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HomeMy WebLinkAboutAgenda - 06-28-1994 - VIII-L " 1 ORANGE COUNTY BOARD OF COMMISSIONERS Action Agenda Item No. VJ= 1. ACTION AGENDA ITEM ABSTRACT Meeting Date: June 28, 1994 SUBJECT: Contracts between the orange County Health Department and the UNC School of Medicine for its Departments of Family Medicine, OB/GYN and 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 OB/GYN. Mebane - 227-2031 Durham - 688-7331 3. Contract with the Department of Pediatrics PURPOSE: To provide the renewal of Professional Service Contracts between the orange County Health Department (OCHD) and the UNC-CH School of Medicine for its Departments of Family Medicine, OB/GYN and Pediatrics. These contracts provides faculty members who serve as part-time medical director and clinicians. BACKGROUND: The contracts with University have been continuing since 1987, in the case of Family Medicine, and longer in the case of OB/GYN and 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, Tuberculosis, Sexually Transmitted Disease, General Communicable Disease Control and Adult Health Preventive Services. The terms have been modified slightly to enhance communication of responsibilities and to clarify the professional liability coverage. The OCED agrees to pay the University Fifty thousand two hundred and forty-six dollars and sixty-six cents ($50,246.66) , in return for an average of 20 hours per week of faculty time from the Department of Family Medicine. The OCHD agrees to pay the Department of OB/GYN Eight thousand five hundred dollars ($8,500) , in return for four and one quarter hours per week of physician time. Finally, the OCED agrees to pay the Department of Pediatrics Fourteen thousand one hundred seventy five dollars ($14,175) for FY93-94 and Sixteen thousand nine hundred ten dollars ($16,910) , for FY94-95, for ten percent of a junior faculty member and five percent of a senior faculty member. The contract with the Department of Pediatrics is being submitted late because the development of the contract was overlooked during a change of personnel in the Department of Pediatrics. Funds for this contract are provided in the Manager's Recommended Budget. RECOMMENDATIONS) The Manager recommends that contracts be approved subject to the approval of the County Attorney and Purchasing Director, and that the Chair to authorized to sign the contracts. 2 STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into this first day of July, 1994 , 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. 3 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 2 of 8 d. advise and interpret the regulatory requirements related to medical aspects of the OCHD'S functions; 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. 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) 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. �I 4 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 3 of 8 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; 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 Hillsborough and Wednesday (all day) and Thursday (afternoon) in Carrboro; PNC on Thursday; CH half-days on Monday and Wednesday; general clinic -adult health and communicable disease on Monday in Hillsborough and Tuesday in Carrboro; adult health promotion once a month at each location; county employee health promotion scheduled as needed; TB patients are scheduled during FP/STD clinics in the afternoons. 5 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 4 of 8 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: Monday CH Clinic - Hillsborough 10:00 am - 2 :00 pm = 2 hrs. Tuesday FP/STD Clinic - Hillsborough 2:00 pm - 5:00 pm = 3 hrs. Wednesday FP/STD Clinic - Carrboro 2:00 pm - 5 :00 pm = 3 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 ten ( 10) on site clinical hours per week, the Department agrees to provide ten ( 10) hours of administrative time for an average of twenty (20) hours per week. These ten ( 10) hours will be scheduled to the mutual convenience of both parties to include some scheduled on-site administrative time, as well as phone 6 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 5 of 8 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 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 concluded. 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 FIFTY THOUSAND, NINE HUNDRED AND SIXTY DOLLARS ( $50, 960 ) . At the rate of $49. 00 per hour for an average of 20 hours per week from July 1, 1994 , through June 30, 1995, payments shall be made in 7 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 6 of 8 equal monthly installments of FOUR THOUSAND TWO HUNDRED FORTY-SIX DOLLARS AND SIXTY-SIX CENTS ($4,246.66) . 14 . The University shall bill the OCHD on a monthly basis with the first bill being dated July 1, 1994 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, 1994, to the 30th day of June, 1995, 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 8 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 7 of 8 (90) days prior to termination. In the event of such termination 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. I I 9 1 AGREEMENT Between UNC School of Medicine 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: 10 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 194-'95. The following physicians are designated by the Department of Family Medicine to fulfill the terms of the attached contract: Medical Director Back-up Physician 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 11 STATE OF NORTH CAROLINA COUNTY OF ORANGE 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 This Agreement made and entered into this the 13th day of June, 1994 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; and the Orange County Health Department, hereinafter referred to as the "OCHD. " W I T N E S S E T H : WHEREAS, OCHD desires to contract with The University for obstetrical and gynecological professional services to improve obstetrical care, patient understanding and satisfaction, as well as enhance the communication between the care providers in the Orange County Health Department and The University's Department of Obstetrics and Gynecology; and WHEREAS, The University's Department of Obstetrics and Gynecology desires to provide these services for OCHD; NOW, THEREFORE, in consideration of the premises and of the following mutual promises, covenants, and conditions, OCHD and The University agree as follows: A. A third year resident in Obstetrics and Gynecology will be assigned for a minimum period of ten weeks to the Hillsborough Clinic every Thursday beginning at 1:00 p.m. extending to 4:30 p.m. An exception to this time schedule is the 3rd Thursday of each month when the resident will begin at 1: 30 p.m. and conclude at 5:00 p.m. The assigned resident shall notify the clinic manager no later than 1:00 p.m. of a change in the expected arrival time in clinic. The resident's function will be: 1. To provide normal prenatal care 12 Page 2 of 3 Agreement Between Orange County Health Department and The University of North Carolina at Chapel Hill Department of Obstetrics and Gynecology 2 . To provide obstetrics and gynecologic consultation regarding patients referred by the nurse practitioner. 3 . To assist in the dispensing of prenatal medications . 4 . To consult with the senior attending at UNC Hospital about patient referrals and high risk patients. 5. To attend the post clinic conference. All care rendered will be appropriately documented in writing. B. The University's Department of Obstetrics and Gynecology proposes to contract for 50 clinics per year (there being no clinic during Thanksgiving week and allowance being made for one additional week relative to an agreed upon holiday) . Each clinic will require 3 1/2 hours of resident time and 3/4 hour travel time. The cost per hour is $40. 00. For fifty (50) clinics the total cost per year would be $8, 500. 00 . University will bill OCHD monthly and OCHD will pay the University within 30 days of receipt of University's invoice. C. Upon request, The University will provide evidence of Professional Liability coverage by the North Carolina Memorial Hospital in the amount of at least $1, 000, 000.00 on all duly appointed members of the duly appointed Housestaff under the self insurance program of the of the University of North Carolina at Chapel Hill, in order to cover financial liability which may arise from the negligence or wrongful acts or omissions of such residents/housestaff while on rotation at Orange County Health Department. D. This Agreement shall run for a period of one (1) year from the 1st day of July, 1994 to the 30th day of June, 1995 and shall be renewed from year to year thereafter upon written notice executed by both parties. E. 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 90 days prior to termination. In the event of such termination any payment due shall be prorated to the date of termination. F. It is the intent and purposes of this Department to send a senior resident; however, due to circumstances beyond our control, it may be that a resident other than 3rd year may necessarily attend the clinic. 13 Page 3 of 3 Agreement Between Orange County Health Department and The University of North Carolina at Chapel Hill Department of Obstetrics and Gynecology G. The OCHD hereby agrees with The University that, in its educational and/or employment practices, said contracting party will comply with such non-discrimination laws as may be applicable to it in the performance of this contract. H. 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. I. 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 on the day and year listed below. FOR AND ON BEHALF OF FOR AN ON BEHALF OF THE UNIVERSITY OF ORANGE COUNTY HEALTH NORTH CAROLINA AT CHAPEL HILL DEPARTMENT Daniel B. Reimer, Director Wayne R. Jones, Vice Chancellor Business and Finance Date: Date: "This instrument has been preaudited in the manner required by the Local Government Budget FOR AND ON BEHALF OF THE UNIVERSITY OF and Fiscal Control Act. " NORTH CAROLINA HOSPITALS Director, Orange County Finance Eric B. Munson, Executive Director Date: Date: Chairman, Board of Commissioners Date: 14 STATE OF NORTH CAROLRI A COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into as of the first day of July, 1993, by and bctw=n 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 es the "Department" and the Oran County Health Department, hereinafter referred to as the "OCHD." WITNESSETH; WHEREAS,the OCHD is the operator of a clinic for adolescents on Wednesday afternoons at its clinic in Hillsborough, North Carolina and desires the Department to provide medical care for adolescents at OCHD; and WHEREAS, the Department desires to participate in the provision of medica:care for the adoltseenrs at OCHD; and WHEREAS,performance of the activity described herein is consistent with the University's goals of=search,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 agzee as follows: 1. A pediat*ician from The University wd71 provide pediatric services in the Health Department's H 1sborough Clinic one half day each week (4 hours) on Wednesday afternoons during the contract period_ The half day will be devoted to an adolescent clinic. This pediatrician's functions will be to: L Provide medical services for adolescents. 15 b. Provide consultation to OCHD staff on matters pe;�ai g to the- adolescent health program including the collaborative development and approval of adolescent health protocols. C. Provide phone consultation during regular Health Department hours to OCHD staff regarding treatment and follow-up of adolescent clients seen in the clinic or at school. 2. The Department will maintain current registration and licensure and provide evidence of such to the OCED upon request. 3. The Department will insure self for malpractice. 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 Health Department will reimburse quarterly the University's Department of Pediatrics at an annual rate of S14;,175 for partial salaries, fringe benefits and related travel of pediatricians. 7. The University shall bill the Health Department on a quarterly basis with the first bill being dated.July 1, 1993 and the Health Department shall pay the University within thirty(30) days of receipt of University's bill. Any adjustments to the billing shall be taken into account in the next succeeding bDI or as soon thereafter as practicable. S. In the event that the assigned pediatricians become unwilling or unable to petiomm 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 semtinam and any payment due as of the dam of termination shall be paid. 16 9. This Agreement shat run for a pe_iod of twtly- (12) months, tom the first day of July, 1993, to the thirtieth day of June, 1994, and shall be renewable annually thereafter upon written notice executed by both parties. 10. 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 prorate to the date of termination. 11. The OCEID and The University hereby agree that, in their educational and/or employment practices, each vU 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 Division of Health Services in the conduct of this service not inconsistent with University policies or regulations. 12. 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 officizs of both parties. 13. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Agrtment 17 U� WITNESS WHEREOF, the parties have.hereunto signed this Agreement in their official capacities of tine day and year listed below. FOR AND ON BEHALF OF FOR AND O?NT BEHALF OF ORANGE COUNTY HEALTH DEPARTMENT TEE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL Daniel B. Reimer, Di=ctor Wayne R ]ones, 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: Chairmen, Orange County Board of Commissioners DATE: 18 STATE OF NORTH CAROLINTA COUNTY OF ORANGE AGREEMENT ISIS AGREEMENT, made and entered into as of the first day of July, 1994.by and bctw=n the University of North Carolina at Chapel Frill, hereinafter referred to as "The University," for its Dcparrtment of Pediatrics in the School of Medicine, hereinafter referred to as the 'Departsncnt" and the Orange County Health Department, hereinafter referred to as the "OCHD." WITNESSETH; WHEREAS,the OCHD is the operator of a clinic for adolescents on Wednesday afternoons at its clinic in FEilsborough, North Carolina and desires the Department to provide medical care for adolescents at OCHD; and WHEREAS, the Department desires to participate in the provision of medical care for the 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 surtt to be paid, the OCHD and The University agree as follows: 1. A pediatrician from The University will pro dde pediatric services in the Health Department's Hillsborough Clinic one half day each week(4 hours) on Wednesday afternoons daring the contract period. The baL-:day will be devoted to an adolescent clinic. This pediatrician's functions will be to: L Provide medical services for adolescents. 19 b. Provide consultation to OC ED staff, on matters penaining to the s - adolescent health program including the,collaborative development and approval of adolescent health protocols. C. Provide phone consultation dating regular Health Department hours to OCHD staff regarding tr�atmcnt and follow-up of adolescent clients seen in the clinic or at school_ 2. The Department will maintain c=rnt registration and licensure and provide evidence of such to the OCHD upon request. I The Department will insum self for malpractice. 4. The Department will relate to all patients and staff of the OCHD in a protcssional and instructional manner. S. Tbc Department will offer medical consultation in accord with the accepted methods and procedures. 6. The Health Department will reimburse quarterly the University's Department of Pediatrics at an annual rate of S 16,910 for partial salaries, fringe benefits and related travel of pediatricians. 7. The University shalt bill the Health Department on a quarterly basis with the fast bill being dated July 1, 1994 and the Health Department shall pay the University within thirty(30) da Ys of receipt of University's bill. Any adjustments to the billing shall be taken into account in the next succeeding bill or as soon thereafter as practicable. 8. In the event that the assigned pt&ztricians become unwilling or unable to perform the duties required by this Agreement,The University and OCHD shall attempt to mutually agar upon replacement U such mutual agreement is not achieved, then this Agreement shall terminate and any payment due as of the date of termination shall be paid_ 20 9. This Ag=mcnt shat run for a period of m•ely e (12) months, from the first day of July, 1994, to the thirtieth day of June, 1995, and shall be renewable annually thereafter upon written notice executed by both parties. 10. This Agreement or its renewals may be ter=* ated 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 terrination. 11. The OMD 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 OC HD, Orange County and the North Carolina Division of Health Services in the conduct of this service not inconsistent with University policies or regulations. 12. This agreement contains the entire understanding of the parties and shall not be altered, amended, or modified, excepr by an agreement in writing exccutcd by the duly authorized ofirieials of both parties. 13. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Agreement. 21 R�- WITNESS WHEREOF, the parties have hereunto signed this Agre—ement in their official capacities of the day and year lismd below. FOR A-TD 0*.NT BEHALF OF FOR AND ON BEHALF OF ORANGE COURTTY HEALTH DEPARTMENT THE U NTTVERSITY OF NORTH CAROLINA AT CHAPEL HILL Daniel B.Reimer, Director Wayne R Jones,Vice- Chancellor Business and Finance DATE: DATE: ORA tNIGE COLTTTY FINANCE DIRECTOR: "This instrument has been preauditrd in the manner required by the Local Government Budget and Fiscal Control Act_" Orange County Finance Director DATE: ('hsirm?n,Orange County Board of Commissioners DATE: