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HomeMy WebLinkAboutAgenda - 04-05-1993 - III-D 1 ORANGE COUNTY BOARD OF COMMISSIONERS Action Agenda Item No. D ACTION AGENDA ITEM ABSTRACT Meeting Date: April 5, 1993 SUBJECT: Contracts between the Orange County Health Department (OCHD) and the UNC-CH School of Medicine, Departments of Family Medicine and Pediatrics DEPARTMENT: HEALTH PUBLIC HEARING: Yes X No ATTACHMENT(S) : INFORMATION CONTACT: HEALTH DIRECTOR'S OFFICE X2411 Two Contracts TELEPHONE NUMBER: Hillsborough -732-8181 Chapel Hill -968-4501 Mebane -227-2031 Durham -688-7331 PURPOSE: To approve the renewal of Professional Services Contracts between the Orange County Health Department and the UNC-CH School of Medicine, Departments of Family Medicine and Pediatrics. BACKGROUND: The contract with Family Medicine has been continuing since 1987 in various forms. The contract provides the services of a facility members who acts as part-time Medical Director and Clinician. On December 7, 1992, the Board of Commissioners approved an expansion of the contract with Family Medicine to provide qualified laboratory personnel in order to meet the requirements of the new Clinical Laboratory Improvements Amendments (CLIA) of 1988. After approval by the Board of Commissioners, but before endorsement by UNC-CH, the Health Department learned that the CLIA requirements could be met through the State Laboratory and its regional consultants. Therefore, the Family Medicine Contract was returned to its previous format with a savings of Two-thousand and thirty seven dollars ($2,037.00) . The contract with the Department of Pediatrics has been in existence since 1983 with several modifications. The agreement provides the time of pediatricians and residents serving patients in the Health Department Adolescent Clinic. This arrangement has been closely coordinated with the Adolescent in Need Program serving Orange High School students. Processing of Pediatrics Contract has been delayed until the Family Medicine Contract was complete because of the inter-relationship of funding. Funds for both contracts have been included in the approved 1992-93 budget. RECOMMENDATION(S) : The Managers recommends that both contracts be approved and that the Chair be authorized to sign. 2 STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into this first day of July, 1992, 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. 14WI: -a—JD 3 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 2 of 7 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 4 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 3 of 7 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; 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. 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. 4. 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. 1993 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 4 of 7 5. It is required that on-site physician attendance shall occur as follows: Monday CH Clinic - Hillsborough 10:00 am - 2:00 pm Tuesday FP/STD Clinic - Hillsborough 2:00 pm - 5:00 pm Wednesday FP/STD Clinic - carrboro 2:00 pm - 5:00 pm Thursday PNC Clinic - Hillsborough 10:00 am - 12:00 pm 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. 6. 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. 7. In addition to the eleven (11) on site clinical hours per week, the Department agrees to provide eleven (11) hours of administrative time for an average of twenty-two (22) hours per week. These eleven (11) hours will be scheduled to the mutual convenience of both parties. 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. 8. The Department will maintain current registration and licensure and warrant such to the OCHD. 6 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 5 of 7 9. The Department will insure self for malpractice. 10. The Department will relate to all patients and staff of the OCHD in a professional manner. 11. The Department will offer medical consultation in accord with the accepted methods and procedures. 12. The OCHD agrees to pay the Department in return for the above services FIFTY-THREE THOUSAND, ONE HUNDRED AND NINETY-SIX DOLLARS ($53,196) . At the rate of $46.50 per hour for an average of 22 hours per week from July 1, 1992 through June 30, 1992, payments shall be made in equal monthly installments of FOUR THOUSAND THREE HUNDRED SEVENTY-ONE DOLLARS ($4371.00) . 13. The University shall bill the OCHD on a monthly basis with the first bill being dated July 1, 1992 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. 14. 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. 15. 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 AGREEMENT Between UNC School of Medicine and Orange County Health Department Page 6 of 7 and any payment due as of the date of termination shall be paid. 16. This Agreement shall run for a period of twelve (12) months, from the first day of July, 1992, to the thirtieth day of June, 1993, and shall be renewable annually thereafter upon written notice executed by both parties. 17. 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. 18. 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. 19. 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. 20. 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. 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 141' . Daniel B. Reimer, Director Wayn R. Jones,V e- Chancellor Business and Finance DATE: y/°/9,3 DATE: 7 /L —9 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: 4//:C-Z9 3 A Chairman, Orange County Board • C. ssioners DATE: / ; / �'-3 / 9 STA'L'E OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into as of the first day of July, 1992, 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." WITNES SETH; 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 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 sums to be paid, the OCHD and The University agree as follows: 1. A pediatrician from The University will provide pediatric services in the Health Department's Hillsborough 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: a. Provide medical services for adolescents. 10 b. Provide consultation to OCHD staff on matters pertaining 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 OCHD upon request. 3. The Department will insure self for malpractice. 4. The Department will relate to all atients and staff of the OCHD in a professionaltienimanne . 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$13,500 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, 1992 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 bill or as soon thereafter as practicable. 8. 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 _ 9. This Agreement shall run for a period of twelve (12) months,from the first day of July, 1992, to the thirtieth day of June, 1993, 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 prorated to the date of termination. 11. 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 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 officials of both parties. 13. 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 4111P Daniel B. Reimer, Director Wayn R. Jones,V e- Chancellor Business and Finance DATE: 5'5`"/ 9.3 DATE: 9 1 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: 47// A'3 0 A A Chairman, Or/5--,/93 ge County Board • C. ssioners DATE: