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HomeMy WebLinkAboutAgenda - 09-05-1995 - VIII-F � 1 ORANGE COUNTY BOARD OF COMMISSIONERS Action Agenda Item No. VI'Tr-F ACTION AGENDA ITEM ABSTRACT Meeting Date% September 5, 1995 SUBJECT: Contracts between the Orange County Health Department (OCHD) and the UNC School of Medicine for its Departments of Family Medicine and Community Pediatrics DEPARTMENT: HEALTH PUBLIC HEARING: Yes X No ATTACHMENT(S) : INFORMATION CONTACT: HEALTH DIRECTOR'S OFFICE X2411 1. Contract with the Department of Family Medicine. TELEPHONE NUMBER: Hillsborough - 732-8181 2. Contract with the Department Chapel Hill - 968-4501 of Community Pediatrics Mebane - 227-2031 Durham - 688-7331 PURPOSE: To provide the renewal of Professional Service Contracts between the OCHD and the UNC-CH School of Medicine for its Departments of Family Medicine and Community Pediatrics. These contracts provides faculty members who serve as part-time medical director and clinicians. BACKGROUND: The contracts with the University have been continuing since 1987, in the case of Family Medicine, and since 1984 in the case of Community Pediatrics. The agreements provide a cost effective means of assuring high quality medical supervision of the Family Nurse Practitioners, and other staff serving in the following clinics: Family Planning, Prenatal Care, Child Health, Adolescent Health, Tuberculosis, Sexually Transmitted Disease, General, Communicable Disease Control, and Adult Health Promotion Services. The contract with Community Pediatrics has been increased with the transfer of responsibility for the Child Health clinics from Family Medicine to Pediatrics. The contract with Family Medicine has been reduced because of that transfer and a reduction in administrative time no longer required by the department. The OCHD agrees to pay the University Twenty eight thousand Eighty dollars ($28,080) for the Department of Family Medicine and Nineteen thousand Sixty-four dollars ($19,064) for the Department of Community Pediatrics. These contacts are being submitted after the beginning of the fiscal year because of the last minute changes in responsibility for the Child Health Clinic. Funds for these contracts are provided in the approved budget. RECOMMENDATIONS) The Manager recommends that contracts be approved and that the Chair to authorized to sign the contracts. 8WC95/895UNCFN.doc 2 t STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into this first day of July, 1995, by and between the University of North Carolina at Chapel Hill, hereinafter referred to as "The University, " for its Department of Pediatrics 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 OCHD is the operator of two clinics in Carrboro, North Carolina and in Hillsborough, North Carolina and desires the Department to provide medical care for children and adolescents at OCHD; and WHEREAS, the Department desires to participate in the provision of medical care for children and adolescents at OCHD; and WHEREAS, performance of the activity described herein is consistent with the University's goals of research, teaching, education and public service. 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. A pediatrician from the University will provide pediatric services in the OCHD's clinics for an average of twelve ( 12) hours each week except for 10 weeks during the summer when the time will average 7 .5 hrs/week due to the suspension of the adolescent clinic in Carrboro. Since the clinic does not operate for 12 - 13 weeks, this would allow for 9 - 13.5 hours of paid planning time over the summer. The total number of hours covered in the contract is 579 hrs. This time will cover preparation time for and attendance at case conferences and continuing education meetings on the second Monday of each month as well as on-site attendance at the following clinics: Tues. Adolescent Clinic Carrboro 12:30pm - 5:OOpm Wed. Child Health Clinic Hillsborough 9:30am - 11:30am Wed. Adolescent Clinic Hillsborough 12:30pm - S:OOpm t ' 3 + AGREEMENT Between UNC School of Medicine for Pediatrics and Orange County Health Department Page 2 of 5 2. The pediatrician's functions will be to: a. Provide medical direction to the child health program at the OCHD and 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 program. b. Provide medical services for children. c. Provide medical services for adolescents. d. Serve as primary supervising physician for the nurse practitioners employed by the OCHD who provide medical services in the child health clinic and as needed in the adolescent clinic. e. Co-sign charts of patients seen by the nurse practitioners within five (5) working days. f. Provide consultation to OCHD staff on matters pertaining to the child health and adolescent health programs including the collaborative development and approval of program protocols. g. Provide phone consultation during regular OCHD hours to OCHD staff regarding treatment and follow-up of children and adolescents seen in the clinic or at school. Emergency phone consultation shall be available as needed during non-business hours. h. Provide 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 Division of Community Pediatrics shall designate the name of the primary pediatrician and the names of any physicians who will provide clinical services or will serve as back-up to the primary pediatrician when this person is unavailable. a. Any changes in these designations will be mutually agreed to by the Chair of the Division of Community Pediatrics and the Director of OCHD. b. The University and OCHD will indicate their mutual agreement to the designation of the primary pediatrician and any other physicians involved as described above by signing the "Designation of Primary Pediatrician" attachment to this contract. 4 j AGREEMENT Between UNC School of Medicine for Pediatrics and Orange County Health Department Page 3 of 5 c. The services of this contract will be provided by the Primary Pediatrician and the back-up physician 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 Primary Pediatrician will report activities and services performed to OCHD as requested by the Health Director. 4 . The Department will relate to all patients and staff of the OCHD in a professional and instructional manner. 5. The Department will offer medical consultation in accord with the accepted methods and procedures. 6. The Department will maintain current registration and licensure and provide evidence of such to the OCHD upon request. 7. 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, in consultation as to amount with the OCHD, 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. 8. The OCHD will reimburse quarterly the University's Department of Pediatrics at an annual rate of Nineteen thousand, sixty-four dollars ($19,064) for partial salaries, fringe benefits and related travel of pediatricians. 9. The University will bill the OCHD on a quarterly basis with the first bill being dated July 1, 1995 and the Orange County Health Department 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 practicable. 5 AGREEMENT Between UNC School of Medicine for Pediatrics and Orange County Health Department Page 4 of 5 10. In the event that the assigned pediatricians 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. 11. This Agreement shall run for a period of twelve ( 12) months, from the first day of July, 1995, to the thirtieth day of June, 1996, and shall be renewable annually thereafter upon written notice executed by both parties. 12. This Agreement or it 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 any payment due shall be prorated to the date of termination. 13. The OCHD and The University hereby agree that, in their educational and/or employment practices, each will comply with such nondiscrimination laws as may be applicable to them 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 this service not inconsistent with University policies or regulations. 14. 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. 15. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Agreement. AGREEMEMT Between UNC School of Medicine for Pediatrics 6 and Orange County Health Department Page 5 of 5 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: 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: Designation of Primary Pediatrician Attachment to Contract between the Department of Pediatrics, University of North Carolina, School of Medicine and the Orange County Health Department for fiscal year 195 - '96. The following physicians are designated by the Department of Family Medicine to fulfill the terms of the attached contract: Primary Pediatrician Back-up Pediatrician Copies of current registration and licensure for these physicians are attached. Signed: Chair, Division of Community Pediatrics Date Agreed: Health Director, Orange County Health Department Date 8 STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into this first day of July, 1995, 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/Personal Health Services Director in matters of medical policy; b. advise the Health Director/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/Personal Health Services Director. d. advise and interpret the regulatory requirements related to medical aspects of the OCHD'S functions; r 9 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 2 of 8 e. provide coordination to 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/Division Directors; h. assist the Health Director/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/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. discharge the above listed responsibilities through and with knowledge aforehand of the Director; p. 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) , tuberculosis (TB) , sexually transmitted disease (STD) , general communicable disease control (GEN) and adult health preventive services (AH/HP) , within State and Federal guidelines and program rules. Clinical duties shall include: a. Collaborative development and approval of clinic protocols; b. Primary technical supervision of the nurse practitioners who are employees of the OCHD; 10 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 3 of 8 c. Co-signing charts of patients seen by the nurse practitioners of the OCHD within five (5) working days; d. Medical consultation visits to OCHD patients during scheduled on-site clinic times; e. Routine medical services as needed during scheduled on-site clinic times when the nurse practitioner is not available or clinic is extremely heavy; 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 or will serve as back-up to the Medical Director when this person is unavailable. 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 the following clinics: FP/STD on Monday (afternoon) , Tuesday (all day) , and Friday (morning) in Sillsborough and Wednesday (all day) and Thursday (afternoon) in Carrboro; PNC on Thursday; general clinic -adult health, communicable disease and immunization on Monday in Hillsborough and Tuesday in Carrboro; immunization on Wednesday (morning) in Hillsborough, Thursday (all day) and Friday (morming) in Carrboro; adult health and county employee health and other worksites scheduled as needed; TB patients are scheduled during FP/STD clinics in the afternoons; breast and cervical cancer screening 11 • AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 4 of 8 clinics on Thursdays (morning) in Carrboro and Friday (afternoon) in Hillsborough. 5. Clinics are operational during the normal business hours of 8:00 a.m. to 5 :00 p.m. , Monday through Friday. Wednesday and Thursday clinics are likely to extend until 5:30 p.m. , and Tuesday clinics are likely to extend until 6:00 p.m. The Department is responsible for medical activities conducted during the entirety of these hours. 6. It is required that on-site physician attendance shall occur as follows: Tuesday FP/STD Clinic - Hillsborough 12 :30 pm - 3:00 pm = 2 .5 hrs. Wednesday FP/STD Clinic - Carrboro 1:45 pm - 5: 15 pm = 3.5 hrs. Thursday PNC Clinic - Hillsborough 10:00 am - 12 :00 pm = 2 hrs. Although Medical Director or back up physician attendance is not required on premises at other times, it should be available whenever needed. 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 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. In addition to the eight (8) on site clinical hours per week, the Department agrees to provide two (2) hours of administrative time for an average of ten ( 10) hours per week. These two (2) hours will be scheduled to the mutual convenience of both parties to include some scheduled on-site administrative time, as well as 12 AGREEMENT Between the UNC School of Medicine and Orange County Health Department Page 5 of 8 phone coverage and provision of continuing education to staff. The clinical and administrative services will be provided by the Medical Director and the back-up physician 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, in consultation as to amount with the OCHD 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 of 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 TWENTY-EIGHT THOUSAND, EIGHTY DOLLARS ($28,080) . At the rate of $54 .00 per hour for an average of 10 hours per week from July 1, 1995, 1 ' 13 AGREEMENT Between the UNC School of Medicine and Orange County Health Department Page 6 of 8 through June 30, 1996, payments shall be made in equal monthly installments of TWO THOUSAND, THREE HUNDRED FORTY DOLLARS ($2, 340.00) . 14 . The University shall bill the OCHD on a monthly basis with the first bill being dated July 1, 1995 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 twelve ( 12) months, from the 1st day of July, 1995, to the 30th day of June, 1996, 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 any payment due shall be prorated to the date of termination. 14 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 7 of 8 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. AGREEMENT Between UNC School of Medicine 15 and Orange County Health Department Page 8 of 8 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: 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: 16 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 fiscal year 195-196. The following physicians are designated by the Department of Family Medicine to fulfill the terms of the attached contract: Marcia Angle, M.D. Medical Director Margaret Helton, M.D. Back-up Physician Adam Goldstein, M.D. Back-up 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