CTR051841 A1.pdf
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- Attached to
- Master Agreement AZ|CTR051841
- Contract number
- CTR051841
- Issued by
- Arizona
About this file
This document is an Interagency Service Agreement (ISA) Amendment between the Arizona Department of Health Services (ADHS), specifically the Bureau of Chronic Disease and Health Promotion's Office of Tobacco, and the University of Arizona College of Medicine, Department of Family and Community Medicine. The amendment is for Contract No. CTR051841 and is labeled as Amendment No. 1, effective from June 29, 2020 to April 28, 2021.
The contract supports the Helpers Program for Behavioral Health (Helpers BH), a clinic system intervention designed to proactively support tobacco cessation among behavioral health clients. The University will work with four current behavioral health system partners to update the program, expand to at least one additional clinic site, and identify new counties for implementation. The total contract amount is $185,000, broken down into categories including $139,998 for personnel services, $2,077 for travel expenses, $26,649 for other operating expenses, and $16,276 for indirect costs. The contractor is authorized to transfer up to 10% of the total agreement amount among categorical line items, with transfers exceeding this percentage requiring an agreement amendment.
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INTERAGENCY SERVICE AGREEMENT
(ISA) AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave. Suite 530
Phoenix, Arizona 85007
Contract No.: CTR051841 Amendment No.: 1 Procurement Officer Nicole Marquez
Helpers Program for Behavioral Health
Effective upon signature of both parties, it is mutually agreed that the Contract referenced is amended as follows:
1. Pursuant to the Uniform Terms and Conditions, Provision Twelve (12), Miscellaneous, Section 12.4, the Contract is hereby amended as follows:
1.1. The Scope of Services is revised and replaced with the Scope of Services of this Amendment One (1);
and
1.2. The Price Sheet is revised and replace by the Price Sheet of this Amendment One (1).
ALL OTHER PROVISIONS SHALL REMAIN IN THEIR ENTIRETY.
Contractor hereby acknowledges receipt and acceptance of above amendment and that a signed copy must be filed with the Procurement Office before the effective date.
The above referenced Contract Amendment is hereby executed this ___________ day of ____________________, 2021 at Phoenix, Arizona
Signature / Date Procurement Officer
Authorized Signatory’s Name and Title
University of Arizona Contractor’s Name
Johnson, Elisha - (elishajohnson)
Digitally signed by Johnson, Elisha - (elishajohnson) Date: 2021.01.22 12:56:15 -07'00'
25th January
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave. Suite 530
Phoenix, Arizona 85007
Contract No.: CTR051841 Amendment No.: 1
Procurement Officer Nicole Marquez
SCOPE OF SERVICES
1. Background
1.1 Commercial tobacco use is the most preventable cause of death in the United States, contributing to approximately more than 480,000 deaths annually. State and local tobacco control programs are designed ultimately to help reduce disease, disability, and death related to commercial tobacco use.
1.2 The mission of the Arizona Department of Health Services, Bureau of Chronic Disease and Health Promotion
(ADHS BCDHP), Office of Tobacco is to work with partners to build individual, organizational and community capacities to reduce the impact of commercial tobacco use.
1.3 Persons with serious mental illness or (SMI) or substance use disorder (SUD) have a life expectancy that is twenty-five (25) years shorter than the general population. In Arizona, that disparity in early mortality is even greater – thirty-two (32) years. An important cause of premature mortality is smoking-related chronic diseases such as; chronic obstructive pulmonary disease (COPD), cardiovascular disease, diabetes, and metabolic syndrome.
1.4 In the state of Arizona, about fourteen percent (14%) of the adult population are current smokers, compared to sixteen percent (16%) nationally. This rate is believed to be double for persons with SMI or SUD. Despite the lack of exact figures on smoking in the behavioral health (BH) population in Arizona as a whole, the Arizona Smokers Helpline (ASHLine) reported in 2018, thirty-seven percent (37%) of its clients self-reported having a chronic behavioral health condition.
2. Objective
2.1 The ADHS BCDHP, Office of Tobacco will Contract with The University of Arizona College of Medicine, Department of Family and Community Medicine to implement the Helpers Program for Behavioral Health (Helpers BH), a clinic system intervention designed to shift the cultural milieu of the BH clinic to proactively support tobacco cessation among BH clients. Helpers BH addresses:
2.1.1 Systemic and cultural barriers to tobacco cessation in Behavioral Health,
2.1.2 Motivational approaches to encourage tobacco cessation, and
2.1.3 Modifying the clinical environment to encourage quitting.
2.2 Helpers BH consists of:
2.2.1 Assessment of clinical environmental factors (facility, policies) related to tobacco cessation,
2.2.2 A Helpers BH training that prepares clinic staff to offer brief interventions to support cessation and incorporate cessation into workflow as a billable service,
2.2.3 Guidance on offering a tobacco cessation group,
2.2.4 Simple client educational handouts to promote cessation, and
2.2.5 Assessment of clinic administrative data systems that can be used to monitor impact of Helpers BH on client service delivery and outcomes, and technical support to problem solve, maintain clinic staff and leadership engagement.
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave. Suite 530
Phoenix, Arizona 85007
Contract No.: CTR051841 Amendment No.: 1
Procurement Officer Nicole Marquez
3. Tasks
The University shall:
3.1 Work with four (4) current behavioral health system partners including; Southeastern Arizona Behavioral
Health Services-La Fronters (SEABHS-La Frontera), Community Organization for Drug Abuse Control (CODAC), La Frontera Arizona, and Marana Health Center (MHC) to:
3.1.1 Update Helpers BH based on feedback from recently completed pilot and implementation sites,
3.1.2 Develop a plan to identify, train, and provide ongoing professional development and technical support, to partner agency staff to serve as site champions,
3.1.3 Expand the Helpers BH program to at least one (1) additional behavioral health clinic site that serves rural, border populations disproportionately impacted by tobacco, and
3.1.4 Evaluate the facilitators and barriers to implementation and larger scaling in other behavioral health systems.
3.2 Identify one (1) – two (2) new counties interested in addressing tobacco use in behavioral health populations and/or other tobacco control priority populations to:
3.2.1 Work with county and local project officers to identify local behavioral health system and/or other community partners, and
3.2.2 Identify and prepare for readiness for implementing Helpers BH in at least two (2) other behavioral health clinics for subsequent grant years.
3.3 Increase the percentage of BH members within participating clinics who receive tobacco cessation-related services, tobacco cessation referrals (e.g. to ASHLine), or cessation medications; and
3.4 Collaborate with BH agencies and payers to identify metrics and sustainable data systems to monitor and assess impact of Helpers BH implementation in increasing delivery of tobacco cessation-related services, including offering of cessation pharmacotherapy.
4. Deliverables
The University shall:
4.1 Submit a Contractor Expenditure Report (CER), (see Exhibit A) due fifteen (15) days after month end. An electronic version will be made available upon request to ADHS BCDHP, Office of Tobacco;
4.2 Develop and submit an Annual Action Plan using standardized processes to include the following items:
baseline clinic program activity reports, quarterly clinic program activity reports, evaluation plan, and site work plans;
4.3 Develop and submit Quarterly reports. Quarterly reports in Year One (1) will be submitted to ADHS on
January 29, 2021 and April 29, 2021. Quarterly reports in subsequent program years will be due thirty (30) days after the end of each quarter; and
4.4 Develop and submit Evaluation reports including program highlights, successes, challenges, and barriers;
Due July 31st of each year, beginning July 31, 2021.
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave. Suite 530
Phoenix, Arizona 85007
Contract No.: CTR051841 Amendment No.: 1 Procurement Officer Nicole Marquez
5. Requirements
The University shall meet all of the following requirements:
5.1 Revisions to strategies, evaluation plan, goals, objectives, and timelines shall require approval from ADHS BCDHP, Office of Tobacco, Office Chief; and
5.2 Staffing changes shall be reported to the ADHS BCDHP, Office of Tobacco within five (5) business days.
6. Notices, Correspondence, Reports and Invoices
6.1. Notices, Correspondence, Reports and Invoices from the University to ADHS shall be sent to:
Arizona Department of Health Services Bureau of Chronic Disease and Health Promotions Attn: Emily Carlson, Office Chief, Tobacco Prevention and Cessation 150 N. 18th Avenue, Suite 310 Phoenix, AZ 85007
6.2. Notices, Correspondence, and Reports from ADHS to the University shall be sent to:
University of Arizona Department of Family and Community Medicine Attn: , Email: @email.arizona.edu
6.3 Payments from ADHS to the University shall be sent to:
University of Arizona Sponsored Projects & Contracting Services P.O. Box 41867 Tucson, AZ 85717
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N. 18th Ave. Suite 530
Phoenix, Arizona 85007
Contract No.: CTR051841 Amendment No.: 1 Procurement Officer Nicole Marquez
Price Sheet
Effective: June 29, 2020 - April 28, 2021
Line Items Amount
1. Personnel Services/ERE $139,998.00
2. Professional and Outside Expenses $0.00
3. Travel Expenses $2,077.00
4. Other Operating Expenses $26,649.00
5. Capital Outlay Expenses $0.00
6. Other (Indirect Costs) $16,276.00
Total Contract Amount (Not to Exceed) $185,000.00
The Contractor is authorized to transfer up to a maximum of ten percent (10%) of the total Agreement amount among the categorical line items. Transfers of funds are only allowed among funded line items as detailed in the original ISA.
Transfers exceeding ten percent (10%) of the contracted amount, or to non-funded line items, shall require an Agreement Amendment.
| 2021-01-25T13:41:13-0700 | |
| Christopher Balderrama |
File details come from the government source that posted it. Updated .