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HomeMy WebLinkAbout2009-052 DSS - UNC Hospitals Madicaid Program- . ~_> STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT BETWEEN THE UNIVERSITY OF NORTH CAROLINA HOSPITALS AND ORANGE COUNTY, NORTH CAROLINA Contract# 68-1001 LTNC Hospital THIS AGREEMENT, made and entered into this the 1st day of July, 2009 by and between ORANGE COUNTY (hereinafter referred to as the COUNTY) and THE UNIVERSITY OF NORTH CAROLINA HOSPITALS, (hereinafter referred to as UNCH) Orange County, North Carolina. WITNESSETH: WHEREAS, the parties have agreed with each other that the County will provide certain services for The University of North Carolina Hospitals in connection with the Orange County Department of Social Services (hereinafter referred to as OCDSS), Medicaid Program; and WHEREAS, the UNCH has agreed to pay certain compensation for said service and the parties desire to execute this contract to delineate their understanding of this agreement; NOW, THEREFORE, the parties hereby agree as follows: 1. Orange County agrees to make available to UNCH the services of one full time Income Maintenance Caseworker and one part-time supervisor providing up to 15 hours of supervision a week. 2. UNCH agrees to reimburse the County within 15 days of receipt of monthly billings for the county share of the salary, benefits, and the indirect costs to which the parties have agreed are involved in maintaining one Social Services Income Maintenance Caseworker at UNCH. UNCH also agrees to reimburse the county for the costs of a part- time supervisor. The county share of these positions is approximately 50 percent. Salary and benefits for the Income Maintenance Caseworker and the supervisor include: base salary according to the Orange County pay plan; FICA taxes; local government retirement; vacation, sick, petty, or other leave under approved county plan; paid holidays as observed by county; county paid insurance (health, dental, and life). UNCH will also pay half of the administrative overhead and indirect costs associated with these positions. This includes all other supportive services provided by OCDSS or Orange County. The total cost of this contract is $55,562. - 3. Other supportive services provided by OCDSS without additional charge to UNCH include continuing program training of the Income Maintenance Caseworker and consultation with other counties in the catchment area about applications for pre-and post-discharge patients. 4. Other supportive services provided by LTNCH without charge to OCDSS include: office space; parking space; office equipment; clerical support; and telephone service. 5. The Income Maintenance Caseworker shall receive all potential medical assistance applications originating at UNCH. Specifically, the Income Maintenance Caseworker shall perform intake and processing functions on MPW and MIC applications for Orange County and intake functions only for all other applications, consisting of the following: conducting interviews that initiate an application; obtaining signatures; obtaining documentation available at the time of interview; forwarding applications to the appropriate county for processing; meeting verification requirements, processing and data entry timeframes, and sending appropriate notices timely in all processing functions. 6. The Income Maintenance Caseworker shall be assisted by iJNCH staff in obtaining information and documentation required to complete the application process. 7. The Social Services Income Maintenance Caseworker shall work cooperatively with LTNCH staff and the staff of any Department of Social Services to make appropriate referrals of patients and family members., with problems not related to eligibility determination. 8. As an employee of the County, the Income Maintenance Caseworker shall be directly supervised by and accountable to OCDSS. Due to the nature of this agreement and the working relationship with LTNCH, it is necessary that close contact be kept with LTNCH administration and certain members of the hospital medical staff. In recognition of this factor, LJNCH will name a staff member to act as liaison between the OCDSS, the Income Maintenance Caseworker, the departments of L1NCH and other staff personnel. Assignment of work to the Income Maintenance Caseworker and coordination of sick, vacation, and other leave will be the joint responsibility of this LJNCH staff member and the OCDSS supervisor. 9. UNCH shall participate in the interviewing and selection process utilized by OCDSS for the hiring of the Income Maintenance Caseworker covered by this agreement, in accordance with County policy and procedures. 10. Both the County and UNCH agree and understand that if at any time UNCH determines that the Income Maintenance Caseworker's performance or professional interactions are inadequate or inappropriate, LJNCH may request that OCDSS initiate appropriate action to correct that employee's deficiencies, or to dismiss that employee if indicated. Any disciplinary action shall be pursued in compliance with the Orange County Personnel ordinance and the State Personnel Act and UNCH shall provide sufficient documentation to support any such action. 11. Both the County and LTNCH agree and understand the conditions outlined in the Business Associate Agreement. 12. This Agreement shall be effective from July 1, 2009 to June 30, 2010. 13. This Agreement shall be reviewed at least annually, prior to June 1st and may be terminated by either party upon 60 days written notice. 14. The Agreement contains the entire understanding of the parties and shall not be altered, amended or modified, except by an agreement in writing executed by the duly authorized officials of both parties. IN WITNESS WHEREOF, the parties hereto have caused this contract to be signed by its duly authorized officials. FOR AND ON BEHALF OF: FOR AND ON BEHALF OF: ORANGE COUNTY, NORTH CAROLINA THE UNIVERSITY OF NORTH ~~~ W~-~.t--~ ~_ nJ Chair, Orange County Board of Commissioners CAROLINA HOSPITALS Todd L. Peterson Executive Vice President and Chief Operations Officer DATE: O Attest: Clerk o e range County Board of Commissioners DATE: ~~a-~~Of This instrument has been preaudited in the manner required by the Local Government Budget and Fiscal Control Act. Ga mp s, range County Fin nc Offi er BUSINESS ASSOCIATE AGREEMENT This Agreement is made effective the 1St day of July, 2009, by and between the University of North Carolina Hospitals, hereinafter referred to as "Covered Entity", and Orange County, hereinafter referred to as "Business Associate", (individually, a "Party" and collectively, the "Parties"). This Agreement supersedes any previously executed Business Associate Agreement between the parties. WITNESSETH: WHEREAS, Sections 261 through 264 of the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, known as "the Administrative Simplification provisions," direct the Department of Health and Human Services to develop standards to protect the security, confidentiality and integrity of health information; and WHEREAS, pursuant to the Administrative Simplification provisions, the Secretary of Health and Human Services has issued regulations modifying 45 CFR Parts 160 and 164 (the "HIPAA Security and Privacy Rule"); and ~- WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business Associate will provide certain services to Covered Entity, and, pursuant to such arrangement, Business Associate may be considered a "business associate" of Covered Entity as defined in the HIPAA Security and Privacy Rule (the agreement evidencing such arrangement is described on Exhibit A attached hereto and made a part hereof, and is hereby referred to as the "Arrangement Agreement"); and WHEREAS, Business Associate may have access to Protected Health Information (as defined below) in fulfilling its responsibilities under such arrangement; THEREFORE, in consideration of the Parties' continuing obligations under the Arrangement Agreement, compliance with the HIPAA Security and Privacy Rule, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree to the provisions of this Agreement in order to address the requirements of the HIPAA Security and Privacy Rule and to protect the interests of both Parties. DEFINITIONS Except as otherwise defined herein, any and all capitalized terms in this Section shall have the definitions set forth in the HIPAA Security and Privacy Rule. In the event of an inconsistency between the provisions of this Agreement and mandatory provisions of the HIPAA Security and Privacy Rule, as amended, the HIPAA Security and Privacy Rule shall control. Where provisions of this Agreement are different than those mandated in the HIPAA Security and Privacy Rule, but are nonetheless permitted by the HIPAA Security and Privacy Rule, the provisions of this Agreement shall control. The term "Protected Health Information" means individually identifiable health information including, without limitation, all information, data, documentation, and materials, including without limitation, demographic, medical and financial information, that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual. "Protected Health Information" includes without limitation "Electronic Protected Health Information" as defined below. The term "Electronic Protected Health Information" means Protected Health Information which is transmitted by Electronic Media (as defined in the HIPAA Security and Privacy Rule) or maintained in Electronic Media. Business Associate acknowledges and agrees,that all Protected Health Information that is created or received by Covered Entity and disclosed or made available in any form, including paper record, oral communication, audio recording, and electronic display by Covered Entity or its operating units to Business Associate or is created or received by Business Associate on Covered Entity's behalf shall be subject to this Agreement. CONFIDENTIALITY AND SECURITY REQUIREMENTS (a) Business Associate agrees: (i) to use or disclose any Protected Health Information solely: (1) for meeting its obligations as set forth in any agreements between the Parties evidencing their business relationship, or (2) as required by applicable law, rule or regulation, or by accrediting or credentialing organization to whom Covered Entity is required to disclose such information or as otherwise permitted under this Agreement, the Arrangement Agreement (if consistent with this Agreement and the HIPAA Security and Privacy Rule), or the HIPAA Security and Privacy Rule, and (3) as would be permitted by the HIPAA Security and Privacy Rule if such use or disclosure were made by Covered Entity; (ii) to account for certain disclosures of Protected Health Information as required by Section 164.528 of the HIPAA Security and Privacy Rule. A copy of Covered Entity's policy regarding accounting of disclosures is available at http://www.med.unc.edu/security/hipaa/documents/d13.pdf ; (iii) to provide appropriate HIPAA training to its personnel within thirty days of the date of this agreement as follows: (1) general HIPAA training for all of Business Associate's personnel, and (2) Business Associate will compare the UNC HCS policies and procedures outlined in the training materials to the general HIPAA training provided by the Business Associate to its personnel, and, if there are material differences, will train all of its personnel who service the UNC HCS account on those different policies/procedures. (Business Associate may obtain a copy of the UNC HCS training materials at http://www.unchealthcare.orq/site/hipaa Internet); (iv) at termination of this Agreement, the Arrangement Agreement (or any similar documentation of the business relationship of the Parties), or upon request of Covered Entity, whichever occurs first, if feasible, Business Associate will return or destroy all Protected Health Information received from or created or received by Business Associate on behalf of Covered Entity that Business Associate still maintains in any form and retain no copies of such information, or if such return or destruction is not feasible, Business Associate will extend the protections of this Agreement to the information and limit further uses and disclosures to those purposes that make the return or destruction of the information not feasible; and (v) to ensure that its agents, including a subcontractor, to whom it provides Protected Health Information received from or created by Business Associate on behalf of Covered Entity, agrees to the same restrictions and conditions that apply to Business Associate with respect to such information, and agrees to implement reasonable and appropriate safeguards to protect any of such information which is Electronic Protected Health Information. In addition, Business Associate agrees to take reasonable steps to ensure that its employees' actions or omissions do not cause Business Associate to breach the terms of this Agreement. (b) Notwithstanding the prohibitions set forth in this Agreement, Business Associate may use and disclose Protected Health Information as follows: (i) if necessary, for the proper management and administration of Business Associate or to carry out the legal responsibilities of Business Associate, provided that as to any such disclosure, the following requirements are met: (A) the disclosure is required by law; or (B) Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will be held confidentially and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached; (ii) for data aggregation services, if to be provided by Business Associate for the health care operations of Covered Entity pursuant to any agreements between the Parties evidencing their business relationship. For purposes of this Agreement, data aggregation services means the combining of Protected Health Information by Business Associate with the protected health information received by Business Associate in its capacity as a business associate of another covered entity, to permit data analyses that relate to the health care operations of the respective covered entities. (c) Business Associate will implement appropriate safeguards to prevent use or disclosure of Protected Health Information other than as permitted in this Agreement. Business Associate will implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of any Electronic Protected Health Information that it creates, receives, maintains, or transmits on behalf of Covered Entity as required by the HIPAA Security and Privacy Rule. (d) The Secretary of Health and Human Services shall have the right to audit Business Associate's records and practices related to use and disclosure of Protected Health Information to ensure Covered Entity's compliance with the terms of the HIPAA Security and Privacy Rule. (e) Business Associate shall report to Covered Entity (see Exhibit B) any use or disclosure of Protected Health Information which is not in compliance with the terms of this Agreement, as well as any Security Incident, of which it becomes aware within forty-eight (48) hours of such discovery. For purposes of this Agreement, "Security Incident" means the attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with system operations in an information system. In addition, Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of Protected Health Information by Business Associate in violation of the requirements of this Agreement, as well as to provide complete cooperation to Covered Entity should Covered Entity elect to review or investigate such noncompliance or Security Incident. Business Associate shall indemnify and hold harmless Covered Entity for any injury or damages arising from any noncompliance or Security Incident attributable to the negligence of Business Associate, including the failure to execute the terms of this Agreement. III. AVAILABILITY OF PHI Business Associate agrees to make available Protected Health Information to the extent and in the manner required by Section 164.524 of the HIPAA Security and Privacy Rule. Business Associate agrees to make Protected Health Information available for amendment and incorporate any amendments to Protected Health Information in accordance with the requirements of Section 164.526 of the HIPAA Security and Privacy Rule. In addition, Business Associate agrees to make Protected Health Information available for purposes of accounting of disclosures, as required by Section 164.528 of the HIPAA Security and Privacy Rule (see Section II(a)(ii) above). IV. TERMINATION Notwithstanding anything in this Agreement to the contrary, Covered Entity shall have the right to terminate this Agreement and the Arrangement Agreement immediately if Covered Entity determines that Business Associate has violated any material term of this Agreement. If Covered Entity reasonably believes that Business Associate will violate a material term of this Agreement and, where practicable, Covered Entity gives written notice to Business Associate of such belief within a reasonable time after forming such belief, and Business Associate fails to provide adequate written assurances to Covered Entity that it will not breach the cited term of this Agreement within a reasonable period of time given the specific circumstances, but in any event, before the threatened breach is to occur, then Covered Entity shall have the right to terminate this Agreement and the Arrangement Agreement immediately. V. MISCELLANEOUS Except as expressly stated herein or the HIPAA Security and Privacy Rule, the parties to this Agreement do not intend to create any rights iri~ any third parties. The obligations of Business Associate under this Agreement shall survive the expiration, termination, or cancellation of this Agreement, the Arrangement Agreement and/or the business relationship of the parties, and shall continue to bind Business Associate, its agents, employees, contractors, successors, and assigns as set forth herein. This Agreement may be amended or modified only in a writing signed by the Parties. No Party may assign its respective rights and obligations under this Agreement without the prior written consent of the other Party. None of the provisions of this Agreement are intended to create, nor will they be deemed to create any relationship between the Parties other than that of independent parties contracting with each other solely for the purposes of effecting the provisions of this Agreement and any other agreements between the Parties evidencing their business relationship. This Agreement will be governed by the laws of the State of North Carolina. No change, waiver or discharge of any liability or obligation hereunder on any one or more occasions shall be deemed a waiver of performance of any continuing or other obligation, or shall prohibit enforcement of any obligation, on any other occasion. The parties agree that, in the event that any documentation of the arrangement pursuant to which Business Associate provides services to Covered Entity contains provisions relating to the use or disclosure of Protected Health Information which are more restrictive than the provisions of this Agreement, the provisions of the more restrictive documentation will control. The provisions of this Agreement are intended to establish the minimum requirements regarding Business Associate's use and disclosure of Protected Health Information. In the event that any provision of this Agreement is held by a court of competent jurisdiction to be invalid or unenforceable, the remainder of the provisions of this Agreement will remain in full force and effect. In addition, in the event a party believes in good faith that any provision of this Agreement fails to comply with the then-current requirements of the HIPAA Security and Privacy Rule, such party shall notify the other party in writing, For a period of up to thirty days, the parties shall address in good faith such concern and amend the terms of this Agreement, if necessary to bring it into compliance. If, after such thirty-day period, the Agreement fails to comply with the HIPAA Security and Privacy Rule, then either party has the right to terminate upon written notice to the other party. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written above. COVERED ENTITY: By: Title: CUTI E VP & inn BUSINESS ASSOCIATE: By: Title: EXHIBIT A ARRANGEMENT AGREEMENT EXHIBIT B CONTACT INFORMATION To report to Covered Entity any use or disclosure of Protected Health Information which is not in compliance with the terms of this Agreement which might be considered a privacy breach, Business Associate should contact the Privacy Officer at the applicable entity; to report to Covered Entity any Security Incident (as defined in the Agreement), Business Associate should contact the Security Officer at the applicable entity: The University of North Carolina at Chapel Hill The University of North Carolina Hospitals The University of North Carolina Physicians & Associates Rex Healthcare, Inc. (including Rex Hospital, Inc.) If Business Associate is uncertain about the proper entity to contact, it should call the University of North Carolina Health Care System Hotline number: (919) 843-2233.