YH23-0067_ASU_Amend_5_Executed__2_.pdf
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- Attached to
- Master Agreement AZ|CTR074296
- Contract number
- CTR074296
- Issued by
- Arizona
About this file
This is Contract Amendment #5 to an indefinite delivery vehicle contract between the Arizona Health Care Cost Containment System (AHCCCS) and Arizona Board of Regents, acting on behalf of Arizona State University (ASU), under the DGI program. The contract is identified as YH23-0067 / CTR062538 and is effective upon final signature dated April 9-10, 2024. The amendment modifies the Scope of Work (SOR) III Year 2 Price Sheet and Budget Narrative and Justification for the period September 30, 2023, through September 29, 2024, with all other contract portions remaining in effect.
The amendment establishes a total project cost of $217,000 for Year 2, funded through a federal State Opioid Response III Grant (SOR III) from the Substance Abuse & Mental Health Services Administration (SAMHSA) under CFDA 93.788 (Federal Award Identification Number H79TI085739). The budget allocation includes $82,229 in personnel costs across eight positions, $26,868 in fringe benefits, $3,034 in travel expenses, $38,146 in other operating costs (including consultant fees, printing, advertising, and conference registration), and $66,723 in indirect charges calculated at 44.4% of modified total direct costs. No equipment, supplies, or contractual line items are funded. The contractor is authorized to transfer up to 10% of the total budget between line items with prior written approval from the Program Manager. All travel expenditures require itemized receipts and must comply with State of Arizona Accounting Manual allowable rates.
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CONTRACT AMENDMENT
1. AMENDMENT #:
2. CONTRACT #:
YH23-0067
CTR062538
3. EFFECTIVE DATE OF AMENDMENT:
Upon Final Signature
4. PROGRAM:
DGI
5. CONTRACTOR/PROVIDER NAME AND ADDRESS:
Arizona Board of Regents
Acting on Behalf of the Arizona State University (ASU) Office of Research & Sponsored Projects Administration
P.O. Box 876100 Tempe, Arizona 85287-6011
6. PURPOSE:
To remove and replace the existing SOR III Year 2 Price Sheet and Budget Narrative and Justification with the attached for the period September 30, 2023, through September 29, 2024.
7. THE ABOVE REFERENCED CONTRACT IS HEREBY AMENDED AS FOLLOWS:
Contract YH23-0067 is hereby amended to remove and replace the existing SOR III Year 2 Price Sheet and
Budget Narrative and Justification with the attached for the period September 30, 2023, through September 29, 2024.
All other portions of the Contract remain in effect.
NOTE: Please sign, date, and return one scanned copy to: Marie Horn, Senior Procurement Specialist at marie.horn@azahcccs.gov
Electronic Submission: An electronic or portable document file (PDF) copy of this amendment shall serve as the original.
8. IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT.
9. NAME OF CONTRACTOR/PROVIDER:
Arizona Board of Regents, Acting on Behalf of the Arizona State University
10. ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
SIGNATURE OF AUTHORIZED INDIVIDUAL: SIGNATURE:
TYPED NAME:
Kristy Macdonald
TYPED NAME:
Tracey Thomas
TITLE:
Assistant Director, Research Operations
TITLE:
Procurement Manager
DATE: DATE:
DocuSign Envelope ID: B0434BCB-CDF2-4722-BB5D-4788B07A570C
4/9/20244/10/2024 mailto:marie.horn@azahcccs.gov
PRICE SHEET
SOR III Year 2
FUNDING / METHOD OF REIMBURSEMENT
September 30, 2023 – September 29, 2024
ASU - SIRC
YH23-0067
ACCOUNT CLASSIFICATION AMOUNT
Personnel $82,229
ERE/Fringe $26,868
Travel Expense $3,034
Equipment $0
Supplies $0
Contractual $0
Other Operating $38,146
Total Direct Charges $150,277
Indirect Charges or Admin (If authorized) $66,723
TOTAL $217,000
With prior written approval from the Program Manager, the contractor is authorized to transfer up to a maximum of 10% of the total budget amount between line items. Transfers of funds are only allowed between funded line items.
Transfers exceeding 10% or to a non-funded line item shall require an amendment.
All travel related expenditures will require itemized receipts and will not exceed the State allowable rates which can be found at the State of Arizona Accounting Manual (SAAM) https://gao.az.gov/publications/saam
In compliance with 2 CFR Part 200, Grants & Agreements §200.331, Requirements for Pass Thru Entities (subrecipient), the information below is solely to comply with 2 CFR Part 200 and does not reflect the funding amount or period of performance of the contract. Please refer to the Contract & Cost Reimbursement Line-Item Budget for funding amount and Period of Performance.
Grantor: Substance Abuse & Mental Health Services Administration (SAMHSA) Grantee: Arizona Health Care Cost Containment System Grant Name: State Opioid Response III Grant (SOR III)
CFDA: 93.788
Federal Award Identification Number
(FAIN)
Award Amount
Issue Date Award Period Period of Performance
(Project Performance
FFATA
(Y/N)
H79TI085739 $33,080,062 09/05/2023 09/30/2023-
09/29/2024
09/30/2023- 09/29/2024
Y https://gao.az.gov/publications/saam
Budget Narrative and Justification SOR III – Year 2
ASU - SIRC
YH23-0067
September 30, 2023 – September 29, 2024
A. Personnel:
Position (1)
Name (2)
Key Staff (3)
Annual Salary/Rate (3)
Level of Effort (5)
Total Salary Charge to Award
(6)
Principal Investigator Natasha Mendoza Yes $102,000 100% $5,667
Co-Investigator Stephanie Lechuga Pena $97,700 64.48% $7,000
Co-Investigator Manuel Cano $90,000 100% $5,000
Clinic Coordinator Maria Hanlin $83,373.35 8% $6,670
Project Manager Elisabeth Williams $73,500 8% $5,880
Senior Program Manager Isabel Larsen $88,103.80 2% $1,762
Research Specialist Nika Hernandez $51,500 50% $25,750
Research Specialist Michelle Sanatana $49,000 50% $24,500
TOTAL REQUEST $82,229
JUSTIFICATION:
The Principal Investigator (Mendoza) is responsible for the ASU portion of the SOR project, leading staff efforts in three (3) main areas on the SOR project, expanded technical assistance for recovery residence providers and ongoing medication for opioid use disorder (MOUD) resource dissemination (new curriculum, MOUD pocket guide, MOUD docuseries, etc.), working in collaboration with the Co-Investigator to oversee the new provider survey component.
The Co-Investigator (Lechuga Pena) is responsible for taking the lead on a new survey component aimed at assessing provider perceptions of transitional housing needs among individuals exiting treatment services and working closely with the Principal Investigator and staff to coordinate data collection, reporting and recommendations.
The Co-Investigator (Cano) is responsible for leading the data analysis efforts for the Project MATTRR’s and Recovery Home Academy project, cleaning, analyzing, and reporting on data collected as part of the provider survey, conducting and/or overseeing complex analyses, creating data visualizations, writing clear and concise reports that summarize data analysis findings, collaborating with other members of the research team to ensure that data collection and analysis is conducted in a timely and efficient manner.
The Clinic Coordinator (Hanlin) is responsible for managing the day-to-day logistics and administration of the ECHO program including but not limited to reminder emails to participants, inputting new program registrations, data entry into the ECHO Institute database (iECHO), CME coordination and guest presenter liaising.
The Project Manager (Williams) is responsible for overseeing the management of the program including outreach and recruitment of new Centers of Excellence, planning of annual curricula, participant data collection (post-session and annual surveys), participation in hub team huddles and planning meetings, and quarterly report development.
The Senior Program Manager (Larsen) is responsible for providing overall project administrative support for the Principal Investigator and staff.
The Research Specialist (Hernandez) is responsible for ensuring project logistics are organized and that project reporting is comprehensive and timely and providing support for data collection, analysis, interpretation, and reporting.
The Research Specialist (Sanatana) is responsible for assisting project leads in developing a scoping literature review, disseminating findings from project evaluation, supporting Project MATTRRs curriculum development, and offering coordination support for gap analysis related to housing.
B. Fringe Benefits:
Position (1)
Name (2)
Rate (3)
Total Salary Charged to Award
(4)
Total Fringe Charged to Award
(5)
Principal Investigator Natasha Mendoza 27.10% $5,667 $1,536
Co-Investigator Stephanie Lechuga Pena 27.10% $7,000 $1,897
Co-Investigator Manuel Cano 27.10% $5,000 $1,355
Clinic Coordinator Maria Hanlin 34.20% $6,670 $2,281
Project Manager Elisabeth Williams 34.20% $5,880 $2,011
Senior Program Manager Isabel Larsen 34.20% $1,762 $603
Research Specialist Nika Hernandez 34.20% $25,750 $8,807
Research Specialist Michelle Santana 34.20% $24,500 $8,379
FEDERAL REQUEST $26,868
JUSTIFICATION: ASU defines fringe benefits as direct costs, estimates benefits as a standard percent of salary applied uniformly to all types sponsored activities, and charges benefits to sponsors in accordance with the Federally negotiated rates in effect at the time salaries are incurred. Benefit costs are expected to increase per year, the rates used in the proposal budget are based on the current Federally negotiated Rate Agreement rate plus annual escalation for out years. Below is a breakdown of the rates used above for FY 23. Any start date of six (6) months or more into a fiscal year will use the following fiscal year’s rates according to ASU policy.
Employee Related Expenses (ERE) Faculty Staff Post Docs Students RA/TA
Workers Comp Insurance 0.21% 0.21% 0.21% 0.21% 0.21%
Retiree Accumulated Sick Leave 0.35% 0.39% 0.38% 0% 0%
Unemployment Insurance 0.01% 0.04% 0% 0% 0%
FICA Tax 6.52% 6.87% 6.57% 1.31% 0.19%
Combined Retirement 7.36% 9.11% 0% 0% 0%
ASRS Long Term Disability 0.13% 0.15% 0.17% 0% 0%
Group Health Insurance 9.71% 15.05% 15.57% 0% 0%
RATA Health Insurance 0% 0% 0% 0% 9.04%
RATA Dental Insurance 0% 0% 0% 0% 0.07%
Group Dental Insurance 0.07% 0.11% 0.10% 0% 0%
Life/ACC Death/Disability 0.07% 0.08% 0.08% 0% 0%
Dependent Care Flex Spending 0.01% 0.01% 0.01% 0% 0%
Medical Exp Flex Spending 0.02% 0.02% 0.02% 0% 0%
Employee Tuition Reimbursement 0.16% 1.50% 0% 0% 0%
Sabbatical Payments 2.20% 0% 0% 0% 0%
Employee Assistance 0.06% 0.06% 0.06% 0% 0%
Accrued Vacation Payouts 0.20% 0.94% 0.01% 0% 0%
Fertility/Adoption 0.01% 0.01% 0% 0% 0%
Gender Affirming 0.02% 0.02% 0% 0% 0%
Pool Adjustment from FY22 (Over)/Under Recovery
0.03% -0.37% -1.45% 0.10% 1.96%
ERE Total 27.1% 34.2% 21.7% 1.6% 11.5%
C. Travel:
Please note: All travel expenditures will require itemized receipts and will not exceed the State allowable rates which can be found in the State of Arizona Accounting Manual (SAAM) https://gao.az.gov.publications/saam https://gao.az.gov.publications/saam
Purpose (1)
Destination (2)
Item (3)
Calculation (4)
Travel Cost Charged to the Award
(5)
In-State Travel Maricopa County Mileage $0.655/mile x 1,395 $914
AATOD Conference Las Vegas, NV Lodging $209/night x 1/staff x 5/nights $1,045
AATOD Conference Las Vegas, NV Airfare $400 $400
AATOD Conference Las Vegas, NV Per Diem $59/day x 1/staff x 6/days $354
AATOD Conference Las Vegas, NV Ground Transportation
$40/day x 6/days $240
AATOD Conference Las Vegas, NV Misc charges (luggage) $70 $70
AATOD Conference Las Vegas, NV Concur Travel Fee $11
FEDERAL REQUEST $3,034
JUSTIFICATION:
Local travel to connect with behavioral health stakeholders in rural AZ and disseminate educational materials within the State of Arizona. Local travel is based upon Arizona’s allowable mileage reimbursement rate of .655/mile. Note: Per Diem is a generic term used for budgeting purposes only. Actual reimbursement is subject to the State of Arizona Accounting Manual (SAAM) travel policy and actual receipts.
Out-of-state travel request is for one (1) staff member to attend the American Association for the Treatment of Opioid Dependence (AATOD) Conference in Las Vegas, Nevada being held May 18-22, 2024. Dr. Mendoza has submitted an abstract to discuss Project MATTRR’s, which will educate providers across the Southwest Region (including AZ) about the impact of technical assistance with medication for opioid use disorder. She will bring back important information related to National Policy associated with treatment of opioid use disorder, which will inform ASU material development. ASU’s travel system software provider, Concur Technologies, assesses a charge of $11/per person for each travel expense report submitted.
D. Equipment:
Item(s) (1)
Quantity (2)
Amount (3)
% Charged to the Award
(4)
Total Cost Charged to the Award
(5)
FEDERAL REQUEST $0
JUSTIFICATION:
E. Supplies (Items costing less than 45,000 per item):
Item(s) (1)
Rate (2)
Cost (3)
FEDERAL REQUEST $0
JUSTIFICATION:
F. Contractual:
COSTS FOR CONTRACTS MUST BE BROKEN DOWN IN DETAIL AND A NARRATIVE JUSTIFICATION PROVIDED. A SEPARATE ITEMIZED BUDGET IS REQUIRED FOR EACH CONTRACTOR. IF APPLICABLE, NUMBER OF CLIENTS SHOULD BE INCLUDED IN THE
COSTS.
Name (1)
Service (2)
Rate (3)
Other (4)
Total (5)
FEDERAL REQUEST $0
JUSTIFICATION:
G. Construction: (NOT ALLOWED)
H. Other: (Include Other Consultants)
Item Rate Cost
Consultants (HUB Team) $2,500/each x 7 $17,500
Consultants (Az Recovery Home Advisory Board) $200/each x 8/consultants x 6/months $9,600
Printing – MOUD and SOR related materials $8,077 $8,077
Advertising (Social media funds e.g. Facebook) $1,600 $1,600
Shipping (FedEx) for MOUD guide mailing $700 $700
Marketing (Salesforce Marketing Annual Fee) $169 $169
AATOD Conference Registration Fee $500/each x 1/staff $500
FEDERAL REQUEST $38,146
JUSTIFICATION:
Consultants (Hub Team) make up the MOUD ECHO and are experts who specialize in prevention, intervention, treatment, harm reduction and/or policy related to the ongoing opioid crisis. Hub teams members meet every other week and facilitate MOUD training to a wide audience of providers every other week via Zoom.
Consultants (Arizona Recovery Home Advisory Board) is essential for its foundational setup and ongoing activities aimed at enhancing Level II recovery home standards. Funding will cover the costs of developing and disseminating best practice guidelines, facilitating bi-monthly remote meetings through September 2024, and supporting administrative needs. This investment ensures the board can effectively collaborate, share knowledge, operate efficiently, and independently.
Advertising/Social media funds are to promote SOR-related projects including the new MOUD curriculum and emerging Toolkit for recovery residences via paid advertising to increase participation (e.g. Facebook, Google).
AATOD registration for one (1) staff member to attend the conference in Las Vegas, NV May 18-22, 2024.
I. Total Direct Charges:
FEDERAL REQUEST – TOTAL DIRECT CHARGES - $150,277
J. Indirect Cost Rate or Administration (See Footnote below):
Calculation (1)
Revised Total (2)
F&A Costs based on MTCD @ 44.40% Base: $150,277 $66,723
FEDERAL REQUEST $66,723
JUSTIFICATION: Indirect costs are calculated on Modified Total Direct Costs (MTDC) using F&A rates approved by U.S.
Department of Health and Human Services (DHHS). The most current rate for on-campus research is 44.4% from FY21 and forward and the rate agreement is dated May 24, 2023. Items excluded from F&A calculation include capital equipment, subcontracts over the first $25,000, tuition remission, participation support, rental/maintenance of off-campus space and patient care fees.
FOOTNOTE:
(1) Please specify whether utilizing indirect or administrative overhead.
(2) For administrative overhead, please provide a justification of costs included in administration.
(3) For indirect costs, please specify if using the de minimis rate or provide a copy of the approved indirect cost agreement.
The de minimis rate of 10 percent for non-federal entities is subject to Uniform Guidance, 20 CFR 200.414.
K. Total Project Costs:
FEDERAL REQUEST – TOTAL PROJECT COSTS –
(Sum of Total Direct Costs and Indirect (Or Admin) Costs)
$217,000
L. Budget Summary: (Should include future years, as applicable to the grant, and projected total):
Category Year 1 Year 2* Total Project Costs
Personnel $95,384 $82,229 $177,613
Fringe $30,528 $26,868 $57,396
Travel $2,623 $3,034 $5,657
Equipment $0 $0 $0
Supplies $0 $0 $0
Contractual $0 $0 $0
Other $22,317 $38,146 $60,463
Total Direct Charges $150,852 $150,277 $301,129
Indirect Charges or Administration $66,978 $66,723 $133,701
Total Project Costs $217,830 $217,000 $434,830
*For Requested Future Years
For the proposed programmatic activities listed above, indicate the total number of unduplicated individuals that will be served each grant year and over the entire project period.
Programmatic activities – providing treatment and recovery support services (if not applicable, indicate 0)
Number of Unduplicated Individuals to be Served with Grant Funds
Year 1 9/30/22 – 9/29/23
Year 2 9/30/23 – 9/29/24
TOTAL
Treatment Services 0 0 0
Recovery Support Services 0 0 0
GPRA Target** 0 0 0
**Of those individuals receiving treatment and recovery support services, indicate the total number of individuals who will complete the GPRA Client Outcome Measures. All GPRA intakes must be followed by an interview GPRA follow-up at a minimum 80% rate.
When a provider/agency is solely coordinating, navigating, and/or liaising into non-grant funded treatment and recovery support services, GPRA is not required.
Programmatic activities – providing prevention services (if not applicable, indicate 0)
Number of Unduplicated Individuals to be Served with Grant Funds
Year 1 9/30/22 – 9/29/23
Year 2 9/30/23 – 9/29/24
TOTAL
Prevention Services 0 0 0
| 2024-04-10T07:30:39-0700 | |
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