
 
5.5. Availability of Funds for the Next Fiscal Year.  Funds may not be presently available for performance under 
this Contract beyond the first year of the budget term or Contract term.  The State may reduce payments 
or terminate this Contract without further recourse, obligation or penalty in the event that insufficient funds 
are appropriated in the subsequent budget term.  The State shall not be liable for any purchases or 
Subcontracts entered into by the Contractor in anticipation of such funding. The Procurement Officer shall 
have the discretion in determining the availability of funds.    
 
5.6. Availability of Funds for the Current Contract Term.  Should the State Legislature enter back into session 
and decrease the appropriations through line item or general fund reductions, or for any other reason 
these goods or services are not funded as determined by ADHS, the following actions may be taken by 
ADHS:

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
5.6.1. 
Accept a decrease in price offered by the Contractor; 
 
5.6.2. 
Reduce the number of goods or units of service and reduce the payments accordingly; 
 
5.6.3. 
Offer reductions in funding as an alternative to Contract termination; or 
 
5.6.4. 
Cancel the Contract.    
 
6. 
Contract Changes 
 
6.1. Amendments, Purchase Orders and Change Orders.  This Contract is issued under the authority of the 
Procurement Officer who signed this Contract.  The Contract may be modified only through a Contract 
Amendment, Purchase Order and/or Change Order within the scope of the Contract, unless the change is 
administrative or otherwise permitted by the Special Terms and Conditions.  Changes to the Contract, 
including the addition of work or materials, the revision of payment terms, or the substitution of work or 
materials, directed by an unauthorized State employee or made unilaterally by the Contractor are violations 
of the Contract and of applicable law.  Such changes, including unauthorized Contract Amendments, 
Purchase Orders and/or Change Orders, shall be void and without effect, and the Contractor shall not be 
entitled to any claim under this Contract based on those changes. 
 
6.2. Subcontracts.  The Contractor shall not enter into any subcontract under this Contract without the advance 
written approval of the Procurement Officer.  The subcontract shall incorporate by reference all material 
and applicable terms and conditions of this Contract. 
 
6.3. Assignments and Delegation.  The Contractor shall not assign any right nor delegate any duty under this 
Contract without the prior written approval of the Procurement Officer.  The State shall not unreasonably 
withhold approval. 
 
7. 
Risk and Liability 
 
7.1. Risk of Loss.  The Contractor shall bear all loss of conforming material covered under this Contract until 
received and accepted by authorized personnel at the location designated in the Purchase Order, Change 
Order or Contract.  Mere receipt does not constitute final acceptance.  The risk of loss for nonconforming 
materials shall remain with the Contractor regardless of receipt. 
 
7.2. Mutual Indemnification.  Each party (as “indemnitor”) agrees to indemnify, defend 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. 
 
7.3. Force Majeure. 
 
7.3.1. 
Liability and Definition.  Except for payment of sums due, neither party shall be liable to the other 
nor deemed in default under this Contract if and to the extent that such party’s performance of 
this Contract is prevented by reason of force majeure.  The term “force majeure” means an 
occurrence that is beyond the control of the party affected and occurs without its fault or 
negligence.  Without limiting the foregoing, force majeure includes acts of God; acts of the public 
enemy; acts of terrorism; war; riots; strikes; mobilization; labor disputes; civil disorders; fire; flood; 
lockouts; injunctions-interventions not caused by or resulting from the act or failure to act of the 
parties; failures or refusals to act by government authority not caused by or resulting from the act 
or failure to act of the parties; and other similar occurrences beyond the control of the party 
declaring force majeure, which such party is unable to prevent by exercising reasonable

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
diligence. 
 
7.3.2. 
Exclusions.  Force Majeure shall not include the following occurrences: 
 
7.3.2.1. Late delivery of Materials caused by congestion at a manufacturer’s plant or 
elsewhere, or an oversold condition of the market; 
 
7.3.2.2. Late performance by a subcontractor unless the delay arises out of a force majeure 
occurrence in accordance with this force majeure term and condition; or 
 
7.3.2.3. Inability of either the Contractor or any subcontractor to acquire or maintain any 
required insurance, bonds, licenses or permits. 
 
7.3.3. 
Notice.  If either party is delayed at any time in the progress of the work by force majeure, the 
delayed party shall notify the other party in writing of such delay, as soon as is practicable and 
no later than the following working day of the commencement thereof, and shall specify the 
causes of such delay in such notice.  Such notice shall be delivered or mailed certified-return 
receipt and shall make a specific reference to this article, thereby invoking its provisions.  The 
delayed party shall cause such delay to cease as soon as practicable and shall notify the other 
party in writing when it has done so.  The time of completion shall be extended by Contract 
Amendment for a period of time equal to the time that the results or effects of such delay prevent 
the delayed party from performing in accordance with this Contract. 
 
7.3.4. 
Default.  Any delay or failure in performance by either party hereto shall not constitute default 
hereunder or give rise to any claim for damages or loss of anticipated profits if, and to the extent 
that, such delay or failure is caused by force majeure. 
 
7.4. Third Party Antitrust Violations.  The Contractor assigns to the State any claim for overcharges resulting 
from antitrust violations to the extent that those violations concern materials or services supplied by third 
parties to the Contractor for or toward the fulfillment of this Contract. 
 
8. 
Description of Materials The following provisions shall apply to Materials only: 
 
8.1. Liens. The Contractor agrees that the Materials supplied under this Contract are free of liens.  In the event 
the Materials are not free of liens, Contractor shall pay to remove the lien and any associated damages or 
replace the Materials with Materials free of liens. 
 
8.2. Quality. Unless otherwise modified elsewhere in these terms and conditions, the Contractor agrees that, 
for one year after acceptance by the State of the Materials, they shall be: 
 
8.2.1. 
Of a quality to pass without objection in the Contract description; 
 
8.2.2. 
Fit for the intended purposes for which the Materials are used; 
 
8.2.3. 
Within the variations permitted by the Contract and are of even kind, quantity, and quality within 
each unit and among all units; 
 
8.2.4. 
Adequately contained, packaged and marked as the Contract may require; and  
 
8.2.5. 
Conform to the written promises or affirmations of fact made by the Contractor. 
 
8.3. Inspection/Testing.  Subparagraphs 8.1 through 8.2 of this paragraph are not affected by inspection or 
testing of or payment for the Materials by the State.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
8.4. Compliance With Applicable Laws.  The Materials and services supplied under this Contract shall comply 
with all applicable federal, state and local laws, and the Contractor shall maintain all applicable license 
and permit requirements. 
 
8.5. Survival of Rights and Obligations After Contract Expiration and Termination. 
 
8.5.1. 
Contractor’s Representations.  All representations and warranties made by the Contractor under 
this Contract in paragraphs 7 and 8 shall survive the expiration or termination hereof.  In addition, 
the parties hereto acknowledge that pursuant to A.R.S. § 12.510, except as provided in A.R.S. § 
12-529, the State is not subject to or barred by any limitations of actions prescribed in A.R.S. 
Title 12, Chapter 5. 
 
8.5.2. 
Purchase Orders and Change Orders.  Unless otherwise directed in writing by the Procurement 
Officer, the Contractor shall fully perform and shall be obligated to comply with all Purchase 
Orders and Change Orders received by the Contractor prior to the expiration or termination 
hereof, including, without limitation, all Purchase Orders and Change Orders received prior to but 
not fully performed and satisfied at the expiration or termination of this Contract. 
 
9. 
State’s Contractual Remedies 
 
9.1. Right to Assurance.  If the State, in good faith, has reason to believe that the Contractor does not intend 
to, or is unable to, perform or continue performing under this Contract, the Procurement Officer may 
demand in writing that the Contractor give a written assurance of intent to perform.  Failure by the 
Contractor to provide written assurance within the number of Days specified in the demand may, at the 
State’s option, be the basis for terminating the Contract. 
 
9.2. Stop Work Order. 
 
9.2.1. 
Terms.  The State may, at any time, by written order to the Contractor, require the Contractor to 
stop all or any part of the work called for by this Contract for a period up to ninety (90) Days after 
the order is delivered to the Contractor, and for any further period to which the parties may agree.  
The order shall be specifically identified as a stop work order issued under this clause.  Upon 
receipt of the order, the Contractor shall immediately comply with its terms and take all 
reasonable steps to minimize the incurrence of costs allocable to the work covered by the order 
during the period of work stoppage. 
 
9.2.2. 
Cancellation or Expiration.  If a stop work order issued under this clause is canceled or the period 
of the order or any extension expires, the Contractor shall resume work. The Procurement Officer 
shall make an equitable adjustment in the delivery schedule or Contract price, or both, and the 
Contract shall be amended in writing accordingly.  
 
9.3. Non-exclusive Remedies.  The rights and remedies of ADHS under this Contract are not exclusive, and 
ADHS is entitled to all rights and remedies available to it, including those under the Arizona Uniform 
Commercial Code and Arizona common law. 
 
9.4. Right of Offset.  The State shall be entitled to offset against any sums due the Contractor in any Contract 
with the State or damages assessed by the State because of the Contractor’s non-conforming 
performance or failure to perform this Contract.  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 State shall represent a fair and reasonable amount for the actual 
damages and shall not be a penalty for non-performance.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
10. 
Contract Termination 
 
10.1. Cancellation for Conflict of Interest.  Pursuant to A.R.S. § 38-511, the State may cancel this Contract 
within three (3) years after Contract execution without penalty or further obligation if any person 
significantly involved in initiating, negotiating, securing, drafting or creating the Contract on behalf of the 
State is, or becomes at any time while the Contract or an extension of the Contract is in effect, an 
employee of or a consultant to any other party to this Contract with respect to the subject matter of the 
Contract.  The cancellation shall be effective when the Contractor receives written notice of the 
cancellation, unless the notice specifies a later time.  If the Contractor is a political subdivision of the 
State, it may also cancel this Contract as provided in A.R.S. § 38-511. 
 
10.2. Gratuities.  The State may, by written notice, terminate this Contract, in whole or in part, if the State 
determines that employment or a Gratuity was offered or made by the Contractor or a representative of 
the Contractor to any officer or employee of the State for the purpose of influencing the outcome of the 
procurement, securing the Contract or an Amendment to the Contract, or receiving favorable treatment 
concerning the Contract, including the making of any determination or decision about Contract 
performance.  The State, in addition to any other rights or remedies, shall be entitled to recover exemplary 
damages in the amount of three times the value of the Gratuity offered by the Contractor. 
 
10.3. Suspension or Debarment.  The State may, by written notice to the Contractor, immediately terminate 
this Contract if the State determines that the Contractor or its subcontractor has been debarred, 
suspended or otherwise lawfully prohibited from participating in any public procurement activity, including 
but not limited to, being disapproved as a subcontractor of any public procurement unit or other 
governmental body.   
 
10.4. Termination Without Cause. 
 
10.4.1. Both the State and the Contractor may terminate this Contract at any time with thirty (30) days’ 
notice in writing specifying the termination date.  Such notices shall be given by personal delivery 
or by certified mail, return receipt requested. 
 
10.4.2. If the Contractor terminates this Contract, any monies prepaid by the State, for which no service 
or benefit was received by the State, shall be refunded to the State within 5 days of the 
termination notice.  In addition, if the Contractor terminates the Contract, the Contractor shall 
indemnify the State for any sanctions imposed by the funding source as a result of the 
Contractor’s failure to complete the Contract. 
 
 
10.4.3. If the State terminates this Contact pursuant to this Section, the State shall pay the Contractor 
the Contract price for all Services and Materials completed up to the date of termination.  In a 
fixed price contract, the State shall pay the amount owed for the Services or Materials by 
multiplying the unit of service or item cost by the number of unpaid service units or items.  In a 
cost reimbursement contract, the ADHS shall pay for any costs that the Contractor can document 
as having been paid by the Contractor and approved by ADHS.  In addition, the Contractor will 
be paid its reasonable actual costs for work in progress as determined by GAAP up to the date 
of termination.  Upon such termination, the Contractor shall deliver to the ADHS all deliverables 
completed.  ADHS may require Contractor to negotiate the terms of any remaining deliverables 
still due. 
 
10.5. Mutual Termination.  This Contract may be terminated by mutual written agreement of the parties 
specifying the termination date and the terms for disposition of property and, as necessary, submission 
of required deliverables and payment therein. 
 
10.6. Termination for Default.  The State reserves the right to terminate the Contract in whole or in part due to

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
the failure of the Contractor to comply with any material obligation, term or condition of the Contract, to 
acquire and maintain all required insurance policies, bonds, licenses and permits, or to make satisfactory 
progress in performing the Contract.  In the event the ADHS terminates the Contract in whole or in part 
as provided in this paragraph, the ADHS may procure, upon such terms and in such manner as deemed 
appropriate, Services or Materials, similar to those terminated, and Contractor shall be liable to the ADHS 
for any excess costs incurred by the ADHS in obtaining such similar Services or Materials. 
 
10.7. Continuation of Performance Through Termination.  Upon receipt of the notice of termination and until 
the effective date of the notice of termination, the Contractor shall perform work consistent with the 
requirements of the Contract and, if applicable, in accordance with a written transition plan approved by 
the ADHS.  If the Contract is terminated in part, the Contractor shall continue to perform the Contract to 
the extent not terminated.  After receiving the notice of termination, the Contractor shall immediately notify 
all subcontractors, in writing, to stop work on the effective date of termination, and on the effective date 
of termination, the Contractor and subcontractors shall stop all work.  
 
10.8. Disposition of Property.  Upon termination of this Contract, all property of the State, as defined herein, 
shall be delivered to the ADHS upon demand. 
 
11. 
Arbitration   
 
Pursuant to A.R.S. § 12-1518, disputes under this Agreement shall be resolved through the use of arbitration, 
after exhausting applicable administrative review, to the extent required by A.R.S. § 12 -1518, except as may 
be required by other applicable statutes (Title 41). 
 
 
12. 
Communication 
 
12.1. Program Report.  When reports are required by the Contract, the Contractor shall provide them in the 
format approved by ADHS.  
 
12.2. Information and Coordination.  The State will provide information to the Contractor pertaining to activities 
that affect the Contractor’s delivery of services, and the Contractor shall be responsible for coordinating 
their activities with the State’s in such a manner as not to conflict or unnecessarily duplicate the State’s 
activities.  As the work of the Contractor progresses, advice and information on matters covered by the 
Contract shall be made available by the Contractor to the State throughout the effective period of the 
Contract. 
 
13. 
Client Grievances   
 
If applicable, the Contractor and its subcontractors shall use a procedure through which clients may present 
grievances about the operation of the program that result in the denial, suspension or reduction of services 
provided pursuant to this Contract and which is acceptable to and approved by the State.  
 
14. 
Sovereign Immunity  
 
Pursuant to A.R.S. § 41-621(O), the obtaining of insurance by the State shall not be a waiver of any sovereign 
immunity defense in the event of suit. 
 
15. 
Administrative Changes   
 
The Procurement Officer, or authorized designee, reserves the right to correct any obvious clerical, 
typographical or grammatical errors, as well as errors in party contact information (collectively, “Administrative 
Changes”), prior to or after the final execution of a Contract or Contract Amendment.  Administrative Changes 
subject to permissible corrections include: misspellings, grammar errors, incorrect addresses, incorrect 
Contract Amendment numbers, pagination and citation errors, mistakes in the labeling of the rate as either

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
extended or unit, and calendar date errors that are illogical due to typographical error.  The Procurement Office 
shall subsequently send to the Contractor notice of corrections to administrative errors in a written confirmation 
letter with a copy of the corrected Administrative Change attached. 
 
16. 
Survival of Terms After Termination or Cancellation of Contract  
 
All applicable Contract terms shall survive and apply after Contract termination or cancellation to the extent 
necessary for Contractor to complete and for the ADHS to receive and accept any final deliverables that are 
due after the date of the termination or cancellation. 
 
17. 
Health Insurance Portability and Accountability Act of 1996 (HIPAA)   
 
17.1. The Contractor warrants that it is familiar with the requirements of HIPAA, as amended by the Health 
Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009, and accompanying 
regulations and will comply with all applicable HIPAA requirements in the course of this Contract.  
Contractor warrants that it will cooperate with the Arizona Department of Health Services (ADHS) in the 
course of performance of the Contract so that both ADHS and Contractor will be in compliance with 
HIPAA, including cooperation and coordination with the Arizona Department of Administration-Arizona 
Strategic Enterprise Technology (ADOA-ASET) Office, the ADOA-ASET Arizona State Chief Information 
Security Officer and HIPAA Coordinator and other compliance officials required by HIPAA and its 
regulations.  Contractor will sign any documents that are reasonably necessary to keep ADHS and 
Contractor in compliance with HIPAA, including, but not limited to, business associate agreements. 
 
17.2. If requested by the ADHS Procurement Office, Contractor agrees to sign a “Pledge To Protect 
Confidential Information” and to abide by the statements addressing the creation, use and disclosure of 
confidential information, including information designated as protected health information and all other 
confidential or sensitive information as defined in policy.  In addition, if requested, Contractor agrees to 
attend or participate in HIPAA training offered by ADHS or to provide written verification that the 
Contractor has attended or participated in job related HIPAA training that is: (1) intended to make the 
Contractor proficient in HIPAA for purposes of performing the services required and (2) presented by a 
HIPAA Privacy Officer or other person or program knowledgeable and experienced in HIPAA and who 
has been approved by the ADOA-ASET Arizona State Chief Information Security Officer and HIPAA 
Coordinator. 
 
18. 
Comments Welcome    
 
The ADHS Procurement Office periodically reviews the Uniform Terms and Conditions and welcomes any 
comments you may have. Please submit your comments to: ADHS Procurement Administrator, Arizona 
Department of Health Services, 150 North 18th Avenue, Suite 280, Phoenix, Arizona 85007. 
 
19. 
Unique Entity Identifier (UEI) Requirement   
 
Pursuant to 2 CFR 25.100 et seq., no entity (defined as a Governmental organization, which is a State, local 
government, or Indian tribe; foreign public entity; domestic or foreign nonprofit organization; domestic or foreign 
for-profit organization; or Federal agency, but only as a sub-recipient under an award or sub-award to a non-
Federal entity) may receive a sub-award from ADHS unless the entity provides its Unique Entity Identifier 
Number to ADHS. The number can be created in SAM.gov.  If already registered the UEI has been assigned 
and can be viewed in SAM.gov . 
 
20. 
The Federal Funding Accountability and Transparency Act (FFATA or Transparency Act - P.L.109-282, 
as amended by section 6202(a) of P.L. 110-252), found at https://www.fsrs.gov/ 
 
If applicable, the subrecipient or sub-awardee is required to abide by the Federal Funding Accountability and 
Transparency Act (FFATA or Transparency Act – P.L. 109-282, as amended by section 6202(a) of P.L. 110-

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
252), found at https://www.fsrs.gov/. The associated Grant Reporting Certification Form and completion 
instructions will be sent to the subrecipient from ADHS Program(s) responsible for the specific contract. The 
subrecipient or sub-awardee must return the completed form to ADHS Program(s) by the 15th of the month 
following that in which the award was received. Failure to complete a required Grant Reporting Certification 
Form may result in loss of funding. 
 
21. 
2 CFR §200.216 PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE 
SERVICES OR EQUIPMENT   
 
21.1. Recipients and sub-recipients are prohibited from obligating or expanding loan or grant funds to: 
 
21.1.1. Procure or obtain; 
 
21.1.2. Extend or renew a contract to procure or obtain; or 
 
21.1.3. Enter in a contract (or extend or renew a contract) to procure or obtain equipment, services, or 
system that uses covered telecommunications equipment or services as a substantial or essential 
component of any system, or as critical technology as part of any system. As described in Public 
Law 115-232, section 889, covered telecommunications equipment is telecommunications 
equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary 
or affiliate of such entities). 
 
21.1.3.1. For the purpose of public safety, security of government facilities, physical security 
surveillance of critical infrastructure, and other national security purposes, video 
surveillance 
and 
telecommunications 
equipment 
produced 
by 
Hytera 
Communications Corporation, Hangzhou Hikvision Digital Technology Company, or 
Dahua Technology Company (or any subsidiary or affiliate of such entities). 
 
21.1.3.2. Telecommunications or video surveillance services provided by such entities or using 
such equipment. 
 
21.1.3.3. Telecommunications or video surveillance equipment or services produced or 
provided by an entity that the Secretary of Defense, in consultation with the Director 
of the National Intelligence or the Director of the Federal Bureau of Investigation, 
reasonably believes to be an entity owned or controlled by, or otherwise connected 
to, the government of a covered foreign country. 
 
22. 
Technology Replacement  
 
In any event where product is discontinued, no longer available or technically inferior to newly developed 
product, the Contractor shall provide an equivalent replacement model at no additional cost and shall honor the 
original contract terms. 
 
23. 
Authorization for Provision of Services 
 
Authorization for purchase of services under this Agreement shall be made only upon ADHS issuance of a 
Purchase Order that is signed by an authorized agent.  The Purchase Order will indicate the Agreement number 
and the dollar amount of the funds authorized.  The Contractor shall only be authorized to perform services up 
to the amount of 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 2) the Purchase Order is changed or modified with an official ADHS Procurement Change Order, and/or 
an additional Purchase Order is issued for purchase of services under this Agreement.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
Additional Terms and Conditions for Title 2, Subtitle A, Chapter II, Part 200, Subpart C: §200.201 USE 
OF GRANT AGREEMENTS (INCLUDING FIXED AMOUNT AWARDS), COOPERATIVE AGREEMENTS 
AND CONTRACT. 
 
 
24. 
CIVIL RIGHTS ASSURANCE STATEMENT.   
 
The Contractor and Subcontractors are subject to Title VI of the Civil Rights Act of 1964, Section 504 of 
Rehabilitation Act of 1973, Title II of the Americans with Disabilities Act of 1990, the Age Discrimination Act of 
1975, Title IX of the Education Amendment of 1972, and offers all persons the opportunity to participate in 
programs or activities regardless or race, color, national origin, age, sex, or disability. Further, it is agreed that 
no individual will be turned away from or otherwise denied access to or benefit from any program or activity that 
is directly associated with a program of the RECIPIENT on the basis of race, color, national origin, age, sex (in 
educational activities) or disability. 
 
25. 
AMERICANS WITH DISABILITIES ACT OF 1990. 
 
25.1. The Contractor shall comply with the Americans With Disabilities Act of 1990 (Public Law 101-336) and 
the Arizona Disability Act of 1992 (A.R.S § 41-1492 et. seq.), which prohibits discrimination of the basis 
of physical or mental disabilities in delivering contract services or in the employment, or advancement in 
employment of qualified individuals. 
 
25.2. Persons with a disability may request a reasonable accommodation, such as a sign language interpreter, 
by contracting the Contract Manager for the solicitation. Request should be made as early as possible to 
allow time to arrange the accommodation. 
 
26. 
FEDERAL FUNDING.  Funding for these services is contingent upon the availability of federal government 
funding. No commitment of any kind is made by the State concerning this Grant unless there are monies 
provided by a federal grant. The Grantee should take this fact into consideration.  
 
26.1. For the purposes of this Grant, a capital expenditure means expenditures to acquire capital assets, as 
defined in 2 C.F.R. 200.12, or expenditures to make additions, improvements, modifications, 
replacements, rearrangements, reinstallations, renovations, or alterations to capital assets that materially 
increase their value or useful life, with a cost of $250 or greater.   
 
26.2. Grantee agrees to maintain property records for equipment purchased with grant funds and perform a 
physical inventory and reconciliation with property records at least every year.  Grantee agrees that funds 
will not be used for the construction of new facilities. 
 
26.3. Grantee agrees to follow equipment disposition policies as determined by the Federal Awarding Agency 
at Award Completion or as depicted in the State of Arizona Accounting Manual. Grantee also agrees to 
follow the directives in ADHS Property and Procedure Policy FIN 111.  
 
26.4. Charges to Federal awards for salaries and wages must be based on records that accurately reflect the 
work performed. These records must: Be supported by a system of internal control which provides 
reasonable assurance that the charges are accurate, allowable, and properly allocated; Be incorporated 
into the official records of the non-Federal entity; Reasonably reflect the total activity for which the 
employee is compensated by the non-Federal entity, not exceeding 100% of compensated activities (for 
IHE, this per the IHE's definition of IBS); Encompass both federally assisted and all other activities 
compensated by the non-Federal entity on an integrated basis, but may include the use of subsidiary 
records as defined in the non-Federal entity's written policy; Comply with the established accounting 
policies and practices of the non-Federal entity (See paragraph above for treatment of incidental work for 
IHEs.; and Support the distribution of the employee's salary or wages among specific activities or cost 
objectives if the employee works on more than one Federal award; a Federal award and non-Federal 
award; an indirect cost activity and a direct cost activity; two or more indirect activities which are allocated

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
using different allocation bases; or an unallowable activity and a direct or indirect cost activity.  Budget 
estimates (i.e., estimates determined before the services are performed) alone do not qualify as support 
for charges to Federal awards, but may be used for interim accounting purposes only.  
 
26.5. Grantee understands that financial reports are required as an accounting of expenditures for either 
reimbursement or ADHS-approved advance payments.  
 
26.6. The final request for reimbursement of grant funds must be received by the ADHS no later than sixty (60) 
days after the last day of the award period.    
 
26.7. All goods and services must be received or have reasonable expectations thereof and placed in service 
by Grantee by the expiration of this award.   
 
26.8. Grantee agrees that all encumbered funds must be expended and that goods and services must be paid 
by GRANTEE within sixty (60) days of the expiration of this award unless funding guidelines permit funds 
to be used at a future date.  
 
26.9. Grantee agrees to remit all unexpended grant funds to the ADHS within thirty (30) days of written request 
from the ADHS.   
 
26.10. Grantee agrees to account for interest earned on federal grant funds and shall manage interest income 
in accordance with the Cash Management Improvement Act of 1990 and as indicated in the State of 
Arizona Accounting Manual (SAAM) located at the following website.  https://gao.az.gov/publications/saam 
Interest earned in excess of allowable limits must be remitted to the ADHS within thirty (30) days after 
receipt of a written request from the ADHS. 
 
26.11. Grantee agrees not to use grant funds for food and/or beverage unless explicitly approved in writing by 
the ADHS. 
 
26.12. Grantee agrees to comply with all applicable laws, regulations, policies and guidance (including specific 
cost limits, prior approvals and reporting requirements, where applicable) governing the use of grant 
funds for expenses related to conferences, meetings, trainings, and other events, including the provision 
of food and/or beverages at such events, and costs of attendance at such events unless explicitly 
approved in writing by the ADHS.  
 
26.13. No funds shall be used to supplant federal, state, county or local funds that would otherwise be made 
available for such purposes.  Supplanting means the deliberate reduction of state or local funds because 
of the existence of any grant funds. 
 
26.14. Grantee agrees that grant funds are not to be expended for any indirect costs that may be incurred by 
Grantee for administering these funds unless explicitly approved in writing by the ADHS.  This may 
include, but is not limited to, costs for services such as accounting, payroll, data processing, purchasing, 
personnel, and building use which may have been incurred by the Grantee. 
 
26.15. Grantee will comply with the audit requirements of OMB Office of Management and Budget’s (OMB) 
Uniform Administrative Requirements, Cost Principles and Audit Requirement for Federal Awards and 
provide the ADHS with the Single Audit Report and any findings within ninety (90) days of receipt of 
such finding(s). If the report contains no findings, the Grantee must provide notification that the audit 
was completed. All completed Single Audits should be uploaded in the format specified to the Federal 
Audit Clearinghouse no later than nine months after the entities fiscal year-end at the attached Link: 
https://harvester.census.gov/facweb/default.aspx/ 
 
26.16. Grantee understands and agrees that misuse of award funds may result in a range of penalties, including 
suspension of current and future funds, suspension or debarment from federal grants, recoupment of

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
monies provided under an award, and civil and/or criminal penalties. 
 
26.17. Grantee agrees not to do business with any individual, agency, company or corporation listed in the 
Excluded Parties Listing Service.   
 
Link: System for Award Management https://www.sam.gov/portal/public/SAM/. 
 
26.18. Grantee agrees to ensure that, no later than the due date of the Grantee’s first financial report after the 
award is made, Grantee and any subgrantees have a valid Unique Entity Identifier (UEI) profile and 
active registration with the System for Award Management (SAM) database.  
 
26.19. Grantee certifies that it presently has no financial interest and shall not acquire any financial interest, 
direct or indirect, which would conflict in any manner or degree with the performance of services required 
under this Agreement. 
 
26.20. Compliance with 41 U.S.C. 4712 (including  prohibitions on reprisal; notice to  employees) Grantee must 
comply with, and is subject to, all applicable provisions of 41 U.S.C. 4712, including all applicable 
provisions that prohibit, under specified circumstances, discrimination against an employee as 
reprisal for the employee's disclosure of information related to gross mismanagement of a federal 
grant, a gross waste of federal funds, an abuse of authority relating to a federal grant, a substantial 
and specific danger to public health or safety, or a violation of law, rule, or regulation related to a 
federal grant. 
 
26.21. Grantee certifies to comply with the Drug-Free Workplace Act of 1988, and implemented in 28 CFR Part 
83, Subpart F, for grantees, as defined in 28 CFR, Part 83 Sections 83.620 and 83.650.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
SCOPE OF WORK 
1. BACKGROUND: 
 
1.1. The vision of the Arizona Department of Health Services (ADHS) is "Health and Wellness for all Arizonans." 
The ADHS conducts a five (5) year statewide needs assessment, the Arizona State Health Assessment 
(SHA), to examine key health indicators and provide a comprehensive overview of the health of Arizonans. 
Annual updates to the SHA are also published. ADHS published the 2019 Arizona State Health 
Assessment, which utilizes an evidence-based public health approach to improve the health and wellness 
of Arizona residents. Findings from the SHA inform the priorities outlined in the 2021-2025 Arizona Health 
Improvement Plan (AzHlP) and guide programming within ADHS, including that under the Title V Maternal 
and Child Health Services Block Grant (hereafter Title V MCH Block Grant) and the Preventive Health and 
Health Services Block Grant. The AzHlP creates a roadmap to improve the health of Arizonans over the 
next five (5) years through the development of partnerships and resources to work collectively on shared 
health improvement goals and strategies. The Title V MCH Block Grant places a high emphasis on 
engaging with family, young adults, and communities in MCH programs funded by Title V Funds. This 
includes building capacity between counties and the local community to partner in decision-making 
regarding Title V Programs to help achieve the identified MCH priorities. 
 
1.2. The mission of the Bureau of Women’s and Children’s Health (BWCH) is to “strengthen the family and 
community by promoting and improving the health status of women, infants, and children.” The BWCH 
administers the federally funded Title V MCH Block Grant and Preventive Health and Health Services 
Block Grant, in addition to other federally funded, private, and state supported programs; 
 
1.3. This IGA was initiated in July 2020 and originally only included strategies and activities funded through the 
Title V MCH Block Grant. In July 2022, strategies and activities funded through the Preventive Health and 
Health Services Block Grant were added to the IGA. 
 
 MCH Healthy Arizona Families Program: 
1.4. The MCH Health Arizona Families Program is funded through the Title V MCH Block Grant.  
 
1.5. BWCH is responsible for the implementation of the Health Resources and Services Administration (HRSA) 
funded Title V MCH Block Grant. Established in 1935, in Title V of the Social Security Act, the goal of the 
Title V MCH Block grant is to improve the health and well-being of America's mothers, children and families 
including children with special health care needs by supporting and promoting the development and 
coordination of systems of care for the MCH population, which are family-centered, community based and 
culturally appropriate. The Title V MCH Block Grant has five (5) population domains which include: 
Women/Maternal Health, Perinatal/lnfant Health, Child Health, Children with Special Health Care Needs, 
Adolescent Health. The sixth (6thj) domain addresses Cross Cutting and Systems Building; 
 
1.6. The Title V MCH Block Grant also requires that a five (5) year statewide needs assessment be conducted 
and submitted as one (1) of the grant deliverables. The purpose of the Title V MCH statewide needs 
assessment is to identify the priority health needs and issues of Arizona's maternal and child health 
populations through a collaborative and systematic data collection and analytic process with stakeholder 
input. This needs assessment process is guided by eight (8) overarching principles and values that include: 
 
1.6.1.  Listen to those who are not traditionally involved, 
1.6.2.  Learn from community members as well as the MCH Community, 
1.6.3.  Honor and respect the work that others in the community and state have completed to assess the 
wellbeing of Arizona residents,

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
1.6.4.  Assess health disparities across communities including racial, socioeconomic and access, 
1.6.5.  Use a life course development approach and address social determinants of health as a framework 
for planning, 
1.6.6.  Recognize that social, political and economic policies and conditions impact health outcomes, 
1.6.7.  Value the community as a core partner in public health and work to assure the equity in health, 
and 
1.6.8.  Plan, develop and evaluate programs and systems of care which are comprehensive, community-
based, culturally competent, coordinated and effective. 
1.7. The Title V MCH Block Grant uses a three-tiered National Performance Measurement Framework 
(Attachment A) which includes National Outcome Measures (NOMs), National Performance Measures 
(NPMs) and state-initiated Evidence-based or informed Strategy Measures (ESMs). The framework 
provides flexibility to a state in identifying the best combination of measures to address the MCH priority 
needs that were identified based on the findings of the Five-year Needs Assessment (available on the 
ADHS 
website: 
httos://www.azdhs.gov/prevention/womens-childrens-health/reports-fact-
sheets/index.php#title-v) 
1.8. Key populations of interest for the MCH Healthy Arizona Families Program are: infants; children and 
adolescents (inclusive of children and youth with special health care needs); and women of reproductive 
age. 
1.9. The purpose of integrating family/young adult advisors is to create opportunities for the voices, wisdom, 
and experiences of individuals, families, and communities, who receive Title V services, to be included in 
the process and financially compensated for their time effort dedicated to shaping grant funded activities. 
The contributions of family and young adult advisors impact the design, delivery, and evaluation of 
programs and policies impacting systems of care in Arizona. 
  Public Health Improvement Program:  
1.10. The Public Health Improvement (PHI) Program is funded through the Preventive Health and Health 
Services Block Grant. 
1.11. BWCH is responsible for the implementation of the Centers for Disease Control and Prevention (CDC) 
funded Preventive Health and Health Services Block Grant. The Preventive Health and Health Services 
Block Grant Program was established in 1981 through the consolidation of several previously categorical 
health and social service grants (e.g., emergency medical services, hypertension, home health services, 
health education and risk reduction, urban rodent control, and community water fluoridation). The 
Preventive Health and Health Services Block Grant Program provides federal funding for 61 recipients: all 
50 states, the District of Columbia, 2 American Indian tribes, 5 US territories, and 3 freely associated states 
and is administered by CDC's Center for State, Tribal, Local, and Territorial Support. 
 
1.12. The Preventive Health and Health Services Block Grant gives recipients the ability to address prioritized 
public health needs in their jurisdictions in collaboration with local and tribal public health agencies and 
organizations. Recipients set their own goats and program objectives and implement local strategies to 
address their prioritized public health needs related to Healthy People 2030 objectives. 
1.13. The Preventive Health and Health Services Block Grant Measurement Framework allows for 
standardized data collection and aggregation of the outputs, outcomes, and achievements of health 
departments using grant funds. The framework consists of four key measures: 
 
1.13.1. Improvement in the capacity of information systems to collect data of public health importance;

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
1.13.2. Improvement in the efficiency or effectiveness of operations, programs, or services; 
1.13.3. Emerging public health needs addressed; 
1.13.4. Evidence-based public health interventions implemented. 
1.14. Key populations of interest for the PHI Program are: all Arizonans. 
2. PURPOSE: 
 
The purpose of this IGA is to leverage partnerships between ADHS and Local County Health Departments by 
providing Title V MCH Block Grant and Preventive Health and Health Services Block Grant funding to support 
the implementation of high impact strategies that address the health priorities identified in the AzHlP, county 
health improvement plans (CHIPs) and 2020 Title V MCH Needs Assessment. This IGA is intended to provide 
flexibility to the Local County Health Department to meet the needs of local communities. 
3. OBJECTIVES: 
 
 MCH Healthy Arizona Families Program: 
3.1. Counties will implement evidence-based/evidence-informed strategies at the local community level that:  
 
3.1.1. Promote and implement evidence-based or evidence-informed strategies that enhance preventive 
and primary care services for pregnant women, mothers and infants up to age one (1) for the 
Women/Maternal and Perinatal/Infant population domains,  
3.1.2. Promote and implement evidence-based or evidence-informed strategies that enhance preventive 
and primary care services for the Child Health, Adolescent Health and Children with Special Health 
Care Needs population domains, 
 
3.1.3. Integrate family, young adult, community engagement in any of the county selected Title V funded 
MCH Block Grant activities in conjunction with the ADHS Engaging Families and Young Adult 
Program.  
3.1.4. Promote and implement evidence-based or evidence-informed strategies that enhance cross-cutting 
and system building infrastructure.  
PHI Program:  
3.2. Counties will implement evidence-based/evidence-informed strategies at the local community level that: 
3.2.1. Promote and implement healthy community interventions that target policy, system and 
environmental approaches that will shape the communities in which we live, learn, work, and play; 
and 
3.2.2. Promote and implement healthy people interventions that target individual behavior and support 
making healthy choices. 
4. SCOPE OF WORK: 
 
MCH Healthy Arizona Families Program:   
4.1. Counties can select to implement strategies within population domains and/or in National Performance 
Measures.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
4.1.1. 
Population domains include:  
 
4.1.1.1. Women/Maternal Health – women ages eighteen (18) to forty-four (44), before, during, 
and beyond pregnancy; and across the life course; 
 
4.1.1.2. Perinatal/Infant Health – infants during the time surrounding childbirth, particularly three 
(3) months before and one (1) year after, 
 
4.1.1.3. Child Health – children one (1) to ten (10) years of age, 
 
4.1.1.4. Adolescent Health – young people ages ten (10) to nineteen (19) years of age, 
 
4.1.1.5. Children/Youth with Special Health Care Needs – children/youth with a diverse range of 
needs ranging from behavioral and emotional conditions to chronic conditions, to more 
medically complex health issues,  
 
4.1.1.6. Cross-cutting and Systems Building - priority need such as oral health, access to care, 
injury prevention, etc. that is related to program capacity and/or systems-building as it 
applies to all/any of the MCH population domains, or Emerging Issues - projects and/or 
strategies that become prominent and are unique to a particular County, for example, 
reassignment of staff to address the COVID-19 pandemic or any other public health 
emergency, conducting focus groups to determine how to improve services for 
children/youth with special health care needs, etc. 
 
4.1.2. 
NPMs selected by the State and identified through the findings of a five (5) year needs assessment 
include: 
 
4.1.2.1. NPM #1 - Well-woman visits - Percent of women, ages 18 through 44, with a preventive 
medical visit in the past year, and family planning services,  
 
4.1.2.2. NPM #4 Breastfeeding – A) Percent of infants who are ever breastfed and B) Percent of 
infants breastfed exclusively through six (6) months of age, 
 
4.1.2.3. NPM #5 - Safe Sleep — A) Percent of infants placed to sleep on their backs B) Percent 
of infants placed to sleep on a separate approved sleep surface C) Percent of infants 
placed to sleep without soft objects or loose bedding; 
 
4.1.2.4. NPM #6 Developmental Screening - Percent of children, ages nine (9) through thirty-five 
(35) months, who received a developmental screening using a parent-completed 
screening tool in the past year,  
 
4.1.2.5. NPM #7 Injury Hospitalization — 7.1) Rate of hospitalization for non-fatal injury per 
100,000 children, ages zero through nine (0—9) and 7.2) Rate of hospitalization for non-
fatal injury per 100,000 adolescents, ages ten through nineteen (10-19) 
 
4.1.2.6. NPM #9 Bullying — Percent of adolescents, ages twelve (12) through seventeen (17), 
who are bullied or who bully others, 
 
4.1.2.7. NPM #10 Adolescent well visits — Percent of adolescents, ages twelve (12) through 
seventeen (17), who are bullied or who bully others;  
 
4.1.2.8. NPM #12 Transition — Percent of adolescents with and without special health care 
needs, ages twelve (12) through seventeen (17), who received services necessary to 
make transitions to adult health care;

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
4.1.2.9. NPM #13 Preventive dental visits for pregnant women, children and adolescents — A) 
Percent of women who had a dental visit during pregnancy; and B) Percent of children, 
ages one (1) through seventeen (17), who had a preventive dental visit in the past year; 
and 
 
4.1.2.10.  NPM #15 Adequate Insurance — Percent of children, ages zero through seventeen (0-
17), who are continuously and adequately insured 
 
4.1.3. 
If strategies selected by the Counties do not align with the State selected NPMs listed above, 
BWCH in partnership with Counties will develop State Performance Measures (SPMs) as needed 
to measure priority needs that have not been addressed through the selected NPMs, and  
 
4.1.4. 
Counties may elect to provide Family Planning Services which would qualify under NPM #1 and 
the Women/Maternal Health population domain: 
 
4.1.4.1. Implement a clinic based reproductive health program which enhances maternal and 
child health, 
 
4.1.4.2. Provide accessible, comprehensive education, screening and contraceptive services to 
underserved individuals of reproductive age, and  
 
4.1.4.3. Adhere to the ADHS Family Planning Policy and Procedure Manual (available on the 
ADHS website: https://www.azdhs.gov/prevention/womens-childrens-health/womens-
health/index.php#family-planning). 
 
4.1.5. 
Contractor will implement family and/or young adult engagement opportunities into any of the 
selected Title V funded activities. Engagement opportunities can include, but are not limited to: 
reviewing program materials, serving on committees or advisory councils, focus groups, task 
forces, listening sessions, or other evidence-based or evidence-informed strategies, 
4.1.5.1. Allocate MCH HAF grant funds or identify another funding source to compensate family 
and young adult advisors for time and effort dedicated to grant related activities (Exhibit 
1: See Compensation Chart); 
4.1.5.2. Implement a formalized agreement with family and/or young adult advisors to document 
partnership, hours, and compensation (Exhibit 2: MCHHAF Family & Young Adult 
Advisor Agreement); 
4.1.5.3. Contractor will engage with ADHS’ Engaging Families and Young Adults Program 
(EFYAP) contractor to recruit, train, and/or coordinate placement of advisor/s in the 
identified county level activity; 
4.1.5.3.1. Engaging Families and Young Adults Program: Will train, and coordinate 
placement of Family and Young Adult Advisors within designated County 
activities.  
4.1.5.4. Utilize the Activity Planner as needed to describe elements to plan and coordinate project 
details (EXHIBIT 3: Activity Planner); and  
4.1.5.5. Contractor will identify a mechanism and follow county procedures to ensure that 
compensation of the advisor aligns with policies for providing stipends. 
4.2. This IGA offers a variety of evidence-based and evidence-based informed strategies designed to promote 
and positively impact the health status and outcomes of the MCH population in Arizona.  Contingent upon

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
available funding, Local County Health Departments are expected to implement at multiple levels, in 
accordance with local community needs, infrastructure activities that integrate and build on each other to 
optimize the health improvements of the community. Counties have the option to select from a menu of 
evidence-based/evidence-informed strategies (Attachment B) or to propose their own evidence-
based/evidence informed strategies that are identified as a need in their communities;  
 
4.3. In addition, Skill Sets in each of the NPMs to support implementation and further assist with thinking not 
only about evidence and strategies to make change but the capacity of the workforce to carry out activities 
(Attachment B); and 
 
4.4. Where applicable, strategies shall be inclusive of children with special health care needs. Though counties 
are not required to implement strategies to specifically target this population, strategies designed for 
children, adolescents, and families assume an integrated approach that includes this population;  
 
 PHI Program:  
4.5. Under the PHI Program, the county health departments may use several strategies to support focal 
initiatives to achieve healthy communities. As health departments often may not have dedicated funds and 
resources to build and strengthen their organizations, the Public Health Improvement funds allow for that 
flexibility within the established strategies. The funds may be used for activities to seek accreditation and 
re-accreditation, improve health department efficiency and effectiveness, increase performance 
management capacity, and enhance public health readiness activities in the face of emerging issues. 
4.6. The County must select one (1) or more strategies from the strategic areas outlined below: 
4.6.1. 
Strategic Area: Seeking Public Health Accreditation Board (PHAB) Accreditation or 
Reaccreditation 
4.6.1.1. Implement activities, training, and tools for the Local Health Department (LHD) to apply 
for PHAB accreditation; and 
4.6.1.2. Implement activities, training, and tools for the (LHD) to achieve PHAB reaccreditation 
sustainability; 
4.6.2. 
Strategic Area: Evaluate and Continuously Improve Processes, Programs, Quality Improvement, 
and Interventions Performance Management 
4.6.2.1. Implement tools or training to develop or maintain a performance management system 
supported by leadership and management to monitor achievement of organizational 
objectives; 
4.6.2.2. Implement activities, tools, or training to develop or maintain a culture of quality 
improvement integrated into organizational practice, processes, and interventions; and 
4.6.2.3. Conduct training or capacity building with local stakeholders to support the department's 
and county's implementation of a quality improvement plan or quality improvement 
activities; 
4.6.3. 
Strategic Area: Maintain a Competent Workforce 
4.6.3.1. Implement activities and training to build multidisciplinary skills needed for the health 
department to achieve its mission, goals, and objectives;

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
4.6.3.2. Implement activities to build and support a health department with a supportive work 
environment, employee recognition, employee wellness efforts, and professional 
development; and 
4.6.3.3. Conduct activities to support the larger public health workforce of the community; 
4.6.4. 
Strategic Area: Conduct and Disseminate Assessments Focused on Population Health Status and 
Public Health Issues Facing the Community 
4.6.4.1. Conduct collaborative activities with the community to develop, enhance, and disseminate 
the community health assessment; 
4.6.5. 
Strategic Area: Develop Policies and Plans 
4.6.5.1. Conduct or participate in collaborative activities with the community to develop and 
implement the community health improvement plan, 
4.6.5.2. Conduct activities to track and implement goals set in the county health improvement plan, 
4.6.5.3. Complete activities to develop, implement, and maintain a strategic plan, and 
4.6.5.4. Complete activities to develop, implement, and maintain an all hazards emergency 
operations plan; 
4.6.6. 
Strategic Area: Health Equity 
4.6.6.1. Develop and implement strategies that address health inequity and cultural competence, 
4.6.7. 
 Strategic Area: Administrative and Management Capacity 
4.6.7.1. Develop and maintain internal health department policies and procedures for operations, 
human resources, information management, financial management, and management 
of ethical issues, 
4.6.8. 
In addition, with prior approval from ADHS, the County can also use their PHI Program funding to 
address emerging issues: 
4.6.8.1. Conduct activities to address an emerging health issue aligned with state and nationally 
identified emerging health issues (percentage of funds to be approved by ADHS). 
5. EVALUATION: 
 
5.1. Performance measures and evaluations allow the counties and ADHS to collaboratively track progress, 
process indicators, outcomes measures, and impacts. As part of the local evaluation plan, the counties 
will be responsible for measuring the short term, and intermediate outcomes. Monitoring progress on short-
term outcomes provides an opportunity for the counties to make adjustments to strategies to ensure 
increased long-term impact. ADHS in coordination with the counties will be responsible for measuring the 
long-term and impact outcomes. Process indicators, outcomes measures, and impacts must clearly relate 
to the selected strategies and activities identified within each County’s Annual Action Plan; and 
5.2. ADHS will provide technical support to counties on selecting the appropriate indicators to measure process 
and outcomes as they align with the 2021-2025 Title V MCH Priorities and Performance Metrics for the 
MCH Healthy Arizona Families Program and as they align with the 2021-2025 AzHlP priorities and Healthy 
People 2030 objectives for the PHI Program.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
6. APPROVALS: 
 
6.1. The quarterly reports, annual action plans, annual budget workbook, and monthly CERs with receipts 
supporting expenses billed for in-state and out-of-state travel and equipment purchases of $250 or more, 
as required and/or requested shall be approved by ADHS prior to payment reimbursement; 
 
6.2. Upon approval of the Action Plan, any changes to the approved activities, or strategies must be 
resubmitted to ADHS for review and approval prior to implementation; 
6.3. Any requests to provide additional information on quarterly reports will require resubmission of the report 
for ADHS review and approval prior to payment reimbursement; 
 
6.4. Purchases of Capital Equipment (single item purchase of $5,000 or more) will require approval prior to 
purchasing; 
 
6.5. All marketing materials (the use of ADHS logo, brochures, posters, public service announcements, paid 
media, videos, etc.) which have been developed, written, published, or recorded by the Counties and paid 
for with funds from this award must be first approved by ADHS prior to the dissemination of such materials 
or airing or use of such announcements; 
 
6.6. All County local emerging issues and related supporting documentation must be approved by ADHS prior 
to implementation; and the percentage of funds used to conduct activities to address an emerging health 
issue aligned with state and nationally identified emerging health issues must be approved by ADHS prior 
to implementation; 
  
6.7. Any evaluation or study to be conducted that involves human subjects must be approved by ADHS prior 
to conducting;  
6.8. Request approval in writing to the ADHS Block Grants Program Manager for purchases of single items of 
capital equipment at or above the purchase price of five thousand dollars ($5,000.00); 
 
6.8.1. Requests can be made via email and shall include the following information: 
6.8.2. Type of equipment requesting to be purchased, 
6.8.3. Cost of equipment, and 
6.8.4. How the proposed purchase supports the current approved scope of work and annual action plan; 
and 
6.9. Request to waive participation in the ADHS Family and Young Adult Engagement program can be 
submitted to ADHS Block Grants Program Manager for review and approval.  The request should include 
a brief description documenting the need to waive participation and be sent via email to the program 
manager. 
7. TASKS: 
 
7.1. The Local County Health Department Contractor shall for the overall IGA: 
 
7.1.1. Develop and submit a separate Annual Budget Workbook for each program (Title V and Public 
Health Improvement), due January 15th of each year for the following year's budget period, 
including the federally approved indirect rate letter, 
7.1.2. Develop and implement an Annual Action Plan within the first forty-five (45) days of each budget 
period (i.e., on or before August 15th),

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
7.1.3. Implement the selected approved evidence-based and/or evidence-informed strategies outlined 
in County Action Plans,  
 
7.1.4. Identify at minimum one (1) advisor to include in one of the Title V funded activities;  
 
7.1.5. Submit MCHHAF Family & Young Adult Advisor Agreement to the ADHS Block Grants Program 
Manager within 180 days of contract execution that outlines the agreement between the program 
and advisor. The agreement includes the following: 
 
7.1.5.1. How they will compensate a Family and/or Young Adult Advisor; 
7.1.5.2. Promote, strengthen, and enhance Family and Young Adult engagement in systems-level 
initiative; 
7.1.5.3. Ensure that the voices of individuals, families, and communities who receive services are 
included in the creation of the policies and procedures that govern those services; 
7.1.5.4. Establish protocols around communication and check-in with an assigned direct contact 
or supervisor, to ensure that Family and Young Adult Advisors know who to connect with 
about which components of their service, and how to connect with that person, or persons; 
7.1.5.5. Ensure that Family and Young Adult Advisors have the relevant knowledge and support 
they need to participate and contribute to their maximum potential, including access to 
equipment and resources necessary to perform their duties, similar to that which would 
be assigned to an employee; 
7.1.5.6. Develop a mechanism for compensating Family and Young Adult Advisors for their time, 
expertise, and/or other costs they incur; 
7.1.5.7. Provide mentoring and support to ensure Family and Young Adult Advisors understand 
their partnership role and are prepared to participate as fully as possible; 
7.1.5.8. Provide skill-building opportunities for Family and Young Adult Advisors who participate 
in system-level initiatives; 
7.1.5.9. Prepare and send information, agendas, and materials in advance of all activities, so all 
participants know what to expect and have an opportunity to review and prepare; and 
7.1.5.10. Ensure meeting materials are written in plain language and are culturally and 
linguistically appropriate for all participants, 
7.1.6. Participate in all calls (monthly, bi-monthly, quarterly), technical assistance calls, webinars, 
meetings, and training, and 
7.1.7. Participate in the development of a shared comprehensive evaluation plan and report out on any 
performance measures related to the implementation of their activities (process and/or 
intermediate), or as defined by the funding sources, 
7.2. Complete tagging and inventory of equipment in compliance with the policy in the State of Arizona 
Accounting Manual, https://qao.az.gov/sites/default/files/2535%20Stewardship%20190304.pdf; 
7.2.1. Submit documents to the ADHS Block Grants Program Manager pertaining to the asset, i.e., 
receiving papers, invoice, purchase order, receipt, etc., and

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
7.2.2. Documents shall include the make, model, serial number, and acquisition date of the asset. 
7.3. All out-of-state travel shall follow the travel and per diem policies as outlined in the State of Arizona 
Accounting Manual;  
7.3.1. https://gao.az.gov/state-arizona-accounting-manual-saam    
7.4. Food purchases for events are an allowable cost under this grant. Food costs less than $500 per event 
and cumulative cost less than $5,000 annually do not require prior approval when spent within the State 
of Arizona Accounting Manual policies; 
7.4.1. When food costs exceed the allowable thresholds set forth in the IGA, requests to purchase food 
shall be required by completing the Request for Purchase of Food form (Attachment F) and 
submitting to the MCH HAF Program Manager, 
7.4.1.1. Requests shall be submitted ten (10) business days prior to needing to purchase food 
items; 
7.4.1.2. Blanket food approval requests can be submitted for approval if multiple events, of the 
same nature, are reoccurring. The request shall indicate the number of events that will be 
held during the year and number of people attending; and 
7.4.1.3. No food shall be purchased or reimbursed until the form has been approved and signed 
by the ADHS Block Grants Program Manager. 
7.4.2. Purchases shall follow the Food and Beverages policy outlined in the State of Arizona Accounting 
Manual, https://gao.az.gov/state-arizona-accounting-manual-saam which includes but is not limited 
to: 
7.4.2.1. Food provided must not exceed the allowable ADHS per person per person, per diem 
meal rates.  
7.4.3. Justification for providing food at events requires but is not limited to: 
7.4.3.1. How providing food serves a valid public purpose and does not violate the "gift clause", 
7.4.3.2. Is an integral part of the function, and 
7.4.3.3. Benefits to the community. 
7.4.4.  A speaker/presentation during the time the meal is provided is required, and 
7.4.5. Food provided should be healthy items. Please see the ADHS Healthy Meeting Policy for further 
guidance 
on 
nutritional 
guidelines 
for 
events/meetings: 
https://azdhs.qov/documents/prevention/nutrition-physical-activity/healthy-meetina policy.pdf.  
7.5. Comply with all federal reporting requirements; 
7.6. At least one (1) Program Manager or coordinator from each of the MCH HAF IGA programs must be in 
attendance at the Annual HPHC/MCH HAF IGA Summit; 
7.7. Counties implementing Family Planning Programs with MCH Healthy Arizona Families Program funding 
shall abide by all standards and protocols outlined in the Family Planning Policies & Procedures manual

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
(Available 
here: 
https://www.azdhs.qov/prevention/womens-childrens-health/womens-
health/index.php#family-planninq) and  
7.8. County program staff implementing strategies in this IGA will be required to participate in a one-time MCH 
HAF IGA orientation webinar, date to be determined. 
7.9. ADHS will provide: 
 
7.9.1. 
Review, feedback, and approval of the Annual Action Plan(s) within 30 days of submitting,  
 
7.9.2. 
Review, feedback, and approval of the annual Budgets Workbooks, CERs and Supporting 
Documentation within thirty (30) days of submission, 
 
7.9.3. 
Feedback, technical assistance, and training to support the approved Annual Action Plan(s), 
Annual Budget, Quarterly Reporting, and Supporting Documentation, 
 
7.9.4. 
Samples of evidence-based and/or evidence-informed strategies and supporting resources, 
 
7.9.5. 
A Quarterly Reporting template upon execution of the contract, 
 
7.9.6. 
The Annual Action Plan template upon execution of the contract, 
 
7.9.7. 
Annual Budget Workbook and CER templates upon execution of the contract, 
 
7.9.8. 
Outcome Measures and examples of process, or intermediate performance measures, as 
needed, 
 
7.9.9. 
Access to virtual technical assistance and guidance from ADHS staff, Local County Health 
Department peers/mentors, and subject matter experts related to the strategies for which the 
County has received funding, and 
 
7.9.10. Coordinate and conduct annual Contractor site visits. 
 
7.9.11. ADHS will provide technical assistance and resources to support counties and family advisors 
associated with the Engaging Families and Young Adult Program 
 
8. STATE PROVIDED ITEMS: 
 
8.1. Attachment A – Maternal and Child Health National Performance Measures Framework; 
 
8.2. Attachment B – Evidence-Based and Evidence-Informed Strategies for MCH Domains; 
 
8.3. Attachment C – Contractor Expenditure Report (CER); 
 
8.4. Attachment D – Financial Supporting Documentation; 
 
8.5. Attachment E – Line Item Budget Move Request; 
 
8.6. Attachment F – Request for Purchase of Food;  
 
8.7. Attachment G – Emerging Issues Approval Process; and 
 
8.8. Exhibit 1: Compensation Chart

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
8.9. Exhibit 2: MCHHAF Family & Young Adult Advisor Agreement 
 
8.10. Exhibit 3: Activity Planner 
 
8.11. Upon execution of contract: 
 
8.11.1. Action Plan Template, 
 
8.11.2. Quarterly Report Template, 
  
8.11.3. Contractor Expenditure Report (CER) template, and 
 
8.11.4. Budget Workbook Template. 
 
9. RESTRICTIONS:  
9.1. Funds cannot be used for any of the following: 
9.1.1. 
Lobbying activities, including the preparation, distribution, or use of any kit, pamphlet, booklet, 
publication, electronic communication, radio, television, or video presentation designed to support 
or defeat any proposed or pending regulation, administrative action, or order issued by the 
executive branch of any State or local government, 
9.1.2. 
Inpatient services, 
9.1.3. 
Cash payments to intended service recipients of health services, 
9.1.4. 
The purchase or improvements of land; the purchase, construction or permanent improvement 
(other than minor remodeling) of any building or other facility; or the purchase of major medical 
equipment — unless the ADHS has obtained a waiver from the Secretary of DHHS, 
9.1.5. 
 Satisfying any requirements for the expenditure of non-federal funds as a condition for the receipt 
of federal funds, 
9.1.6. 
. Providing funds for research or training (or other financial assistance) to any entity other than a 
public or non-profit private entity, and 
9.1.7. 
Payment for any item of service (other than an emergency item or service) furnished by or at the 
medical direction or prescription of an ineligible or uncertified individual or entity. 
10. DELIVERABLES: 
 
10.1. 
Annual Action Plan within the first forty-give (45) days of each budget period;  
 
10.2. 
Contractor Expenditure Report (CER) to ADHS, due thirty (30) days following each month of services. 
 
10.2.1. Receipts supporting expenses billed for any in-state/out-of-state travel and equipment 
purchases of $250 or more are to also be submitted, and  
10.2.2. Upon request from ADHS, all receipts supporting expenses billed for a selected CER shall be 
submitted for review. 
10.3. 
Written Quarterly Reports, due thirty (30) days after each quarter end (QI : July — September; Q2: 
October — December; Q3: January — March; and Q4: April — June);

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
10.4. 
A final CER invoice no later than forty-give (45) days following the end of each contract year;  
 
10.5. 
Annual Budget Workbook due by January 15th, for the next year’s fiscal period;  
 
10.6. 
MCH Healthy Arizona Families Program ONLY: Family Planning Programs funded through this IGA will 
submit monthly data into the Title V Family Planning Database as outlined in the policies and 
procedures manual. 
 
10.7. 
Submit monthly CERs (Attachment C) and maintain sufficient documentation in the form of receipts in 
support of expenses incurred for any purchases that are being claimed for reimbursement or applied 
as match dollars to a budget (Attachment D), 
 
10.7.1. Supporting documentation shall be kept by the Contractor and does NOT need to be submitted 
with quarterly CERs with the exception of travel documentation (in-state and out-of-state) and 
single purchases of equipment exceeding $250, and  
10.7.2. Documentation supporting all expenses being billed shall be provided as requested by ADHS.  
10.8. 
Provide the ADHS Block Grants Program Manager with contact information of all program staff funded 
under this IGA within thirty (30) days of IGA execution to include: 
 
10.8.1. Name, title, email address and phone numbers, 
10.8.2. Staff Resumes, and 
10.8.3. Program area assigned. 
10.9. 
Submit to the ADHS Block Grants Program Manager all staffing and programmatic changes within 
fifteen (15) days providing information outlined in 10.8;  
 
10.10. 
Request to transfer budget amounts between line items, exceeding twenty-five percent (25%) of total 
annual budget or to a non-funded line item, will require a revised budget be submitted to the ADHS 
Block Grants Program Manager and an IGA amendment issued by ADHS Procurement; and;  
 
10.11. 
Submit brochures, posters, public service announcements, paid media, videos, sponsorships, etc., to 
be paid for with funds from this IGA prior to development and use; 
 
11. NOTICES, CORRESPONDENCE, REPORTS, AND INVOICES:  
 
11.1. Notices, correspondences, report, supporting documentation, and invoice/CERs from the County 
contractors to ADHS shall be sent to:  
 
  
Ashley Neves 
  
Block Grants Program Manager 
  
Arizona Department of Health Services 
  
150 N. 18th Avenue, Ste. 310 
  
Phoenix, AZ 85007-3242 
  
Email: ashley.neves@azdhs.gov

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.:  CTR055260 
IGA Amendment No:  4 
Procurement Officer 
Lucas Terry 
 
11.2. Notices, Correspondence, Reports and Payments from ADHS to the Contractor shall be sent to: 
 
  
Cheryl Bucalo 
  
Maricopa County 
  
4041 N. Central Avenue #1400  
  
Phoenix, AZ 85012 
  
Email: Cheryl.bucalo@maricopa.gov

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
 
Contract No.: 
CTR055260 
IGA Amendment No: Four (4) 
 
Procurement Officer 
Lucas Terry 
 
32 
 
PRICE SHEET 
JULY 1, 2023 – JUNE 30, 2024 
 
PROGRAM: MCH HEALTHY ARIZONA FAMILIES (MCH HAF) 
FEDERAL FUNDING: TITLE V MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT 
 
 
Account Classification 
 
Line-Item Totals  
Personnel 
$235,377.00 
Employee Related Expenses 
$95,775.00 
Professional & Outside Services 
$26,543.00  
Travel Expenses 
$504.00 
Occupancy Expenses 
$3,086.00 
Other Operating Expenses 
$8,863.00 
Capital Outlay Expenses 
$0.00 
Indirect Cost (if authorized) 
$63,813.00 
Total Contract Amount (Not to Exceed)  
$433,961.00 
 
PROGRAM: PUBLIC HEALTH IMPROVEMENT (PHI) 
FEDERAL FUNDING: PREVENTIVE HEALTH & HEALTH SERVICES BLOCK GRANT 
 
 
Account Classification 
 
Line-Item Totals  
Personnel 
$143,710.00 
Employee Related Expenses 
$58,476.00 
Professional & Outside Services 
$67,202.00 
Travel Expenses 
$7,901.00 
Occupancy Expenses 
$4,629.00 
Other Operating Expenses 
$18,337.00 
Capital Outlay Expenses 
$0.00 
Indirect Cost (if authorized) 
$30,025.00 
Total Contract Amount (Not to Exceed)  
$330,280.00 
 
 
THE COUNTY IS AUTHORIZED TO TRANSFER UP TO A MAXIMUM OF TWENTY-FIVE PERCENT (25%) OF THE TOTAL BUDGET 
AMOUNT BETWEEN LINE ITEMS.  
 
TRANSFER EXCEEDING TWENTY-FIVE PERCENT (25%) OR TO A NON-FUNDED LINE ITEM SHALL REQUIRE AN AMENDMENT.