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HomeMy WebLinkAboutAgenda - 06-26-2007-4gORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 26, 2007 Action Agenda Item No. ~-~-- - SUBJECT: Contract with UNC School of Dentistry and Health Department for Services of a Dentist DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): INFORMATION CONTACT: Contract Rosemary Summers, 245-2411 PURPOSE: To consider approving a contract for the provision of dental clinical services for the Health Department by a UNC School of Dentistry faculty member. BACKGROUND: The Health Department's clinical dental program began in 1980 through a grant from the Robert Wood Johnson Foundation. The UNC School of Dentistry has been an integral part of the provision of services to Orange County residents through the Health Department. The model that was gradually adopted had a number of different part-time faculty members who provided services at the Health Department. Over time, this resulted in high turnover of dentists as there was no individual commitment to the clinics or the patients. When a dentist left, often clinics were cancelled due to the lack of a replacement. Continuity of care for the patients was affected by this rapid turnover of itinerant dentists. The Board of Commissioners, upon recommendation of the Board of Health, approved a .8 FTE dentist position in June of 2003. Recruitment of a dentist has been difficult because of the competitive private practice salaries of dentists. The last dentist that was an employee of the Health Department (2005-2006), Dr. Stephanie Rodriguez, returned to Texas (her home state), after one year of service with the Health Department. Subsequently, the Department was unable to recruit a dentist, and for 2006-2007, contracted with the UNC Dental School for a Visiting Clinical Professor, and has received for one year the services of a dentist that completed residency training in the spring of 2006. That commitment was for one year and the dentist is matriculating in the fall into an Oral Surgery Program in another state. The Health Department, with the assistance of the Personnel Department, began re-recruitment for this position in January, and tendered an offer to a dentist from Michigan who accepted and subsequently rescinded his acceptance due to personal circumstances. Re-recruitment has yielded a candidate that would like to maintain state retirement benefit options. The School of Dentistry has indicated a willingness to create a position in the School of Dentistry that would fulfill the County's needs for a stable dental presence and contract with the County to fill this position. The person in this position would be assigned exclusively to the Orange County Health Department for the provision of dental clinical services. The School is currently in the process of creating a position of Clinical Associate Professor and will need to follow all University guidelines for advertising and hiring this position. The draft contract has a provision for Health Department input and approval of the person being offered the position. This is similar in nature to the long-standing contract the Department has had with UNC Family Practice for the Medical Director services. It is anticipated that University contract review and recruitment may take until the end of July to accomplish. Meanwhile, the services will be covered through "day" arrangement contracting with a variety of providers. The draft contract is attached, but is not in final form as it still needs both University and County Attorney review and the salary and benefit level for the university will not be determined until after July 1. In order to facilitate proceeding with this contract arrangement and secure a dentist as soon as possible, staff is asking permission to proceed with this arrangement under the Manager's approval. FINANCIAL IMPACT: Funds to support this contract would come from a transfer from the Health Department's personnel line to professional contract services. The total amount of funds allocated for the salary and benefits for this position is $128,000. The actual amount will depend on when the person actually begins. The contract amount is for a not to exceed total of $132,559 and includes salary, benefits (at the University rate), and a few items that will be reimbursed on a receipt basis. The total is currently part of the proposed 2007-2008 fiscal year budget for the Health Department. RECOMMENDATION(S): The Manager recommends that the Board approve the contract in principal and authorize the Manager to execute and sign the final contract pending final review by staff and the County Attorney. 3 STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT BETWEEN THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF DENTISTRY FOR ITS DEPARTMENT OF DENTAL ECOLOGY AND ORANGE COUNTY HEALTH DEPARTMENT THIS AGREEMENT, made and entered into this the IS` day of July, 2007, by and between The University of North Carolina at Chapel, School of Dentistry, for its Department of Dental Ecology; and The Orange County Health Department hereinafter referred to as "The Health Department". WITNESSETH WHEREAS, The Health Department desires the services of one Clinical Associate Professor to provide direct clinical services for clients of the Dental Health Service of the Orange County Health Department for the academic year 2007-2008; WHEREAS, The Health Department desires to reimburse The School of Dentistry for the salary plus fringe of one Clinical Associate Professor; WHERAS, The School of Dentistry wishes to provide the services of one Clinical Associate Professor to The Health Department; NOW, THEREFORE, in consideration of the premises and of the following mutual promises, covenants, and conditions, The School of Dentistry and The Health Department agree as follows: 1. The Health Department will reimburse The School of Dentistry at the close of each quarter for up to I/4 of the total amount. The total annual amount should not exceed $128,000 except for those items in Number 8, which will be reimbursed by receipt of expenses. 2. The School of Dentistry will provide the services of one mutually agreed upon Clinical Associate Professor to The Health Department for the purpose of rendering comprehensive clinical dental services for 32 hours per week (.8FTE) in the Dental Health Service of the Health Department. 3. The School of Dentistry will provide the services of one mutually agreed upon Clinical Associate Professor to The Health Department for the purpose of attending dentist supervision of residents and students providing services under this agreement. 4. School of Dentistry will bill the Health Department at the close of each quarter, not to exceed one fourth of the total contract amount. 4 Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page 2 of 6 5. The person whose services are to be provided pursuant to the Agreement is, for all purposes an employee of The University of North Carolina School of Dentistry. 6. While the School of Dentistry Clinical Associate Professor is working at the Orange County Health Department, professional liability insurance coverage will be provided by the School of Dentistry with coverage of at least $1 million, per incident, $3 million per year. Certificate of insurance to be provided to the Health Department prior to the Clinical Associate Professor's assumption of duties. 7. The Orange County Health Department will agree to the Personnel Policies of the University in its provision of accruing and approving the use of vacation, sick and educational leave requests and generally allow ten vacation days, ten sick days, five educational days and 11 holidays that OCHD employees observe for the fiscal year 2007-2008. The vacation request must be submitted to the health department division director at least two months in advance. 8. In addition to salary and benefits (Medicare tax, Social Security tax, retirement system contribution, liability insurance, life, medical and dental insurance) the Orange County Health Department will provide payment on a receipt basis for the following benefits not to exceed a total of $4,559: Travel-to attend NC Annual State Dental Meeting Training-Continuing Education Annual Dental License Renewal DEA License Renewal Annual Dues-American Dental Association 9. The contract will be reviewed annually to include salary adjustments for cost of living increases based on the UNC School of Dentistry cost of living increases. Between The University of North Carolina School of Dentistry fonts Department of Dental Ecology And OCHD Page 3 of 6 10. The Clinical Associate Professor services provided to the Orange County Health Department shall include the following: A. Provides all necessary routine clinical dental care for adults and comprehensive clinical dental services for children. 1. Meets daily production standard of $2,500 to $3,000 per day. 2. Assures that all clinical staff are meeting production standards. B. Using the dentist professional judgment performs the following as needed: 1. Examines and determines dental needs of client. 2. Writes treatment plan and obtains informed consent. 3. Amalgam and composite restorations. 4. Simple extractions and those extractions that become surgical. 5. Pulpotomies, stainless steel crowns, sealants, prophylaxis, periodontal scaling; fluoride. 6. Performs emergency dental treatment for relief of pain and/or infection. 7. Triage dental emergency patients appointments daily. 8. Assess the client's dental needs and makes referrals to appropriate specialist 9. Prescribes appropriate medications to treat or prepare a patient for treatment 10. Accurately documents treatment rendered in dental patient records to manage risk, provide continuity of care and assure quality of care. 11. Reads and co-signs all entries in the dental patient record for every visit. 12. Review medical and dental histories of all dental patients. 13. Treat patients with complex medical conditions: HIV/AIDS, diabetes, asthma, allergies, cardiac conditions and other medical conditions. 14. Assure that necessary precautions are taken for each patient to reduce the risk of medical and dental complications. C. Supervise the clinical treatment services performed by all staff in the OCHD. Dental Health Service to a cultural diverse population. , 1. Orders treatment services to be rendered and/or reviews and confirms treatment plan. 2. Checks and verifies that dental treatment rendered by general practice residents, dental students and dental hygiene students meets Standard of Care and are in full compliance with the Dental Laws and Dental Rules of NC State Board of Dental Examiners. D. Responsible for the orientation, training and evaluation of General Practice Residents, dental students, dental hygiene students and dental assisting students (delegate responsibilities to appropriate OCHD staff). 1. Attends GPR Faculty/Attendings Quarterly Meetings. 2. Participates in the GPR recruitment process. 3. Responsible for the residents and students behavior while at the OCHD (late arrival, leaving early, production, patient care). Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page 4 of 6 E. Serves as a preceptor for students from UNC School of Dentistry. Holds a Clinical Assistant Professor appointment in the Department of Dental Ecology, UNC School of Dentistry. 1. Follows UNC School of Dentistry Pediatric Syllabus as Standards of Care for pediatric patients. 2. Follows UNC School of Dentistry Standards of Care as a guideline for treating patients at OCHD. 3. As preceptor, adheres to the UNC School of Dentistry Clinical Competency/Self- Assessment/Competency Program protocols for evaluation of dental students. 4. Must be calibrated by a dental hygiene faculty member from UNC to function as a preceptor for dental hygiene students on rotation at OCHD. 5. Fills out all evaluation forms for students and residents. 6. Is accessible and interacts with residents and students. 7. Responsive to the needs of the residents and students. 8. Answers questions and provides training for residents and students. F. Meets OCHD Quality Assurance Protocols. 1. Follows general dentistry Standards of Care. 2. Participates in a carefully structured, active peer review of dental operators through regularly scheduled, rotating chart audits conducted by the Risk Management Coordinator. The audits will focus upon appropriateness of care, comprehensiveness of care, and continuity of care. 3. Follows the Dental Laws and Dental Rules of NC State Board of Dental Examiners. G. Adheres to the following work schedule: 1. Works 32 hours per week. 2. Scheduled to work Tuesday through Friday from 8:00 am to 5:00 pm. 3. Arrives to work on time. 4. Compensatory time that has been accrued Tuesday through Thursday over the 8 hour day can be taken off on Friday afternoons. 5. Maybe required to work outside the regular work week performing duties assigned by the health director in response to emergency situations that arise in Orange County. H. Community Activities: 1. Participate with dental societies, state dental public health staff, and local civic/community groups in planning and implementing community-wide events to promote dental and oral health. 2. The dentist service as the health department's liaison with the local dental society. 11. This Agreement shall run for a period of one year, from the 15` day of July 2007 to the 30`" day of June 2008, and shall be renewable thereafter. Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page 4 of 6 12. 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 30 days prior to termination. In the event of such termination any payment due shall be prorated to the date of termination. 13. In cornplrance with 42 U.S.C. 1395x (v)(1)(1) and implementing regulations, The School of Dentistry and The Health Department agree, until the expiration of four year after the services are furnished under this contract, to allow the Secretary of the Department of.Health and Human Services and the Comptroller General access to this contract and to the books, documents and records of The School of Dentistry and The Health Department necessary to verify the nature and extent of this contract. The School of Dentistry and The Health Department further agree that if any of the duties of this contract are carried out by a subcontractor of The School of Dentistry or The Health Department such subcontract shall contain a clause to the effect that, until the expiration of four years after the services are furnished under such subcontract, the Secretary of the Department of Health and Human services and the Comptroller General shall have access to such subcontract and to the books, documents and records of the subcontractor necessary to verify the nature and extent of the costs of such subcontract. 14. "The Health Department and the School of Dentistry will comply with such non- discrimination and confidentiality laws as may be applicable in the performance of this agreement and acknowledge that in receiving, storing, processing or otherwise dealing .with any .confidential information, they 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." 15. The School of Dentistry will be responsible for training its Clinical Associate Professor to follow the OSHA Blood-borne Pathogens Standard, assuring that its Clinical Associate Professor comply with the health requirements established by North Carolina state regulations and the School of Dentistry. 16. The School of Dentistry will maintain proper records of its Clinical Associate Professor and instruct them about Hepatitis B vaccinations about the Clinical Assistant Professor's responsibility for post-exposure follow-up and any incurred costs, about the responsibility for the provision of protective equipment, and the proper post-exposure record-keeping. 8 Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page 5 of 6 17. In addition, the Clinical Associate Professor must meet all current immunization requirements for health care settings, including proof of a positive Varicella titer or vaccination and proof of a positive MMR titer or required vaccinations. 18. The health department must provide HIV, HBV and HCV testing for the source patient in the event of a blood borne pathogen exposure. In the event the Clinical Associate Professor is exposed to blood or bodily fluids, the health department will be responsible for providing an initial response, according to the Orange County Health Department Blood-borne Pathogens Standard. The Clinical Associate Professor will be required to return to the UNC School of Dentistry Employee Health for post-incident testing and counseling if feasible. In the event the Clinical Associate Professor is unable to do so in a timely manner, the health department will provide access to testing and counseling for the Clinical Associate Professor. The Clinical Associate Professor will be responsible for the payment of services. 19. "The Health Department will not be responsible for damages arising from personal injury to the Clinical Associate Professor of the School of Dentistry while the Clinical Associate Professor is present at the Health Department, unless personal injury was caused by the negligence of the Health Department, its employees, or agents. Nothing in this agreement is intended to serve as a waiver of sovereign or governmental immunity by Orange County." 20. The Agreement includes a six month contract review period effective on the first day of employment. From the first day of employment and during the six months, the OCHD has the authority to terminate the contract with the School of Dentistry due to non-compliance of item number ten of contract. The OCHD agrees to consult with the School of Dentistry within 5 business days of occurrence, should any issues arise. 21. The 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 official of both parties. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms and conditions of this Agreement. Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page 6 of 6 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 AND ON BEHALF OF THE THE ORANGE COUNTY HEALTH UNIVERSITY OF NORTH CAROLINA DEPARTMENT AT CHAPEL HILL Rosemary L. Summers Date Dr. John Williams Date Health Director Dean, School of Dentistry Richard Mann Date Vice Chancellor for Finance and Administration This instrument has been preaudited in the Manner required by the Local Government Budget and Fiscal Control act. Kenneth Chavious Date Director, Orange County Finance Laura E. Blackmon. Date Orange County Manager