HomeMy WebLinkAbout2009-031 Health - Chapel Hill Training & Outreach Inc for Family Service Coordination & Business Assoc Agreement~,~~ ~ " 0 2''-LL0
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Agreement Between Orange County Head Start of the Chapel Hill Training
Outreach Project, Inc.
And
Orange County Health Department
(This Agreement has been amended as of August 28, 2008 for programmatic
changes only. The financial agreement remains in force as originally signed)
I. Purpose of this collaboration:
1. To provide family service coordination services to families eligible for and
enrolled in Orange County Head Start and Orange County Health
Department's Child Service Coordination Program.
2. To avoid duplication of effort, or conflict with, preexisting family plans by
taking into account and building upon, as appropriate, information
obtained from the family and community agencies involved.
3. To coordinate the resources, skills, and expertise of Orange County Head
Start (OCRs) and Orange County Health Department (OCHD) to provide
high quality services for families and children that meet each agency's
goals.
II. Brief Description of the Collaboration:
This collaboration for one social worker position presents parents with one,
unified program case coordinator who will provide regular contacts to the
family in order to identify and follow-up on child and family needs. The
Family Service Coordinator will support the development of family self-
sufficiency and promote skill development in the areas of problem solving,
decision making and accessing needed health and human services. To this
end, the Family Service Coordinator is responsible for implementation and
follow-through of social services, parent involvement, and health needs of
each assigned OCHS child and family according to the OCHS Family and
Community Partnership Plan, the federal Head Start Performance Standards,
and Orange County Health Department Child Service Coordination
requirements.
III. Parties involved and key collaboration contact person(s) in each
program:
This collaboration is being established between two distinct programs. The
collaboration will be managed and problem solved at the administrative level
by Orange County Head Start Director, Angela Wilcox, and OCHD Director of
Personal Health Services, Wayne Sherman.
Key support staff will include:
OCHD: Kathleen Goodhand, MSW, Family Home Visiting Services
Supervisor
Beckie Hermann, RN, Family Home Visiting Services
Coordinator
Sue Rankin, RN, Communicable Disease Coordinator
Patty Rhodes, RNBC, Child Care Health Consultant
Renee Kemske, MPH, RD, LDN Registered
Dietitian/Licensed Nutritionist
OCHS: Gwen Vareene-Pierce, Family Services Manager
Ennis Baker, Early Childhood Manager and Mental Health
Specialist
Martha Monroe, Health and Nutrition Manager
Kim Bracey, Special Services Manager
IV. Orange County Head Start Responsibilities:
The Orange County Head Start (OCRs) Family Services Manager is
responsible for daily supervision and professional growth supervision,
including participating in annual performance reviews of the OCHS-OCHD
Family Service Coordinator, to ensure that the job duties and case
management functions described in the OCHS Family Service Worker job
description and Attachment A are carried out. The OCHS Family Services
Manager will ensure compliance with all Head Start Performance Standards
for Family and Community Partnerships and is responsible for tracking and
monitoring compliance. In addition, the OCHS Family Services Manager will
be assisted by the Health and Nutrition Manager to monitor compliance with
Performance Standards for Health; and be assisted by the Early Childhood
and Mental Health Manager to monitor compliance with Performance
Standards for Early Childhood Development and Mental Health; and be
assisted by the Special Services Manager to monitor compliance with
Performance Standards for Disabilities as they apply to the role of OCHS -
OCHD Family Service Coordinator.
V. Orange County Health Department Responsibilities:
The OCHD Family Home Visiting Services Coordinator is responsible for
assuring that CSC services are delivered to families appropriately per
protocol and that billing is accurate. The Family Home Visiting Services
Coordinator will review and approve time sheets, leave requests,
reimbursement requests and time studies before forwarding them to Central
Administrative Service's staff for processing through Orange County Payroll.
The Family Home Visiting Services Coordinator will be responsible for
leading the WPPR evaluation process (annual performance review) with
substantial input from OCHS staff, and ascertaining that the document is
completed per Orange County Health Department policies and procedures.
The Family Home Visiting Services Coordinator will ensure that the social
worker attends mandated OCHD Annual Training (Bloodborne Pathogens,
HIPAA, confidentiality, etc.), maintains mandated CPR certification, and is
available for disaster response duties as assigned by the Health Director.
Additionally, OCHD will provide medical consultation and information as
requested by OCHS related to communicable diseases, tuberculosis, and
care of chronic illnesses in daycare settings according to acceptable medical
and public health standards. Upon request, OCHD will provide nutrition
counseling services by a Registered Dietitian (RD) to those children referred
for high-risk conditions. A registered nurse will participate quarterly on the
OCHS Health Advisory Board.
VI. Program Coordination Expectations:
1. All staff are expected to support both the OCHS and OCHD goals and
objectives. New staff will be given orientation to the model and
techniques for coordinating the two programs including the role of all staff
and the expectations of this service delivery model. The model assures
that:
• Reporting systems are in place for both programs to effectively
monitor delivery of expected services to families jointly enrolled as
outlined in Attachment A.
• A system of regular checks is in place that includes items such as
records review; observation of staff interaction with families;
regular staff meetings; case reviews and mini workshops.
• A system exists to avoid duplication by assuring that all
applications to OCHS are checked against the OCHD CSC log
initially and at enrollment.
• Joint Family Service Coordinator has a caseload that ensures
quality services to families as outlined in Attachment A.
• Joint Family Service Coordinator is an integral part of the OCHS
program and the OCHD program.
• Joint Family Service Coordinator is included in the programmatic
planning and decision-making process as appropriate.
• Joint Family Service Coordinator can confidently explain to
parents, staff and the community what the OCHS -OCHD policies
are concerning such areas as confidentiality; selection and
enrollment; reporting child abuse/neglect; screening and referrals
for enrolled children; family partnership agreements; and parent
involvement opportunities.
2. All staff are expected to follow an agreed upon problem resolution
process, which includes open, respectful and honest discussion at regular
staff meetings about problems and issues that arise. The first step for
resolving Family Services area problems is by discussion with the OCHS
Family Services Manager. OCHS -OCHD Family Service Coordinator
should follow the "OCRs Procedures for Communications" Policy and
work effectively as a team member with fellow OCHS staff and other
community agencies. Consultation with the OCHD FHV Service
Coordinator is warranted for ongoing, unresolved problems that impact
work performance.
3. Designated staff from both agencies will participate on the interview team
for hiring new OCHS-OCHD staff. Orange County Head Start Policy
Council must concur with recommendations for hiring. The OGHS Family
Service Coordinator job description, encompassing both OCHS and
Health Department position qualifications, will be used when making
hiring decisions. Orange County personnel employment requirements
and procedures must be met prior to setting the salary and offering the
position. The Orange County Health Department's policies/schedules
regarding benefits, compensatory time, holidays, workweek, workday,
evaluation, and raises will be followed.
VII. Evaluation and Program Improvement:
1. At least quarterly, the OCHS Family Services Manager and the OCHD
Family Home Visiting Services Coordinator will formally meet to review
program progress and identify problem areas. A brief written assessment
will be produced including a written plan to address problem areas.
2. An annual self-assessment of the service collaboration will be conducted.
The OCHS Director or her designee, with assistance from other OCHS
and OCHD Staff will solicit feedback from staff and families involved in
the collaboration to assess the success of the model, management
needs/problems, communication needs/problems, etc. The goal is to
create and implement awin-win partnership for both programs that has a
positive impact on children and families. Concerns regarding the
implementation of this agreement will be discussed by the Directors of the
Agencies and their designated staff. Failure to meet the expectations of
this agreement by either party may result in the decision to discontinue
the agreement.
VIII. Payment for Services/Shared Costs:
Orange County Head Start agrees to pay to Orange County Health
Department the actual expenses related to salary and fringe benefits of one
Orange County Head Start Family Service Coordinator up to a maximum of
$4875 per month through December 31, 2008 as long as federal Head Start
funds continue to be available. Any amount in excess of this must be agreed
to by both parties. OCHS agrees to provide office space, supplies, computer,
phone, mileage reimbursement and training resources.
Orange County Health Department agrees to provide the number of Medicaid
billable units of service submitted by the OCHS-OCHD Family Service
Coordinator in this agreement to the OCHS Program annually. Revenue
earned is used to partially offset OCHD Administrative and Supervision costs.
IX. Renewal/Termination of agreement by either party:
Renewal of this agreement shall be on an annual basis, subject to program
continuation based on a review of program outcomes and subject to available
funding. Renewal shall commence upon written notice executed by both
parties. This agreement shall run from January 1, 2008 through December
31, 2008 as long as Federal Head Start funds continue to be available. This
agreement or its renewals may be terminated at any time without penalty by
either party provided that written notice of such termination is furnished to the
other party at least ninety (90) days prior to termination. In the event of such
termination, any payment due shall be prorated to the date of termination.
X. Amendments to the collaboration agreement:
No provision of this agreement shall be construed or interpreted as creating a
pledge of the faith and credit of Orange County Head Start or Orange County
Health Department within the meaning of any constitutional debt limitation.
No provision of this agreement shall be construed or interpreted as creating a
delegation of governmental powers nor as a donation by or lending of the
credit of OCHS or OCHD within the meaning of the Constitution of the State
of North Carolina. This agreement shall not and does not directly or indirectly
or contingently obligate OCHS or OCHD to make any payments beyond
those appropriate in the sole discretion of OCHS or OCHD for any fiscal year
in which this agreement shall be in effect. No deficiency judgment may be
rendered against OCHS or OCHD in any action for breach of a contractual
obligation under this agreement and the taxing power of OCHS or OCHD is
not and may not be pledged directly or indirectly or contingently to secure any
moneys due under this agreement.
This 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 have hereunto signed this agreement in
their official capacities of the day and year listed below.
FOR AND ON BEHALF OF ORANGE
COUNTY HEALTH DEPARTMENT
Rosemary L ummers, Health Director
Date: ®~S / B `~
FOR AND ON BEHALF OF
THE CHAPEL HILL TRAINING
OUTR CH PROJ CT, INC.
Mic el Mathers, Ex cutive Director
Date: ~ ~~/~ ~~
FOR AND ON BEHALF OF ORANGE COUNTY
ORANGE COUNTY FINANCE DIRECTOR:
This instrument has been preaudited in the Manner required by the Local
Government Budget and Fiscal Control Act.
Ga re
Orange y Finance Director
ATTACHMENT A
Standards and Conditions
Personnel:
Per contractual agreement, one (1) Orange County Health Department Social Worker II Class
Family Service Coordinator will carry out mutually agreed upon job duties for the Orange County
Head Start program.
Services to be provided to OCHS families/children:
• Enrollment of OCHS assigned families in accordance with OCHS Family and Community
Partnership Plan.
• Assessment of family needs including, but not limited to, child care, health, special needs
of child, knowledge of infant and toddler development, home environment, parenting
skills, parental stress, education and job training.
• Partnership building with OCHS enrolled families to establish mutual trust and to identify
family goals, strengths, and necessary services and other supports. Family Partnership
Agreements are established with families as early after enrollment as possible and
documented in the OCHS file within 30 days.
• Obtain pre-existing family plans by coordinating with the families and the other
agencies/personnel who may also be working with OCHS families to support the
accomplishments of goals and to avoid duplication of services.
• Within 45 days of enrollment, obtain up-to-date immunization records, health status
(medical home) information and complete a nutrition assessment.
• Within 45 days of enrollment of each child on caseload, in conjunction with the
Health/Nutrition Manager, Disabilities Coordinator and the Early Childhood/Mental Health
Manager, provide for an appropriate developmental screening to identify concerns
regarding child's development, sensory, behavioral, motor, language, social, cognitive,
perceptual and emotional skills.
• Work collaboratively with OCHS parents to identify and continually access, either directly
or through referrals, services and resources that are responsive to each family's interests
and goals. This includes: emergency or crisis assistance in such areas as food, housing,
clothing and transportation; education and other appropriate interventions; opportunities
for parents to participate in counseling or receive information on mental health issues that
place families at risk, such as substance abuse, child abuse and neglect and domestic
violence; and opportunities for continuing education and employment training.
• Involve parents in their child's education option at OCHS (Central, Efland, New Hope and
Pathways Elementary) by assisting parents to establish a positive relationship with their
child's teacher and modeling how to share knowledge about their child so that child care
staff can individualize the program to support each child's individual pattern of
development and learning.
• Coordinate parent participation in the program, including scheduling and attending
regular OCHS parent meetings, surveying family interests, recruiting for OCHS Policy
Council, and providing parent trainings required by the Performance Standards and on
other topics that parents request.
• Facilitate families' transition from Pre-Kindergarten per OCHS Transition Policy and
Procedures.
• Comply with HIPAA privacy and security guidelines of 'protected health information' as
outlined by Orange County Health Department.
• OCHD RD nutrition counseling guidelines: The Family Service Coordinator will
coordinate scheduling, referral from the practitioner, and transportation for RD
services. The RD may provide off-site nutrition appointments as staffing allows and will
be decided on a case-by-case basis with the Family Service Coordinator. Medicaid
covers Medical Nutrition Therapy with an RD for children up to age 20 years of age with
high-risk conditions. For non-Medicaid recipients, fees are based on a sliding scale
based on income. The RD will provide direct feedback for referred children to the Family
Service Coordinator.
Conditions for services to OCHS families/children:
• The OCHS -OCHD Family Service Coordinator will case manage and coordinate all
services to an average caseload of 35 families, which will include a maximum average of
12 families who are also part of the OCHD Family Service Coordination program.
• OCHD will assure that a process is in place such that, within 45 days of a child's
enrollment, OCHS will be able to obtain adequate information on the jointly managed,
"matched", OCHS families to document compliance with OCHS regulations for: Family
Partnership Agreements, Health Status (medical home), up-to-date immunizations,
nutrition assessments, and developmental screening.
• OCHS Family Services Manager will supervise day to day activities of the Family
Service Coordinator including:
providing regular and consistent opportunities for reflective supervision
processing leave requests (i.e. vacation, personal) and acting as
contact person for work illness and emergency requests
processing workshop and travel requests,
overseeing organization of daily tasks and directing daily activities
assisting staff to trouble-shoot emergency needs of families,
assisting with parent meetings as needed,
evaluating staff performance related to job duties and procuring training
to enable staff to carry out their Head Start role
ascertaining staff safety in the field by being available for "sign out" at
the end of each workday
consulting with OCHD's Family Home Visiting Coordinator as needed
regarding employee job performance, CSC responsibilities, and
potential Child Protective Services referrals
• OCHS Family Services Manager and the OCHD Family Home Visiting Services
Coordinator will provide joint support and advocacy to the Family Service Coordinator
by:
receiving and reviewing written caseloads on a monthly basis
monitoring case load size to ensure quality services to families
-providing at a minimum quarterly and as needed joint reflective supervision (a
joint meeting with supervisors and staff member)
providing resource and referral information when needed
providing ongoing observations and feedback on delivery of services
related to the agency's program requirements and best practices
(i.e. at least annual home visit observations, periodic chart reviews,
and parent satisfaction surveys)
completing Work Planning and Performance Reviews at least annually
according to policies and procedures of OCHD
keeping staff informed of agency-specific administrative protocols and
updates
disseminating information in a timely manner (federal, state & local)
representing staff issues to administration
advocating for career growth
Compensation:
Compensation rate for the position will be at a level commensurate with employee's education,
training and experience in keeping with both agencies' wage and comparability schedules.
~~9f 1-~-d ~ yf'
Family Service Coordination Agreement
Calendar Year 2009
Page 1 of 9
AGREEMENT BETWEEN
ORANGE COUNTY HEALTH DEPARTMENT AND
CHAPEL HILL TRAINING AND OUTREACH, INC.
FOR
FAMILY SERVICE COORDINATION SERVICES
I. Purpose of this collaboration:
1. To provide family service coordination services to families eligible for and
enrolled in Orange County Head Start and Orange County Health
Department's Child Service Coordination Program.
2. To avoid duplication of effort, or conflict with, preexisting family plans by
taking into account and building upon, as appropriate, information
obtained from the family and community agencies involved.
3. To coordinate the resources, skills, and expertise of Orange County Head
Start (OCRs) and Orange County Health Department (OCHD) to provide
high quality services for families and children that meet each agency's
goals.
II. Brief Description of the Collaboration:
This collaboration for one social worker position presents parents with one,
unified program case coordinator who will provide regular contacts to the
family in order to identify and follow-up on child and family needs. The Family
Service Coordinator will support the development of family self-sufficiency
and promote skill development in the areas of problem solving, decision
making and accessing needed health and human services. To this end, the
Family Service Coordinator is responsible for implementation and follow-
through of social services, parent involvement, and health needs of each
assigned OCHS child and family according to the OCHS Family and
Community Partnership Plan, the federal Head Start Performance Standards,
and Orange County Health Department Child Service Coordination
requirements.
III. Parties involved and key collaboration contact person(s) in each
program:
This collaboration is being established between two distinct programs. The
collaboration will be managed and problem solved at the administrative level
by Orange County Head Start Director, Angela Wilcox, and OCHD Director of
Personal Health Services, Wayne Sherman.
Key support staff will include:
OCHD: Kathleen Goodhand, MSW, Family Home Visiting Services
Supervisor
S:\Managers Working Files\Contracts\Personal Health- Head Start\CY 09 Contract with Head Start\OCHD-OCRs Contract 1-1-09 - 12-31-
09.doc
Family Service Coordination Agreement
Calendar Year 2009
Page 2 of 9
Beckie Hermann, RN, Family Home Visiting Services
Coordinator
Sue Rankin, RN, Communicable Disease Coordinator
Patty Rhodes, RNBC, Child Care Health Consultant
Renee Kemske, MPH, RD, LDN Registered
Dietitian/Licensed Nutritionist
OCHS: Gwen Vareene-Pierce, Family Services Manager
Ennis Baker, Early Childhood Manager and Mental Health
Specialist
Martha Monroe, Health and Nutrition Manager
Jennifer Miller, Child Development Specialist
IV. Orange County Head Start Responsibilities:
The Orange County Head Start (OCHS) Family Services Manager is
responsible for daily supervision and professional growth supervision,
including participating in annual performance reviews of the OCHS-OCHD
Family Service Coordinator, to ensure that the job duties and case
management functions described in the OCHS Family Service Worker job
description and Attachment A are carried out. The OCHS Family Services
Manager will ensure compliance with all Head Start Performance Standards
for Family and Community Partnerships and is responsible for tracking and
monitoring compliance. In addition, the OCHS Family Services Manager will
be assisted by the Health and Nutrition Manager to monitor compliance with
Performance Standards for Health; and be assisted by the Early Childhood
and Mental Health Manager to monitor compliance with Performance
Standards for Early Childhood Development and Mental Health; and be
assisted by the Child Development Specialist to monitor compliance with
Performance Standards for Disabilities as they apply to the role of OCHS -
OCHD Family Service Coordinator.
V. Orange County Health Department Responsibilities:
The OCHD Family Home Visiting Services Coordinator is responsible for
assuring that CSC services are delivered to families appropriately per
protocol and that billing is accurate. The Family Home Visiting Services
Coordinator will review and approve time sheets, leave requests,
reimbursement requests and time studies before forwarding them to Central
Administrative Service's staff for processing through Orange County Payroll.
The Family Home Visiting Services Coordinator will be responsible for leading
the WPPR evaluation process (annual performance review) with substantial
input from OCHS staff, and ascertaining that the document is completed per
Orange County Health Department policies and procedures. The Family
Home Visiting Services Coordinator will ensure that the social worker attends
mandated OCHD Annual Training (Bloodborne Pathogens, HIPAA,
S:\Managers Working Files\Contracts\Personal Health- Head Start\CY 09 Contract with Head Start\OCHD-OCHS Contract 1-1-09 - 12-31-
09.doc
Family Service Coordination Agreement
' - Calendar Year 2009
Page 3 of 9
confidentiality, etc.), maintains mandated CPR certification, and is available
for disaster response duties as assigned by the Health Director.
Additionally, OCHD will provide medical consultation and information as
requested by OCHS related to communicable diseases, tuberculosis, and
care of chronic illnesses in daycare settings according to acceptable medical
and public health standards. Upon request, OCHD will provide nutrition
counseling services by a Registered Dietitian (RD) to those children referred
for high-risk conditions. A registered nurse will participate quarterly on the
OCHS Health Advisory Board.
VI. Program Coordination Expectations:
All staff are expected to support both the OCHS and OCHD goals and
objectives. New staff will be given orientation to the model and techniques
for coordinating the'two programs including the role of all staff and the
expectations of this service delivery model. The model assures that:
• Reporting systems are in place for both programs to effectively
monitor delivery of expected services to families jointly enrolled as
outlined in Attachment A.
• A system of regular checks is in place that includes items such as
records review; observation of staff interaction with families; regular
staff meetings; case reviews and mini workshops.
• A system exists to avoid duplication by assuring that all applications
to OCHS are checked against the OCHD CSC log initially and at
enrollment.
• Joint Family Service Coordinator has a caseload that ensures
quality services to families as outlined in Attachment A.
• Joint Family Service Coordinator is an integral part of the OCHS
program and the OCHD program.
• Joint Family Service Coordinator is included in the programmatic
planning and decision-making process as appropriate.
• Joint Family Service Coordinator can confidently explain to parents,
staff and the community what the OCHS -OCHD policies are
concerning such areas as confidentiality; selection and enrollment;
reporting child abuse/neglect; screening and referrals for enrolled
children; family partnership agreements; and parent involvement
opportunities.
2. All staff are expected to follow an agreed upon problem resolution
process, which includes open, respectful and honest discussion at regular
staff meetings about problems and issues that arise. The first step for
resolving Family Services area problems is by discussion with the OCHS
Family Services Manager. OCHS -OCHD Family Service Coordinator
should follow the "OCRs Procedures for Communications" Policy and
work effectively as a team member with fellow OCHS staff and other
community agencies. Consultation with the OCHD FHV Service
S:\Managers Working Files\Contracts\Personal Health- Head Start\CY 09 Contract with Head Start\OCHD-OCRs Contract 1-1-09 - 12-31-
09.doc
Family Service Coordination Agreement
Calendar Year 2009
Page 4 of 9
Coordinator is warranted for ongoing, unresolved problems that impact
work performance.
3. Designated staff from both agencies will participate on the interview team
for hiring new OCHS-OCHD staff. Orange County Head Start Policy
Council must concur with recommendations for hiring. The OCHS Family
Service Coordinator job description, encompassing both OCHS and
Health Department position qualifications, will be used when making hiring
decisions. Orange County personnel employment requirements and
procedures must be met prior to setting the salary and offering the
position. The Orange County Health Department's policies/schedules
regarding benefits, compensatory time, holidays, workweek, workday,
evaluation, and raises will be followed.
VII. Evaluation and Program Improvement:
1. At least quarterly, the OCHS Family Services Manager and the OCHD
Family Home Visiting Services Coordinator will formally meet to review
program progress and identify problem areas. A brief written assessment
will be produced including a written plan to address problem areas.
2. An annual self-assessment of the service collaboration will be conducted.
The OCHS Director or her designee, with assistance from other OCHS
and OCHD Staff will solicit feedback from staff and families involved in the
collaboration to assess the success of the model, management
needs/problems, communication needs/problems, etc. The goal is to
create and implement awin-win partnership for both programs that has a
positive impact on children and families. Concerns regarding the
implementation of this agreement will be discussed by the Directors of the
Agencies and their designated staff. Failure to meet the expectations of
this agreement by either party may result in the decision to discontinue the
agreement.
VIII. Payment for Services/Shared Costs:
Orange County Head Start agrees to pay to Orange County Health
Department the actual expenses related to salary and fringe benefits of one
Orange County Head Start Family Service Coordinator up to a maximum of
$5010 per month through December 31, 2009 as long as federal Head Start
funds continue to be available. Any amount in excess of this must be agreed
to by both parties. OCHS agrees to provide office space, supplies, computer,
phone, mileage reimbursement and training resources.
Orange County Health Department agrees to provide the number of Medicaid
billable units of service submitted by the OCHS-OCHD Family Service
Coordinator in this agreement to the OCHS Program annually. Revenue
earned is used to partially offset OCHD Administrative and Supervision costs.
S:\Managers Working Files\Contracts\Personal Health- Head Start\CY 09 Contract with Head Start\OCHD-OCHS Contract 1-1-09 - 12-31-
09.doc
Family Service Coordination Agreement
Calendar Year 2009
Page 5 of 9
IX. RenewaUTermination of agreement by either party:
Renewal of this agreement shall be on an annual basis, subject to program
continuation based on a review of program outcomes and subject to available
funding. Renewal shall commence upon written notice executed by both
parties. This agreement shall run from January 1, 2009 through December
31, 2009 as long as Federal Head Start funds continue to be available. This
agreement or its renewals may be terminated at any time without penalty by
either party provided that written notice of such termination is furnished to the
other party at least ninety (90) days prior to termination. In the event of such
termination, any payment due shall be prorated to the date of termination:
X. Amendments to the collaboration agreement:
No provision of this agreement shall be construed or interpreted as creating a
pledge of the faith and credit of Orange County Head Start or Orange County
Health Department within the meaning of any constitutional debt limitation.
No provision of this agreement shall be construed or interpreted as creating a
delegation of governmental powers nor as a donation by or lending of the
credit of OCHS or OCHD within the meaning of the Constitution of the State
of North Carolina. This agreement shall not and does not directly or indirectly
or contingently obligate OCHS or OCHD to make any payments beyond those
appropriate in the sole discretion of OCHS or OCHD for any fiscal year in
which this agreement shall be in effect. No deficiency judgment may be
rendered against OCHS or OCHD in any action for breach of a contractual
obligation under this agreement and the taxing power of OCHS or OCHD is
not and may not be pledged directly or indirectly or contingently to secure any
moneys due under this agreement.
This 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 have hereunto signed this agreement in
their official capacities of the day and year listed below.
FOR AND ON BEHALF OF ORANGE
COUNTY HEALTH DEPARTMENT
Rosemary .Summers
Health Di ctor
FOR AND ON BEHALF OF THE
CHAPEL HILL TRAINING AND
OUTREACH, INC.
Michael Mathers
Executive Director
Date: s~~~~~~ `'/
Date:
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09.doc
Family Service Coordination Agreement
Calendar Year 2009
Page 6 of 9
FOR AND ON BEHALF OF ORANGE COUNTY
~-~~
Valerie Foushee, ha
Orange County Boar of Commissioners
Date: ,3
ORANGE COUNTY FINANCE DIRECTOR:
This instrument has been preaudited in the Manner required by the Local
Government Budget and Fiscal Control Act.
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09.doc
Family Service Coordination Agreement
Calendar Year 2009
Page 7 of 9
ATTACHMENT A
Standards and Conditions
Personnel:
Per contractual agreement, one (1) Orange County Health Department Social Worker II
Class Family Service Coordinator will carry out mutually agreed upon job duties for the
Orange County Head Start program.
Services to be provided to OCHS families/children:
• Enrollment of OCHS assigned families in accordance with OCHS Family and
Community Partnership Plan.
• Assessment of family needs- including, but not limited to, child care, health,
special needs of child, knowledge of infant and toddler development, home
environment, parenting skills, parental stress, education and job training.
• Partnership building with OCHS enrolled families to establish mutual trust and to
identify family goals, strengths, and necessary services and other supports.
Family Partnership Agreements are established with families as early after
enrollment as possible and documented in the OCHS file within 30 days.
• Obtain pre-existing family plans by coordinating with the families and the other
agencies/personnel who may also be working with OCHS families to support the
accomplishments of goals and to avoid duplication of services.
• Within 45 days of enrollment, obtain up-to-date immunization records, health
status (medical home) information and complete a nutrition assessment.
• Within 45 days of enrollment of each child on caseload, in conjunction with the
Health/Nutrition Manager, Disabilities Coordinator and the Early
Childhood/Mental Health Manager, provide for an appropriate developmental
screening to identify concerns regarding child's development, sensory,
behavioral, motor, language, social, cognitive, perceptual and emotional skills.
• Work collaboratively with OCHS parents to identify and continually access, either
directly or through referrals, services and resources that are. responsive to each
family's interests and goals. This includes: emergency or crisis assistance in
such areas as food, housing, clothing and transportation; education and other
appropriate interventions; opportunities for parents to participate in counseling or
receive information on mental health issues that place families at risk, such as
substance abuse, child abuse and neglect and domestic violence; and
opportunities for continuing education and employment training.
• Involve parents in their child's education option at OCHS (Central, Efland, New
Hope and Pathways Elementary) by assisting parents to establish a positive
relationship with their child's teacher and modeling how to share knowledge
about their child so that child care staff can individualize the program to support
each child's individual pattern of development and learning.
• Coordinate parent participation in the program, including scheduling and
attending regular OCHS parent meetings, surveying family interests, recruiting
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Family Service Coordination Agreement
Calendar Year 2009
Page 8 of 9
for OCHS Policy Council, and providing parent trainings required by the
Performance Standards and on other topics that parents request.
• Facilitate families' transition from Pre-Kindergarten per OCHS Transition Policy
and Procedures.
• Comply with HIPAA privacy and security guidelines of `protected health
information' as outlined by Orange County Health Department.
• OCHD RD nutrition counseling guidelines: The Family Service Coordinator will
coordinate scheduling, referral from the practitioner, and transportation for RD
services. The RD may provide off-site nutrition appointments as staffing allows
and will be decided on a case-by-case basis with the Family Service
Coordinator. Medicaid covers Medical Nutrition Therapy with an RD for children
up to age 20 years of age with high-risk conditions. For non-Medicaid recipients,
fees are based on a sliding scale based on income. The RD will provide direct
feedback for referred children to the Family Service Coordinator.
Conditions for services to OCHS familieslchildren:
• The OCHS -OCHD Family Service Coordinator will case manage and coordinate
all services to an average caseload of 35 families, which will include a maximum
average of 12 families who are also part of the OCHD Family Service
Coordination program.
• OCHD will assure that a process is in place such that, within 45 days of a child's
enrollment, OCHS will be able to obtain adequate information on the jointly
managed, "matched", OCHS families to document compliance with OCHS
regulations for: Family Partnership Agreements, Health Status (medical home),
up-to-date immunizations, nutrition assessments, and developmental screening.
• OCHS Family Services Manager will supervise day to day activities of the Family
Service Coordinator including:
providing regular and consistent opportunities for reflective supervision
processing leave requests (i.e. vacation, personal) and acting as
contact person for work illness and emergency requests
processing workshop and travel requests,
overseeing organization of daily tasks and directing daily activities
assisting staff to trouble-shoot emergency needs of families,
assisting with parent meetings as needed,
evaluating staff performance related to job duties and procuring training
to enable staff to carry out their Head Start role .
ascertaining staff safety in the field by being available for "sign out" at
the end of each workday
consulting with OCHD's Family Home Visiting Coordinator as needed
regarding employee job performance, CSC responsibilities, and
potential Child Protective Services referrals
• OCHS Family Services Manager and the OCHD Family Home Visiting Services
Coordinator will provide joint support and advocacy to the Family Service
Coordinator
by:
receiving and reviewing written caseloads on a monthly basis
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Family Service Coordination Agreement
Calendar Year 2009
Page 9 of 9
monitoring case load size to ensure quality services to families
providing at a minimum quarterly and as needed joint reflective
supervision (a joint meeting with supervisors and staff member)
providing resource and referral information when needed
providing ongoing observations and feedback on delivery of services
related to the agency's program requirements and best practices
(i.e. at least annual home visit observations, periodic chart reviews,
and parent satisfaction surveys)
completing Work Planning and Performance Reviews at least annually
according to policies and procedures of OCHD
keeping staff informed of agency-specific administrative protocols and
updates
disseminating information in a timely manner (federal, state & local)
representing staff issues to administration
advocating for career growth
Compensation:
Compensation rate for the position will be at a level commensurate with employee's
education, training and experience in keeping with both agencies' wage and
comparability schedules.
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~~F~a~~
BUSINESS ASSOCIATE AGREEMENT
This Agreement is made effective the 15' day of January 2009, by and between Orange County
Government, Health Department, hereinafter referred to as "Covered Entity", and Chapel Hill Training and
Outreach, Inc. hereinafter referred to as "Business Associate," (individually, a "Party" and collectively, 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 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 Privacy Rule (the
agreement evidencing such arrangement is entitled "Agreement Between Orange County Health Department and
Chapel Hill Training and Outreach Inc., for Family Service Coordination Services:, effective January 1, 2009, 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,
the Parties agree to the provisions of this Agreement in order to address the requirements of the HIPAA Privacy
Rule and to protect the interests of both Parties.
DEFINITIONS
Except as otherwise defined herein, terms used in this Agreement shall have the same meaning as those terms
set forth in the HIPAA Privacy Rule.
II. CONFIDENTIALITY REQUIREMENTS
(a) Business Associate shall:
(i) use or disclose any protected health information solely as permitted or required
by this Agreement, the Arrangement Agreement (if consistent with this Agreement and the HIPAA
Privacy Rule), or as required by law.'
(ii) 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. 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;
(iii) implement appropriate safeguards to prevent use or disclosure of protected
health information other than as permitted or required by this Agreement;
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(iv) permit the Secretary of Health and Human Services 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 Privacy Rule;
(v) report to Covered Entity any use or disclosure of protected health information
which is not in compliance with the terms of this Agreement of which it becomes aware; and
(vi) 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.
(b) Notwithstanding the prohibitions set forth in this Agreement or the Arrangement
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 such services are 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.
III. AVAILABILITY OF PROTECTED HEALTH INFORMATION
Business Associate shall:
(a) at the request of Covered Entity, provide access to protected health information in a designated
record set to Covered Entity or, as directed by Covered Entity, to an individual, in a time and manner sufficient to
permit Covered Entity to comply with the requirements of 45 CFR 164.524.
(b) at the request of Covered Entity or an individual, make any amendment(s) to protected health
information in a designated record set that are directed by or agreed to by Covered Entity, in a time and manner
sufficient to permit Covered Entity to comply with the requirements of 45 CFR 164.526.
(c) document disclosures of protected health information and information related to such disclosures
in a manner sufficient to permit Covered Entity to respond to a request by an individual for an accounting of
disclosures of protected health information in accordance with 45 CFR 164.528 and provide such documentation
to Covered Entity or an individual as directed by Covered Entity.
IV. TERMINATION
(a) Term: This Agreement terminates when the Arrangement Agreement terminates or as provided
in Paragraph IV.b. below (termination for cause).
(b) Termination for cause: Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity shall either:
(i) provide an opportunity for Business Associate to cure the breach or end the
violation or, if Business Associate does not cure the breach or end the violation within the time
specified by Covered Entity, terminate this Agreement and the Arrangement Agreement; or
(ii) immediately terminate this Agreement and the Arrangement Agreement if
Business Associate has breached a material term of this Agreement and cure is not possible.
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(c) Return or destruction of protected health information: 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, Business Associate shall:
(i) if feasible, 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. Business Associate shall only destroy protected health information
with the written approval of Covered Entity. After return or destruction, Business Associate shall
retain no copies of such information.
(ii) if return or destruction is not feasible, Business Associate will provide Covered
Entity with documentation explaining the reason that it is not feasible. If the protected health
information is not returned or destroyed, 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.
(d) Survival: 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.
V. MISCELLANEOUS
(a) 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.
(b) A reference in this Agreement to a section in the HIPAA Privacy Rule means the section as in
effect or as amended.
(c) In the event of an inconsistency between the provisions of this Agreement (including definitions)
and mandatory provisions of the HIPAA Privacy Rule, as amended, the HIPAA Privacy Rule shall control. Where
provisions of this Agreement are different than those mandated in the HIPAA Privacy Rule, but are nonetheless
permitted by the HIPAA Privacy Rule, the provisions of this Agreement shall control.
(d) Except as expressly stated herein or the HIPAA Privacy Rule, the parties to this Agreement do
not intend to create any rights in any third parties.
(e) 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.
(f) This Agreement will be governed by the laws of the State of North Carolina.
(g) 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.
(h) 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 that are more restrictive than the provisions of this Agreement, the provisions of the
more restrictive documentation will control.
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(i) 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.
(j) The headings in this Agreement are for convenience of reference only and shall not define or limit
any of the terms or provisions hereof.
above.
IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written
COVERED ENTITY:
BUSINESS ASSOCIATE:
By: By:_
Title: S / ~~S Gl°~f/ Title:
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