HomeMy WebLinkAbout1998 S Health - NC Dept of Health and Human Services and Orange County Health Dept for 1998-99 - 05-06-1998- ~ _
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FOR THE PERMANENT AGENDA ~~~E
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CONSOLIDATED CONTRACT
BETWEEN
THE STATE OF NORTH CAROLINA
AS REPRESENTED BY
THE STATE HEALTH DIRECTOR
(Hereinafter called the "State'
AND
Orange County Health Department
(Local Health Department -Hereinafter called the "Department")
FOR THE PURPOSE OF
MAINTAINING AND PROMOTING THE ADVANCEMENT OF
HEALTH IN NORTH CAROLINA
This Contract Shalt Cover a Period From
July 01,1998 to June 30,1999
NOW, THEREFORE, the State and the Department agree that the provisions and clauses herein set forth shall be
incorporated in and constitute the terms and condfions applicable for the following activities involving State funding.
(State funding or funds means state, federal, and/or special funding or funds throughout this contract.)
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A. WORK TO BE PERFORMED
The Department shall perform activities in compliance with applicable program rules
contained in the North Carolina Administrative Code as well as all applicable Federal and
State laws and regulations.
2. The Department shall perform the activities specified in the Program Contract Addenda for
State funded budgets.
3. The Department shall administer and enforce all rules which 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 shall 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 County
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 narrative, if
completed.
B. .FUNDING STIPULATIONS
1. Funding for this contract is subject to the availability of State, Federal, and special funds for
the purpose set forth in this Contract.
2. .During the period of this Contract, the Department shall not use State, Federal or Special
Project funds received under this Contract 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 personal health
programs.
4. Fees generated by the Food 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 child health activities.
6. The Department shall comply with Standards for Mandated Public Health Services, 15A
NCAC 25, Section .0200; and Administrative Procedures Manual for Federal Block Grant
Funds, 1 NCAC 33, Sections .0100 - .1502.
7. The Department shall maintain employee time records to document employee salaries and
fringe benefits charged to state funds. The percentage of time each employee spends in
each activity shall be converted to dollars based upon the employees' salary and benefits
8. The Department participating in Medicaid Reimbursement shall:
a. Comply with the terms of the Medicaid Interagency Agreement and the Provider
Participation 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
Medicaid reimbursement is sought, through public or private third party payors except
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 for services covered by a program operating under 15A NCAC 24A rules
when those services are not supported by other state or federal funds. All payment program
rules and procedures as specified in the Purchase of Medical Care Services manual must be
followed.
10. The Department shall provide interpreter services at no cost to clients or their families for
those services provided free to the general public.
11. 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 $400.00 per participant upon successful completion of the course.
b. Nursing service personnel participating in the the Public Health Nurse Supervisors
Training Course. Reimbursement is limited to no more than $600.00 per participant
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
Nursing. Reimbursement is limited to $25.00 per participant per event.
12. The Department shall have an annual audit performed in accordance with The Single Audit
Act of 1984 as implemented by OMB Circular A-133.The audit report should be submitted to
the Controller's Office within (nine) 9 months following the close of the contract. Audit
findings and resolution of said findings shall be handled by the Controllers Office.
13. Equipment is a type of fixed asset consisting of specific items of property that: (1) are
tangible in nature; (2) have a life longer than one year, and (3) have a significant value.
a. For Inventory Purposes
1. Equipment must be accounted for in accordance with Local Government
Accounting System Procedure No. 15.
2. Women, Infants and Children Program
All equipment with an acquisition cost of $500.00 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
State/Federal funds must receive prior written approval from the appropriate
Division when the acquisition cost exceeds $500.00.
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2. Women, Infants and Children Program
All medical equipment and computer equipment, regardless of cost and all
other equipment with an acquisition cost of $500.00 or more must receive
prior approval from the program office.
3. The use of Maternal and Child Health Medicaid fees for capital improvements
requires prior written approval from the Division of Women's and Children's
Health.
C. FISCAL CONTROL
The Department shall comply with the Local Govemment Budget and Fiscal Control Act,
North Carolina General Statute Chapter 159, Article 3.
a. The Department shall maintain a purchasing and procurement system in accordance
with generally accepted accounting practices and procedures set forth by the Local
Govemment Commission.
b. The Department shall execute written agreements with 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. The Department is not relieved of any of the duties and responsibilities
provided in this contract.
2. The 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 records pertinent to its role as a subcontractor
of the Department.
4. The Department will make available to the State upon request a copy of
subcontracts supported with State/Federal funds.
d. The Department must receive prior approval from the state to subcontract when any
of the following conditions exist:
The Department propses to subcontract to a single enity fifty
percent (50%) or more of the total state and federal funds made
available through this contract.
2. The Department proposes to subcontract fifty percent (50%) or more,
or $50,000 which ever is greater, of the total state and federal funds
made available through this contract for a single public health service
activity.
3. The Department proposes to subcontract for services in the Women,
Infants and Children Program.
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e. The Department shall retain all budgets, budget revisions, contracts, contract
addenda, and financial records in accordance with the current Records Disposition
Schedule for County and District Health Departments issued by the Division of
Archives and 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
Budget -WIC Form 3370 and Local Health Department Budget Form 2948.
a. The Department shall prepare budget revisions for prior approval of the State when
State funds will be increased or decreased.
b. The Department shall submit all revisions prior to the end of the term specified in this
Contract. Budget revisions received by the State after the end of the contract period
will be returned without action.
3. The Department shall observe the following conditions when budgeting and reporting eamed
revenues:
a. All payments from persons, and public or private third party payors, shall be utilized
for the activity that generated the revenue and shall not reduce or replace locally
appropriated funds during the period of this contract. The Department may use
revenues from any Division of Women's and Children's Health supported activity in
any other activity supported by the Division.
b. All eamed income must be budgeted in the program where eamed, except that
income eamed by a program which has no activity budget can be budgeted in a
program approved by the State. With regard to revenue generated by maternal and
child health related services, program is defined as any activity supported by the
Division of Women's and Children's Health.
c. All 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
will be governed by applicable Federal regulations, including but not limited to 45
CFR 74.
e. When budgeting:
Line item 9000 on the program budget must be used to budget the total of
line items 101, 102 and 103.
ii. Line 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.
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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Line item 102 on the Local Expenditure Report must be used to report TXIX
eamed revenues that were expended.
iii. Line item 103 on the Local Expenditure Report must be used to report other
eamed revenues that were expended.
g. A local account shall be maintained for unexpended TXIX fees. Accounts shall be
maintained in sufficient detail to identify the program source generating the fees.
h. The amount of Title XIX fees budgeted in FY 1998-99 must equal or exceed
the amount of Title XIX revenues eamed during FY 1996-97. The state will not
approve program activity budgets that do not include an amount of Title XIX fees
sufficient to meet the requirements of this section. The state may waive this
requirement if the Department provides sufficient justification.
4. The Department shall submit a quarterly report of actual receipts and expenditures 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 within 45
days from the end of the reporting quarter. Failure to meet the reporting deadline
will result in an immediate suspension of payments until the overdue report is
received.
b. The Department shall 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 or corrected expenditure reports within
four (4) months after the end of the contract period. Any such reports must be
prepared for the specific quarter to be amended or corrected. 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 shall submit monthly WIC expenditure reports to the State no
later than the 8th of the following month. Final expenditure report is due by
August 14.
f. Reimbursement of WIC approved expenditures for July, August, and September
cannot exceed one-fourth of the total budget for the contract period.
g. The Department shall submit monthly Minority Infant Mortality Reduction and
Healthy Start expenditure reports to the state no later than the 15th of the
following month.
h. The Department shall submit expenditure reports for Mosquito Control activity in
accordance with 15A NCAC 188, Sections .0104 and .0107.
The Department shall submit request for payment for services provided under 15A
NCAC 24 A rules to the Claims Processing Unit, Purchase of Medical Care
Services, DHHS.
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The Department shall submit request for reimbursement for nurse training to the
Office of Public Health Nursing. Form 3300 -Public Health Nurse Training Activity
must be used as the invoice for payment.
5. The Department shall submit on an annual basis Staff Time Activity Report, 3389,
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 POLICIES
The Department shall adhere to and fully comply with State personnel policies as found in
North Carolina General Statute, Chapter 126, and 1 NCAC 8. Such policies include, but
are not limited to, the following:
1. Equal employment opportunity;
2. Affirmative action;
3. Policies for local government employment subject to the State Personnel Act;
4. "Local Classification and Salary Range";
5. "Compensation Policy for Local Competitive Services Employees"; and
6. "Recruitment and Selection Policy and Procedures";
7. Environmental Health Specialists 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. 130A-4(b). This delegation
shall be done according to 15A NCAC 18A .2300.
a. Local health departments are responsible for sending their newly-
employed environmental health specialists (interns) to 33 days (6.5 weeks)
of initial field training/orientation at the training center within 180 days from
date of employment.
b. An-angements for initial field training/orientation for newly-employed
environmental health specialists will be handled by the Education and
Training Staff, Division of Environmental Health.
c. A local health department which is contracting with an environmental
health specialist employed by another department shall be responsible for
assuring that all original documents, correspondence, and 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 Department Staffing
15A NCAC Section .0301(c), and shall assure that all nursing staff who provide
public health services funded by this contract comply with this rule.
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E. CONFIDENTIALITY
All information as to personal facts and circumstances obtained by Department personnel
in connection with the provision of services or other activity under this Contract shall be
privileged communication, shall be held confidential, and shall not be divulged without the
responsible person's written consent except as may be otherwise required by applicable
law or regulation. Such information may be disclosed in summary, statistical, or other
form which does not directly or indirectly identify particular individuals.
F. CIVIL RIGHTS
The Department shall assure that no person, on the grounds of race, color, age,
religion, sex, marital status, immigration status, or national origin (unless
otherwise medically indicated) or otherwise qualified handicapped individual solely
by reason of his/her handicap be excluded from participation in, be denied the
benefits of, or be subjected to discrimination under any program or activity
covered by this Contract.
2. The Department shall complete HHS Form 441, 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 Title Vt of the civil Rights Act of 1964; and HHS Form 641,
Assurance of Compliance wi#h Section 504 of the Rehabilitation Act of 1973.
3. The American with Disabilities Act 1990 (ADA) makes it unlawful to discriminate in
employment against a qualified 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 anct its
principals and subcontractors will comply with regulations in A.D.A. Title I
(Employment), Title II (Public Services), and Title III (Public Accommodations) in
fulfilling the obligations under this agreement.
G. RESPONSIBILITIES OF THE STATE
The State shall provide to the Department upon request technical assistance in
the preparation of the Consolidated Contract, Activity Budgets and Contract
Addenda.
2. The State shall specify those administrative forms/reports and their respective
revision dates that are required by particular activities pertaining to the
Department's budget with the State in Listing of Required Fiscal and Statistical
Reports (Addendum 1) for the contract period. New forms/reports not listed in
Required Fiscal and Statistical Reports shall be implemented during a contract
period only with the approval of the State Health Director.
3. The State shall provide to the Department within thirty (30) days after receiving an
acceptable activity budget from the Department an approved signed copy of the
budget.
4. The State shall provide funds to the Department upon approval of the Contract
Addenda, activity budgets, and signing of this contract.
5. The State shall assist the Department 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 determine compliance with the
terms of this contract.
7. The State shall be assured that the Department maintains expenditure of locally
appropriated funds for maternal health, child health, and family planning activities
equal to or greater than that reported on the Staff Time Activity Report for the
period beginning July 1, 1984, and ending June 30, 1985. This maintenance of
effort shall be measured by salary equivalencies which are to be maintained in
accordance with Section B. 7. of this contract.
H. DISBURSEMENT OF FUNDS
The State shall disburse funds to the Department as follows:
Provided the Consolidated Contract is properly executed and all quarterly
expenditure reports are filed within the established time frames, payments equal
to 1/12 of the total program approved budget shall be made in the following
months:
July August September October 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 March 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 one-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 will be based on actual reported expenditures. Monthly
payments will be made provided that expenditure reports are received as required
in 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 activity budget and any subsequent budget
revisions.
6. Funds for Childhood Lead Poisoning Prevention will be disbursed once per year.
The amount will be determined by the number of confirmed cases identified in
each county. A separate contract addendum must be submitted with budget
page in order to receive these funds. Funds for training will be disbursed upon
request.
7. Increased or decreased payments necessitated by changes in the total budgeted
amount will be reflected 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 specified in C. 4. a, b, e, g and h. Payments will resume in the months
subsequent to receipt of the expenditure reports.
9. Payment is limited to the total amount of the budget by line item as reported on
Expenditure Report 3389.
10. Final payments will be made based on the 4th quarter expenditure report. Final
payments will be equal to the difference between approved reported expenditures
and the sum of previous payments. Final payments should be made not later than
September provided that an original signed copy of an expenditure report for each
quarter has been received by the Office of the Controller. Final payment will be
made only after the Staff Time Activity Report, 3389, Environmental Health
Report, 3788, and Food and Lodging, 3888 are received by the State.
AMENDMENT OF CONTRACT
Amendments, modifications, or waivers of this contract may be made at any time by
mutual agreement of all parties. Amendments shall be in writing and signed by
appropriate authorities.
J. PROVISION OF TERMINATION
This contract may be terminated for reasons other than non-compliance 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
The State shall assure compliance with all terms of this contract.
a. Upon determination of non-compliance, the State shall give the
Department sixty (60) days written notice to come into compliance. If the
deficiency is corrected, the Department shall submit a written report to the
State which sets forth the con-ective action taken.
b. If the above deficiencies should not be corrected to the satisfaction of the
State after the sixty (60) day period, disbursement of funds for the
particular activity may be temporarily suspended pending negotiation of a
plan of corrective action.
c. If the deficiency is still not con-ected within the next thirty (30) days
following temporary suspension of funding, program funds may be
permanently suspended until the Department can provide evidence that
the deficiencies have been corrected.
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d. In the event of the Department's non-compliance 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 not occur until: (1) the provisions of Section K-1 (a-c) have been
followed, documented, and have failed to provide a resolution, (2) all other
reasonable administrative remedies have been exhausted.
2. 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
v l o~~t~
Health Directo ate
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Finance Officer D to
STATE OF NORTH CAROLINA
By
State Health Director
or Authorized Agent
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hai an of ounty Com issioners Date
(when requir )