HomeMy WebLinkAboutAgenda - 05-06-1998 - 8hORANGE COUNTY
Board of Commissioners
Action Agenda
Item No.~~~
Action Agenda Item Abstract
Meeting Date: May 6, 1998
Subject: 1998-99 Contract between the NC Department of Health and Human Services and Orange County Health
Department.
Department: HEALTH
Attachments(s):
(1) Eleven Page Contract
Public Hearing Yes X No
Budget Amendment Needed Yes X No
Information Contact:
Health Director's Office X2411
Telephone Number
Hillsborough-732-8181
Chapel Hill - 968-4501
Mebane - 227-2031
Durham- 688-7331
Purpose:
To approve the annual consolidated contract between the NC Department of Health and Human Services and the
Orange County Health Department, which provides State and Federal funds to the Health Department to partially
support mandated services.
Background:
The attached contract stipulates the state contract support in the amount of $562,014 for the programs listed below.
This is a reduction of $6,747, or 1.2%. There are reductions in the general aid to counties, environmental health,
health promotioq breast and cervical cancer, and in the second year of the Intensive Home Visiting grant. There
is a slight increase in the Child Health amount.
General _ CSHS Orthopedic
Maternal Health Child Health
AIDS (Federal) Child Service Coordination
Family Planning Breast & Cervical Cancer
Immunization Action Plan Intensive Home Visiting
Environmental Health Food and Lodging
Block Grant that includes Communicable Disease, Adult Health and Health Promotion
Each year the State contracts with the Health Department to render specified, mandated services. The attached
contract outlines the terms in dollar amounts for each program activity as well as local allocations and revenues
which support these mandated services. Minor changes in the contract terms are acceptable and do not
substantially alter the working relationship.
Recommendation:
The Manager recommends that the Board approve the contract, subject to the endorsement of the County Attorney
and County Purchasing Director and authorize the Chair to sign the contracts, assurances and budget pages.
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CONSOLIDATED CONTRACT
- BETWEEN
THE S T A i ~ OF NORTH CArtOUNA
AS REPRESENTED BY
THE STATc HEALTH DIRECTOR
(Hereinafter called the "State'
AND
Oranae County Health Department
(Local Health Department - Hereinafter called the "Oepartment")
FOR THE PURPOSE OF
MAINTAINING ANO PROMOTING THE ADVANCEMENT OF
HEALTH IN NORTH CAROLINA
This Contract Shail Cover a Period Fram
July Q1, i S98 to June 30, 1 X99
NOW, THEREFORE, the State and the Department agree that the provisions and clauses herein set forth shall be
incorporated in and constitute ttte terms and conditions applicable for the fallowing activities involving State funding.
(State funding or funds means state, federal, and/or speaal funding or funds tfiraughout this contract)
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_ _ A. WORK TO 8E PERFORMED
The Depar'tmentshall perorm activities in compliance with applicable program rules
contained in the lyorth Carolina Administrative Code as well as all applicable Federal and
State laws and regulations.
2. The Department shall perfom; t,'~e activities specfced in the Program Contract Addenda ;or
State funded budgets.
The Department shall administer and enforce all r*~Jes wi;ictt have been adopted by the
Commission for Health Services or approved by the State and adopted by the Local Board of
Health.
4. The Department steal! provide to the State copies of rules adopted by the Local Board of
Health pursuant to G.S. 130A-39 and Public Health Ordinances adopted by the Courry
Commissioners, within 30 days of adoption.
5. The Department shall provide to the State a Community Diagnosis Prioritization of Problems
every biennium. The Department shall also provide a Community Diagnosis narrtive, if
completed.
8. FUNDING STIPULATIONS
7. Funding far this contract is subject to the avaitabil"ity of State, Federal, and special funds for
the purpose set forth in this Contract.
2. . Durfng the period of this Contra, the Department shall not use State, Federal or Special
Project funds received under this Contrail to reduce locally appropriated funds as reflected
in the Local Health Department Budgets.
3. The Department shall not use personal health program funds to support environmental
health personnel nor use environmental health program funds to support persona( health
programs.
4. Fees generated by the Fcod and Lodging fees collection program may only be used to
support Environmental Health activities.
5. Funds for Childhood Lead Poisoning Prevention may be used to support both environmental
health and ch7d health activities.
6. The Department shalt comply witt; Standards for Mandated Public Health Services, 15A
NCAC 25, Se~ion .0200; and Administrative Proc.~dures Manual for Federal 8loctc Grant
Funds, 1 NCAC 33, Sections .0 i GO - . ~ 502.
7. The Department shall maintain employes time records to dowmerrt employee salaries and
fringe benefits charged to state funds. The percentage of time each employee spends in
each ac;avity shall be converted to dollars traced upon the employees' salary and benefits
8. The Cepar'trrent partidpatin5 in Medicaid Reimbursement shall:
a. Comply with the terms of the Medicaid interagency Agreement and the Provider
Partiapation Agreement effective October 1, 1992 and any subsequent approved
addenda or new Agreement approved and established during the period of this
contract
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b. Make every reasonable effort to collect its cost in providing services, for which r
Medicaid reimbursement is sought, through public or private third party payors exact
where prohibited by Federal regulations or State law. No one shall be refused ~_
services solely because of an inability to pay. --
9. Subject to the approval of the appropriate Division, a local health department may seek
reimbursement far services covered by a program operating under 15A NCAC 24A rules
when those services are not supported by other state or federal funds. Al! payment prcgram
rules and procedures as spectied in the Purchase of Medics! Care Services manual must be
followed.
t0. The Department shall provide interpreter services at no cost to clients or their families for
those services provided free to the general public.
71. Subject to the availability of funds and approval of the Office of Public Health Nursing, a
local health department may request reimbursement for.
a. Nursing service personnel participating in the Introduction to Principles and Practices
of Public Health and Public Health Nursing course.Reimbursement is limited to no
more than 5400.00 per partiapant upon successful completion of the course.
b. Nursing service personnel partidpating in the the Public Health Nurse Supervisors
Training Course. Reimbursement is limited to no more than 3c00.00 per partiapant
upon successful completion of the course.
c. Community Health Assistants and Public Health Nurses attending certain pre-
approved Continuing Education courses offered by the Office of Public Health t._
Nursing. Reimbursement is limited to 325.00 per partidpant per event.
12. The Department shall have an annual audit perforated in accordance with The Single Audit
Act of 1984 as implemented by OMB Circular A-133.The audif report should be submitted to
the Controller's Office within (nine) 9 months following the dose of the contract. Audit
findings and resolution of said findings shall be handled by the Controllers Office.
t3. Equipment is a type of fixed asset consisting of speafic items of property that: (1) are
tangible in nature; (Z) have a life longer than one year, and (3) have a significant value.
a. For Inventory Purposes
Equipment must be accounted for in accordance with Local Government
Accounting System Procedure No. 15.
2. Women, Infants and Children Program
A11 equipment with an acquisition cost of 5500.00 or more must be inventoried
with the Division of Women's and Children's Health.
b. For Prior Approval Purposes
1. All equipment purchased or leased where there is an option to purchase with
StatelFederal funds must receive prior written approval from the appropriate
Division when the acquisition cost exceeds 5504.04.
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2. V~Jomen, Infants and Children Program
~ll medical a ;uipment and computer equipment, regardless of cast and all
ether equipment with an acquisition cost of 5500.00 or more must receive
~rcr approval frm the program cf;ice.
3. ; re use of Na:emal and Child Heai`~h yledicaid fees for capital improvements
requires prior written approval from the Division of Women's and Children's
'realth.
C. FISCAL CONTRO!_
1. The Cepartment shall comply with the Local Government budget and Fiscal Ccntroi pct,
North Carotira General Statute Chapter 1 ~9, ArtiGe 3.
a. Tile Department shall maintain a purchasing and procurement system in accordance
with generally accepted accounting prac`,ices and procedures set forth by the Local
Gover:;ment Commission.
b. The Oe~artment shall execute written agreements whit all parties who invoice the
. Department for payment for the provision of services to patients.
c. When subcontracting, the following conditions must be met:
1. i he Department is not relieved of arty of the duties and responsibilities
provided in this contrail.
2. fie subcontractor will agree to abide by the standards contained herein or to
provide such information as to allow the Department to comply with these
standards.
3. The subcontractor will agree to allow state and federal authorized
representatives access to any re~rds pertinent to its rote as a subcontractor
of the Department
4. The Oepar'Jnent +nn11 make available to the State upon request a copy of
subcontracts supported with StateJFederal funds.
d. The Cepartment must receive prior approval fmm the state to subcontract when any
of the following conditions exist:
1. The Cepartment propses to subcontract to a single enity frfty
percent (50°10) or more of the total state and federal funds made
available through this contract.
2. The Department proposes to subcontract fifty percent (50°l0) or more,
or 350,000 whid't ever is greater, of the total state and federal funds
made available through this contract for a single public health service
activity.
3. The pepartment proposes to subcontract for services in the Women,
Infants and Children Program.
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The Department shall retain all budgets, budget revisions, contracts, contract
addenda, and finanaaJ records in accordance with the current Records Disposition
Schedule for County and Cistrict Health Departments issued by the Division of
Archives artd History, Department of Cultural Resources.
2. The Department shall prepare and maintain a budget for each activity covered by this
contract in a manner consistent with instructions provided with Local Health Department
@udget - W1C Form 3370 and Local Health Department @udget Fom~ 2948.
a. The OeparLment shall prepare budget revisions for prior approval of the State when
State funds will be increased or decreased.
The Department shall submit all revisions prior to the end of the term speafied in this
Corttrad. Budget revisions received by the State after the end of the contract period
wil! be returned without action.
3. The Department shall observe the foAowing conditions when budgeting and reporting eamed
revenues:
a. AU payments from persons, and public a~ private third party payors, shall be utilized
for the aeetivvity that generated the revenue and shall not reduce or replace locally
appropriated funds durfng the period of this cantrad. The Department may use
revenues from arty Division of Women's and Children's Health supported activity in
any other activity supported by the Division.
b. Al! eamed income must be budgeted in the program where eamed, except that
income eamed by a program which has no adn+ity budget can be budgeted in a
program approved by the State. With regard to revenue generated by maternal and
d'tild health related services, program is defined as any activity supported by the
Divisiart of Women's and Children's Health.
c. Al! fees collected shall be used in the current year or succeeding fiscal years.
d. Use of program income generated by the expenditure of Federal categorical funds
wit! be governed by applicable Federal regulations, including but not limited to 45
CFR 74.
e. When budgeting:
Lute item 9000 on the program budget must be used to budge# the total of
line items t 0 f , 102 and 103.
a, tine item 102 on the program budget must be used. to budget TXIX eamed
revenues.
iii. Line item 103 on the program budget must be used to budget other eamed
revenues.
f. When reporting expenditures:
Line item 9000 on the Local Expenditure Report must be used to report the
total of line items 101, 102 and 103.
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ii. Line item 102 on the Local Expenditure Report must be used to report T`,C1X
- == eamed revenues that were expended.
ni. Line item 103 on the Local Expenditure Report must ~e used to rapert ether
eamed revenues that were expended.
g. A local account shall be maintained for unexpended iX1X fees. Ac:.ounts shall be
maintained in sumcient detail to identity the Grogram scurca •~enerating the fees.
The amount of Title XIX f=_ss budgeted in r~`(1998-~9 must equal or exceed
the amount of Title XllC revenues eamed during FY ; 99c^^-97. ~ r,e state will not
approve program activity budgets that do not indude an amcunt of Title XIX fees
sufficient to mee# the requirements of this section. The state may waive this
requirement if the Deparment provides sur~aent jusification.
4. The Department shall submit a quarterly report of actual receipts and ax;:enditures of the
Department according to instructions provided with Local Expenditure =reports, Form
2949 and Form 2950.
a. The Department shall submit quarterly expenditure reports to the State withirt_45
days from the end of the reporting quarter. Failure to meat the r~oorting deadline
will result in an immediate suspension of payments until the overue report is
received.
b. The Department shalt submit the final Expenditure Report to the State within 45
days after the end of the contract period. Report is due by August 14.
c. The Department shall submit amended ar con•eded expenditure reports within
four (4) months after the end of the contract period. Any such reports must be
prepared for file specfic quarter to be amended or collected. Reports received
after October 31 will be returned without action.
d. The Department shall refund to the State all unexpended State funds within 45
days after notification of overpayment When payment is not received by the
State within 45 days, future payments to the Department may be reduced by the
amount due or payments may be suspended until the refund is received by the
State.
e. The Department shat! submit monthly WiC expenditure reports to the State na
later than the 8th of the following month. Fnal expenditure report is due by
August 14.
f. Reimbursement of W1C approved expenditures for July, August, and September
cannot exceed one-fourth of the total budget for the contract period.
g. The Cepartment shall submit monthly Minority Infant Mortality Reduction and
Healthy Start expenditure reports to the state no later than tr-e 15th of the
following month.
h. The Department shall submit expenditure reports for Mosquito Control activity in
accordance with t5A NCAC 188, Sections .0104 and .0107.
I. The Department shall submit request far payment far services provided under 15A
NCAC 24 A rules to the Claims Processing Unit, Purchase of Medical Care
Services, OHHS.
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j. The Department shalt submit request for reimbursement for nurse training to the
Office of Public Health Nursing. Form 33CC -Public Health Nurse Training Activity
must be used as the invoice for payment.
The Department shall submit on an annual basis Star Time AC,ivity Report, 3388,
Environmental Health Report, 3738, and Food and Lodging Report, 3888. The reports
shall accompany the final expenditure report and must be received by the State within 45
days after the end of the contract period.
D. PERSONNEL POLICSES
The Department shall adhere to and fully comply with State personne! policies as found in
North Carolina General Statute, Chapter 126, and 1 NCAC 8. Such policies include, but
are not limited to, the following:
Equal employment opportunity,
2. Affirmative action;
3. Polices for local government employment subject to the State Personnel Act;
4. "Local Classification and Salary Range";
5. "Compensation Policy far Loca! Competitive Services Employees"; and
6. "Recruitment and Selection Policy and Procedures";
7. Environmental Health Specalists employed by the Department shall be delegated
authority by the State to administer and enforce State environmental health rules
and laws as directed by the State pursuant to G.S. 13QA-4(b). This delegation
shall be done according to 15A NCAC 18A .23Ca.
a. Local health departments are responsible for sending their newiy-
emplayed environmental health specalists (interns) to 33 days (6.5 weeks)
of initial field training/orientation at the training center within 180 days from
date of employmenrt.
b. An-angements for inifial field training/orientation for newly-employed
environmental health specialists will be handfed by the Education and
Training Staff, Division of Environmental Health.
c. A (Deal health department which is contracting with an environmental
health speaalist employed by another department shalt be responsible for
assuring that all original documents, correspondence, artd other public
records be maintained in the health department using the contractor and
the contract shall stipulate that the contractor shall be available for
consultation to the public being served.
8. The Department shall comply with Minimum Standard Health Depanxnent Starring
15A NCAC Section .03C1(c), and shall assure that all nursing staff who provide
public health services funded by this contract compy/ with this rule.
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-~- E. CONFiDENT1ALlTY
Aq information as to personal facts and circumstances obtained by Department personnel
in conneilion with the provision of services or other a~ ivity under this Contract shall be
privileged communication, shall be held confidential, and shall not be divulged without the
responsible person's wrtten consent except as may tie otherwise required by applicable
law or regulation. Such information may be diseased in summary, statistical, or other
form which does not dirac+,ly or indirectly identify particular individuals.
F. CM!_ RIGHTS
The Department shall assure that no person, on the grounds of race, color, age,
religion, sex, marftal status, immigration status, or nations! origin (unless
otherwise medically indicated) or otherwise qualifted handicapped individual solely
by reason of hisJher handicap be exduded from par5apation in, be denied the
benefits of, or be subjected to discrimination under any program or activity
covered by this Central.
2. The Department shall complete HHS Form 44t, Assurance of Compliance with
the Department of Health and Welfare regulations, under Title Vi of the Civil
Rights Act of 1964; for the Women, infants and Children Program, FNS-64,
Assurance of Compliance with the Department of Agriculture Food and Nutrition
Service, under T"~ie Vt of the avil Rights Ad of 1964; and HHS Form 641,
Assurancz of Compliance with Section 504 of the Rehabilitation Act of 1973.
3. The Amercan with Disabilities Act 1980 (ADA) makes it unlawful to discriminate in
employment against a qua(rfied individual with a disability and outlaws
discrimination against individuals with disabilities in State and local government
services and public accommodations. The Department certifies that it and its
prindpals and subpntrailors will comply with regulations in A.DA. Title
(Employment), T'rtie 11(Public Services), and Title 111 (Public Accommodations) in
fulfilling the obligations under this agreement
G. RES?ONSI81Lti lES OF T'r{E STATE
1. The State shalt provide to the Department upon request technical assistance in
the preparation of the Cunsofidated Contrail, Activity Budgets and Contract
Addenda
2. The State shall spelfy those administrative formsirepvrts and their respective
revision dates that are required by particular activities pertaining to the
Department's budget with the State in Listing of Required Fscal and Statistical
Reports (Addendum t) far the control period. New formslreports not listed in
Required Fiscal and Statistical Reports shall be implemented during a contract
period only with the approval of the State Health Cireilor.
3. The State shall prvide to the Department within thirty (30) days aver receiving an
acceptable actriity budget from the Depar`snent an approved signed copy of the
budget.
4. The State shall provide funds to the Department upon approval of the Control
Addenda, activity budgets, and signing of this cxantracL
5. The State shall assist the Oepartment to comply with all applicable laws,
regulations, and standards relating to the activities covered in this contract
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6. The State reserves the right to conduct reviews to detemine compliance with the
terms of this contract.
7. The State shall be assured that the Departrrtent maintains expenditure of focally
appropriated funds for maternal health, child health, and family planning activities
equal to or greater than that reported on the Starr Time AC.ivity Report for the
period beginning July 1, 1984, and ending June 30, 1985. This maintenance of
effort shat! be measured by salary equivalences which are to be maintained in
accordance with Section B. 7. of this contract.
H. DISBURSEMENT OF FUNDS
The Sta#e shall disburse funds to the Department as follows:
Provided the Consolidated Contract is properly executed and aft quarterly
expenditure reports are filed within the established time frames, payments equal
to 1112 of the total program approved budget shall be made in the following
months:
July August September Qctober November January February
April May
Based on expenditures reported for the first. second, and third quarters, payments
shall be adjusted either upward or downward, in payments made in the following
months:
December Maroh June
2. For departments selecting quarterly reimbursement option, payments shall be
made when the quarterly expenditure report is received. Quarterly payment for
reported expenditures shall be limited to onus-fourth of the budgeted amount
3. For departments receiving Rural Obstetrical Care Incentive funds, payment of
such funds shall be made in one lump sum the month following receipt and
approval of the activity budget.
4. For departments receiving Healthy Start or Minority Infant Mortality Reduction
project funds, payment wr71 be based on actual reported expenditures. Monthly
payments wt71 be made provided that expenditure reports are received as required
irtt C. 4. g.
5. Food and lodging fees will be disbursed to the department in one sum the month
following receipt and approval of the ailivity budget and any subsequent budget
rEYi510RS.
6. Funds for Childhood Lead Poisoning Prevention rnn71 be disbursed once per year.
The amount will be determined by the number of confirmed cases identified in
each county. A separate contrail addendum must be submitted with budget
page in order to receive these funds. Funds far training will be disbursed upon
request.
7. Increased or decreased payments necessitated by changes in the total budgeted
amount will be r'etlected in the monthly payments subsequent to approval of the
budget revision.
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. --:-_ 8 Payments shall be suspended when expenditure reports are not received by the
' - time specfied in C. 4. a, b, e, g and h. Payments will resume in the months
subsequent to receipt of the expenditure repcrts.
9. Payment is limited to the total amount of the budget by line item as reported cn
Expenditure Report 33c"g.
10. Final payments will be made based on the ~th quarter expenditure report. Final
payments will be equal to the difference befi~veen approved reported expenditures
and the sum of previous payments. Fnat payments should be made not later Shan
September provided that an original signed copy of an expenditure report for earn
quarter has been received by the Office of the Contro8er. Final payment will be
made only after khe Stan lime Activity Report, 3389, Environmental Health
Report, 3788, and Foed and Lodging, 3888 are rerxived by the State.
AMENDMENT OF CONTRACT
Amendments, modifications, or waivers of this contract may be made at any time by
mutual agreement of atl parties. Amendments shall be in writing and signed by
appropriate authorities.
PROVISION OF TERMINATION
This contrail may be terminated for reasons other than non-camptianre upon sixty (60)
days written notice by either party. If termination should occur, the Department shall
receive payment only for allowable expenditures.
The State may withhold payment to the Department until the State can determine whether
the Department is entitled to further payment or whether the State is entitled to a refund.
K COMPLIANCE
1. The State shall assure pmpliance with all temps of this contract.
a. Upon determination of non-compliance, the State shalt give the
Department sixty (60) days written notice to come into compliance. If the
deficiency is corrected, the Cepartment shat! submit a written report to the
State which sets forth the prrective action taken.
b. If the above denaences should not be prreded to the satisfaction of the
State after the sixty (60) day period, disbursement of funds for the
particular aCrrrty may be Eemporariiy suspended pending negotiation of a
plan of carreC.tie anion.
c. if the defidenef is stilt not corrected within the next thirty (30) days
following temporary suspension of funding, program funds may be
permanentty suspended until the Cepartment can provide evidence that
the defiaenaes have been corrected.
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d. In the event of the Cepartment's rtcn-c: r'tpliance with clauses of this ~
contract, the State may cancel, terminate, or suspend this contract in
whole or in part and the Department may be declared ineligible for further
State contracts or agreements. Such terminations for non-compliance
shall net occur until: (1) the provisions of Sec'Jon K-1 (a-c) have been
fo(loweci, documented, and have failed to provide a resolution, (Z) ail other
reasonable administrative remedies have been exhausted.
Z. If the Department or the State should be determined out of compliance with the
provisions of the contract, either party may file a formal appeal with the Office of
Administrative Hearings.
IN WITNESS WHEREOF, the Department and the State have executed this
agreement in duplicate originals, one of which is retained by each of the parties.
LOCAL SIGNATURES STATE OF NORTH CAROLINA
Health Director Date
By
State Health Director
or Authorized Agent
Finance Officer Date
Chairman of County Commissioners Date
(when required)
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