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HomeMy WebLinkAboutAgenda - 06-12-2007-4kORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 12, 2007 Action Age Item No. ` -"" SUBJECT: Contract Renewal for Pharmacy Services for Health Department DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): INFORMATION CONTACT: Contract Rosemary Summers, 245-2411 Business Associate Agreement PURPOSE: To renew a contract for pharmacy services for the Health Department. BACKGROUND: For the past seven years, the Health Department has contracted with an individual pharmacist to provide pharmacy services for the department. This will be the sixth year of contracting with the same pharmacist. The contract for FY 2007-2008 includes a 3.5% increase over last year for a total of $11,628 per year. This year, duties are added to assist primary care clients with applications for drug company low income assistance programs. Pharmacy services last year enabled the Health Department to provide pharmaceutical services to over 5,000 patients seen in one of the department's clinical services. The pharmacist also consults with the Health Department regarding public health preparedness dispensing sites and is available on-site if needed during a communicable disease outbreak. FINANCIAL IMPACT: The total cost of the contract is $11,628 for the fiscal year for approximately 350 hours of on-site pharmacy services. The $11,628 is included in the recommended Health Department budget. RECOMMENDATION(S): The Manager recommends that the Board approve the contract renewal and authorize the Chair to sign, pending the approval of the 2007-2008 budget and County Attorney review. Pharmacy Contract July 1, 2007 -June 30, 2008 CONTRACT FOR PHARMACY SERVICES FOR THE ORANGE COUNTY HEALTH DEPARTMENT This contract is between Robert E. Dupuis, herein referred to as "Contractor," and the Orange County Health Department, hereinafter referred to as the "Department." It shall be effective July 1, 2007 and shall terminate on June 30, 2008. It is understood that the Contractor will provide direct pharmacy services at the two pharmacy sites of the Health Department. It is further understood that there will be mutual cooperation between the Contractor and the Department in conducting the activities as described below: The Contractor agrees to: A. Administrative Duties Assist in the development of written policies and procedures for legal, safe and effective drug therapy, distribution, control and use. 2. Work with the Department pharmacy nurse in: a. Developing and maintaining a formulary b. Evaluating and improving procedures for drug procurement, storage, packaging and labeling 2 Work with the Department Assurance Nurse in the Medication Assistance Program (MAP) in: a. Verifying correct drug and dosage of pharmaceuticals provided by drug companies b. Splitting drugs as requested by clinician c. Labeling drugs d. Notifying Assurance Nurse when drugs are ready for dispensing 4. Oversee all activities related to the operation of the pharmacies at the Hillsborough Whiffed Center and Chapel Hill Southern Human Services Center. Prepare and submit a quarterly report reviewing pharmacy activities and related issues. 6. Prepare and submit an annual report summarizing pharmacy activities and accomplishments for the current year and goals/plans for the next year. 7. Assist the Clinical Services Nursing Supervisor in budget preparation for pharmaceuticals and related supplies, when requested. 8. Assist the Clinical Services Nursing Supervisor in acquiring pharmaceuticals in acost-efficient manner. 9. Evaluate and improve therapeutics within the Health Department. 10. Provide pharmacy training for new Public Health Nurses and Nurse Practitioners. 11. Evaluate pharmaceutical software for Health Department pharmacy Pharmacy Contract July 1, 2007 -June 30, 2008 functions as requested by the Division Director. 12. To the extent the Contractor keeps records, the Contractor agrees to make all such records available to the Department for auditing, reporting or any other purpose deemed necessary by the Department. B. Drug Distribution 1. Prepack stock formulary pharmaceuticals adhering to pharmacy law requirements and ensuring maintenance of adequate prepacked supplies. 2. Label medications received through the Medication Assistance Program (MAP). 3. Review dispensing logs at all Health Department sites weekly. 4. Review dispensing logs within 24 hours when more than 30 prescriptions have been distributed. 5. Maintain the drug distribution system in compliance with all laws, regulations and standards. 6. Provide drug information on an on-call basis when needed by staff. 7. Assist with the development and/or the procurement of necessary drug information/patient education materials to include information in languages other than English when needed. 8. Be available to directly dispense medications not approved for Public Health Nurse dispensing in times of communicable disease outbreaks. 9. Review at least 3 clinical charts from each site monthly comparing them to the dispensing log for accuracy and completeness. Document findings in the "OCHD Pharmacy Quality Assurance Indicator, Chart Review" log. 10. Complete pharmacy incident report on all errors and forward to the Clinical Nursing Supervisor for development of corrective actions. 11. Comply with such non-discrimination laws and/or employment practices as may be applicable in fulfilling this contract. I1. The Department agrees to: A. Designate a nursing supervisor to provide guidance and assistance with related administrative or technical aspects of providing pharmacy services at Health Department sites as requested. B. Participate in the ongoing evaluation of the role of the pharmacist and provide an annual evaluation of pharmacist's performance of contract. C. Pay the Contractor in return for the contracted deliverable services a total of $11,628 per year payable in 12 equal installments of $969 each upon invoice from the Contractor. Pharmacy Contract 4 July 1, 2007 -June 30, 2008 D. Enable the pharmacist to perform all activities mandated by laws, regulations and standards. E. Obtain required pharmacy licenses for all sites. F. Allow the pharmacist to participate in other related activities in the Health Department as agreed to by both parties G. Comply with such non-discrimination laws and/or employment practices as may be applicable in fulfilling this contract. III. Confidentiality The Contractor agrees to sign the OCHD Personal Health Services Division Confidentiality Agreement and agrees to maintain confidentiality per this Agreement. The Contractor will comply with such confidentiality laws as may be applicable in the performance of this agreement and acknowledges that in receiving, storing, processing or otherwise dealing with any confidential information, Contractor will safeguard and not further disclose the information except as permitted by the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended. IV. Licensure The Contractor agrees to maintain current North Carolina Pharmacy Licensure and to present proof of licensure annually. V. Insurance/Liability A. The Contractor agrees to obtain personal liability insurance in the amount of $1 Million per occurrence and $3 Million per aggregate. Proof of insurance will be presented to the Department annually. B. The Contractor agrees to hold Orange County and the Department harmless from any and all accidental injury or personal loss during pharmacy services to the Department. VI. Independent Contractor The Contractor shall perform all work and services as an independent contractor and not as an officer, agent, servant or employee of Orange County or the Department. The Contractor shall have control of and the right to control the details of the services and work performed. The Contractor shall not be considered an officer, agent, servant or employee of Orange County or the Department, nor shall the Contractor be entitled to any benefits available or granted to employees of Orange County or the Department. VII. Termination Either party may terminate this agreement without cause with 60 days written notice. This agreement may be terminated with cause at any time by either party upon at least 30 days prior written notice to the other party upon default of one or more of its obligations hereunder, unless such default is cured within 30 days of the notice of termination. Pharmacy Contract July 1, 2007 -June 30, 2008 IN WITNESS WHEREOF, the Contractor and the Department have executed this agreement in duplicate originals, one of which is retained by each of the parties. FOR AND ON BEHALF OF THE ORANGE COUNTY HEALTH DEPARTMENT: Rosemary L. Summers, Health Director Date Orange County Health Department FOR AND ON BEHALF OF THE COUNTY OF ORANGE: Moses Carey Jr., Chair Date Orange County Board of Commissioners CONTRACTOR: Robert E. Dupuis, Pharm.D., BCPS Date ORANGE COUNTY FINANCE DIRECTOR "This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act." Kenneth T. Chavious Date Orange County Finance Director 6 BUSINESS ASSOCIATE AGREEMENT This Agreement is made effective the 15t day of July, 2007 by and between Orange County Government, Health Department, hereinafter referred to as "Covered Entity", and Robert Dupuis, hereinafter referred to as "Business Associate," (individually, a "Party" and collectively, the "Parties"). WITNESSETH: WHEREAS, Sections 261 through 264 of the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, known as "the Administrative Simplification provisions," direct the Department of Health and Human Services to develop standards to protect the security, confidentiality and integrity of health information; and WHEREAS, pursuant to the Administrative Simplification provisions, the Secretary of Health and Human Services has issued regulations modifying 45 CFR Parts 160 and 164 (the "HIPAA Privacy Rule"); and WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business Associate will provide certain services to Covered Entity, and, pursuant to such arrangement, Business Associate may be considered a "business associate" of Covered Entity as defined in the HIPAA Privacy Rule (the agreement evidencing such arrangement is entitled "Contract for Pharmacy Services for the Orange County Health Department, dated July 1 2007 through June 30, 2008, and is hereby referred to as the "Arrangement Agreement"); and WHEREAS, Business Associate may have access to Protected Health Information (as defined below) in fulfilling its responsibilities under such arrangement; THEREFORE, in consideration of the Parties' continuing obligations under the Arrangement Agreement, the Parties agree to the provisions of this Agreement in order to address the requirements of the HIPAA Privacy Rule and to protect the interests of both Parties. DEFINITIONS Except as otherwise defined herein, terms used in this Agreement shall have the same meaning as those terms set forth in the HIPAA Privacy Rule. II. CONFIDENTIALITY REQUIREMENTS (a) Business Associate shall: (i) use or disclose any protected health information solely as permitted or required by this Agreement, the Arrangement Agreement (if consistent with this Agreement and the HIPAA Privacy Rule), or as required by law. (ii) ensure that its agents, including a subcontractor, to whom it provides protected health information received from or created by Business Associate on behalf of Covered Entity, agrees to the same restrictions and conditions that apply to Business Associate with respect to such information. In addition, Business Associate agrees to take reasonable steps to ensure that its employees' actions or omissions do not cause Business Associate to breach the terms of this Agreement; (iii) implement appropriate safeguards to prevent use or disclosure of protected health information other than as permitted or required by this Agreement; (iv) permit the Secretary of Health and Human Services to audit Business Associate's records and practices related to use and disclosure of protected health information to ensure Covered Entity's compliance with the terms of the HIPAA Privacy Rule; (v) report to Covered Entity any use or disclosure of protected health information which is not in compliance with the terms of this Agreement of which it becomes aware; and (vi) mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of protected health information by Business Associate in violation of the requirements of this Agreement. (b) Notwithstanding the prohibitions set forth in this Agreement or the Arrangement Agreement, Business Associate may use and disclose protected health information as follows: (i) if necessary, for the proper management and administration of Business Associate or to carry out the legal responsibilities of Business Associate, provided that as to any such disclosure, the following requirements are met: (A) the disclosure is required by law; or (B) Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will be held confidentially and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached; (ii) for data aggregation services, if such services are to be provided by Business Associate for the health care operations of Covered Entity pursuant to any agreements between the Parties evidencing their business relationship. III. AVAILABILITY OF PROTECTED HEALTH INFORMATION Business Associate shall: (a) at the request of Covered Entity, provide access to protected health information in a designated record set to Covered Entity or, as directed by Covered Entity, to an individual, in a time and manner sufficient to permit Covered Entity to comply with the requirements of 45 CFR 164.524. (b) at the request of Covered Entity or an individual, make any amendment(s) to protected health information in a designated record set that are directed by or agreed to by Covered Entity, in a time and manner sufficient to permit Covered Entity to comply with the requirements of 45 CFR 164.526. (c) document disclosures of protected health information and information related to such disclosures in a manner sufficient to permit Covered Entity to respond to a request by an individual for an accounting of disclosures of protected health information in accordance with 45 CFR 164.528 and provide such documentation to Covered Entity or an individual as directed by Covered Entity. IV. TERMINATION (a) Term: This Agreement terminates when the Arrangement Agreement terminates or as provided in Paragraph IV.b. below (termination for cause). (b) Termination for cause: Upon Covered Entity's knowledge of a material breach by Business Associate, Covered Entity shall either: (i) provide an opportunity for Business Associate to cure the breach or end the violation or, if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity, terminate this Agreement and the Arrangement Agreement; or (ii) immediately terminate this Agreement and the Arrangement Agreement if Business Associate has breached a material term of this Agreement and cure is not possible. (c) Return or destruction of protected health information: At termination of this Agreement, the Arrangement Agreement (or any similar documentation of the business relationship of the Parties), or upon request of Covered Entity, whichever occurs first, Business Associate shall: (i) if feasible, return or destroy all protected health information received from or created or received by Business Associate on behalf of Covered Entity that Business Associate still maintains in any form. Business Associate shall only destroy protected health information with the written approval of Covered Entity. After return or destruction, Business Associate shall retain no copies of such information. (ii) if return or destruction is not feasible, Business Associate will provide Covered Entity with documentation explaining the reason that it is not feasible. If the protected health information is not returned or destroyed, Business Associate will extend the protections of this Agreement to the information and limit further uses and disclosures to those purposes that make the return or destruction of the information not feasible. (d) Survival: The obligations of Business Associate under this Agreement shall survive the expiration, termination, or cancellation of this Agreement, the Arrangement Agreement and/or the business relationship of the parties, and shall continue to bind Business Associate, its agents, employees, contractors, successors, and assigns as set forth herein. V. MISCELLANEOUS (a) All protected health information that is created or received by Covered Entity and disclosed or made available in any form, including paper record, oral communication, audio recording, and electronic display by Covered Entity or its operating units to Business Associate or is created or received by Business Associate on Covered Entity's behalf shall be subject to this Agreement. (b) A reference in this Agreement to a section in the HIPAA Privacy Rule means the section as in effect or as amended. (c) In the event of an inconsistency between the provisions of this Agreement (including definitions) and mandatory provisions of the HIPAA Privacy Rule, as amended, the HIPAA Privacy Rule shall control. Where provisions of this Agreement are different than those mandated in the HIPAA Privacy Rule, but are nonetheless permitted by the HIPAA Privacy Rule, the provisions of this Agreement shall control. (d) Except as expressly stated herein or the HIPAA Privacy Rule, the parties to this Agreement do not intend to create any rights in any third parties. (e) .This Agreement may be amended or modified only in a writing signed by the Parties. No Party may assign its respective rights and obligations under this Agreement without the prior written consent of the other Party. None of the provisions of this Agreement are intended to create, nor will they be deemed to create any relationship between the Parties other than that of independent parties contracting with each other solely for the purposes of effecting the provisions of this Agreement and any other agreements between the Parties evidencing their business relationship. (f) This Agreement will be governed by the laws of the State of North Carolina. (g) No change, waiver or discharge of any liability or obligation hereunder on any one or more occasions shall be deemed a waiver of performance of any continuing or other obligation, or shall prohibit enforcement of any obligation, on any other occasion. (h) The parties agree that, in the event that any documentation of the arrangement pursuant to which Business Associate provides services to Covered Entity contains provisions relating to the use or disclosure of protected health information that are more restrictive than the provisions of this Agreement, the provisions of the more restrictive documentation will control. (i) In the event that any provision of this Agreement is held by a court of competent jurisdiction to be invalid or unenforceable, the remainder of the provisions of this Agreement will remain in full force and effect. 9 (j) The headings in this Agreement are for convenience of reference only and shall not define or limit any of the terms or provisions hereof. above. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written COVERED ENTITY: BUSINESS ASSOCIATE: By: By: Title: