90-22-110-1-01__Amendment_1_to_YH22-0034_IGA_-_fully_executed_copy_.pdf
PDF 1 MB Posted
- Attached to
- Master Agreement AZ|CTR060364
- Contract number
- CTR060364
- Issued by
- Arizona
About this file
This document is an Intergovernmental Agreement (IGA) Amendment #1 involving the Arizona Health Care Cost Containment System (AHCCCS), the Arizona Department of Health Services (ADHS), and Maricopa County Special Health Care District doing business as Valleywise Health. The amendment is dated July 1, 2022, with the contract number YH22-0034, and is associated with the DBF program.
The amendment extends the existing agreement for the Psychiatry Residency Training Program from July 1, 2022, through June 30, 2023. The contract is structured as a fixed-price agreement with a monthly deliverable rate of $295,558, resulting in a total annual contract value of $3,547,896. The parties have agreed to meet and mutually determine the price sheet for subsequent fiscal years at least 60 days prior to the start of each subsequent one-year term. The amendment maintains all other original terms and conditions of the initial contract, with the primary changes being the contract extension and an updated price sheet.
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Text version
5.CONTRACTOR/PROVIDER NAME AND ADDRESS:
Maricopa County Special Health Care District dba Valleywise Health
2601 East Roosevelt Street Phoenix, AZ 85008
Arizona Department of Health Services (ADHS)
150 N 18th Ave Phoenix, AZ 85007
1. AMENDMENT #: 2. CONTRACT #: 3. EFFECTIVEDATEOFAMENDMENT: 4. PROGRAM:
1 YH22-0034 July 1, 2022 DBF
6.PURPOSE:
To Extend the term of the Agreement and update the price sheet for the Psychiatry Residency Training Program.
AHCCCS
Atizona Health Care CoA Containment Sysiom
IGA AMENDMENT #1
7.The above referenced agreement is hereby extended from July 1, 2022, through June 30, 2023. The current price sheet is updated with the price sheet below.
Note: Please sign, date, and return an electronic copy to:
Stacy L Ingalls AHCCCS Senior Procurement Specialist
Email address: stacy.ingalls@azahcccs.gov
Electronic Submission: An electronic or portable document file (PDF) copy of this amendment shall serve as the original.
8. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT NOT HERETOFORE CHANGED AND/OR
AMENDED REMAIN UNCHANGED AND IN FULL EFFECT.
IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT.
9. Maricopa County Special Health Care District dba Valleywise Health
10. ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
SIG , 4fxr 1 F ORI INDIVI Alv e
4/ d r
SIGNA7
L11
,v0 A
/I
TYPED NAME:
Mary Rose Garrido Wilcox
TYPED NAME:
Tracey Thomas
TITLE:
Chairman, Board of Directors
TITLE:
Procurement Manager k 1 aa DATE: i i t ao.Da.._
DATE:
Jun 2, 2022
In accordance with A.R.S.11-952, this Agreement has been review 'd by th unde gn this agr4rnnt is i and a d who has determined orm within the powers dive public body.
Legal Counsel for Maricopa Special Health Care District Dba: Valleywise Health
Martin Demos Printed Name
SVP & General Counsel
Da e
19M3t1T+1611%ral Counsel
Title Jun 1,2022
Date
AHCCC
Alizona Health C. Cw,-: CantairwleM
In accordance with A.R.S. § 11-952, this Agreement is in the proper form and is within the power and authority granted to AHCCCS under A.R.S. §§ 36-2903 et seq. and 36-2932 et seq.
Sede_fgsfa Legal Counsel for AHCCCS
Susan Russo
Arizona Department of Health Services:
SIGNATURE OF AUTHORIZED INDIVIDUAL:
Ruth Date 2022.0520 1517.00.07W
Printed Name:
Title:
DATE:
In accordance with A.R.S.11-952, this Agreement is in the proper form and is within the power and authority granted to ADHS under A.R.S. §§ 36-2903 et seq.
and 36-2932 et seq.
OfgitallysignedbyAvb,Co...
Aubrey Joy CorcoranI,:
02225.20 1525 12-SOW
Legal Counsel for ADHS
Ai ihrAv .lov Corcoran Printed Name
Assictnnt Attorney Crtnoral Title
5/20/22 Date
AHCC
Atizona Health Cate, C0333 Contutanterzt 3.1
PRICE SHEET
July 1, 2022, to June 30, 2023
The following payments shall be made from AHCCCS to MIHS in connection with the provisions of this agreement.
Fixed Price Contract
Type of Unit Rate per Unit Unit of
Measure # of Units Total
Monthly Deliverable 295,658 Monthly 12 3,547,896.
TOTAL
3,547,896
PRICE SHEET FOR SUBSEQU ENT FISCALYEARS
For each of the fiscal years following the term of this amendment, the parties agree that they will meet and mutually agree upon the PRICE SHEETfor each subsequent fiscal yearterm, at least sixty (60) days priorto the start of each subsequent one year term.
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