HomeMy WebLinkAbout2004 S Health - Renewal with UNC Family Medicine and Health DepartmentRETURN THIS COPY TO'THE CLERK'S OFFICE
FOR THE PERMANENT AGENDA FILE
STATE OF NORTH CAROLINA ~°,/9'T ~ ~~~z0o~
COUNTY OF ORANGE
AGREEMENT
THIS AGREEMENT, made and entered into this first day of July 2004, by and
between The University of North Carolina at Chapel Hill, hereinafter referred to as
'The University," for its Department of Family .Medicine in the School of Medicine,
hereinafter referred to as the "Department" and the Orange County Health
Department, hereinafter referred to as the "OCHD."
WITN ESSETH:
WHEREAS, the Department desires to provide Medical Director services and to
participate in the provision of medical care for the citizens of the community,
and;
WHEREAS, the OCHD is the operator of two outpatient facilities known as the
Orange County Health Department, located in Chapel Hill and Hillsborough,
North Carolina.
NOW, THEREFORE, in consideration of the premises and the following mutual
covenants and conditions and any sums to be paid, the OCHD and The
University agree as follows:
I. The Department will render professional consultation as Medical Director.
As Medical Director, the Department shall:
a. act as the principal advisor to the Health Director and Personal
Health Services Director in matters of medical policy;
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 2 of 9
b. advise the Health Director and Personal Health Services Director on
the medical implications of alternatives in clinical program
functioning and management;
c. represent the OCHD in interagency relationships which involve
medical expertise at the request of the Health Director;
d. advise and interpret the regulatory requirements related to medical
aspects of the OCHD'S functions;
e. provide coordination for medical components of the clinical
programs of the OCHD;
f. advise and assist staff in epidemiological investigations;
g. be responsive to community public health concerns directly and in
consultation with the Health Director and Division Directors;
h. assist the Health Director and Personal Health Services Director in
establishment of medical procedures and quality/quantity control
mechanisms;
i. assist in data analysis towards identification of public health
concerns;
j. work with the Health Director and Division Directors on formulation
of resbonses to public health concerns;
k. assist with evaluation of medical programs and services, including
recommendations for constructive change;
maintain close contact and availability through on-site visits and
phone consultation to discharge responsibilities at the OCHD;
m. participate in Division Head management meetings and Division
level meetings when requested and appropriate;
n. attend Board of Health meetings when requested;
o. provide medical direction to the school health programs in both
school systems in the County and medical consultation to both
OCHD and school staff working in the school health programs;
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-OS.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 3 of 9
p. discharge the above listed responsibilities through and with
knowledge aforehand of the Health Director;
r. other miscellaneous duties as necessary.
2. The Department shall provide agreed upon medical direction and
clinician services in compliance with State and Federal guidelines and
program rules for the following programs: family planning (FP), prenatal
care (PNC), child health (CH), adolescent health (ADOL), tuberculosis (TB),
sexually transmitted disease (STD), general communicable disease control
(GEN), adult health preventive services (AH/HP), and Primary Care (PC).
Clinical duties shall include:
a. Collaborative development and approval of clinic protocols; for the
mutual benefit of the Department, OCHD and its prenatal patients, it is
agreed by both parties that prenatal patients will be managed
according to OCHD established protocols. These will be reviewed
annually and be consistent with protocols used at UNC Department of
OB/GYN and Family Medicine outlying clinics.
b. Primary medical supervision of the nurse practitioners who are
employees of the OCHD;
c. Co-signing charts of patients seen by new nurse practitioners of the
OCHD within five (5) working days for at least the first six months of their
practice, and face-to-face consultation on a weekly basis for the first
month after approval and at least monthly for the succeeding five
months;
d. Routine medical services during scheduled on-site clinic times as
requested, including documentation of clinical services per OCHD
protocol;
e. Medical consultation visits to OCHD patients during scheduled on-site
clinic times;
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-OS.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 4 of 9
f. Continuing education consultation for nurse practitioners and other
staff to include regular informal consultation and periodic formal
sessions as appropriate;
g. After-hours medical consultation for primary care patients: HealthLink
will provide initial triage of after-hours calls. OCHD Clinicians (3 FNPs
and 1 MD) will provide medical consultation on a rotating basis for
clients referred by HealthLink (1 week/month/clinician). Medical
Director or designee will provide after-hours consultation to on-call FNP
as needed.
h. ,,.~ ~/~/~
~I8"'~°~
3. The Chair of the Department shall designate the name of the Medical
Director and the names of any physicians who will provide clinical
services. The Medical Director shall be board certified in Family Medicine
or an equivalent certification.
a. Any changes in these designations will be mutually agreed to by the
Chair of the Department and the Health Director.
b. The Department and OCHD shall indicate their mutual agreement to
the designation of the Medical Director and any other physicians
involved as described above by signing the "Designation of Medical
Director" attachment to this contract.
4. This agreement covers any and all clinics conducted by OCHD in the
program areas listed in #2 above.
5. Clinics are operational during the normal business hours of 8:00 a.m. to 5:00
p.m., Monday through Friday. One clinic day per site will operate on a flexible
evening schedule (e.g. 10:30 AM - 7:30 PM) to provide greater access to care.
Clinics may run beyond their scheduled time. The Department is responsible
for medical activities conducted during the entirety of these hours.
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-05.doc
AGREEMENT Befween UNC School of Medicine
And Orange County Health Department
Page 5 of 9
6. On-site physician attendance shall occur for a total of 20 hours per week in the
clinical setting. Days and times of this coverage will be mutually agreed to by
the- Department and OCHD. Although Medical Director or back-up physician
attendance is not required on premises at other times, it should be available
as stipulated above. At least 4 hours of direct administrative/consultative time
shall be available to OCHD staff weekly. On-site back-up coverage is
expected during vacations and other anticipated absences. Physicians are
responsible for notifying OCHD of schedule changes. If physician attendance
is impossible due to unremediable circumstances, physician phone coverage
will be provided and nurse practitioner charts will be signed within five (5)
working days.
7. The Medical Director or other designated physicians will be available at least 4
hours per week for phone consultation during business hours and after-hours
coverage, and emergency phone consultation shall be available as needed
during non-business hours through a pager system. Phone coverage will also
be provided for consultation and direction for communicable
disease/epidemic control. At the request of the Health Director, the physician
will provide on-site medical supervision during communicable disease
incidents.
8. The Department agrees to provide the equivalent of .70 FTE to carry out the
duties described above. The clinical and administrative services will be
provided primarily by the Medical Director, with other designated physicians
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-05.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page b of 9
providing back-up coverage. Substitutions in designated physician back-up
will be the responsibility of the Department in consultation with the Health
Director. Vacation leave, continuing education, and other assignments
requiring back-up coverage will be mutually agreed upon by the Chair of the
Department and the Health Director. The Medical Director will report activities
and services performed to OCHD as requested by the Health Director.
9. The Department will maintain current registration and licensure and shall
provide copies to the OCHD as appendices to the Designation of Medical
Director attachment to this contract.
10. The Department will assure that physicians covered under this agreement
are in compliance with OSHA guidelines regarding bloodborne
pathogens including Hepatitis B and TB status as well as documentation of
immunization against measles, mumps, rubella and varicella. In the event
of a bloodborne pathogen exposure, the Department will be responsible
for providing follow-up according to its policies and procedures governing
exposure incidents.
11. The University will be responsible for the negligence of its employees and
agents to the extent of the North Carolina Tort Claims Act. Further, the
University will provide adequate professional liability insurance for the
University and personnel who provide the services described in the
agreement. The insurance limits will be stated in a Confirmation of
Insurance submitted at the time the contract is commenced.
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-OS.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 7 of 9
12. The Department will offer medical consultation in accord with the
accepted methods and procedures.
~ ~~1b~
~~p~r
13. The OCHD agrees to pay the Department in return for the above services $ ~
six hkhc~•{cf aid e/ev~.~c.,
equal monthly installments ofd THOUSAND A;+~B-P1+P~~ DOLLARS
~~o, e~/. a b ~ia~ 33 a-~
($a-~;88~-00) for a total of $a-3 ; ~+~Ez
14. The University shall bill the OCHD on a monthly basis with the first bill being
dated July 1, 2004 and the OCHD shall pay the University within thirty (30)
days of receipt of the University's bill. Any adjustments to the billing shall
be taken into account in the next. succeeding bill or as soon thereafter as
reasonably practicable.
15. The OCHD agrees to furnish all supplies, equipment, office space and a
computer as needed by the Medical Director; to include the Medical
Director in al! appropriate conferences, meetings, correspondence and
publications necessary to appropriately discharge the Medical Director's
duties within budgetary constraints.
16. In the event that the Medical Director and back-up physician become
unwilling or unable to perform the duties required by this Agreement, The
University and OCHD shall attempt to mutually agree upon replacement.
If such mutual agreement is not achieved, then this Agreement shall
terminate and any payment due as of the date of termination shall be
paid.
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-05.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 8 of 9
17. This Agreement shall run for a period of TWELVE (12) months, from the 1st
day of July, 2004, to the 30th day of June, 2005, and shall be renewable
annually thereafter upon written notice executed by both parties.
18. 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.
19. The OCHD hereby agrees with~The University that, in its educational and/or
employment practices, the OCHD will comply with such non-
discrimination law as may be applicable to it in the performance of this
Agreement. The Department hereby agrees to abide by pertinent rules
and regulations of the OCHD, Orange County, and the North Carolina
Department of Health and Human Services in the conduct of service. The
University, the Department and OCHD will comply with such confidentiality
laws as may be applicable in the performance of this agreement and
acknowledge that in receiving, storing, processing or otherwise dealing
with any confidential information, they will safeguard and not further
disclose the information except as permitted by the Health Insurance
Portability and Accountability Act of 1996, Public Law 104-191, as
amended.
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-0S.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 9 of 9
20. No provision of this Agreement shall be construed or interpreted as
creating a pledge of the faith and credit of the County of Orange or
OCHD 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 a lending of
the credit of the County of Orange or OCHD within the meaning of the
Constitution of the State of North Carolina. This Agreement shall and does
not directly or indirectly or contingently obligate the County of Orange or
OCHD to make any payments beyond those appropriated in the sole
discretion of the County of Orange or OCHD for any fiscal year in which
this Agreement shall be in effect. No deficiency judgment may be
rendered against the County of Orange or OCHD in any action for breach
of a contractual obligation under this Agreement and the taxing power of
the County of Orange is not and may not be pledged directly or indirectly
C~`~c~
or contingently. to secure any moneys due under this Agreement. ~;Q,~ ~- Sid
21. 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.
22. The laws of North Carolina shall govern the validity and interpretation of
the provisions, terms, and conditions of the Agreement.
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-05.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 10 of 9
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 ummers, MPH, DrPH
Health Director
DATE: (~
FOR AND ON BEHALF OF
THE UNIVERSITY OF NORTH CAROLINA
AT CHAPEL HILL
~ v
William L.~oper, MD, MPH
Dean, School of Medicine
Vice Chancellor for Medical Affairs
DATE: ~ ~"a~
~,__.
z
Warren P. Newton, MD
Chair, Family Medicine
DATE: ~~O~S~
FOR AND ON BEHALF OF THE COUNTY OF ORANGE
Barry Jac s, air
Orange oun c
DATE:
rd otiCommissioners
ORANGE COUNTY FINANCE DIRECTOR:
'This instrument has been pre-audited in the manner required by the Local
Government Budget and Fiscal Control Act."
Ken Chavious
Finance Director
DATE: ~ (~
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-05.doc
AGREEMENT Between UNC School of Medicine
And Orange County Health Department
Page 1 1 of 9
Designation of Medical Director
Attachment to Contract between the Department of Family Medicine, University
of North Carolina, School of Medicine and the Orange County Health
Department for July 1, 2004 through June 30, 2005.
The following physicians are designated by the Department of Family Medicine
to fulfill the terms of the attached contract:
Michael Fisher, MD Medical Director
Lauren Lingley, MD Physician
Clark Dennison, MD Physician
Andrew Hannigel, MD Physician
Margaret Nusbaum, DO Physician
Copies of current registration and licensure for these physicians are attached.
Signed:
,vw
t0 0"
Warren Newton, Chair
Department f Family Me icine Date
C'v`,C ~ William L. Roper, MD, MPH //~
Dean, School of Medicine CP°Z~~
Vice Chancellor for Medical Affairs
Agr
Rosemary Su mers, Health Director
Orange Cou y Health Department Date
C:\windows\temp\UNC Family Medicine -Medical Director Final 2004-05.doc
May 19, 2004
Addeo m A to ~ Q
Agreement betwee NC and OCHD ~ v`~
For Medical Di ector Services ~~ ~~.
$.
Whereas, the Chapel HilUCarrboro City Sch ols (CHCCS) employ two (2)
School Nurses who are licensed and qualified arse Practitioners (Head Start Program
and Carrboro Elementary School), and;
Whereas, the Chapel HilUCarrboro City
Nurses provide limited nurse practitioner
and;
Whereas, the two School Nurse Practitioners
(CHCCS) seek to have the two School
to students at their respective sites,
medical supervision, and;
Whereas, the Orange County Health Department ( CHD) maintains a Memorandum of
Agreement with the Chapel HilUCarrboro City Sch ols to provide medical direction to
school nurses by the OCHD Medical Director, and;
Whereas, the Department of Family Medicine of the C School of Medicine
(Department) provides Medical Director services to HD through the attached contract
and is agreeable to expanding the contract to provide edical supervision to the CHCCS
School Nurse Practitioners.
Therefore, the above parties agree to the following:
1. OCHD Medical Director (or other mutually agree upon UNC Family Practice
physician) will provide medical supervision to the HCCS School Nurse
Practitioners from August 15, 2004 to June 15, 200
(10 months).
2. CHCCS will maintain medical malpractice insurance qual to or exceeding a $1
million per incident and a $3 million upper limit cove ge for its School Nurse
Practitioners and will fiunish proof of insurance to the CHD and the
Department.
3. CHCCS will submit all nurse practitioner protocols to HD for review by the
Medical Director or designee prior to implementation of he protocols.
4. CHCCS will provide OCHD with copies of the Nurse Pr ctitioner's current
license.
5. OCHD will amend its agreement with CHCCS to include a medical supervision
of its School Nurse Practitioners by the OCHD Medical Di ector or designee with
its corresponding period of coverage and costs.
6. CHCCS will pay OCHD for medical supervision of its Sch of Nurse Practitioners
the amount of $4776/year (2 hours/wk x 6 months; 2 hours/ o x. 4 months) in
one lump payment by September 30, 2004.
May 19, 2004
7. OCHD will pay Department for the a
of $398, an amount which is incorpor
the attached contract.
8. This agreement is in effect from July 1
services in twelve monthly installments
in the monthly payment agreement of
X04 through June 30, 2005. ~ ~ti~,•°~
~~JW
Si~natures•
Rosemary Summers, MPH, DrPH
Orange County Health Director
Date
Neil Pedersen, PhD
CHCCS Superintendent
~--_
,~
Warren Newton, MD
Chair, Family e icine William L. Roper, MD, MPH
L G~, Dean, School of Medicine
Vice Chancellor for Medical Affairs
Orang o ty Finan e Director:
"This instrument ha been pre-audited in the manner
Budget and Fiscal Control Act."
-o
Ken Chavious
Finance Director
Barry"~acobs,
Orange Co ty Bo of
Date
d
~-~~-a~
by the Local Government
Date
Date