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HomeMy WebLinkAbout2002 S Health - N.C. Dept of Health & Human Services Consolidated RETURN THIS COPY TO THE CLERK'S OFFICE FOR THE PERMANENT AGENDA FILE Consolidated Agreement -Final Page 1 of 13 APR z 9 2002 CONSOLIDATED AGREEMENT BETWEEN THE STATE OF NORTH CAROLINA AS REPRESENTED BY THE STATE HEALTH DIRECTOR (Hereinafter called the "State") AND Orange County Health Department (Local Health Department/District/Public Health Authority/Human Services Agency(Wake and Mecklenburg) -- Hereinafter called the "Department') FOR THE PURPOSE OF MAINTAINING AND PROMOTING THE ADVANCEMENT OF PUBLIC HEALTH IN NORTH CAROLINA This Agreement Shall Cover a Period From July 01, 2002 to June 30, 2003 and shall remain in force until the next Fiscal Year Agreement is signed except as provided for in Section J. Termination. NOW, THEREFORE, the State and the Department agree that the provisions and clauses herein set forth shall be incorporated in and constitute the terms and conditions applicable for activities involving State funding. (State funding or funds means state, federal, and/or special funding or funds throughout this agreement.) Consolidated Agreement - Final Page 2 of 13 A. RESPONSIBILITIES OF THE,DEPARTMENT (LOCAL PUBLIC HEALTH UNIT) 1. The Department shall perform activities in compliance with applicable program rules contained in the North Carolina Administrative Code, as well as, all applicable Federal and State laws and regulations. 2. The Department shall perform the activities specified in the Program Agreement Addenda for State funded budgets. The Department must negotiate these Agreement Addenda in good faith to the satisfaction of state representatives as part of the agreement execution. Departments will meet or exceed the Agreement Addenda levels unless extenuating circumstances prevail and are explained in writing to the state section, branch or program. 3. The Department shall administer and enforce all rules that have been adopted by the Commission for Health Services, ratified by the NC General Assembly, or adopted by the Local Board of Health. 4. The Department shall provide to the State copies of rules adopted by the Local Board of Health pursuant to G.S. 130A-39 and Public Health Ordinances adopted by the County Commissioners, within 30 days of adoption. These rules/ordinances are to be sent to the Office of Local Health Services. 5. The Department shall provide to the State a comprehensive community health assessment every four years and a State of the County Report each of the interim three years. Local Health Services/ Health Education Office will administer this four-year cycle. The community assessment should be a collaborative effort with the local Healthy Carolinians Partnership and shall include collection of primary data at the county level as appropriate. The Assessment shall include a list of community health problems based on the findings, a narrative of the assessment findings, and community action plans to address the priority issues. 6. The Department shall provide formal training for their Board of Health (BOH) members through DHHS sponsored offerings through the UNC School of Public Health - Institute of Public Health. First priority will be given to training newly appointed members with the ultimate goal of having all BOH members trained as time and resources allow. Continuing education updates on topics of special interest are strongly encouraged after general board member orientation has been provided for all BOH Members. Individual need of Boards and members will be considered in meeting this objective. B. FUNDING STIPULATIONS 1. Funding for this agreement is subject to the availability of State, Federal, and Special Funds for the purpose set forth in this agreement. 2. During the period of this agreement, the Department shall not use State, Federal or Special Project funds received under this agreement to reduce locally appropriated funds as reflected in the Local Health Department-Local Appropriations Budget. 3. The Department shall not use personal health program funds to support environmental health programs nor use environmental health program funds to support personal health programs. 4. Fees generated by the Food and Lodging Fees Collection Program may only be used to support State and Local food, lodging, and institution sanitation programs and activities. Consolidated Agreement - Final Page 3 of 13 5. Funds for Childhood Lead Poisoning Prevention may be used to support both environmental health and child health activities. 6. The county shall submit monthly reports of On-Site Wastewater activities to the On-Site Wastewater Section in DEH in the format provided by the Section. 7. The Department shall comply with Standards for Mandated Public Health Services, 15A NCAC 25, Section .0200; and Administrative Procedures Manual for Federal Block Grant Funds, 1 NCAC 33, Sections .0100 - .1502. 8. The Department shall maintain signed employee time records to document the actual work activity of each employee on a daily basis. The percentage of time each employee spends in each activity shall be converted to dollars based upon the employee's salary and benefits at least on a monthly basis. The computation shall support the charges for salaries and benefits to all federal and state grants (as required in OMB Circular A87); as well as provide the documentation of detailed labor cost per activity for preparation of Medicaid Cost Report. 9. The Departments participating in Medicaid. Reimbursement shall: a. Execute a Provider Participation Agreement with the Division of Medical Assistance. b. Make every reasonable effort to collect its cost in providing services, for which Medicaid reimbursement is sought, through public or private third party payors except where prohibited by Federal regulations or State law, however no one shall be refused services solely because of an inability to pay. c. Establish their Charge per clinical/support service for all payors (including Medicaid) based on their full costs. All Payors must be charged the same established charge, but contract/program adjustments may be accepted as negotiated payment in full. 10. Subject to the approval of the appropriate Section, a local health department may seek reimbursement for services covered by a program operating under 15A NCAC 24A rules, Purchase of Medical Care Services (POMCS), when those services are not supported by other state or federal funds. All payment program rules and procedures as specified in the Purchase of Medical Care Services Manual must be followed. 11. Provision of Interpreter Services: a. Programs and services supported in whole or in part with federal funds must provide interpreter services at no charge to non-English speaking clients. b. Only those programs and services funded entirely with state and/or local funds, unless prohibited by State law or rule, may charge non-English speaking clients for interpreter services. However, no one shall be refused services solely because of an inability to pay for interpreter services. 12. Subject to the availability of funds and approval of the Public Health Nursing and Professional Development Unit, a local health department may request reimbursement for: a. Nursing service personnel participating in the"Introduction to Principles and Practices of Public Health and Public Health Nursing Course". Reimbursement is limited to no more than $400.00 per participant upon successful completion of the course. Consolidated Agreement - Final Page 4 of 13 b. Nursing service personnel participating in the "Public Health Nurse Supervisors Training Course." Reimbursement is limited to no more than $600.00 per participant upon successful completion of the course. c. Health Department Management level staff(all disciplines) attending certain Management training endorsed by the State Health Director's Office and when the local staff member is a part of a state team accepted into these training/institute may have the enrollment cost of this training paid by the State. 13. The Department shall have an annual audit performed in accordance with "The Single Audit Act of 1984 as implemented by OMB Circular A-133."The audit report shall be submitted to the Local Government Commission (LGC) by the County Administration (if single county health department) or the District Health Department or Public Health Authority (if so organized)within (six) 6 months following the close of the agreement. Audit findings referred to the DHHS Controller's Office by LGC will be investigated and findings verified by the DHHS Controller's Office staff with assistance of the Division of Public Health Program Staff. 14. Equipment are a type of fixed asset consisting of specific items of property that: (1) are . tangible in nature; (2) have a life longer than one year; and (3) have a significant value. a. For Inventory Purposes i. Equipment must be accounted for in accordance with the North Carolina Department of State Treasurer Policies Manual, Chapter 20, Fixed Assets Policy. ii. All equipment with an acquisition cost of$500.00 or more, and purchased with Women, Infants and Children (WIC) Program Funds, must be inventoried with the Women's and Children's Health Section. b. For Prior Approval Pumoses i. All equipment purchased or leased with an acquisition cost exceeding $500.00, where there is an option to purchase with State/Federal funds, must receive prior written approval from the appropriate Section (including the WIC Program). ii. All medical equipment and computer equipment, (purchased or leased) regardless of cost, purchased with WIC Program Funds, must receive prior approval from the WIC Program Office. iii. The use of Women's and Children's Health Medicaid fees for capital improvements requires prior written approval from the Women's and Children's Health Section. 15. The Department agrees to execute the following Federal Certifications attached to this agreement applicable when receiving Federal funds: a. Certification regarding Lobbying. b. Certification regarding Debarment. c. Certification regarding Drug-Free Workplace Requirements. d. Certification regarding Environmental Tobacco Smoke A 1 Consolidated Agreement - Final Page 5 of 13 16. The Department is encouraged to incorporate the basic elements of the NC Public Health identity design (logo and slogan) into appropriate communication materials developed for programs and services that depend upon, in whole or part, state funding. Such communications materials could include, but not be limited to , agency letterhead, business cards, printed materials such as brochures and pamphlets, print advertisements or announcements, signs, marketing and/or promotional materials, etc. The public health logo may be modified for local use (e.g., the name of the local department may be inserted to replace the words"North Carolina Public Health"). Whenever the public health logo is displayed, including display of a modified version for local use, the public health logo"North Carolina Public Health, Everywhere, Everyday, Everybody" must accompany its display. The NC PHAP is in the process of updating this logo with local input. It is the intent of the Division that the updated Logo and Slogan be available by next SFY. All Departments will be strongly encouraged to use the new logo and slogan, if at all possible within the constructs of their county policy, for SYF 03-04. C. FISCAL CONTROL 1. The Department shall comply with the Local Government Budget and Fiscal Control Act, North Carolina General Statute Chapter 159, Article 3. a. The Department shall maintain a purchasing and procurement system in accordance with generally accepted accounting practices and procedures set forth by the Local Government Commission. b. The Department shall execute written agreements with all parties who invoice the Department for payment for the provision of services to patients. c. When subcontracting, the following conditions must be met: i. The Department is not relieved of any of the duties and responsibilities provided in this agreement. ii. The subcontractor will agree to abide by the standards contained herein or to provide such information as to allow the Department to comply with these standards. iii. The subcontractor will agree to allow state and federal authorized representatives' access to any records pertinent to its role as a subcontractor of the Department. iv. Upon request, the Department will make available to the State a copy of subcontracts supported with State/Federal funds. d. The Department must receive prior written approval from the state to subcontract when any of the following conditions exist: i. The Department proposes to subcontract to a single entity fifty percent (50%) or more of the total state and federal funds made available through this agreement ii. The Department proposes to subcontract fifty percent (50%) or more, or$50,000 which ever is greater, of the total state and federal funds made available through this agreement for a single public health service or program. iii. The Department proposes to subcontract for services in the Women, Infants and Children (WIC) Program. Consolidated Agreement - Final Page 6 of 13 e. The Department shall mail a signed copy of all final Funding Authorizations to the DHHS Controller's Office, 2019 Mail Service Center, Raleigh NC 27699-2019. The Department shall retain a copy of all Funding Authorizations, Local Health Department-Local Appropriations Budget, Electronic Spreadsheet— Local Health Department/District Expenditure Report DHHS 2949, Signed Consolidated Agreement, Agreement Addenda, Revisions and other financial records in accordance with the current Records Disposition Schedule for County and District Health Departments issued by the NC Division of Archives and History, Department of Cultural Resources 2. The Department shall prepare and maintain a Local Appropriations Budget (reflecting the plans to use local appropriations or earned fees)for each activity covered by this agreement in a manner consistent with instructions provided in general budgetary guidance from the Division and the specific guidance from the respective programs. a. The Department shall prepare budget revisions to their Local Appropriation budgets when appropriations will be increased or decreased. b. The Department shall submit all revisions to Local appropriations budgets prior to the end of the term specified in this agreement. Budget revisions received by the State after the end of the agreement period will be returned without action. 3. (Local Earned Revenues)The Department shall observe the following conditions when budgeting and reporting earned revenues: a. Locally appropriated funds may not be supplanted by earned revenues from persons, or public or private third party payors. Such revenue shall be used for the activity that generated the revenue, except in the WCH Section programs, where there is some flexibility (see "b" below.) b. All earned revenue (officially classified as local funds) must be budgeted and spent in the program that earned it except, i Revenue generated by WCH Section Programs may be budgeted and expended (consequently reported) in any WCH Section Program activity. ii Revenue generated by a local clinic or program that has no state funded activity budget (no state/federal funds) should be budgeted and associated expenditures reported in a state program activity that most closely matches the deliverables of the respective state program. This process will enable the collection of total expenditures in public health per program. c. All fees collected shall be used in the current year or succeeding fiscal years. d. Use of program income generated by the expenditure of Federal categorical funds will be governed by applicable Federal regulations, including, but not limited to, 45 CFR 4. e. When preparing Local Appropriation Budgets, i. Line item 9000 on the program budget form must be used to budget the total of line items 101, 102 and 103. ii. Line item 101 on the program budget must be used to budget local appropriations. Consolidated Agreement - Final Page 7 of 13 iii. Line item 102 on the program budget must be used to budget TXIX Medicaid earned revenues. iv. Line item 103 on the program budget must be used to budget other earned revenues (e.g., Home Health Fees, Environmental Health Fees, Patient fees (cash), Other insurances, and other grants and donations.). f. When reporting expenditures (local appropriations or earned fees)the department must use the electronic spreadsheet (Local Health Department/District Form DHHS 2949 revised 5/03/01)— hereafter referred as DHHS Spreadsheet— prepared and maintained by the DHHS Controller's Office. This report must be submitted monthly in an electronic format (DHHS 2949— Local Health Dept/District Expenditure Report - Excel Spreadsheet File) as an attachment to an email to designated staff in the Benefits and Payment Section of the Controller's Office. At the time the electronic report is emailed to the DHHS Controller's Office, a "Certification of Expenditures" signed by the health director, shall be faxed to the DHHS Controller's Office. The "Certification" verifies in writing that the total State and Federal expenditures reported were valid. Local expenditures are part of the Expenditure report, but are not included in the amount verified in the"Certification." i. Line item 101 on the DHHS Form 2949 Spreadsheet must be used to report local appropriations that were expended ii. Line item 102 on the DHHS Form 2949 Spreadsheet must be used to report TXIX (Medicaid) earned revenues that were expended. iii. Line item 103 on the DHHS Form 2949 Spreadsheet must be used to report other earned revenues that were expended. g. A local account shall be maintained for unexpended earned revenues (i.e., TXIX fees, private Insurance or private pay(cash)]. Accounts shall be maintained in sufficient detail to identify the program source generating the fees. h. The amount of Title XIX fees budgeted and expended in FY 2002-2003 must equal or exceed the amount of Title XIX revenues earned during FY 2000-2001. The state will not approve program activity budgets that do not include an amount of Title XIX fees sufficient to meet the requirements of this section. The State may waive this requirement if the Department provides sufficient justification. 4. (State/ Federal Revenues)The Department shall submit a monthly report of actual expenditures (State and/or Federal) to the DHHS Controller's Office on the DHHS (Electronic) Spreadsheet (same electronic Spreadsheet DHHS 2949 as referenced in 3 above)—all reported in one spreadsheet, but separated here for clarity of instructions. a. The Department shall submit monthly expenditures for all programs via DHHS 2949 (Electronic) Spreadsheet to the DHHS Controller's Office according to their schedule published annually in December for the next calendar year. The schedule reflects a general period of 15-20 days from the end of the reporting month for submission of the DHHS Spreadsheet, based on weekends and holidays, to allow processing time for the payment. Failure to meet the reporting deadline, as published, MAY result in the exclusion of those expenditures in the Steps-Out payment for that month. The Department must submit these monthly expenditure reports, via this DHHS Spreadsheet, consecutively throughout the agreement period. Consolidated Agreement - Final Page 8 of 13 b. Departments shall keep expenditure reporting current and submit their DHHS Form 2949 Spreadsheets per the published DHHS Controller's Office Schedule. Since funding is based on an Allocation Method versus a Contract Method, there will be 12 payments during the Fiscal Year Period (July through June). However, the actual last service month to be paid in the SFY will be May services - Reported in June. A department cannot catch up expenditures in June from prior service months without severely limiting funds available the next fiscal year since such reporting will require payment out of the next fiscal year budget. Totally state funded budgets (or those predominately state funded)will not have carryforward available to liquidate obligations from prior reporting periods. c. When reporting program activities that are funded by federal funds, these expenditures must be reported according to the authorized federal funding period. This is extremely critical since payment of federal funds cannot be made prior to their effective date (e.g., program "A° during the course of a state/county fiscal year is funded from two (2) separate Federal Fiscal Years—3 months from FFY 02 and 9 months from FFY 03. — In order to claim reimbursement of these federal funds, 3/12 of the Expenditures must occur and be reported in the 3 months of FFY 02 and 9/12 of the expenditures must occur and be reported in the 9 months of FFY 03. d. The Department shall submit the final (DHHS 2949) LHD Expenditure Report (Electronic Version)for all programs to the DHHS Controller's Office according to the schedule published annually in December for the next Calendar Year by the DHHS Controller's Office. The May Services/Reported in June will be the final report period paid from the SFY. Services provided in June and reported in July will be paid out of the next SFY. e. The Department shall have opportunities to submit amended or corrected expenditure reports up to 30 days after the available funding period ends. Any such reports must be prepared for the specific month to be amended or corrected. Reports received after these deadlines will be returned without action. For example 3 months funding (July, Aug, and Sept) must be expended within that time frame and be reported accordingly. If an expenditure revision is necessary for such funds, it must be submitted by the October reporting deadline. f. The Department shall refund to the State all unexpended State funds within 30 days after notification of overpayment. When payment is not received by the State within 30 days,future payments to the Department may be reduced by the amount due or payments may be suspended until the refund is received by the State. g. The Department shall submit expenditure reports for Mosquito Control activity to DENR in accordance with 15A NCAC 1813, Sections .0104 and .0107. h. The Department shall submit requests for payment for services provided under 15A NCAC 24 A rules to the Claims Processing Unit, Purchase of Medical Care Services, DHHS- Controller's Office. i. The Department shall submit requests for reimbursement for nurse training to the Public Health Nursing and Professional Development Unit. Form 3300— Public Health Nurse Training Activity must be used as the invoice for payment. Consolidated Agreement - Final Page 9 of 13 j. Departments providing the WIC Program shall limit the total expenditures for July, August, and September(1st quarter of the State/County Fiscal Year) to no more than one-fourth (1/4) of their total budget for the Agreement Period. If any local encumbrances are recorded for July, August or September, to be paid in'subsequent months, these expenditures must be accounted for in the 25% limit imposed for July, August and September expenditures. 5. The Department shall submit to Local Health Services Section on an annual basis Staff Time Activity Report- DPH 3389, Environmental Health Report-DENR 3738, and Food and Lodging Report- DENR 3888 These reports are due by July 20th. D. PERSONNEL POLICIES 1. The Department shall adhere to and fully comply with State personnel policies as found in North Carolina General Statute, Chapter 126, and 1 NCAC 8. Such policies include, but are not limited to, the following: a. Equal employment opportunity, b. Affirmative action, c. Policies for local government employment subject to the State Personnel Act, d. "Local Classification and Salary Range," e. "Compensation Policy for Local Competitive Services Employees," and f. 'Recruitment and Selection Policy and Procedures." 2. Environmental Health Specialists employed by the Department shall be delegated authority by the State to administer and enforce State environmental health rules and laws as directed by the State pursuant to G.S. 130A-4(b). This delegation shall be done according to 15A NCAC 10. 0100. a. Local health departments are responsible for sending their newly employed environmental health specialists (intems)to centralized training within 180 days from date of employment. b. Arrangements for centralized training for newly-employed environmental health specialists will be handled by the Education and Training Staff, Division of Environmental Health. c. A local health department which is contracting with an environmental health specialist employed by another department shall be responsible for assuring that all original documents, correspondence, and other public records be maintained in the health department using the contractor and the contract shall stipulate that the contractor shall be available for consultation to the public being served. 3. The Department shall comply with Minimum Standard Health Department Staffing 15A NCAC Section .0301(c), and shall assure that all nursing staff who provide public health services funded by this agreement comply with this rule. Consolidated Agreement - Final Page 10 of 13 E. CONFIDENTIALITY All information as to personal facts and circumstances obtained by Department personnel in connection with the provision of services or other activity under this agreement shall be privileged communication, shall be held confidential, and shall not be divulged without the client's, or responsible person's, written consent; except as may be otherwise required by applicable law or regulation. Such information may be disclosed in summary, statistical, or other form which does not directly or indirectly identify particular individuals. Department Employees must sign confidentiality pledges documenting the knowledge of, and the agreement to maintain, personal and medical confidentiality. F. CIVIL RIGHTS 1. The Department shall assure that no person, on the grounds of race, color, age, religion, sex, marital status, immigration status, national origin or otherwise qualified handicapped individual, solely by reason of his/her handicap (unless otherwise medically indicated), be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity covered by this agreement. 2. The Department shall complete HHS Form 690, Assurance of Compliance with Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973; Title IX of the Education Amendments of 1972, and the Age Discrimination Act of 1975. 3. The American with Disabilities Act 1990 (ADA) makes it unlawful to discriminate in employment against a qualified individual with a disability and outlaws discrimination against individuals with disabilities in State and local government services and public accommodations. The Department certifies that it and its principals and subcontractors will comply with regulations in ADA Title I (Employment), Title II (Public Services), and Title III (Public Accommodations) in fulfilling the obligations under this agreement. G. RESPONSIBILITIES OF THE STATE 1. The State shall provide to the Department regular training, and, upon request, technical assistance in the preparation of the Consolidated Agreement, Local Health Department — Local Appropriations Activity Budgets and Agreement Addenda. 2. The State shall provide to the Department"Estimates of Funding Allocations" no later than February 15 of each year to use in preparation of their local budget proposals per current GS. 3. The State shall provide a Funding Authorization" to the Department after the receipt of the Certified State Budget. Funds must be appropriately budgeted by the State in the NC Accounting System (NCAS) prior to the issuance of the "Funding Authorization." 4. The State shall provide funds to the Department upon receipt of this executed agreement and timely submissions of expenditure reports. Payment will be made to the Department according to the DHHS Controller's Office Steps-Out Schedule issued December of each year for the following calendar year. 5. The State shall assist the Department to comply with all applicable laws, regulations, and standards relating to the activities covered in this agreement. 6. The State reserves the right to conduct reviews, audits, and program monitoring to determine compliance with the terms of this agreement and its associated Agreement Addenda. Consolidated Agreement - Final Page 11 of 13 7. The State shall be assured that the Department maintains expenditures of locally appropriated funds (MOE) for maternal health, child health, and family planning program activities equal to, or greater than, that reported on the Staff Time Activity Report for the period beginning July 1, 1984, and ending June 30, 1985. This figure will be increased annually based on a federally accepted inflation index (first updated FY 2000-2001 Agreement.) This revised baseline figure will be calculated and provided to Departments for use in budget preparation. This MOE shall be measured by salary equivalencies that are to be maintained in accordance with Section B.8 of this agreement. H. DISBURSEMENT OF FUNDS The State shall disburse funds to the Department as follows: 1. Monthly disbursements for each program activity will be based on monthly expenditures reported, and shall be adjusted either upward or downward accordingly. Reimbursement of approved expenditures for any report month cannot exceed one month's quotient of the total budget for the agreement period, except by specific authorization in the respective agreement addenda and Funding Authorization for that program. 2. Food and Lodging fees will be disbursed to the department by DEH in one sum the month following receipt of the Funding Authorization. 3. Funds for Childhood Lead Poisoning Prevention will be disbursed once per year. The number of confirmed cases identified in each county will determine the amount. A separate Agreement Addendum must be submitted in order to receive these funds. Funds for training will be disbursed upon request. 4. Subsequent to the notification of a revision of to a "Funding Authorization", increases or decreases in monthly payment amounts will be reflected in the payment the month following this occurrence. 5. Payments shall be suspended when expenditure reports are not received by the time specified in C. 5. a. and c. Payments will resume the month following the receipt of the delinquent expenditure reports according to the DHHS Controllers office schedule for Steps-Out payments issued December of each year for the following calendar year,. 6. Total payment by program activity is limited to the total amount of the "Funding Authorization" and any revisions received after the initial "Funding Authorization notification." 7. Final payments for the SFY will be made based on the Final monthly (May Services/submitted in June Report) expenditure report. Final payments will be equal to the difference between approved reported expenditures and the sum of previous payments up to the limits of the approved budget. Final payments should be made no later than the July Steps-Out period per the DHHS Controllers office schedule issued December of each year for the following calendar year, provided that an expenditure report (DHHS 2949 revised 5-03-01 electronic version) and the"Certification of Expenditures Form"for each month have been received by the DHHS Office of the Controller, and that the Staff Time Activity Report, 3389, Environmental Health Report, 3788, and Food and Lodging, 3888 have been received by the State. Corrections/Amendments to the Expenditures reported by Departments will not be accepted beyond 30 days past the end of the available funding dates of the award. For t A Consolidated Agreement - Final Page 12 of 13 example, Expenditures reported for a grant with an award period of 7/01 through 9/30 cannot be amended after the November Expenditure Report deadline. I. AMENDMENT OF AGREEMENT Amendments, modifications, or waivers of this agreement may be made at any time by mutual consent of all parties. Amendments shall be in writing and signed by appropriate authorities. J. PROVISION OF TERMINATION Either party may terminate this agreement for reasons other than non-compliance upon sixty (60) days written notice. If termination should occur, the Department shall receive payment only for allowable expenditures. The State may withhold payment to the Department until the State can determine whether the Department is entitled to further payment or whether the State is entitled to a refund. K. COMPLIANCE 1. The State shall respond to non-compliance with all terms of this agreement as follows: a. Upon determination of non-compliance, the State shall give the Department sixty (60) days written notice to come into compliance. If the deficiency is corrected, the Department shall submit a written report to the State that sets forth the corrective action taken. b. If the above deficiencies should not be corrected to the satisfaction of the State after the sixty (60) day period, disbursement of funds for the particular activity may be temporarily suspended pending negotiation of a plan of corrective action. c. If the deficiency is still not corrected within the next thirty (30) days following temporary suspension of funding, program funds may be permanently suspended until the Department can provide evidence that the deficiencies have been corrected. d. In the event of the Department's non-compliance with clauses of this agreement, the State may cancel, terminate, or suspend this agreement in whole or in part and the Department may.be declared ineligible for further State contracts or agreements. Such terminations for non-compliance shall not occur until (1)the provisions of Section K-1 (a-c) have been followed, documented, and have failed to provide a resolution, and (2) all other reasonable administrative remedies have been exhausted. 2. Subrecipient Monitoring —OMB Circular A-133,Audits of States, Local Government, and Non-Profit Organizations, was revised on June 24, 1997 to require that pass-through entities monitor the activities of their subrecipients as necessary to ensure that federal awards are used for authorized purposes in compliance with laws, regulations and the provision of contracts or grant agreements and that performance goals are achieved. DHHS Memorandum subject: Subrecipient Monitoring, dated November 11, 1998, addresses the charge to OMB Circular A-133 and directs Divisions to develop risk- based Subrecipient Monitoring Plans. Consolidated Agreement - Final Page 13 of 13 In Compliance with the above DHHS Memorandum, DPH developed, and DHHS approved, a Subrecipient Monitoring Plan dated January 14, 2000. DPH is defined as a "Pass-through entity"for the purposes of the Subrecipient Monitoring Plan. Local Health Departments are defined as a "Subrecipient agency" (i.e., not-for-profit or government agency ...receiving Federal funds.) The Department shall participate fully in "Subrecipient Monitoring" by DHHS-DPH should the Department be deemed high risk by nature of its risk assessment (component of the DPH Plan.) 3. If the Department or the State should be determined out of compliance with the provisions of the agreement, either party may file a formal appeal with the Office of Administrative Hearings. IN WITNESS WHEREOF, the Department and the State have executed this agreement in duplicate originals, one of which is retained by each of the parties. LOCAL SIGNATURES /1: �-- Health Dire or Date D Finance Officer Date v '�Z �3�a Chairman o Co missioners Date (When re fired) STATE OF NORTH CAROLINA By State Health Director Date or Authorized Agent ASSURANCE OF COMPLIANCE ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, SECTION 504 OF THE REHABILITATION ACT OF 1973.TITLE IX OF THE EDUCATION AMENDMENTS OF 1972.AND THE AGE DISCRIMINATION ACT OF 1975 The Applicant provides this assurance in consideration of and for the purpose of obtaining Federal grants,loans,coritracts,property,discounts or other Federal financial assistance from the Department of Health and Human Services. THE APPLICANT HEREBY AGREES THAT IT WILL COMPLY WITH: 1. Title VI of the Civil Rights Act of 1964 (Pub. L 86.352). as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 80), to the end that, in accordance with Tide VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation In, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department 2. Section 504 of the Rehabilitation Act of 1973 (Pub. L 93-112), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 84), to the end that, in accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from participation In, be denied the benefits of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department 3. Title IX of the Educational Amendments of 1972 (Pub. L 92-318), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 86), to the and that, in accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under arty education program or activity for which the Applicant receives Federal financial assistance from the Department. 4. The Age Discrimination Act of 1975 (Pub. L 94-135), as amended, and all requirements Imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 91), to the and that in accordance with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department The Applicant agrees that compliance with this assurance corrstitutes a condition of continued receipt of Federal financial assistance,and that it is binding upon the Applicant its successors, transferees.and assignees for the period during which such assistance is provided. If any real property or structure thereon is provided or improved with the aid of Federal financial assistance extended to the Applicant by the Department, this assurance shall obligate the Applicant,or in the case of any transfer of such property, any transferee, for the period during which the real property or structure is used for a purpose for which the Federal financial assistance is extended or for another purpose Involving the provision of similar services or benefits. If any personal property is so provided,this assurance shall obligate the Applicant for the period during which it retains ownership or possession of the property.The Applicant further recognizes and agrees that the United States shall have the right to seek judicial enforcement of this assurance. The person or persons whose signatures) appear(s) below is/are authorized to sign this assurance, and commit the Applicant to the above provisions. Date Signature and of A fir, Orange 0otriy pia nem Name of Applicant o Qmnge tuty Health IkpaCtment 30D West M:Yrn Street Street Ri11d3X . -- NC 27M City,State,Zip Code Form HHS-690 5/97 r DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH CERTIFICATION REGARDING LOBBYING The undersigned certifies,to the best of his or her knowledge and belief,that 1.No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. 2.If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federally funded contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form SF-LLL,"Disclosure of Lobbying Activities,"in accordance with its instructions. 3.The undersigned shall require that the language of this certification be included in the award document for subawards at all tiers(including subcontracts,subgrants,and contracts under grants,loans,and cooperative agreements)who receive federal funds of$100,000-00 or more and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code.Any person who fails to file the required certification shall be subject to a civil penalty of not less than S 10,000.00 and not more than 5100,000.00 for each such failure. RwIth Direct= Signature Title 0--np 03rity ea1th Dq38rbn3it Agency/Organization . Date (Certification signature should be same as Contract signature.) DEPARTMENT OF HEALTH AND HUMAN SERVICES - DIVISION OF PUBLIC HEALTH CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS (Note: The phrase "prospective lower tier participant," means providers under contract with the Division.) 1.By signing and submitting this document,the prospective lower tier participant is providing the certification set out below. 2.The certification in this clause is a material representation of the fact upon which reliance was placed when this transaction wr-entered into.If it is later determined that the prospective lower tier participant knowingly rendered an ei.-oneous certification,in addition to other remedies available to the Federal Government,the department or agency with which this transaction originate may pursue available remedies,including suspension and/or debarment. 3.The prospective lower tier participant will provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4.The terms"covered transaction,""debarred,""suspended,""ineligible,""lower tier covered transaction," "participant,""person,""primary covered transaction,""principal,""proposal,"and"voluntarily excluded," as used in this clause,have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549,45 CFR Part 76.You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5.The prospective lower tier participant agrees by submitting this proposal that,should the proposed covered transaction be entered into,it shall not knowingly enter any lower tier covered transaction with a person who is debarred,suspended,determined ineligible or voluntarily excluded from participation in this covered transaction unless authorized by the department or agency with which this transaction originated. 6.The prospective lower tier participant further agrees by submitting this document that it will include the clause titled"Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion-- Lower Tier Covered Transaction,"without modification,in all lower tier covered transactions and in all solicitations for lower-tier covered transactions. 7.A participant in a covered transaction may rely upon a certification of a prospective participant in a - lower tier covered transaction that is not debarred,suspended,ineligible,or voluntarily excluded.from covered transaction,unless it knows that the certification is erroneous.A participant may decide the method and frequency of which it determines the eligibility of its principals.Each participant may,but is not required to,check the Nonprocurement List. S.Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause.The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9.Except for transactions authorized in paragraph 5 of these instructions,if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,ineligible,or voluntarily excluded from participation in this transaction,in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies,including suspension,and/or debarment. Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion—Lower Tier Covered Transactions (1)The prospective lower tier participant certifies,by submission of this document,that neither it nor its principals is presently debarred,suspend,proposed for debarment,declared ineligible,nor voluntarily excluded from participation in this transaction by any Federal department or agency. (2)Where the prospective lower tier participant is unable to certify to any of the statements in this ce ification,such prospective participant shall attach an explanation to this proposal. Health rn■ecboc Signature Title Qmmje Omnt:y HaMth 134nctment d�- Agency/Organization Date (Certification signature should be same as Contract signature.) DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS I.By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by: A.Publishing a statement notifying employees that the unlawful manufacture,distribution,dispensing, possession or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; B.Establishing a drug-free awareness program to inform employees about: (1)The dangers of drug abuse in the workplace; (2)The Contractor's policy of maintaining a drug-free workplace; (3)Any available drug counseling,rehabilitation,and employee assistance programs;and (4)The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; C.Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph(a); D.Notifying the employee in the statement required by paragraph(a)that,as a condition of employment under the agreement,the employee will: (l)Abide by the terns of the statement;and (2)Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; E.Notifying the Department within ten days after receiving notice under subparagraph(dx2)from an employee or otherwise receiving actual notice of such conviction; F.Taking one of the following actions,within 30 days of receiving notice under subparagraph(d)(2),with respect to any employee who is so convicted: (1)Taking appropriate personnel action against such an employee,up to and including termination;or (2)Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal,State,or local health,law enforcement,or other appropriate agency;and Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs(a),(b),(c),(d),(e),and(f). 5 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Page 2 II.The site(s)for the performance of work done in connection with the specific agreement are listed below: I. 30D Writ T von Street (Street address) Hillsborough, NC 27278 (City,county,state,zip code) 2. 2501 Homestead Road (Street address) Hhapel Hill, NC 27514 (City,county,state,zip code) Contractor will inform the Department of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,suspension or termination of grants,or government-wide Federal suspension or debarment(Section 4 CFR Part 85, Section 85.615 and)T.620). EXECUTED BY CONTRA OR AU AAORIZED OFFICER 300 West Tryon Street ADDRESS 15ATE Hillsborough, NC 27278 (Certification signature should be same as Contract signature.) +1 "; 0 i DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Certification for Contracts,Grants,Loans and Cooperative Agreements Public Law 103-227,Part C-Environmental Tobacco Smoke,also known as the Pro-Children Act of 1994 (Act),requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health,day care,education, or library services to children under the age of 18,if the services are funded by Federal programs either directly or through State or local governments,by Federal grant,contract,loan,or loan guarantee.The law does not apply to children's services provided in private residences,facilities funded solely by Medicare or Medicaid funds,and portions of facilities used for inpatient drug or alcohol treatment.Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to S 1,000.00 per day and/or the imposition of an administrative compliance order on the responsible entity. By signing and submitting this application,the Contractor certifies that it will comply with the requirements of the Act.The Contractor further agrees that it will require the language of this certification be included in any subawards that contain provisions for children's services and that all subgrantees shall c 'fy accordingly. Health Director Signature Title Orange County Health Department Agency/Organization Date (Certification signature should be same as Contract signature.)