Case Document 2799-1 Filed 05/08/18 Page 1 of 9 EXHIBIT A EXHIBIT A Case Document 2799-1 Filed 05/08/18 Page 2 of 9 Contract Change Order/Amendment State ?Arizona Department of Corrections Contract No.: moon-041943 moo No. 130051DC 1545 West jeffergon Street Phoenix, AZ 85007 Amendment No; 15 Date: May 7, 2018 The Contract is hereby amended as follows: 1. ADC will extend the term of the Contract for a period of one year from July 1, 2018 to June 30, 2019. 2. Minimum Required Staf?ng Plan (MRSP) shall be 1,046.75 FTEs based on the attached staf?ng pattern for each complex/facility. 3. Staf?ng Paybacks/Offsets: Hours will be reported by position by facility. The Regional Office staf?ng will be reported as one "Facility". In the event that less than one hundred percent (100%) of the required staffing hours are worked in a given month for any position, per Facility, Corlzon shall credit ADC for such unfilled hours to the extent that such hours, per position, per facility, fall below the 100% threshold. Positions can be covered by staff based on the staf?ng replacement mix listed on attachment B. For example, if there are two (2) FTE RN's identified for a particular facility, then the calculation of the 103% threshold for the RN position at the facility will be based on the number of hours equal to two (2) FT Es for that month and the total number of ful?lled RN hours. Credit shall be at a rate equal to the average hourly wage for the position (hourly rate offset/payback) for the vacant hours. 4. Contract Sanction: There will be no cap on contract sanctions during this one year extension. Corizon shall remain subject to the per performance measure sanction for any failed performance measure that extends the monitoring period under the rules of the Parson 9. Ryan, et oi. Stipulation. Contract sanctions shall be incurred based upon the Graduated Sanctions Scale table below: Graduated Sanction Table Based on it of Measures Extending Stipulation ii Measures Sanction 1-9 5 2,500 per measure 10-19 5 5,000 per measure 20-29 5 7,500 per mea5ure 30-39 5 10,000 per measure 40-49 5 15,000 per measure 50+ 5 20,000 for measure Example: 40 failed measures would be calculated as follows: (9 measures $2,500) (10 measures $5,000) (10 measures at $7,500) (10 measures 10000) (1 measure 15,000) $22,500 $50,000 75,000 4- $100,000 $15,000 $262,500 for 40 failed measures. Available online at ProculgAZJtov Prepared by: Kristine Yaw, Deputy Chief Procurement Of?cer Date: May 7, 2018 Case Document 2799-1 Filed 05/08/18 Page 3 of 9 Contract Change Order/Amendment Contract No.: (ADC No. 130051DC Amendment No.: 15 Date: May 7,2018 5. Quick Pay: For services beginning July 1, 2018, Corizon shall invoice ADC for services that month utilizing Inmate Count of State Prisons reported on the ADC Daily Count Sheet of the June 15, 2018. The 15th of the month Inmate Count will be used as estimated ADP for the following month. Corizon shall invoice ADC no later than the 20th of the month, for the following month's payment. . Hepatitis C: The per diem includes $5.1 Million for Hepatitis pharmaceutical cost. Corizon shall reconcile and true up on a direct cost basis for the requisite pharmaceuticals. Corizon shall provide a detailed report containing date administered and cost of Hep-C pharmaceuticals for each inmate. Any material increase in this expenditure will require ADC written consent and Legislative approval for necessary funding. . Payment Structure: Pricing based on a modified Per inmate Per Day (PIPD). The base per diem with an adjusted rate for pepulation above or below the base population as described below rather than strict per diem pricing. Pricing is based on an inmate pepulation of 34,074 ?Base Population?. ?Base Per Diem? price is 515.164 PIPD with an adjusted per diem for ADP changes above and below 34,074 will be charged at $4.352 PIPD. Example 1: Average daily population above Base Population: ADP of 35,074 would be charged as (34,074 515.164) (1,000 at $4.352) $521,050.14 per day number of days in month (30) $5,631,504.08. Example 2: Average daily population below Base Population: ADP of 33,074 would be charged as (34,074 3: 515.164) - (1,000 54.352) $512,346.14, per day number of days in month (30) $15,370,384.08. 8. Contract Amendment #14 will expire on June 30, 2018. 9. Additional line items have been added in ProcureAZ to re?ect the new pricing. 10. A revised staf?ng plan (Attachment A), staf?ng replacement mix (Attachment B), and Fee Schedule (Attachment C) are attached hereto and incorporated herein. Intentionally left blank Prepared by: Kristine Yaw, Deputy Chief Procurement Of?cer Date: May 7, 2018 Available online at Procurm Case Document 2799-1 Filed 05/08/18 Page 4 of 9 Contract Change Order/Amendment State of Arizona Department of Corrections Contract No.: ADOCIJMISMJ No. 130051DC 1645 West jeffmon Street Phoenix, AZ 85007 Amendment No; 15 Date: May 7, 2018 ALL OTHER REQUIREMENTS, SPECIFICATIONS, TERMS AND CONDITIONS REMAIN UNCHANGED This Contract Amendment is not binding against the State of Arizona unless signed by an authorized representative of the Contractor and then accepted in writing by an authorized representative of the State. CONTRACTOR HEREBY ACKNOWLEDGES RECEIPT AND UNDERSTANDING OF THE ABOVE AMENDMENT THE ABOVE REFERENCED CONTRACT AMENDMENT SS HEREBYJXECUTED THIS (LATE BYWEEATE ed or Printe?Name Q?f?f? 11:11:50 Sthha d'Rep?tat'g LTM . 1'pr or Printed Name Title chief Procurement Officer emf/7 Date Elm-pared by: Kristine Yaw, Deputy CltiL-I'Pmcuwmcm Of?cer imam: May 7, 2m uniiuc .11 Pmm'ie?iuasm Available I Page 3 0H Case Document 2799-1 Filed 05/08/18 Page 5 of 9 15 FTE POSITIONS mulch! Practitioner Faculty Hullh Administrator Futility Hum! Administrator or ?mlnq much! of Human Aunt-m I PCT Wary Comm-tor Coordinator nan-w Auburn Records Clerk coordinator - ln?c?an Control new H??h Ilkll?ll PA) Hia?h GM Dmclor Associat- {cum} mulch {atheism l-lnl?lh RN Hnl?'l Tosh Therapist Hulk curl: of Page 1 of 2 Case Document 2799-1 Filed 05/08/18 Page 6 of 9 AMENDMENT 15 ATTACHMENT A FTE Posmous 3 5 '2 ?5 mm. m: 0.00 0.00 0:0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Bhutto! Duration 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 England Medical 03mm 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 'D'??wof Minn 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Raglonai Brianna 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Regions! Din-cm ca: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Mules! Comm 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Proud" 3min Rap 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8mm Dock Mam! 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 . Education Winner 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4.00 4.00 Dir-cw 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Lad UM Row-war 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Utilization Man an 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.00 2.00 Rik-910M010}! 0.00 1.00 1.00 1.00 1.00 0.00 0.00 1.00 0.00 1.00 1.00 100 Hcanhm 0.0mm hummer 1.00 1.00 1.00 1.00 1.00 1.00 0.00 1.00 1.00 1.00 0.00 9.00 Roman-l Dental Dir-nor 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 malarial Dimlor 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 VP Bah-vim: Health Service: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Ml!? Regional Item! Hum: Director 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Tum-am Coorulnnur 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 em Sch-dam 1.00 1.00 1.00 1.00 1.00 0.00 0.00 1.00 0.00 1.00 0.00 7.00 Imam Imam Control Hum 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 Buslntu MIMI 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 ulna-m I. Duchamnt Ilgr 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.00 1.00 011 Clark 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Tam-11cc! Tnlnar 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 mad-r 0.50 0.50 0.50 1.00 0.50 0.50 0.50 1.00 0.50 0.50 0.00 6.00 0mm? 0.00 0.00 0.00 0.00 0.00 1.00 0.00 0.00 0.00 0.00 0.00 1.00 IIH RN charge 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.00 TOTAL CONTRACT 37.10 130. 50 151.25 151.70 131.70 87.05 34.70 ?120 32.10 83.45 29.00 1046.75 Page 2 of 2 Case Document 2799-1 Filed 05/08/18 Page 7 of 9 AMENDMENT ?Idlwal m? Hull-Mutu- 5 I Assistant Fn?lly Hunk Autumn-Hurling mm: PCT 11 1: Land hum Gauthier 13 1mm 1! I-llf 1*an all? Hanna" ?mm-int!? Assistant 11 In Illodhl ?ow-d: ?umn?m Maul mu: Ellnl?l [tum - hllc?un Mal :u 12 Ilium! mm :3 :5 ?1de 1.: Wu Fll?I?f! Case Document 2799-1 Filed 05/08/18 Page 8 of 9 AHENDMENT 15 AWACHMENT GIN BE ms: FIE Pnsmous (SAME mum 1E 11' II 31 an ?all 31 1: IBM Mud-h Int-nun Hnu?h RH l-lu?h Ton}: ?aunt-[an 35 "I'll! I-Iu?h 3? VP DI Mll- FPO Imm?plrl?mu Elihu! mam Dlmtur malt-nil ?ll-elm Hl?llng Rwluml 61km Minder 13 Mom! Hindu! CHI mum; mama as Mr Santa ?ap I 3m But Fla-um ll [Him ?m Papluia Case Document 2799-1 Filed 05/08/18 Page 9 of 9 AMENDMENT 15 ATTACHMENT ms at FTE POSITIONS 49 Regional Clinical Pharmacy Director so Lead Outpatient UM Reviewer 51 Utilization Review RH 52 Release I Discharge Planner 53 Healthcare Delivery Facilitator 54 Regional Dental Director 55 Regional Director 56 VP Behavioral Health Services 57 Associate Regional Mental Health Director 58 Teiehealth Coordlnator 59 Chronic Care Scheduler 60 Regional Infection Control Nurse 61 Business Analyst - 62 Training 8: Development 63 UNI Clerk 64 Technical Trainer 65 Scheduler 66 26 Director 67 33 Hit RN charge Page 3 of 3