CTR076712_Contract_Amendment_2.pdf

CONTRACT AMENDMENT

Arizona Department of Economic Security

1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007

CONTRACT NUMBER: AMENDMENT NUMBER:

CTR076712 Two (2)

DESCRIPTION/ LABEL: Area Agencies on Aging (AAA)

CONTRACTOR NAME: Pinal-Gila Council for Senior Citizens (PGCSC)

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

In accordance with the Special Terms and Conditions Section 26.0 Levels of Service, and in accordance with the Carryover Approval Letter dated October 28, 2025 in the amount of $369,606.43; and the Alert dated November 10, 2025 in the amount of $49,825.00; the purpose of this amendment is to revise the Itemized Service Budget for the period of July 1, 2025 through June 30, 2026. The contract reimbursement ceiling is $5,560,093.59.

The Itemized Service Budget is attached as part of this amendment.

ALL OTHER REQUIREMENTS, SPECIFICATIONS, AND TERMS AND CONDITIONS REMAIN UNCHANGED

ACKNOWLEDGEMENT AND AUTHORIZATION

This Amendment shall be fully executed by means of electronic approval in APP.

Region Amendment Contract no. Timeframe SFY ganization Central Arizona Aging (PGCSC) 3 CTR076712 7/1/25-6/30/26 2026

Advocacy Comm. Edu. & Info

ADM ADM ADP ADV ATT CEI CGT CMG

FCS HCB HCB HCB HCB HCB FCS FCS

Fund Source

OAA Admin (III C-1) 265,408.00 OAA Admin (III E) 42,069.00 Title III-B 10,000.00 24,338.54 261,648.95 32,505.53 189,733.45 Title III-B Ombudsman Title III-C1 Title III-C2 Title III-D Prev Hlth Title III-E Caregiver 15,175.03 40,806.94

NSIP

Title VII Eld Abus Title VII OMB State Ind Living 589.00 3,600.47 108,533.46 2,702.00 10,060.00 State OMB State LTC OMB FTE State RSP

STATE DIRECT CARE WORKER

SHIP

Senior Patrol

SSBG 29,000.00

SSBG - HCB Wait List

MIPPA-S.H.I.P.

MIPPA-AAA

MIPPA-ADRC

State Aging Housing Assistance State One-Time Funding Refugee ntract Reimbursement Ceiling 42,069.00 265,408.00 10,589.00 27,939.01 399,182.41 35,207.53 15,175.03 240,600.39

Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) incorporate a state match

Incorporated State Match 10,517.25 66,352.00 556.00 1,353.22 14,547.68 1,807.31 - 10,549.18 Additional State Funding - - 589.00 3,600.47 108,533.46 2,702.00 - 10,060.00 TOTAL STATE FUNDS 10,517.25 66,352.00 1,145.00 4,953.69 123,081.14 4,509.31 - 20,609.18

RECT SERVICES

ALTCS

Program Income Non-Fed In-kind Non-Fed Cash 20,000.00 Other Federal Total - - - - - - - 20,000.00 b-contracted SERVICES

ALTCS

Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total - - - - - - - -

Grand Total 42,069.00$ 265,408.00$ 10,589.00$ 27,939.01$ 399,182.41$ 35,207.53$ 15,175.03$ 260,600.39$

PENSES

Personnel - Direct 28,606.50 176,763.60 16,881.84 21,630.49 9,519.72 162,033.84 ERE - Direct 4,699.09 34,509.49 6,231.96 7,394.51 2,934.34 52,253.43 Professional/Out Direct 1,555.91 9,614.18 918.20 1,176.48 517.78 8,813.01 Sub-contrcted 399,182.41 Travel - Direct 586.93 3,808.70 346.37 443.80 195.32 3,324.48 Space - Direct 3,916.22 24,198.91 2,311.11 2,961.22 1,303.25 22,182.41 Equipment - Direct One-Time Ongoing Material/Supplies-Direct 160.26 990.32 10,589.00 94.58 121.18 53.34 907.79 Operating Svcs - Direct 2,544.09 15,522.80 1,154.95 1,479.85 651.28 11,085.43 Allocated Indirect -Direct

SubTotal DIRECT 42,069.00 265,408.00 10,589.00 27,939.01 - 35,207.53 15,175.03 260,600.39 SubTotal PURCH - - - - 399,182.41 - - - TOTAL SERVICE 42,069.00 265,408.00 10,589.00 27,939.01 399,182.41 35,207.53 15,175.03 260,600.39

Check to 0.00 Revenues equal Expenses -$ -$ -$ -$ -$ -$ -$ -$

Subcontractors Subcontracted Expense - - - - 399,182.41 - - - Direct Direct Expense 42,069.00 265,408.00 10,589.00 27,939.01 - 35,207.53 15,175.03 240,600.39

Case

DAARS Codes Program Codes

Admin Adaptive Aids Attendant Care

Service Detail Code

Service Caregiver Training

Cong. Meals Home Del. Meals Home Del. Meals Legal Assis.

CMG CNG HDM HDM HED INR INR LGL LTC LTC PCS

HCB HCB HCB HCB HPR FCS HCB LSA OMB OMB FCS

FBX FTE

369,047.59 124,982.62 95,795.47 45,466.07 14,958.00

732,359.83 485,256.33

42,153.34 103,098.59 40,725.44

66,467.00 74,840.73 5,347.00

56,405.00 63,448.44 25,394.00 38,071.00 34,135.18 10,263.00 691.45

37,080.00 18,920.00

316,132.44 4,018.00 139,075.23

748,628.47 828,238.83 737,243.29 - 42,153.34 103,098.59 159,117.80 106,058.47 159,256.07 18,920.00 41,416.89

20,519.05 40,719.21 26,980.25 - - - 6,949.03 5,326.23 2,527.91 - - 63,448.44 25,394.00 38,071.00 - - - 34,135.18 10,263.00 37,080.00 - 691.45 83,967.49 66,113.21 65,051.25 - - - 41,084.21 15,589.23 39,607.91 - 691.45

500.00 3,976.00

13,200.00 15,000.00 13,200.00 - 15,000.00 - - - - 4,476.00 - - -

107,755.00 50,002.00 98,999.00 72,315.00

174,935.00 534,779.00

- 381,689.00 657,096.00 - - - - - - - -

761,828.47$ 1,209,927.83$ 1,409,339.29$ -$ 42,153.34$ 103,098.59$ 159,117.80$ 110,534.47$ 159,256.07$ 18,920.00$ 41,416.89$

478,093.51 27,814.75 67,731.35 103,652.07 58,957.08 105,464.49 15,136.00 25,838.18 147,084.44 5,954.34 16,007.19 25,839.49 20,310.10 21,636.53 3,784.00 8,193.53

26,003.50 1,813.18 3,683.91 5,637.63 17,562.47 6,118.84 1,405.33 1,209,927.83 1,409,339.29

9,809.15 570.68 1,389.66 2,126.65 1,209.64 2,308.18 530.13 65,450.92 3,807.83 9,272.41 14,189.95 8,071.23 15,401.17 3,537.25

2,678.52 155.83 379.47 580.71 330.31 630.28 144.77 32,708.43 2,036.73 4,634.60 7,091.30 4,093.64 7,696.58 1,767.70

761,828.47 - - - 42,153.34 103,098.59 159,117.80 110,534.47 159,256.07 18,920.00 41,416.89

- 1,209,927.83 1,409,339.29 - - - - - - - -

761,828.47 1,209,927.83 1,409,339.29 - 42,153.34 103,098.59 159,117.80 110,534.47 159,256.07 18,920.00 41,416.89

(0.00)$ -$ -$ -$ (0.00)$ (0.00)$ -$ 0.00$ -$ -$ 0.00$

- 828,238.83 752,243.29 - - - - - - - - 748,628.47 - (15,000.00) - 42,153.34 103,098.59 159,117.80 106,058.47 159,256.07 18,920.00 41,416.89

Info & Ref. Long Term Care Advo.e Mgmt. Health Edu. Peer Co

Social & Recreation

PCS PGD RPR RSP RSP RSP SHI SHI SHI SHI SHI SOC

FCS HCB HCB FCS FCS FCS SHP SHP SHP SHP SMP HCB

KIN EMG GRP INH MAM MDM MSM OTR

82,485.15 4,454.12

2,400.00 21,764.00 111,352.71

2,950.00 9,900.00

22,695.00

41,302.00 33,005.00

44,099.67 21,833.00 8,627.66

26,916.00 24,547.00

7,694.00

152,048.33

281,583.15 21,833.00 2,400.00 21,764.00 134,047.71 24,547.00 7,694.00 26,916.00 41,302.00 33,005.00 22,981.78

- 4,586.17 - - - - - - - - - 247.65 2,950.00 - - - 22,695.00 - - - - - 9,900.00 7,536.17 - - - 22,695.00 - - - - - 10,147.65

281,583.15$ 21,833.00$ 2,400.00$ 21,764.00$ 134,047.71$ 24,547.00$ 7,694.00$ 26,916.00$ 41,302.00$ 33,005.00$ 22,981.78$

86,855.94 7,134.19 22,288.95 2,048.45

4,724.09 388.03 152,048.33 21,833.00 2,400.00 21,764.00 134,047.71 24,547.00 7,694.00 26,916.00 11,760.00

1,782.04 146.37 11,890.56 976.68

486.61 41,302.00 33,005.00 39.97 1,506.63 488.09

129,534.82 - - - - - - - 41,302.00 33,005.00 11,221.78 152,048.33 21,833.00 2,400.00 21,764.00 134,047.71 24,547.00 7,694.00 26,916.00 - - 11,760.00 281,583.15 21,833.00 2,400.00 21,764.00 134,047.71 24,547.00 7,694.00 26,916.00 41,302.00 33,005.00 22,981.78

- 152,048.33 21,833.00 2,400.00 21,764.00 134,047.71 24,547.00 7,694.00 26,916.00 - - 11,760.00 129,534.82 - - - - - - - 41,302.00 33,005.00 11,221.78

Program Dev. unseling me Repair & Renovati Respite Care State Health Insurance Info. Edu. & Fraud Prog.

State Aging Housing Assistance

TSP TSP TSP ATT HSK RSP ATT ADM HSS RPR

FCS FCS HCB HCB HCB FCS HCB HCB HCB HCB

KIN WLF WLF WLF DCW AHA AHA AHA

TOTAL

265,408.00 42,069.00

16,599.00 1,257,056.49 14,958.00

732,359.83 485,256.33 42,153.34

335,322.71 141,307.73

5,347.00 56,405.00

1,980.00 312,318.00 37,080.00 18,920.00 22,695.00

139,883.00 139,883.00 41,302.00 33,005.00

38,000.00 600,786.00 323,198.00 4,500.00 57,437.00 385,135.00

26,916.00 24,547.00 7,694.00

38,011.83 135,844.00 206,265.00 380,120.83 152,048.33

- 56,579.00 323,198.00 4,500.00 57,437.00 139,883.00 38,011.83 135,844.00 206,265.00 5,560,093.59

- - 922.90 - - - - - - - 214,461.05

- 1,980.00 - - - 139,883.00 38,011.83 135,844.00 206,265.00 892,096.83

- 2,902.90 - - - 139,883.00 38,011.83 135,844.00 206,265.00 1,106,557.88

500.00

3,976.00 20,000.00 28,200.00

- - - - - - - - - 52,676.00

16,380.00 174,137.00 49,502.00 220,816.00

211,174.00 920,888.00

- 277,056.00 - - - - - - - 1,315,841.00

-$ 333,635.00$ 323,198.00$ 4,500.00$ 57,437.00$ 139,883.00$ 38,011.83$ 135,844.00$ 206,265.00$ 6,928,610.59$

1,392,113.55 381,169.84

4,801.83 3,000.00 7,000.00 104,734.37

333,635.00 323,198.00 4,500.00 57,437.00 139,883.00 33,210.00 132,844.00 199,265.00 4,645,431.57 28,578.10

189,471.12

92,649.94 94,462.10

- - - - - - 4,801.83 3,000.00 7,000.00 2,283,179.02

- 333,635.00 323,198.00 4,500.00 57,437.00 139,883.00 33,210.00 132,844.00 199,265.00 4,645,431.57

- 333,635.00 323,198.00 4,500.00 57,437.00 139,883.00 38,011.83 135,844.00 206,265.00 6,928,610.59

-$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 0.00$

- - 56,579.00 323,198.00 4,500.00 57,437.00 139,883.00 33,210.00 132,844.00 199,265.00 3,329,590.57

- - - - - - 4,801.83 3,000.00 7,000.00 2,230,503.02

Transportation Waitlist Direct Care Worker

ALERT CHECK

265,408.00 - 42,069.00 -

822,809.26 434,247.23 14,958.00 -

977,601.83 (245,242.00) 674,261.56 (189,005.23) 42,153.34 -

335,322.71 - 141,307.73 -

5,347.00 - 56,405.00 -

312,318.00 - 37,080.00 - 18,920.00 - 22,695.00 -

139,883.00 - 41,302.00 - 33,005.00 -

600,786.00 - 385,135.00 - 26,916.00 - 24,547.00 - 7,694.00 -

380,120.83 - 152,048.33 -

5,560,093.59 0.00

Validation Worksheet Alert 1.15.25

Organization Central Arizona Aging (PGCSC) Contract No. CTR076712 Period 7/1/25-6/30/26 Amendment No. 3

ALERT/ISB VALIDATION (a) (b) (c) =(a) (b) (d) (e) = (c) + (d) (f) (g) = (f) - (e)

SFY25 Increase/ Total Alert + Contract LN Fund Source Carryover Alert Total Decrease Carryover Budget Difference

1 OAA Admin (III C-1) 265,408.00 265,408.00 265,408.00 265,408.00 - 2 OAA Admin (III E) 42,069.00 42,069.00 42,069.00 42,069.00 - 3 Title III-B 116,003.26 706,806.00 822,809.26 822,809.26 1,257,056.49 434,247.23 4 Title III-B Ombudsman 14,958.00 14,958.00 14,958.00 14,958.00 - 5 Title III-C1 158,465.83 819,136.00 977,601.83 977,601.83 732,359.83 (245,242.00) 6 Title III-C2 35,131.56 639,130.00 674,261.56 674,261.56 485,256.33 (189,005.23) 7 Title III-D Prev Hlth 300.34 41,853.00 42,153.34 42,153.34 42,153.34 - 8 Title III-E Caregiver 51,352.71 283,970.00 335,322.71 335,322.71 335,322.71 -

9 NSIP 8,352.73 132,955.00 141,307.73 141,307.73 141,307.73 -

10 Title VII Eld Abus 5,347.00 5,347.00 5,347.00 5,347.00 - 11 Title VII OMB 56,405.00 56,405.00 56,405.00 56,405.00 - 12 State Ind Living 312,318.00 312,318.00 312,318.00 312,318.00 - 13 State OMB 56,000.00 56,000.00 (18,920.00) 37,080.00 37,080.00 - 14 State LTC OMB FTE - 18,920.00 18,920.00 18,920.00 15 State RSP 22,695.00 22,695.00 22,695.00 22,695.00 -

16 STATE DIRECT CARE WORKER 139,883.00 139,883.00 139,883.00 139,883.00 -

17 SHIP 41,302.00 41,302.00 41,302.00 41,302.00 -

18 Senior Patrol 33,005.00 33,005.00 33,005.00 33,005.00 -

19 SSBG 600,786.00 600,786.00 600,786.00 600,786.00 -

20 SSBG - HCB Wait List 385,135.00 385,135.00 385,135.00 385,135.00 -

21 MIPPA-S.H.I.P. 3,163.00 3,163.00 23,753.00 26,916.00 26,916.00 -

22 MIPPA-AAA 3,674.00 3,674.00 20,873.00 24,547.00 24,547.00 -

23 MIPPA-ADRC 2,495.00 2,495.00 5,199.00 7,694.00 7,694.00 -

25 State Aging Housing Assistance 380,120.83 380,120.83 380,120.83 380,120.83 - 24 State One-Time Funding 152,048.33 152,048.33 152,048.33 152,048.33 - 26 Refugee - - - -

TOTAL 369,606.43 5,140,662.16 5,510,268.59 49,825.00 5,560,093.59 5,560,093.59 0.00 Note: Section above validates that Alert Levels plus adjustments equal the ISB Total submitted by Provider

TRANSFER AUTHORITY - TITLE III B/C TRANSFER AUTHORITY - C1/C2

-$ Transfer Transfer Transfer Transfer Transfer

Fund Source Alert Level Ceiling In/(Out) % Fund Source Alert Level Ceiling In/(Out) % Transfer Authority - Title III-B to III-C or III-C to III-B (30% Maximum of Allocation Excluding Carryover) Transfer Authority - Title C-1 to C-2 (40% Maximum of Allocation Excluding Carryover)

Title III-B 706,806$ 212,042$ 434,247$ 61.44% Title III-C1 819,136$ 327,654$ (245,242)$ -29.94%

Title III-C Title III-C2 639,130$ 255,652$ (189,005)$ -29.57% III-C1 819,136$ 245,741$ (245,242) -29.94% Note: Section above validates transfer authority. Red cells indicates a transfer ceiling has been exceeded)

III-C2 639,130$ 191,739$ (189,005) -29.57%

Total 1,458,266 437,480 (434,247) -29.78% Specialty Funds

Contract Fund Source Alert Level Level Over/Under

TITLE III-B MINIMUM PERCENT LTC FTE 18,920$ 18,920$ -$

Category % Required Requirement Actual Alloc Over/Under SSBG Admin 10% 60,079$ -$ (60,079)$

Minimums Exclude Carryover LTC Overmatch 2,528$ 2,528$

TSP, I&R, Outreach, CMG 16% 109,195$ 700,363$ 591,168$ In-Home Service 8% 54,597$ 261,649$ 207,052$ Legal Service 4% 27,299$ 95,795$ 68,496$ Long Term Care Advo. 14,958.00 1,257,056$ 1,242,098$ Maintenance of Effort for Client OAA

Category % Required Requirement Actual Alloc Over/Under

III-B TOTAL ALLOCATION 706,806$ 206,049$ 2,314,864$ 2,108,815$

Program Income 500$ 500$ SOCIAL SERVICES BLOCK GRANT Non-Fed In-kind 1,396,090$ 1,396,090$ Category DAARS Code Local Req. Actual Alloc Over/Under Non-Fed Cash 401,170$ 401,170$

Administrative Services ADM -$ -$ -$ TOTAL 10% 274,964$ 1,797,759$ 1,522,796$ Adult Day Care/Adult Day Health Care ADC -$ -$ -$ Adaptive Aids ADP -$ -$ -$ Advocacy ADV -$ -$ -$ TITLE III-B CARRYOVER Attendant Care ATT 27,065.00$ 352,198.00$ 325,133.00$ Category DAARS Code Carryover Req. Actual Alloc Over/Under Caregiver Training CGT -$ -$ -$ Case Management CMG 56,348.00$ 316,132.44$ 259,784.44$ Attendant Care ATT 107,902$ 261,649$ 153,747$ Community Education & Information CEI -$ -$ -$ Case Management CMG -$ 558,781$ 558,781$ Congregate Meals CNG -$ 4,018.00$ 4,018.00$ Home Repair and Renovations RPR -$ -$ -$ Emergency Human Services EHS -$ -$ -$ Housekeeping HSK -$ -$ -$ Health Promotion HED -$ -$ -$ Home Nursing NRH -$ -$ -$ Home Delivered Meals HDM 48,224.00$ 139,075.23$ 90,851.23$ Personal Care PRC -$ -$ -$ Home Repair and Renovations RPR 21,833.00$ 21,833.00$ -$ Program Development PGD -$ 82,485$ 82,485$ Housekeeping HSK -$ 4,500.00$ 4,500.00$ Respite RSP -$ -$ -$ Information and Referral INR -$ -$ -$ Transportation TSP -$ 16,599$ 16,599$ Legal Assistance LGL -$ -$ -$ Long-Term Care LTC 8,101$ 45,466$ 37,365$ Long-Term Care Advocacy LTC -$ -$ -$ - - -$ -$ -$ Multipurpose Center Operations MCO -$ -$ -$ - - -$ -$ -$ Home Nursing NRH -$ -$ -$ Outreach OTR -$ -$ -$ TOTAL 116,003$ 964,980$ 848,977$ Peer Counseling PCS -$ -$ -$ Personal Care PRC -$ -$ -$ Program Development PGD -$ 44,099.67$ 44,099.67$ TITLE III-C CARRYOVER Reassurance REA -$ -$ -$ Category DAARS Code Local Req. Actual Alloc Over/Under Respite RSP -$ 57,437.00$ 57,437.00$ Socialization and Recreation SOC -$ 8,627.66$ 8,627.66$ Administrative Services ADM -$ -$ -$ Supplemental Provisions SUP -$ -$ -$ Congregate Meals CNG 158,466$ 732,360$ 573,894$ Transportation TSP -$ 38,000.00$ 38,000.00$ Home Delivered Meals HDM 35,132$ 485,256$ 450,125$ Volunteer Services VOS -$ -$ -$

TOTAL 193,597$ 1,217,616$ 1,024,019$

TOTAL 153,470.00$ 985,921.00$ 832,451.00$

Current Alert Level

TITLE III-D CARRYOVER

Category DAARS Code Local Req. Actual Alloc Over/Under

Health Promotion HED 300$ 42,153$ 41,853$

TITLE III-E CARRYOVER

Category DAARS Code Local Req. Actual Alloc Over/Under

Administrative Services ADM -$ -$ -$ Adult Day Care/Adult Day Health Care ADC -$ -$ -$ Community Education & Information CEI -$ -$ -$ Caregiver Training CGT -$ 15,175$ 15,175$ Case Management CMG -$ 40,807$ 40,807$ Supportive Intervention/Guidance Counseling CNS -$ -$ -$ Information and Referral INR -$ 103,099$ 103,099$ Peer Counseling PCS -$ 40,725$ 40,725$ Respite RSP 51,353$ 135,517$ 84,164$ Supplemental Provisions SUP -$ -$ -$

TOTAL 51,353$ 335,323$ 283,970$

TITLE VII CARRYOVER

Category DAARS Code Local Req. Actual Alloc Over/Under

Program Development PGD -$ -$ -$ Long-Term Care Advocacy LTC -$ 56,405$ 56,405$