HomeMy WebLinkAbout2005 S Health - Chapel Hill-Carrboro City Schools for Behavioral Counseling Services~. -~,Y ~ ,
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CHAPEL HILL-CARRBORO CITY SCHOOLS
MENTAL HEALTH CLINICAL SERVICES AGREEMENT
WITH ORANGE COUNTY HEALTH DEPARTMENT
THIS AGREEMENT, made and entered into the 1st day of September, 2005, by and between the Chapel
Hill-Carrboro City Schools, hereinafter referred to as "CHCCS" and the Orange County Health
Department, hereinafter referred to as "OCHD" that is part of the County of Orange.
WITNESSETH
WHEREAS, OCHD, through its Child and Adolescent Psychosocial Counseling Services, is willing to
provide consultation related to child and adolescent Mental Health to CHCCS personnel and to provide
direct clinical services related to Mental Health to enrolled students in CHCCS, and is willing to
collaborate on programs aimed at the promotion of mental health and the prevention of substance abuse and
chemical dependency,
AND WHEREAS, CHCCS desires to have such services in their school system,
NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereinafter
set forth, CHCCS and OCHD agree as follows:
Services to be Provided
OCHD agrees to assist CHCCS in the identification of students with psychosocial issues that
interfere with academic performance and to provide systematic intervention to such students.
OCHD agrees to provide consultation to CHCCS staff with the services of a Mental Health (MH)
counselor who will participate on site-based Student Support Teams (SST) and provide clinical
treatment services to students enrolled in three CHCCS middle schools (McDougle, Smith and
Phillips) and their families in accordance with state and federal laws and CHCCS and OCHD
policies. Treatment services include group and individual counseling, mentoring, and consultation.
In addition, selected 5~' grade students with psychosocial issues from feeder elementary schools
may be served by the OCHD MH counselor to ease potential middle school transition issues.
OCHD agrees to report activities, including the number of services rendered, to the CHCCS
Health Services Coordinator monthly and agrees to serve on district-wide committees as
appropriate. OCHD shall provide supporting documentation and/or data to the CHCCS Health
Services Coordinator to assist with written program evaluation at the end of the school year.
2. Payments and Documentation
CHCCS agrees to reimburse OCHD for clinical Mental Health services provided to middle school
students at a rate of $25 per hour for 20 hours per week for 30 weeks of the 2005-2006 school year
ending June 10, 2006. The contracted amount for Mental Health services equals $15,000. In
addition, CHCCS will compensate OCHD in the amount of $1800 (12% of contracted amount) for
administrative overhead. The full value of the contract is $16,800. OCHD will invoice CHCCS
monthly.
School based therapy
Students identified by the schools' SSTs would be eligible to be seen by the MH counselor up to
five times. These services may include early identification of violence and illegal drug use,
counseling about violence and substance abuse, conflict resolution, and mentoring. If additional
counseling therapy is deemed necessary and beneficial to the student, the OCHD MH counselor
will contact the parent/guardian(s) regarding ongoing treatment. Community options will be
offered, but a parent with a child covered by Medicaid may elect to continue counseling services
with the OCHD counselor in the school setting. Medicaid billing for ongoing services will be the
responsibility of OCHD. Should the student need long term or intense therapeutic mental health
services, their parent guardian(s) would be referred to a provider of their choice.
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4. Other Requirements
OCHD shall provide a Licensed Clinical Social Worker to serve as the mental health counselor
and agrees to provide CHCCS with a copy of credentials upon request. CHCCS agrees to provide
appropriate confidential counseling space, cooperation in getting students from class for
counseling sessions, assistance with scheduling appointments, and arranging for parental
permission.
5. OCHD is designated as a covered entity under HIPAA Privacy and Security rules. CHCCS agrees
to treat and maintain protected health information (PHI) confidentially as described in the
Business Associate Agreement signed by both parties. Notwithstanding the foregoing, the parties
agree to treat and maintain the confidentiality of all information shazed by the parties in
conformity with the most stringent of applicable federal, state and local privacy laws, regulations
and policies.
Termination for Cause
In the event that OCHD shall cease to exist as an organization or no longer provide Child and
Adolescent Psychosocial Counseling Services or not fulfill the obligations of this contract,
CHCCS may terminate this Agreement with OCHD. If payment has been made for any services
for which no satisfactory accounting has been rendered, OCHD will return such payments to
CHCCS.
This agreement is entered into between OCHD and CHCCS beginning September I, 2005, and ending June
30, 2006. This agreement may be terminated or suspended by either pazty at any time prior to its
expiration date upon written notification of the other party. When possible such notification shall be given
thirty days in advance of termination.
Signed:
Neil G. Pedersen
Superintendent
Chapel Hill-Carrboro City Schools
Date
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Rosemary Summ r
Health Director
Orange Co my Health Department
Date ~~
Ruby Pittman
Finance Director
Chapel H}ll Carrboro City Schools
Date ~ZS~aS
1(~oses Cazey
Chair
Orange Cou ty Bo d of C
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Ken Chavious
Finance Director
Orange County
Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act and the School Budget and Fiscal Control Act.