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HomeMy WebLinkAboutAgenda - 06-05-2012 - 5hORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 5, 2012 Action Agenda Item No. ,5 - h SUBJECT: Renewal of Agreement with UNC Hospitals for DSS to Provide Medicaid Workers DEPARTMENT: Social Services ATTACHMENT(S): Agreement PUBLIC HEARING: (YIN) No INFORMATION CONTACT: Nancy Coston, 245 -2800 PURPOSE: To consider renewal of the agreement for income maintenance staff at UNC Hospitals. BACKGROUND: The Department of Social Services has had an agreement with UNC Hospitals continuously since 1977 to provide Social Services staff at the hospital. These staff members, income maintenance caseworkers, allow patients to apply for Medicaid while at the hospital. The Social Services Board has reviewed this agreement and recommends it be continued with one full -time staff member and part-time supervision. FINANCIAL IMPACT: The hospital will reimburse the County for the non - federal share of these positions, so there are no County costs. The reimbursement amount is estimated to be $55,562 during FY 2012 -2013. This is an agreement renewal and there is no change from the current year in the agreement amount. RECOMMENDATION(S): The Manager recommends the Board accept the Social Services Board recommendation and approve the agreement renewal with UNC Hospitals and authorize the Chair to sign the agreement pending approval of the Orange County FY 2012 -13 budget. STATE OF NORTH CAROLINA COUNTY OF ORANGE UNCH #92 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, 2012 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, 2012 to June 30, 2013. 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 perform 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. K7 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 be the joint responsibility of this UNCH staff member and the OCDSS supervisor. V. The part-time 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. 4 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: a. If at any time UNCH determines that the Income Maintenance Caseworker's 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. 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 least 60 days prior to termination. In the event of such termination any payment shall be prorated to the date of termination. 6. 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. 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. 7. 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. 8. 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. 5 18. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Department of Social Services Nancy Coston Director 113 Mayo Street P.O. Box 8181 Hillsborough, NC 27278 Phone: (919) 245 -2800 UNCH Janice Summers HCS Program Manager UNC Health Care 101 Manning Drive Chapel Hill, NC 27514 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, Jr., County Manager DATE: Chris Ellington, Executive Vice President and Chief Financial Officer. DATE: This instrument has been approved as to technical content. Nancy Coston, Social Services Director Date This instrument has been pre- audited in the manner required by the Local Government Budget and Fiscal Control Act. Clarence A. Grier, Director Date Orange County Financial Services Director This instrument has been approved as to form and legal sufficiency. Annette M. Moore, Staff Attorney Date Office of the County Attorney UNCH #92 6 STATE OF NORTH CAROLINA COUNTY OF ORANGE ATTACHMENT A THE UNIVERSITY OF NORTH CAROLINA HOSPITALS AND ORANGE COUNTY, NORTH CAROLINA BUSINESS ASSOCIATE ADDENDUM This Agreement is made effective the 1st day of July, 2012, by and between Orange County ( "Covered Entity ") and the University of North Carolina Hospitals ( "Business Associate ") (collectively the "Parties "). 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 CFR 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 CFR 164.304. 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 Privacy 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, Covered 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 information and other protected health information related to such disclosures as would 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 9 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. 5. 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 the extent permissible by law, if Business Associate 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 10 the event that a conflict then remains, the Contract terms shall prevail so long 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. Nancy Coston, Social Services Director (Signature of Contractor) (Date Submitted) — (Date Submitted)