HomeMy WebLinkAbout2003 S Health - UNC School of Dentistry for Pediatric Dentistry' #~ t RETURN THIS COPY TO THE CLERK'S OFFICE
FOR THE PERMANENT AGENDA FILE
STATE OF NORTH CAROLINA ~ ~ /~~ /Q
COUNTY OF ORANGE ~~
AGREEMENT BETWEEN
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
~,~ iTS SCHOOL OF DENTISTRY ~ / Q //
FOR ITS ~ ~//
DEPARTMENT OF PEDIATRIC DENTISTRY
AND THE
ORANGE COUNTY HEALTH DEPARTMENT
DENTAL SERVICE
AS PART OF THE COUNTY OF ORANGE
THIS AGREEMENT, made and entered into this the 1st day of July, 2003, by and between the
University of North Carolina at Chapel Hill for its 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' for its Dental Service.
WITNESSETH
WHEREAS, OCHD desires the services of one resident in the Dental Service fo the academic
year 2003-2004;
WHEREAS, this agreement is established for the purpose of securing and providing educational
and learning experiences for pediatric dentistry residents enrolled in the UNC School of Dentistry.
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 month
$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 one 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.
4. The Cooperating Institution must provide HIV, HBV and HCV testing for the source
patient in the event of ablood-borne pathogen exposure. In the event the student is exposed to blood
or bodily fluids, the Cooperating Institution will be responsible for providing initial response, according
to the Institution's Blood-Borne Pathogens Standard. The student will be required to return to the
University of North Carolina Student Health Services for post-incident testing and counseling if
feasible. In the event the student is unable to do so in a timely manner, the Cooperating Institution will
provide access to testing and counseling for the student. The trainee will be responsible for the
payment of services. UNC-CH will reimburse trainee for testing and counseling only but not for any
emergency treatment or medication administered.
~- ~ ~ • 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 negligen of its employees and
agents to the extent of the North Carolina Tort Claims Act. /f //
~ ss ~ ~ ~ a- ~ J/VC/J
6. The School of Dentistry will b responsible for traint~'r residents to follow the OSHA
Blood-borne Pathogens Standards, ~st~rtg 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 1St day of July, 2003 to the
30th day of June, 2004, 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 in its educational and/or employment
practices and HIPPA regulations will comply with such non-discrimination laws as may be
applicable to it in the performance of this agreement.
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.
off M
' - 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 on 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 OF NORTH CAROLINA
AT CHAPEL HILL
Rosemary S mers, a Ith Director
Date:
This instrument has been pre-audited in the
manner required by the Local Government
Budget and Fiscal Control Act.
r
Michael W. oberts, Chair
Department of edi tric Dentistry
Date: ~7~0 3
``i~~ ~
Kenneth Chavious, Director Jo n W. Stam , De ~'
Orange County Finance UNC School of De istr
Date: J~2 ~~.~ Date: ` ~1
Margaret Br n, Chair Nancy D. Su field, Vice Chan Ilor
Orange County Board of CQrry~issioners Finance~Ad istration
Date: ~: ~ ~ rL 16" f Date: _. 4NO ~ bTCT(~ ~