HomeMy WebLinkAbout2016-514-E DSS - OPT - MOU to provide medical transportation to eligible Medicaid clients DocuSign Envelope ID: D843B726-9091-416C-B6AC-7EA85FE2894E
MEDICAID TRANSPORTATION
MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is entered into this 0 day of t 2016,
by and between the Orange County Department of Social Services and Oran e Public
Transportation (referred to collectively as the "Parties").
WHEREAS, Orange Public Transportation (hereinafter referred to as "OPT") and the
Orange County Department of Social Services (hereinafter referred to as "OCDSS") are
departments or agencies of Orange County, North Carolina and are ineligible to enter into
binding contractual relationship with one another; and
WHEREAS, the parties desire to enter into this Memorandum of Understanding in order
to establish the mutually agreed upon conditions upon which OPT will provide certain services
for OCDSS in connection with the Orange County Department of Social Services Medicaid
Program; and
WHEREAS, the OCDSS is mandated to provide transportation to Medicaid covered
services when a client does not have access to personal transportation; and
WHEREAS, OPT is a coordinated transit system run by Orange County Government in
Orange County, North Carolina.
NOW, THEREFORE, the parties to this Memorandum hereby agree as follows:
I. OPT will provide non-emergency medical transportation services to and from medically
necessary appointments to Medicaid clients at the request of OCDSS.
2. OCDSS will reimburse OPT for services provided under this Memorandum at a rate of
$15.65 per one-way trip. OCDSS will not reimburse OPT for no-shows.
3. OPT agrees that continuation of and/or renewal of this Memorandum is contingent on
meeting the following requirements. OPT agrees to:
A. Provide services to enrolled participants within two days of a request.
B. Provide critical services, including dialysis, on short notice when requested.
C. Provide back-up drivers in case the assigned driver is not available.
D. Coordinate maintenance to ensure vehicles are in safe operating order.
E. Review the Transportation Database to verify client eligibility and information. Refer
any discrepancies to OCDSS for investigation.
F. Discuss the specific situation, and present evidence of cause, with the Department of
Social Services staff prior to termination of services for any client. Clients may be
suspended for thirty (30) days for three no-shows without good cause within a three-
month period.
G. Complete the DMA 5124 as part of the annual contract process.
DocuSign Envelope ID: D843B726-9091-416C-B6AC-7EA85FE2894E
4. OCDSS will reimburse OPT for services described in this Memorandum. For
reimbursement, OPT must submit an invoice by the fifth business day of the month for
the preceding month's expenditures to the designated OCDSS Administrator. OCDSS
will reimburse OPT monthly upon receipt of a complete and correctly filed report.
5. OPT agrees to use the provided transportation billing codes on invoices to the OCDSS for
reimbursement.
6. OPT agrees to only submit invoices for trips approved by OCDSS. Trips included on
invoices that were not pre-approved by OCDSS will not be reimbursed.
7. OCDSS agrees to receive all client call regarding scheduling.
8. Any change to the client's destination, address, or phone number will be made by
OCDSS.
9. OPT agrees to meet on-time performance standards such that no more than 5% of trips
should be late for client drop-off to his or her appointment per month. Late is defined as
past the client's appointment time.
10. OPT agrees that not more than one quarter of one percent of all trips be missed by the
OPT or any subcontractor during the course of the contract year.
11. OPT agrees to report all no-shows on a daily basis and cancellations on a monthly basis
to OCDSS via email.
12. OPT agrees to record all client complaints which deal with the matters under the control
of OPT, including the date of the complaint, the nature of the complaint, and what steps
were taken to resolve the complaint.
13. OPT agrees to provide names of all owners, managers, management entities, and
subcontractors.
14. OPT agrees to report any changes such as insurance provider, business ownership or
management or exclusion from participation in Medicare.
15. OPT agrees to disclose, at the outset of the contract, upon renewal and upon request, any
criminal convictions or other reasons for disqualifications from participation in Medicare,
Medicaid or Title XX programs.
16. OPT agrees to participate in program, fiscal and administrative monitoring and/or audits,
making records and staff time available to Federal, State and County staff
17. OPT agrees to allow monitoring of records to ensure that all contract requirements are
met.
18. OPT agrees to take necessary steps for corrective action, as negotiated within a corrective
action plan, for any items found to be out of compliance with Federal, State, and County
laws, regulations, standards and/or terms of this Memorandum.
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DocuSign Envelope ID: D843B726-9091-416C-B6AC-7EA85FE2894E
19. OPT has provided the North Carolina Department of Transportation with certain Annual
Certifications and Assurances as set forth on that certain document entitled "FEDERAL
(FTA) AND STATE (NCDOT) CERTIFICATIONS AND ASSURANCES FOR
COMMUNITY TRANSPORTATION PROGRAMS FOR THE CURRENT FISCAL
YEAR." Said assurances are hereby incorporated into this Memorandum by reference to
the same.
20. OPT will ensure that all vehicles transporting clients shall have at least the minimum
level of liability insurance appropriate for the type of vehicle as defined by Article 7,
Rule R2-36 of the North Carolina Utilities Commission;
21. OPT will ensure that all drivers (including employees, contractors, contractor's
employees, and volunteers) shall be at least 18 years of age.
22. OPT will ensure that all drivers (including employees, contractors, contractor's
employees, and volunteers) shall be licensed to operate the specific vehicle used in
transporting clients in accordance with Chapter 20-7 of the General Statutes of North
Carolina and the Division of Motor Vehicle requirements;
23. OPT agrees to maintain records documenting the following:
A. Valid current copies of Driver's Licenses for all drivers;
B. Current valid vehicle registration, for all vehicles transporting clients;
C. Driving records for all drivers for the past three years and with annual updates;
D. Criminal Background checks through North Carolina Law Enforcement or NCIC
prior to employment and every three years thereafter;
E. Alcohol and drug testing program that meets the Federal Transit Authority guidelines.
Payment for the jz'drug and alcohol testing program will be the responsibility of OPT.
24. OPT will ensure that all vehicles used in the fulfillment of services under this
Memorandum have a valid State registration and State inspection.
25. Any information, data, instruments, documents, studies or reports given to or prepared or
assembled by OPT under this Memorandum shall be kept as confidential and not
divulged or made available to any individual or organization without the prior written
approval of OCDSS unless the information is required to be disclosed pursuant to the
public records laws of the State of North Carolina or any other applicable law or court
order. OPT acknowledges that in receiving, storing, processing or otherwise dealing with
any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this Memorandum.
26. This Memorandum shall be effective from July 1, 2016 to June 30, 2017.
27. This Memorandum shall be reviewed at least annually, prior to May 1st and may be
terminated by either party upon 60 days written notice.
28. The Memorandum contains the entire understanding of the parties and shall not be
altered, amended or modified, except in writing executed by the Department Directors of
both parties.
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DocuSign Envelope ID: D843B726-9091-416C-B6AC-7EA85FE2894E
IN WITNESS WHEREOF, the parties hereto have caused this Memorandum to be signed by its
Department Director.
FOR AND ON BEHALF OF: FOR AND ON BEHALF OF:
ORANGE PUBLIC TRANSPORTATION ORANGE COUNTY DEPARTMENT OF
SOCIAL SERVICES
DocuSigned by: DocuSigned by:
traNitis A/L(1MA, kittlAtli COSfOIA,
0,4384B4-243-364124-
Director Nancy Coston, Director
8/31/2016 8/31/2016
DATE: DATE:
This contr.. ',as,- .7 wyapproved as to form and legal sufficiency.
9/1/2016
4035CB8304CA4A9
Annette M. Moore, Staff Attorney Date
County Attorney's Office
This instrument has been pre-audited in the manner required by the Local Government Budget
and Fisc akwidAct.
8/31/2016
7L14E5.1111ArC14 9
Gary Donaldson, Finance Director Date
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