HomeMy WebLinkAbout2004 S Health - UNC School of Pediatric Dentistry & General Practice Dental Resident Services~~~~ F ~ l~(z~~
STATE OF NORTH CAROLINA
COUNTY OF ORANGE
AGREEMENT BETWEEN
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
FOR ITS SCHOOL OF DENTISTRY
FOR ITS
DEPARTMENT OF PEDIATRIC DENTISTRY
AND THE
ORANGE COUNTY HEALTH DEPARTMENT
DENTAL HEALTH SERVICE
AS PART OF THE COUNTY OF ORANGE
This AGREEMENT is made and entered into this 1st day of July, 2004, by and between the
University of North Carolina at Chapel Hill, School of Dentistry, hereinafter referred to as the "School of
Dentistry", for its Department of Pediatric Dentistry and the Orange County Health Department hereinafter
referred to as the "Health Department" or "cooperative institution" for its Dental Service.
WITNESSETH:
WHEREAS, OCHD desires the services of one resident in the Dental Service for the academic
year 2004 - 2005;
WHEREAS, The Health Department desires to reimburse the School of Dentistry for the services;
NOW, THEREFORE, in consideration of the premises and of the following Mutual promises,
covenants and conditions, School of Dentistry and the Health Department agree as follows:
1. The Health Department will reimburse the School of Dentistry at the close of each quarter
$50.00, for each day of resident services.
2. The School of Dentistry will provide the services of one resident to the Health Department
for the purpose of rendering resident dental services of 1 day/week.
3. The Health Department will not be responsible for damages arising from personal injury
to residents of the School of Dentistry while they are present at the Health Department, unless
personal injury was caused by the negligence of the Health Department, its employees, or
agents. Nothing in this agreement is intended tg serve a waiver of sovereign or governmental
immunity by ~ „ Q~///~~~
4. In the event the resident is exposed to blood or bo ids, the Health Department will be
n~ responsible for providing the resident with an initial response, according to the Institution's Blood-
~'--~> Borne Pathogens Standard. The resident will be required to return to the University of North
sr~ofNZ aro ina Health Services for post-incident testing and counseling if feasible. In the
event the resident is unable to do so in a timely manner, the Health Department will provide
access to testing and counseling for the resident. The resident will be responsible for the
payment of services, but will be able to request reimbursement from the University of North
Carolina.
Between the University of North Carolina at Chapel Hill
School of Dentistry for its
Department of Pediatric Dentistry and OCHD
Page 2 of 3
5. The School of Dentistry will be responsible for the negligence of its employees and
agents to the extent of the North Carolina Tort Claims Act.
6. The School of Dentistry will be responsible for training its residents to follow the OSHA
Blood-borne Pathogens Standards, assuring that its residents comply with health requirements
established by North Carolina state regulations and the School of Dentistry.
7. The School of Dentistry will maintain proper records of its residents rotating through the
Health Department, and instruct its residents about Hepatitis B vaccinations, about the resident's
responsibility for post-exposure follow-up and any incurred costs, about the resident's
responsibility for the provision of protective equipment, and proper post-exposure record-keeping.
8. The person whose services are to be provided pursuant to the Agreement is, for all
purposes, an employee of the School of Dentistry.
9. While the School of Dentistry resident is at the Health Department, the professional
liability insurance coverage will be provided by the School of Dentistry with coverage of at least
$1 million, per incident, $3 million per year.
10. This Agreement shall run for a period of one year, from the 15t day of July, 2004 to the
30th day of June, 2005, and shall be renewable thereafter.
11. The School of Dentistry will bill the Health Department at the close of each quarter at the
rate of $50.00 /day for a maximum of 48 weeks/year (maximum reimbursement: $2,400.00). The
payment will be made payable to the UNC Department of Pediatric Dentistry and mailed to: Ms.
Jo Ann Blalock, Pediatric Dentistry, UNC School of Dentistry, Brauer Hall, Manning Drive, Chapel
Hill, NC 27599-7450.
12. "The Health Department and the School of Dentistry will comply with such non-
discrimination and 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."
13. 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 90
days prior to termination. In the event of such termination any payment shall be prorated to the
date of termination.
14. The 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.
15. The laws of North Carolina shall govern the validity and interpretation of the provisions,
terms and conditions of this Agreement.
Between the University of North Carolina at Chapel Hill
,, School of Dentistry for its
Department of Pediatric Dentistry and OCHD
Page 3 of 3
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 THE
ORANGE COUNTY HEALTH DEPARTMENT
DENTAL SERVICE
FOR AND ON BEHALF OF THE
UNIVERSITY~F NORTH CAROLINA
AT CHAPEL ILL
Rosemary, ~umr{i~rs, Health Director
J. Ttrhothy Wright, fessor & Chair
Department of Pedi ric Dentistry
Date:
This instrument has been pre-audited in the
manner required by the Local Government Bud-
getand Fiscal Control Act
v
Ken eth Chavious, Director
Orange County Fin c ~ O
Date:
Barry Jacobs, C~
Orange Cga~r~t~~ard o mm
~~~~-
Vf ~~
John W. Stamm, D
UNC School of De try
Date: 8'~1~/ d~
_.
Nancy D. Sutt field, Vice Chanc I r
Finance~Admi ' tration
Date: '""~ AEG ~ $ Li~u~
STATE OF NORTH CAROLINA
COUNTY OF ORANGE
AGREEMENT BETWEEN
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF DENTISTRY
FOR ITS
DEPARTMENT OF DENTAL ECOLOGY
AND
ORANGE COUNTY HEALTH DEPARTMENT
AMBULATORY CARE DENTAL SERVICE
THIS AGREEMENT, made and entered into this the 1st day of July, 2004, by and between The
University of North Carolina at Chapel Hill, School of Dentistry, hereinafter referred to as "The School of
Dentistry", for its Department of Dental Ecology; and The Orange County Health Department hereinafter
referred to as "The Health Department" for its Ambulatory Care Dental Service.
'_ WITNESSETH
WHEREAS, The .Health Department desires the services of one resident at the postgraduate year
one level in the Ambulatory Care Dental Service for the academic year 2004-2005;
WHEREAS, The Health'-Department desires to reimburse The School of Dentistry for the salary plus
fringe of one resident at the postgraduate year one level;
,..
WHEREAS,. The School of Dentistry wish to`provide the services of one resident to The Health
Department;
NOW, THEREFORE, in consideration of the premises and of the following mutual promises,
covenants, and conditions, The School of Dentistry, and The Health Department agree as follows:
1. The Health Department will reimburse the School of Dentistry at the close of each quarter for 1/4
the total salary and fringe: $11,808.25. Total annual amount is $47,233.
2. The School of Dentistry will provide the services of one postgraduate year one resident to The
Health Department for the purpose of rendering comprehensive dental services of 4 1 /2
days/wk. The School of Dentistry will provide attending dentist supervision to the resident
providing services under this Agreement.
3. The School of Dentistry will bill The Health Department at the close of each quarter for the
' Orange County Health Department July 1, 2004
Postgraduate Year One Level
salary/fringe of one postgraduate year one resident.
4. The Orange County Health Department will provide ten vacation days for one FTE resident at
the health department for the fiscal year 2004-2005. The vacation days will be cumulative for
the fiscal year. Once the total of the ten days vacation are utilized, no additional vacation
leave will be approved by the health department. The vacation request must be submitted to
the health department at least two months in advance. The Dental Health Service Director
will be responsible for approving all vacation leave and will submit a quarterly report to the
Director of the General Practice Residency Program.
5. The Health Department must provide HIV, HBV and HCV testing for the source patient in the
event of a bloodborne pathogen exposure. In the event the resident is exposed to blood or
bodily fluids, the health department will be responsible for providing an initial response,
according to the Orange County Health Department's Blood-Borne Pathogens Standard. The
resident (university employee) will be required to return to the University Employee Occupational
Health Clinic of North Carolina for post-incident testing and counseling if feasible. The resident
will be responsible for the payment of services. UNC-CH will reimburse the resident for testing
and counseling only, but not for any emergency treatment or medication administered.
6. The person whose services are to be provided pursuant to the Agreement is, for all purposes, an
employee of The UNC School of Dentistry.
7. While the UNC School of Dentistry resident is on rotation at the Orange County Health
Department, their professional liability insurance coverage will be provided by the School of
Dentistry with coverage of at least $1 million, per incident, $3 million per year.
8. This Agreement shall run for a period of one year, from the 1st day of July 2004 to the 30th
day of June 2005, and shall be renewable thereafter.
9. The School of Dentistry will be responsible for training its residents to follow the OSHA Blood-
borne Pathogens Standard, assuring that its residents comply with the health requirements
established by North Carolina state regulations and the School of Dentistry.
10. The School of Dentistry will maintain proper records of its residents rotating through the
Health Department, and instruct its residents about Hepatitis B vaccinations, about the
resident's responsibility for post-exposure follow-up and any incurred costs, about the
'Or:~nge County Health Department
Postgraduate Year One Level
July 1, 2004
resident's responsibility for the provision of protective equipment, and proper post -exposure
record-keeping.
11. 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 90 days
prior to termination. In the event of such termination any payment due shall be prorated to the
date of termination.
12. In compliance with 42 U.S.C. 1395x (v)(1)(I) and implementing regulations, The School of
Dentistry and the Health Department agree, until the expiration of four years after the services
are furnished under this contract, to allow the Secretary of the Department of Health and Human
Services and the Comptroller General access to this contract and to the books, documents and
records of The School of Dentistry and The Health Department necessary to verify the nature
and extent of this contract.
The School of Dentistry and The Health Department further agree that if any of the duties of this
contract are carried out by a subcontractor of The School of Dentistry or The Health Department
such subcontract shall contain a clause to the effect that, until the expiration of four years after
the services are furnished under such subcontract, the Secretary of the Department of Health
and Human Services and the Comptroller General shall have access to such subcontract and to
the books, documents and records of the subcontractor necessary to verify the nature and
extent of the costs of such subcontract.
13. "The Health Department and the School of Dentistry will comply with such non-discrimination
and 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."
14. "The Health Department will not be responsible for damages arising from personal injury to the
resident of the School of Dentistry while the resident is present at the Health Department, unless
personal injury was caused by the negligence of the Health Department, its employees, or
(7rxnge County Health Department
Postgraduate Year One Level
July 1, 2004
agents. Nothing in this agreement is intended to serve as a waiver of sovereign or governmental
immunity by Orange County."
15. The 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.
16. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms
and conditions of this Agreement.
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:
FOR AND ON BEHALF OF THE UNIVERSITY OF
NORTH CAROLINA AT CHAPEL HILL
Rosemary
Health Dju
Date:
This instrument has been preaudited in the
manner required by the Local Government
Budget and Fiscal Control Act.
Kenneth Chavious
Director, Ora~~$~ou}ty Finance
Date: d"//P~/®~
Nancy D. Sutt n eld F,r.4.r~--E
Vice ChaJn~~ll ~.ess and Ad istration
Date:
Chair, C~ fe C unty and of Commissioners
Date: f•~