CTR050594_Price_Sheet.pdf
PDF 198 KB Posted
- Attached to
- Master Agreement AZ|CTR050594
- Contract number
- CTR050594
- Issued by
- Arizona
About this file
This document is a Contract Amendment (Amendment No. 2) issued by the Arizona Department of Health Services, Office of Procurement, located in Phoenix, Arizona. The contract is identified by the number CTR050594 and is associated with the state's Health Start Services program.
The amendment details a price sheet for Annual Health Start Services for the period of 7/1/2022 - 6/30/2023, outlining both required and optional services. Required services include data preparation, client enrollments, prenatal and family follow-up visits, multiple-child visits, screening and intervention visits, home assessments, consultations, and training. The total cost for required services is $349,650.00. Optional services include pregnancy test visits, community and client classes, and birth doula support, with a total of $3,350.00. The total annual contract amount is $353,000.00, with unit rates ranging from $35.00 to $300.00 per service unit, depending on the specific service type and frequency.
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Text version
CONTRACT AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007
CONTRACT NO.: CTR050594 AMENDMENT NO.: 2 Procurement Officer Diana Landeros
PRICE SHEET
Annual Health Start Services Projection Form 7/1/2022 - 6/30/2023
FREQUENCY FUNDING
LINES
REQUIRED SERVICES UNIT OF
MEASURE
UNIT
RATE
HEALTH
START
HEALTH
START $
Required Services
TOTAL $
Data Preparation Per Month $300.00 12 $3,600.00 $3,600.00
Client Enrollments Per Person $100.00 87 $8,700.00 $8,700.00
Client Visits Prenatal Per Person $170.00 275 $46,750.00 $46,750.00
Client Visits Family Follow up Mom/Caregiver
Per Person $170.00 850 $144,500.00 $144,500.00
Client Family Follow-up Child Per Child $170.00 385 $65,450.00 $65,450.00
Multiple-Child Visits Per Child $90.00 400 $36,000.00 $36,000.00
Alcohol, Tobacco, Other Drugs Screening Visits
Per Class $75.00 90 $6,750.00 $6,750.00
Brief Intervention Visits Per Person $35.00 20 $700.00 $700.00
Healthy @ Home Assessments Per Person $75.00 90 $6,750.00 $6,750.00
Nurse Consultation Per Hour $40.00 20 $800.00 $800.00
Social Work/LPC Consultation Per Hour $50.00 23 $1,150.00 $1,150.00
Social Work/LPC Consultation Per Hour $75.00 20 $1,500.00 $1,500.00
Training - CHW/ CHN/ Coordinator Per Day $300.00 90 $27,000.00 $27,000.00
TOTAL $349,650.00
CONTRACT AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007
CONTRACT NO.: CTR050594 AMENDMENT NO.: 2 Procurement Officer Diana Landeros
OPTIONAL SERVICES UNIT OF
MEASURE
UNIT
RATE
HEALTH
START
HEALTH
START $
OPTIONAL
Services TOTAL $
Pregnancy Test Visits Per Person $50.00 1 $50.00 $50.00
Classes for Community Per Class $300.00 3 $900.00 $900.00
Prenatal Visits - Birth Doula Support Per Person $0.00 $0.00
Classes for Clients Per Class $300.00 8 $2,400.00 $2,400.00
TOTAL $3,350.00
TOTAL ANNUAL CONTRACT AMOUNT $353,000.00
**Per Person/Per Day/Per the ADHS General Accounting Office guidelines www.gao.az.gov/travel
File details come from the government source that posted it. Updated .