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HomeMy WebLinkAboutAgenda - 04-01-1997 - 8f + 1 ORANGE COUNTY Board of Commissioners Action Agenda Item No._14 Action Agenda Item Abstract Meeting Date: April 1,,1_997 Subject: Professional Services Contracts between the Health Department and the Departments of Family Medicine and Ob/Gyn Department Health Public Hearing Yes No_X_ Budget Amendment Needed Yes No Attachments(s) Information Contact 1. Agreement with the Department Health Director's Office X2411 of Family Medicine (3 months) 2. Agreement with Department of Telephone Number Ob/Gyn(3 months) Hillsborough 732-8181 3. Agreement with Department of Chapel Hill 968-4501 Family Medicine (15 months) Mebane 227-2031 Durham 688-7331 Purpose: To approve professional contract services for medical back-up between the Health Department and the School of Medicine Departments of Family Medicine and Ob/Gyn. Background: For more than a decade,the Health Department has contracted with the UNC School of Medicine's Departments of Family Medicine, Ob/Gyn and Pediatrics. These agreements were continued on a month-to-month basis for the current year through December 31,1996 while the contracts were being restructured. While the assessment process was expected to be completed by the end of December, it was not finalized until the Board of Health approval at its meeting of March 12, 1997. The attached documents continue services from the Departments of Family Medicine and Ob/Gyn from January 1, 1997 through March 31, 1997. The third attachment with Family Medicine is a 15-month agreement beginning April 1, 1997 through June 30, 1998. The new agreement streamlines the medical supervision of the nurses and nurse practitioners in the health department clinics and assures better continuity between clinical and hospital care as well as the care of women and children. The Health Director sent out bids to the Departments of Family Medicine, Ob/Gyn and Pediatrics as well as Piedmont Health Services. The Family Medicine proposal was preferred both from the perspective of the staff and the lower cost. k 2 The contract for the last two years has been at an annualized rate of$28,080 for 10 hours per week, for an hourly rate of$54.00. Family Medicine agreed to maintain that rate while we have been negotiating new contracts. The new agreement incorporates work formerly accomplished under contract with the Departments of Pediatrics and Ob/Gyn. Therefore, there is an increase in hours from 10 to 20.8 per week and an increase in the hourly rate to $71.00. These changes increase the annualized rate to $76,960 which Family Medicine has agreed to hold steady for 15 months through June 30, 1998. Funds to support these contracts are in the current and proposed budgets. Recommendation: The Manager recommends that the Board: 1) approve the attached contracts, subject to the final review by the County Attorney which will include the insertion of a clause in the 15 month contract indicating that continuation of the agreement beyond June 30, 1997 is subject to appropriation of funds by the Board of Commissioners in the FY1997-98 operating budget to cover the cost of the contract; and 2) authorize the Chair to sign. 3 STATE OF NORTH CAROLINA COUNTY OF ORANGE RENEWAL AGREEMENT BETWEEN ORANGE COUNTY HEALTH DEPARTMENT AND THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL For Its Department of Obstetrics and Gynecology In The School of Medicine AND UNIVERSITY OF NORTH CAROLINA HOSPITALS THIS AGREEMENT,made and entered into this the 1st day of January 1, 1997 by and between The University of North Carolina at Chapel Hill,hereinafter referred to as "The University," for its Department of Obstetrics and Gynecology in the School of Medicine;The University of North Carolina Hospitals hereinafter referred to as"UNC Hospitals;"and the Orange County Health Department,hereinafter referred to as the"OCHD." WITNESSETH: WHEREAS, an agreement was made and entered into as of the 1st day of July, 1995 by and between the Orange County Health Department and The University of North Carolina at Chapel Hill for its Department of Obstetrics and Gynecology in the School of Medicine and the University of North Carolina Hospitals. NOW,THEREFORE, in consideration of the premises and of the following mutual promises, covenants,and conditions, OCHD, UNC Hospitals and The University agree as follows: 1. The Agreement will be continued on a month to month basis beginning Januaray 1, 1997 for a period not to exceed three months. 2. All other terms and conditions shall remain the same. IN WITNESS WHEREOF,the parties have hereunto signed this Agreement in their official capacities on the day and year listed below. FOR AND ON BEHALF OF ORANGE FOR AND ON BEHALF OF THE UNIVERSITY COUNTY HEALTH DEPARTMENT OF NORTH CAROLINA AT CHAPEL HILL Daniel B. Reimer,Director Date Wayne R. Jones,Vice Chancellor Business and Finance "This instrument has been pre-audited in the manner Date: required by the Local Government Budget and Fiscal Control Act." FOR AND ON BEHALF OF THE UNIVERSITY OF NORTH CAROLINA HOSPITALS Director, Orange County Finance Date: Eric B. Munson,Executive Director Date: Chairman,Board of Commissioners Date: STATE OF NORTH CAROLINA 4 COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into this first day of April 1997, by and between The University of North Carolina at Chapel Hill, hereinafter referred to as "The University, " for its Department of Family Medicine in the School of Medicine, hereinafter referred to as the "Department" and the Orange County Health Department, hereinafter referred to as the "OCHD. " W I T N E S S E T H: WHEREAS, the Department desires to provide Medical Director services and to participate in the provision of medical care for the citizens of the community, and; WHEREAS, the OCHD is the operator of two outpatient facilities known as the Orange County Health Department, located in Carrboro and Hillsborough, North Carolina. NOW, THEREFORE, in consideration of the premises and the following mutual covenants and conditions and any sums to be paid, the OCHD and The University agree as follows: 1 . The Department will render professional consultation as Medical Director. As Medical Director, the Department shall: a. act as the principal advisor to the Health Director and Personal Health Services Director in matters of medical policy; b. advise the Health Director and Personal Health Services Director on the medical implications of alternatives in clinical program functioning and management; C. represent the OCHD in interagency relationships which involve medical expertise at the request of the Health Director and/or Personal Health Services Director. d. advise and interpret the regulatory requirements related to medical and laboratory aspects of the OCHD'S functions; 5 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 2 of 8 e. provide coordination for medical components of the clinical programs of the OCHD; f. advise and assist staff in epidemiological investigations; g. be responsive to community public health concerns directly and in consultation with the Health Director and Division Directors; h. assist the Health Director and Personal Health Services Director in establishment of medical procedures and quality/quantity control mechanisms; i. assist in data analysis towards identification of public health concerns; j . work with the Health Director and Division Directors on formulation of responses to public health concerns; k. assist with evaluation of programs; 1 . maintain close contact and availability through on-site visits and phone consultation to discharge responsibilities at the OCHD; m. participate in Division Head management meetings and Division level meetings when appropriate; n. attend Board of Health meetings when appropriate; o. provide medical direction to the school health programs in both school systems in the County and medical consultation to both OCHD and school staff working in the school health programs; p. discharge the above listed responsibilities through and with knowledge aforehand of the Director; q. other-,miscellaneous duties as necessary. 2 . The Department shall provide, for the programs listed below, agreed upon medical direction and clinician services in family. planning (FP) , prenatal care (PNC) , child health (CH) , adolescent (ADOL) , tuberculosis (TB) , sexually transmitted disease (STD) , general communicable disease control (GEN) and adult health AGREEMENT Between UNC School of Medicine and Orange County Health Department 6 Page 3 of 8 preventive services (AH/HP) , within State and Federal guidelines and program rules . Clinical duties shall include: a. Collaborative development and approval of clinic protocols; for the mutual benefit of the Department, OCHD and its prenatal patients, it is agreed by both parties that prenatal patients will be managed according to OCHD established protocols . These will be reviewed regularly and be consistent with protocols used at UNC Department of OB/GYN outlying clinics . b. Primary technical supervision of the nurse practitioners who are employees of the OCHD; c. Co-signing charts of patients seen by the nurse practitioners of the OCHD within five (5) working days; d. Routine medical services during scheduled on-site clinic times; e. Medical consultation visits to OCHD patients during scheduled on-site clinic times; f. Continuing education consultation for nurse practitioners and other staff to include regular informal consultation and periodic formal sessions as appropriate. 3 . The Chair of the Department shall designate the name of the Medical Director and the names of any physicians who will provide clinical services. a. Any changes in these designations will be mutually agreed to by the Chair of the Department and the Director of OCHD. b. The Department and OCHD shall indicate their mutual agreement to the_designation of the Medical Director and any other physicians involved as described above by signing the "Designation of Medical Director" attachment to this contract. 4 . This agreement covers any and all clinics conducted by OCHD in the program areas listed in #2 above. AGREEMENT Between UNC School of Medicine and Orange County Health Department 7 Page 4 of 8 S. Clinics are operational during the normal business hours of 8 : 00 a.m. to 5: 00 p.m. , Monday through Friday. Some clinics may run beyond 5: 00 p.m. The Department is responsible for medical activities conducted during the entirety of these hours. 6. On-site physician attendance shall occur twice a week for three (3) hours each time in Family Planning/STD clinic and three (3) additional half days each week. Days and times of this on-site coverage will be mutually agreed to by the Department and OCHD. Although Medical Director or back up physician attendance is not required on premises at other times, it should be available as stipulated above. On-site back-up coverage is expected during vacations and other anticipated absences. If physician attendance is impossible due to unremediable circumstances, physician phone coverage will be provided and nurse practitioner charts will be signed within five (5) working days. 7 . The Medical Director or other designated physicians will be available for phone consultation during all business hours and emergency phone. consultation shall be available as needed during non-business hours. Phone coverage will also be provided for consultation and direction for communicable disease/epidemic control. 8 . The Department agrees to provide the equivalent of . 52 FTE to carry out the duties described above. The clinical and administrative AGREEMENT Between the UNC School of Medicine $ and Orange County Health Department • Page 5 of 8 services will be provided by the Medical Director and the other designated physicians unless a Department substitute is prearranged. Service beyond the minimum shall be arranged by the Department and the OCHD to avoid unreasonable length of service. The Medical Director will report activities and services performed to OCHD as requested by the Health Director. 9. The Department will maintain current registration and licensure and shall provide copies to the OCHD as appendices to the Designation of Medical Director attachment to this contract. 10 . The University will be responsible for the negligence of its employees and agents to the extent of the North Carolina Tort Claims Act. Further, the University will provide adequate professional liability insurance for the University, its students and personnel, who provide the services described in the agreement. The insurance limits will be stated in a Certificate of Insurance submitted at the time the contract is commenced. 11 . The Department will relate to all patients and staff of the OCHD in a professional manner. 12 . The Department will offer medical consultation in accord with the accepted methods and procedures. 13 . The OCHD- agrees to pay the Department in return for the above services NINETY-SIX THOUSAND, TWO HUNDRED DOLLARS ($96, 200) for the period of April 1, 1997 through June 30, 1998 . Payments shall be made in equal monthly installments of SIX THOUSAND, FOUR HUNDRED THIRTEEN DOLLARS AND THIRTY THREE CENTS ($6413. 33) . AGREEMENT Between the UNC School of Medicine and Orange County Health Department 9 • Page 6 of 8 14 . The University shall bill the OCHD on a monthly basis with the first bill being dated April 1, 1997 and the OCHD shall pay the University within thirty (30) days of receipt of the University' s bill. Any adjustments to the billing shall be taken into account in the next succeeding bill or as soon thereafter as reasonably practicable. 15. The OCHD agrees to furnish all supplies, equipment and other staff needed by the Medical Director; to include the Medical Director in all appropriate conferences, meetings, correspondence and publications necessary to appropriate discharge of Medical Director' s duties within budgetary constraints. 16. In the event that the Medical Director and back-up physician become unwilling or unable to perform the duties required by this Agreement, The University and OCHD shall attempt to mutually agree upon replacement. If such mutual agreement is not achieved, then this Agreement shall terminate and any payment due as of the date of termination shall be paid. 17 . This Agreement shall run for a period of FIFTEEN (15) months, from the 1st day of April, 1997, to the 30th day of June, 1998, and shall be renewable annually thereafter upon written notice executed by both parties . 18 . 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 ninety (90) days prior to termination. In the event of such termination AGREEMENT Between UNC School of Medicine 10 and Orange County Health Department Page 7 of 8 any payment due shall be prorated to the date of termination. 19. The OCHD hereby agrees with The University that, in its educational and/or employment practices, the OCHD will comply with such non-discrimination law as may be applicable to it in the performance of this Agreement. The Department hereby agrees to abide by pertinent rules and regulations of the OCHD, Orange County, and the North Carolina Department of Environment, Health and Natural Resources in the conduct of service. 20 . This 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. 21 . The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Agreement. IN WITNESS WHEREOF, the parties have hereunto signed this Agreement in their official capacities of the day and year listed below. FOR AND ON BEHALF OF FOR AND ON BEHALF OF ORANGE COUNTY HEALTH DEPARTMENT THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL Daniel B. Reimer, Director Wayne R. Jones, Vice- Chancellor, Business and Finance DATE: DATE: AGREEMENT Between UNC School of Medicine e and Orange County Health Department 11 Page 8 of 8 FOR AND ON BEHALF OF ORANGE COUNTY ORANGE COUNTY FINANCE DIRECTOR: "This instrument has been preaudited in the manner required by the Local Government Budget and Fiscal Control Act. " Orange County Finance Director DATE: CHAIRMAN, ORANGE COUNTY BOARD OF COMMISSIONERS DATE: 12 Y Designation of Medical Director Attachment to Contract between the Department of Family Medicine, University of North Carolina, School of Medicine and the Orange County Health Department for April 1, 1997 through June 30, 1998 . The following physicians are designated by the Department of Family Medicine to fulfill the terms of the attached contract: Medical Director Physician Physician Physician Copies of current registration and licensure for these physicians are attached. Signed: Chair, Department of Family Medicine Date Agreed: Health Director, Orange County Health Department Date