CTR079830_SPO_Form_10.pdf

Page 1 of 4 SPO Form 103 - Sole Source Procurement Authorization (Rev 12.05.23)

Procurement Determination:

Sole Source Authorization A.A.C. R2-7-E301

SECTIONS I THROUGH III MUST BE COMPLETED BY THE REQUESTOR

USE ADDITIONAL PAGE AS NECESSARY

SECTION I - State Governmental Unit Request

1. State Governmental Unit

2. Requestor 3. Email

4. Title 5. Telephone

SECTION II - Background

6. Service(s)/Material(s)

7. Supplier

8. Contract ID

9. Sole Source Type

10. Requesting Term 11. Estimated Cost

Arizona Department of Child Safety

Tasia Grzecka Tasia.Grzecka@azdcs.gov

Procurement Manager 602-796-2139

Provide the Arizona Department of Child Safety Healthy Families Arizona program with a referral process for the Healthy Families Arizona (HFAz) program for hospitals in Maricopa County.

Southwest Human Development (SWHD); 86-0407179 Ginger Ward; CEO Amy Jaffe; Associate Director with Healthy Families; ajaffe@swhd.org; (602) 427 4681 Address: 2850 N. 24th Street, Phoenix, Arizona 85008

CTR079830

Two (2) years upon execution $400,000

‐ Authorization request

Docusign Envelope ID: 9F5331D0-80CB-48FA-87F1-F9C41D657B5C

Page 2 of 4 SPO Form 103 - Sole Source Procurement Authorization (Rev 12.05.23)

SECTION III - Justification

12. Rationale

13. Provide details of the procurement need, reason for the single source, and how the proposed procurement is advantageous to the State

Arizona Department of Child Safety Department (ADCS) awarded multiple contracts to provide support to families under the Healthy Families Program in January 2024. There is a need for contractors with existing and established Memorandum of Agreements (MOA) with county hospitals to manage, distribute, and maintain referral data in Maricopa County. Inability to establish Healthy Family Program referrals would disrupt service and negatively impact families in the county.

Funding Sources: State Funds, Federal Funds and other funds from existing Inter-service Service Agreements (ISA) and/or Inter agency Agreements (IGA).

On November 18, 2025 Sole Source BPM007292 went out for publication on the Arizona Procurement Portal. On November 21, 2025, no other entities were identified in being able to provide the resource required. ADCS proposes to extend the current contract with the supplier SWHD for two (2) years.

Establishing this agreement with the current supplier ensures the ADCS program is able to continue to manage referrals, enhance communication with the hospitals, and receive appropriate service assignments for families. This award is contingent upon a finalized agreement and signed contract with ADCS to deliver Healthy Family referrals from hospitals through direct service implementation by SWHD.

Select applicable option in accordance with R2‐7‐E301(A):

Page 3 of 4 SPO Form 103 - Sole Source Procurement Authorization (Rev 12.05.23)

14. Describe the procurement process, efforts to locate other sources/evidence of one source, and determination that the price is fair and reasonable. Include the sole source notice and number (BPM00XXXX) and attach a copy to the determination.

15. A notice was posted in the State's eProcurement system to registered vendors with an invite to comment on the sole-source request for three

(3) working days, and it was determined that no reasonable alternative source exists for the procurement need. A copy of the notice is attached.

16. Signature 17. Date of Request

In accordance with the Procurement Rules, the Arizona Uniform Terms and Conditions must be made a part of all Contracts. If you will be required to sign a software licensing agreement or sign any other agreement containing terms and conditions, these will need additional review to ensure that the terms and conditions do not invalidate the Arizona Uniform Terms and Conditions. Approval of this request does not allow for agencies to exceed their dollar acquisition amount of delegated authority.

A Sole Source Procurement notice; BPM007292 executed on 11/18/2025, did not identify an additional supplier with the existing and established MOUs to manage, distribute, and maintain referral data in Maricopa County. Based on the finding of the Sole Source Notice, ADCS proposes to move forward with SWHD to contract for this service. SWHD has spent over twenty years establishing relationships with hospitals allowing them to obtain MOUs. SWHD has the infrastructure to maintain consistent referrals to the Healthy Families program.

The barrier for additional suppliers continues to be the MOU needed for Healthy Families Arizona (HFAZ) staff to enter hospitals to obtain referrals and make initial contact with families.

Specifically for Maricopa County, SWHD currently has MOUs with the larger hospitals as they were the only HFAZ provider for 10+ years. ADCS continues to explore methods for bringing the hospital referral process internal, but at this time a process has not been developed.

ADCS determines that SWHD's price is fair and reasonable.

12/09/25

Page 4 of 4 SPO Form 103 - Sole Source Procurement Authorization (Rev 12.05.23)

TO BE COMPLETED BY PROCUREMENT AUTHORITY

SECTION IV - Approval

18. Determination

19. Approved Expiration Date

20. Comments, conditions, or restrictions (as applicable)

21. Print Name 22. Title

23. Signature 24. Date of Approval

25. Use section as necessary

STATE GOVERNMENTAL UNIT NOTICE: This is an official written determination in response to a procurement authorization request.

A copy of the form shall be maintained by the State Governmental Unit and the State Procurement Office.

Upon completion, Requestor shall forward the signed form to the Contract Owner.

Contract Owner shall upload the signed approval version of this form in the eProcurement system.

If anticipated expenditure is above State Governmental Unit's delegation, forward document to SPOCompliance@azdoa.gov.

- Request Authorized Pursuant to R2-7-E301

Docusign Envelope ID: 9F5331D0-80CB-48FA-87F1-F9C41D657B5C

12/9/2025

December 31, 2027

Lex Sargento Chief Procurement Officer