HomeMy WebLinkAbout2011-296 DSS - UNC Hospitals - Agreement for Medicaid maintenance caseworker and part time supervisor .2-
STATE OF NORTH CAROLINA UNCH
992
COUNTY OF ORANGE
AGREEMENT BETWEEN
THE UNIVERSITY OF NORTH CAROLINA HOSPITALS
AND
ORANGE COUNTY,NORTH CAROLINA
THIS AGREEMENT, made and entered into this the 1st day of July, 2011 by and
between Orange County ("County") by and through the Orange County Department of Social
Services ("OCDSS') and The University of North Carolina Hospitals, ("UNCH") in Orange
County,North Carolina. _
WITNESSETH:
WHEREAS,the parties have agreed with each other that the County will provide certain
services for The University of North Carolina Hospitals in connection with the Orange County
Department of Social Services(hereinafter referred to as OCDSS),Medicaid Program;and
WHEREAS,the UNCH has agreed to pay certain compensation for said service and the
parties desire to execute this contract to delineate their understanding of this agreement;
NOW,THEREFORE,the parties hereby agree as follows:
1. Term. The term of this Agreement shall be from July 1,2011 to June 30,2012.
2. The County agrees to the following:
a. Scope of Services: The County agrees to provide UNCH the services of one full
time Income Maintenance Caseworker and one part-time supervisor providing up
to 10 hours of supervision a week.
i. The Income Maintenance Caseworker shall receive all potential medical
assistance applications originating at UNCH. Specifically, the Income
Maintenance Caseworker shall perforin intake and processing functions
on MPW and MIC applications for Orange County and intake functions
only for all other applications,consisting of the following: conducting
interviews that initiate an application; obtaining signatures; obtaining
documentation available at the time of interview; forwarding
applications to the appropriate county for processing; meeting
verification requirements, processing and data entry timeframes, and
sending appropriate notices timely in all processing functions.
ii. The Income Maintenance Caseworker shall be assisted by UNCH staff in
obtaining information and documentation required to complete the
application process.
iii. The Income Maintenance Caseworker shall work cooperatively with
UNCH staff and the staff of any Department of Social Services to make
appropriate referrals of patients and family members with problems not
related to eligibility determination.
iv. The Income Maintenance Worker is an employee of the County and will
be directly supervised by and accountable to OCDSS. Due to the nature
of this agreement and the working relationship with UNCH, it is
necessary that close contact be kept with UNCH administration and
certain members of the hospital medical staff. In recognition of this
factor, UNCH will name a staff member to act as liaison between the
OCDSS, the Income Maintenance Caseworker, the departments of
UNCH and other staff personnel. Assignment of work to the Income
_. ... __
Maintenance Caseworker and coordination of sick, vacation, and other
_ .. .._.
" "...........leave will tlii"s UNCH staff rrrember aril the"
OCDSS supervisor.
V. The part-tithe Supervisor is an employee of Orange County and will
provide supervision and oversight of the Income Maintenance Worker.
b. The County will provide other agreed upon supportive services to UNCH
without additional charge, include continuing program training of the Income
Maintenance Caseworker and consultation with other counties in the catchment
area about applications for pre-and post-discharge patients.
c. The County will provide a monthly invoice to UNCH for the County's share of
the costs for the services of the income maintenance worker and for the part-time
supervisor. The county share of these positions is approximately 50 percent of
the cost of salary and benefits. Salary and benefits for the income maintenance
caseworker and the supervisor include: base salary according to the Orange
County pay plan;FICA taxes; local government retirement;vacation,sick,petty,
or other leave under approved county plan;paid holidays as observed by county;
county paid insurance(health,dental,and life).
3. UNCH agrees to the following:
a. Payment. UNCH will reimburse the County within fifteen (15)days of receipt
of monthly billings for the following:
i. The county share of the salary,benefits,and the indirect costs for both
the income maintenance caseworker and the part-time supervisor. The
reimbursement of the county's share of these positions is approximately
50 percent of the total cost of salary and benefits for these two positions.
Salary and benefits for the income maintenance caseworker and the
supervisor include: base salary according to the Orange County pay
plan; FICA taxes; local government retirement; vacation, sick,petty, or
other leave under approved county plan; paid holidays as observed by
county;county paid insurance(health,dental,and life).
ii. Administrative overhead and indirect costs associated with the income
maintenance worker and supervisor positions. This includes all other
supportive services provided by OCDSS or Orange County.
iii. The total cost of this contract is$49,587.
b. To participate in the interviewing and selection process utilized by OCDSS for
the hiring of the income maintenance caseworker and supervisor covered by this
agreement,in accordance with County policy and procedures.
C. To provide the following supportive services to OCDSS: office space;parking
space;office equipment;clerical support;and telephone service.
4. The Parties agree to the following:
C", "lf'at any time°'UNCx"dotermiries th at'the Indome-MmritenanC2 Casewakees'or
Supervisor's performance or professional interactions are inadequate or
inappropriate, UNCH may request that OCDSS initiate appropriate action to
correct that employee's deficiencies. Any disciplinary action taken shall be in
compliance with the Orange County Personnel Ordinance and the State
Personnel Act. Upon request UNCH shall provide sufficient documentation to
support any such action.
b. To abide by the conditions set forth in attached Business Associate Agreement,
which is attached hereto and incorporated by reference.
5. Termination. 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 Ieast.,60days prior to termination. In the event of such termination any
payment shall be prorated to the date of termination.
6. Indemnity. UNCH agrees to defend, indemnify and hold harmless the County from all
loss,liability,claims or expense,including attorney's fees,arising out of or related to the
Agreement and arising from bodily injury including death or property damage to any
person or persons caused in whole or in part by the negligence or misconduct of the
UNCH except to the extent same are caused by the negligence or willful misconduct of
the County. It is the intent of this provision to require the UNCH to indemnify the
County to the fullest extent permitted under North Carolina law.
7. Amendments or Modification. This Agreement shall not be altered, amended or
modified,except by an agreement in writing executed by the duly authorized officials of
both parties.
8. Subcontract or Assignment. The County shall not sub-contract out any of the services
provided for in this Agreement or make any assignment of this Agreement (including
rights to payments)without the prior written consent of the UNCH.
9. Relationship of the Parties. The County is an independent contractor. Neither the
County nor any employee of the County shall be deemed to be an officer, employee or
agent of UNCH. OCDSS personnel shall not be employees of, or have any contractual
relationship with the UNCH.
10. Intent to be Bound. The parties have read this Agreement, including the Business
Associates Agreement attached, and agree to be bound by all of its terms, and further
agree that the documents constitute the complete and exclusive statement of the
Agreement between the parties.
16. Entire Understanding. 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.
17. Governing Law. The laws of North Carolina shall govern the validity and interpretation
of the provisions,terms and conditions of this Agreement.
18, Ndtides.' Any'iiotice 'fcquiied by this Agreeiiienf"shall be in writing and deiliVdred by
certified or registered mail,return receipt requested to the following:
Orange County Department of Social Services UNCH
Nancy Coston Janice Summers
Director HCS Program Manager
113 Mayo Street UNC Health Care
P.O.Box 8181 101 Manning Drive
Hillsborough,NC 27278 Chapel Hill,NC 27514
Phone:(919)245-2800 Phone:(919)966-5581
IN WITNESS WHEREOF,the parties hereto have caused this contract to be signed by its duly
authorized officials.
FOR AND ON BEHALF OF: FOR AND ON BEHALF OF:
ORANGE COUNTY,NORTH CAROLINA THE UNIVERSITY OF NORTH CAROLINA
HOSPITALS
Frank W.Clifton, r. County Manager
Executive Director,The Oniversity
of North Carolina Hospitals
DATE: 12- - 1 DATE:
This instrument has been approved as to technical content.
Nancy Coston,S6ial Services Director Date
This instnunent has been pre-audited in the manner required by the Local Government Budget
and Fiscal Control Act.
Clarencok Grier,Director Date
Orange County Financial Services Director
This ns e s been approved as to form and legal sufficiency.
Ann to M.Moore,Staff Attorney Date
Office of the County Attorney
UNCH#92
STATE OF NORTH CAROLINA
COUNTY OF ORANGE
ATTACfIMENT A
THE UNIVERSITY OF NORTH CAROLINA HOSPITALS
AND
ORANGE COUNTY,NORTH CAROLINA
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the Ist day of July, 2011, by and between Orange County
("Covered Entity") and the University of North Carolina Hospitals (`Business Associate')
cd1l�cti�sel`Elie"`PaPCit S" _.._,..._ .- _.__..._._.
1. BACKGROUND'
a. Covered Entity and Business Associate are parties to a contract entitled UNCH#92(the
"Contract'), whereby Business Associate agrees to perform certain services for or on
behalf of Covered Entity.
b. Covered Entity is an organizational unit of Orange County(the"County")that has been
designated in whole or in part by the County as a health care component for purposes of
the HIPAA Privacy and Security Rules.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a"business associate"within the meaning of the
HIPAA Privacy and Security Rules.
d. The Parties enter into this Business Associate Addendum to the Contract with the
intention of complying,with the HIPAA Privacy and Security Rules provision that a
covered entity may disclose electronic protected health information or other protected
health information to a business associate,and may allow a business associate to create
or receive electronic protected heath information or other protected health information
on its behalf,if the covered entity obtains satisfactory assurances that the business
associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context,the following terms shall have
the following meaning in this Agreement;
a. "Electronic Protected Health Information"shall have the same meaning as the term
"electronic protected health information"in 45 CFR 160.103,limited to the information
created or received by-Business Associate from or on behalf of Covered Entity.
b. "HIPAA"means the Administrative Simplification Provisions,Sections 261 through
264,of the federal Health Insurance Portability and Accountability Act of 1996,Public
Law 104-191.
c. • "Individual"shall have the same,meaning as the term"individual"in 45 CFR160.103
and shall include a person who qualifies as a personal representative in accordance with
45 CFR 164.502(g).
d. "Privacy and Security Rules"shall mean the Standards for Privacy of Individually
Identifiable Health Information and the Security Standards for the Protection of
UNCH#92
Electronic Protected Health Information set out in 45 CFR part 160 and part 164,
subparts A and E.
e. "Protected Health Information"shall have the same meaning as the term"protected
health information"in 45 CFR 160.103,limited to the information created or received by
Business Associate from or on behalf of Covered Entity.
f. "Required By Law"shall have the same meaning as the term"required by law"in 45
CPR 164.103.
g. "Secretary"shall mean the Secretary of the United States Department of Health and
Human Services or his designee.
h. "Security Incident"shall have the same meaning as the term"security incident"in 45
-_____-____.___._-----...,_.
i. Unless otherwise defined in this Agreement,terms used herein shall have the same
meaning as those terms have in the Privacy and Security Rules.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose electronic protected health information
or other protected health information other than as permitted or required by this
Agreement or as required by law.
b. Business Associate agrees to implement administrative,physical,and technical
safeguards that reasonably and appropriately protect the confidentiality, integrity,and
availability of the electronic protected health information and other protected health
information that it creates;receives,maintains,or transmits on behalf of Covered Entity,
as required by the Priv&cy and Security Rules.
c. Business Associate agrees to mitigate,to the extent practicable,any harmful effect that is
known to Business Associate of a use or disclosure of electronic protected health
information or other protected health information by Business Associate in violation of
the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity(i)any use or disclosure of
electronic protected health information or other protected health information not
provided for by this Agreement of which it becomes aware and(ii)any security incident
of which it becomes aware.
e. Business Associate agrees to ensure that any agent,including a subcontractor,to whom it
provides electronic protected health information and/or other protected health
information received from,or created or received by Business Associate on behalf of
Covered Entity(i)agrees to be bound by the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information,and(ii)
agrees to implement reasonable and appropriate safeguards to protect such information.
f. Business Associate agrees to.provide access,at the request of Covered Entity,to
electronic protected health information and other protected health information in a
Designated Record Set to Covered Entity or,as directed by Covered Entity,to an
individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees,at the request of Covered Entity,to make any amendment(s)
to electronic protected health information and other protected health information in a
UNCH#92
Designated Record Set that Covered Entity directs or agrees to pursuant to 45 CFR
164.526.
h. Unless otherwise prohibited by law,Business Associate agrees to make internal
practices,books,and records,including policies and procedures concerning electronic
protected health information and other protected health information,relating to the use
and disclosure of electronic protected health information and other protected health
information received from,or created or received by Business Associate on behalf of,
Coveted Entity available to the Covered Entity,or to the Secretary,in a time and manner
designated by the Secretary,for purposes of the Secretary determining Covered Entity s
compliance with the Privacy and Security Rules.
i. Business Associate agrees to document such disclosures of electronic protected health
be required for Covered Entity to respond to a request by an individual for an accounting
of disclosures of electronic protected health information and other protected health
information in accordance with 45 CFR 164.528,and to provide this information to
Covered Entity or an individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement,if
the Contract permits,Business Associate may use or disclose electronic protected health
information and other protected health information to perform functions,activities,or
services for,or on behalf of,Covered Entity as specified in the Contract,provided that
such use or disclosure:
1) would not violate-the Privacy and Security Rules if done by Covered Entity;or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
b. Except as otherwise limited in this Agreement or by other applicable law or agreements,
if the Contract permits,Business Associate may use electronic protected health
information and other protected health information as necessary for the proper
management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements,
if the Contract permits,Business Associate may disclose electronic protected health
information and other protected health information for the proper management and
administration of the Business Associate,provided that:
1) disclosures are required by law;or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as required by law or for the purpose for which it was disclosed to
the person,and the person notifies the Business Associate of any instances of
which it is aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements,
if the Contract permits,Business Associate may use electronic protected health
information and other protected health information to provide data aggregation services
to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
UNCH#92
e. Notwithstanding the foregoing provisions,Business Associate may not use or disclose
electronic protected health information or other protected health information if the use or
disclosure would violate any term of the Contract or other applicable law or agreements.
S. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause.Upon Covered Entity's knowledge of a material breach by
Business Associate,Covered Entity may,at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the
violation,and terminate this Agreement and services provided by Business
_._.___.--_._._.-.-._-._-. Associate;to-th"xtentrpermissible-by-law,if-Business Associute-does-not-cure-the—•-•--------°---------•°-
breach or end the violation within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business
Associate,to the extent permissible by law;or
3) If neither termination nor cure is feasible,report the violation to the Secretary as
provided in the Privacy and Security Rules.
c. Effect of Termination.
1) Except as provided in paragraph(2)of this section or in the Contract or by other
applicable law or agreements,upon termination of this Agreement and services
provided by Business Associate,for any reason,Business Associate shall return or
destroy all electronic protected health information and other protected health
information received from Covered Entity,or created or received by Business
Associate on behalf of Covered Entity. This provision shall apply to electronic
protected health information and other protected health information that is in the
possession of subcontractors or agents of Business Associate. Business Associate
shall retain no copies of the electronic protected health information or other
protected health information..
2) In the event that Business Associate determines that returning or destroying the
electronic protected health information or other protected health information is not
feasible,Business Associate shall provide to Covered Entity notification of the
conditions that make return or destruction not feasible.Business Associate shall
extend the protections of this Agreement to such electronic protected health
information and other protected health information and limit further uses and
disclosures of such electronic protected health information and other protected
health information to those purposes that make the return or destruction infeasible,
for so long as Business Associate maintains such electronic protected health
information and other protected health information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement,all terms and conditions of the Contract shall
remain in force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract,the
Interpretation that is in accordance with the Privacy and Security Rules shall prevail. In
UNCH#92
the event that a conflict then remains.the Contract terms shall prevail so tong as they are
in accordance with the Privacy and Security Rules.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis
for Covered Entity to terminate the Contract for cause.
41 .alur'..f ment Director) (Signature of ontractor)
(Date Submitted) (Date Submitted)
(Signature of Department Director)
(Date Submitted)