HomeMy WebLinkAbout2017-515-E Health - NC Public Health Association for smoking cessation coaching DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
[Departmental Use Only]
TITLE NCPHA Quitline NC
FY 2017-2018
ORANGE COUNTY
CONTRACT UNDER $15,000.00
NORTH CAROLINA
THIS AGREEMENT, made and entered into this 7th day of September, 2017, ("Effective Date")
by and between Orange County, North Carolina, a political subdivision of the State of North Carolina, (the
"County"),party of the first part; and North Carolina Public Health Association (the "Provider"),party of the
second part;
WITNESSETH:
For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby
contracts for the services of the Provider, and the Provider agrees to provide the following services to the
County in accordance with the terms of this Agreement, time being of the essence:
The services and/or materials (hereinafter referred to collectively as "Services") to be furnished
under this Agreement are as follows: Provide smoking cessation counseling and Nictotine Replacement
Therapy (NRT) as described in the attached Exhibit A, "Cost Sharing Agreement for QuitlineNC
Comprehensive Services".
The term of this agreement rendered shall be from October 4, 2017 to June 30,2018.
Provider represents and agrees that Provider is qualified to perform and fully capable of performing and
providing the services required or necessary under this Agreement in a fully competent, professional and
timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in
the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies,
ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not
sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or
responsibility granted or required by this Agreement,without the prior written approval of the County.
SPECIFIC TERMS
1. Payment: The County agrees to pay at the rates specified for Services satisfactorily
performed in accord with this Agreement. The amount to be paid by the County shall not exceed Five
Thousand dollars, ($5,000). Payment shall be made within thirty (30) days of an invoice properly submitted
to County. Should Provider fail to perform its duties under the terms of this Agreement, County may, without
fault or penalty,withhold any payment associated with the work to be performed until such time as said work
is completed.
2. Non—waiver: Failure by County at any time to require the performance by Provider of any
of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor
shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of
this Non-Waiver Clause.
3. Independent Contractor: The Provider shall operate as an independent contractor and the
County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated
as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or
workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of
any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider.
4. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability
Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may
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be required by County's Risk Manager as such insurance requirements are described in the Orange County
Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is
incorporated herein by reference and may be viewed at
http://www.orangecountync.gov/departments/purchasing division/contra cts.ph p). if County's Risk
Manager determines additional insurance coverage is required such additional insurance shall consist of N/A
(if no additional insurance required mark N/A as being not applicable). Provider shall not commence work
until such insurance is in effect and certification thereof has been received by the County's Risk Manager.
5. Indemnity: The Provider agrees to defend, indemnify, and hold harmless Orange County
from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable
attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or
destruction of any property caused in whole or in part by any negligent or intentional act or omission on the
part of the Provider, its agents, or assigns directly or indirectly related to the Services to be performed
pursuant to this Agreement on the part of the Provider.
6. Termination: This Agreement may be terminated at any time by mutual written agreement of
the parties or by the County upon written notice to the Provider. County may suspend this Agreement upon
reasonable notice to the Provider.
7. Entire Agreement and Signatures: The parties have read this Agreement and agree to be
bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the
Agreement between the parties unless and until modified in writing and signed by the parties. This
Agreement together with any amendments or modifications may be executed electronically. All electronic
signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of
the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66.
8. Priority: In determining the basic services to be provided, should any documents be
referenced in or attached to this Agreement, the terms of this Agreement shall have priority in any conflict
between the terms of referenced documents and the terms of this Agreement.
9. Governing Law: Both parties agree that this Agreement shall be governed by the laws of the
State of North Carolina. Provider shall at all times remain in compliance with all applicable local, state, and
federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws,
policies,rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living
Wage Policy (each policy is incorporated herein by reference and may be viewed at
http://www.orangecountync.gov/departments/purchasing division/contracts.php.). Any violation of this
requirement is a breach of this Agreement and County may immediately terminate this Agreement without
further obligation on the part of the County. This paragraph is not intended to limit and does not limit the
definition of breach to discrimination. By executing this Agreement Provider affirms that Provider is and
shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By
executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the
services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58.
10. Dispute Resolution: Any and all suits or actions to enforce, interpret, or seek damages with
respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in
the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the
parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding
arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of
any dispute prior to the bringing of such suit or action.
11. Non Appropriation: Provider acknowledges that County is a governmental entity, and the
validity of this Agreement is based upon the availability of public funding under the authority of its statutory
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DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
mandate. In the event that public funds are unavailable and not appropriated for the performance of County's
obligations under this Agreement, then this Agreement shall automatically expire without penalty to County
immediately upon written notice to Provider of the unavailability and non-appropriation of public funds.
[SIGNATURE PAGE TO FOLLOW]
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DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
IN WITNESS WHEREOF,County and the Provider have signed this Agreement, effective as of
the day first written above.
O GE OUNTY PR II Red by:
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By: (1R37994R755F477 By: —Ewea-r'vrb 1 re c to r
County Manager Title:
200 S. Cameron St. North Carolina Public Health Association
P.O. Box 8181 222N. Person Street, Suite 208
Hillsborough,NC 27278 Raleigh, NC 27601
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DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
Exhibit A
Cost Sharing Agreement for QuitlineNC Comprehensive Services
Introduction
The North Carolina tobacco and Prevention and Control Branch (TPCB") of the North Carolina Division of
Public Health in the North Carolina Department of Health and Human Services ("DHHS") works with diverse
communities to reduce tobacco disease, death and health care costs. The North Carolina Tobacco-Use
Quitline ("QuitlineNC"), funded by TCPB, employs scientific evidence-based methods to help tobacco users
quit smoking. The North Carolina Public Health Association ("NCPHA") has entered into a Memorandum of
Agreement with TPCB to enable third-parties to enter into cost-sharing agreements with the NCPHA for
Quitline services. The Orange County Health Department has expressed interest in becoming a third party
payer to expand the sources of payment for purchase Nicotine Replacement Therapy for Orange County
residents enrolled in the QuitlineNC. The following represents a proposal for service delivery between the
Orange County Health Department and the NC Public Health Association (NCPHA).
General Demographic Information
The Orange County Health Department requests Quitline NC provide Nicotine Replacement Therapy for
residents of Orange County, North Carolina. There are approximately 133,800 residents, of which
approximately [16% (n=21,408)] are tobacco users. Based on historical trends in 2015 and 2016, the projected
"reach" or number of residents expected to call the QuitlineNC for services is 120 per year. Eligible service
users are Orange County residents who are 18 years or older.
Cessation Service for Orange County Residents
During the period July 1, 2017—June 30, 2018, Orange County residents that enroll in the Quitline will receive
telephone-based and integrated web-based counseling or web only counseling and free Nicotine
Replacement Therapy (NRT) as follows: an initial telephone screening call, four or eight of weeks of free
nicotine patches, gum, lozenges or combination therapy, up to four counseling calls per member, mailed
materials, and unlimited courtesy calls to the Orange County participant for additional Quitline support.
QuitlineNC participants must speak with a coach to receive free NRT. The Orange County Health Department
will also be able to take advantage of any statewide or nationwide promotion of 1-800-QuitNow.
Per the Memorandum of Agreement between NCPHA and the DHHS (see Contract Number 00030671, Scope
of Services), specific service delivery protocol by QuitlineNC will be as follows:
• Initial screening to determine Orange County participant smoking status, provide service explanation
and offer counseling; initial counseling call may be completed "on the spot" if a counselor is available;
otherwise an appointment will be made for a date and time selected by the Orange County
participant. QuitlineNC will initiate the counseling call at the scheduled
time. If the Orange County participant is not reached within a total of four (4) call backs, other
attempts will be made to try to reach the Orange County participant to complete the engagement.
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DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
Exhibit A
• Up to four(4)telephone counseling sessions (one 45 minute session and three 15 minute sessions)
• Eight weeks of nicotine replacement therapy (NRT), based on participation in counseling sessions:
four weeks sent to the Orange County participant home address via UPS upon completion of the
first telephone counseling call (45 min.) and an additional 4 weeks sent via UPS if the Orange County
Health Department participant completes second counseling call.
• An information packet which includes a quit tobacco use guide will be mailed to all participants
completing the screener call. Those who complete the first counseling call and are approved for NRT
will also receive simplified instructions along with the NRT kit.
QuitlineNC orts
The Orange County Health Department will receive the following reports monthly:
• Utilization Report: tracking of participants served and level of services utilized.
• Demographic Report: Demographics including gender, race, age, educational levels etc. of the
Orange County participants by month and year to date.
• How Heard About by County: Report defining how the Orange County participant heard about
the use of QuitlineNC.
Costs for Services, Protocol/Database Changes,Verification,and utc a Evaluation
Alere Wellbeing, Inc. ("Alere") is the prime vendor to QuitlineNC. Alere, while contracted with the TPCB,will
provide QuitlineNC services, including up to 8 weeks of Nicotine Replacement Therapy, at State specific unit
cost rates. This is a cost-sharing agreement,whereby selected services will be paid by the Orange County
Health Department,while other services will be provided by the TPCB at no cost to the Orange County
Health Department, as shown below:
Pricing structure
Nicotine Replacement Unit Costs 1st 4 weeks 2nd 4 weeks
Patches $48.00 per shipment $48.00 $48.00
Gum $30.00 per box $90.00 $30.00
Lozenges $38.00 per box $105.00 $38.00
Combination Therapy - 4 $108.00 $48.00
wks patches and two boxes
of gum
Combination Therapy - 4 $124.00 $48.00
wks patches and two boxes
of lozenges
In addition, an Administrative fee equal to 10%of the total contract price will be charged for the cost of
administrative services including the monthly cost and aggregate service reports.
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DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
Exhibit A
Promotional evel ent
The Orange County Health Department agrees to partner with TPCB to initiate promotional development for
roll-out of the project. This will be done on an interim basis. TPCB will let Orange County Health Department
know of any statewide or nationwide media campaigns that will reach Orange County residents.
Payment for Services
The Orange County Health Department will pay directly to Public Health Association ("NCPHA")for participant
services and for the administration fees which include monthly reporting. Orange County Health Department
will make advance payment for contracted services to:
North Carolina Public Health Association
222 N. Person Street
Suite 208
Raleigh, NC 27601
Prioritization of Services
In the event that QuitlineNC funding is diminished, prioritization will be given to continuing the services outlined
in this contract.
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DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
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LIABILITY AND PROPERTY COVERAGE CERTIFICATE
COVERAGE PROVIDER:
NCACC Liability and Property Pool
215 North Dawson Street This certificate is provided by the NCACC Liability and Property
Pool and is issued as a matter of information only. This
Raleigh,NC 27603 certificate confers no rights upon the certificate holder other than
MEMBER: those provided in the coverage document. This certificate does
North Carolina Alliance of Public Health Agencies not amend,extend,or alter the coverage afforded by the
222 N.Person Street,Suite 208 coverage documents listed herein.
Raleigh,NC 27601
COVERAGES
Type of Coverage I Coverage I Effective I Expiration I
Contract# Date Date Limits
Liability
'General Liability—
X Each Occurrence,
No Aggregate applies LP-NC-456-17 July 1,2017 July 1,2018
X Public Officials Liability, $2,000,000 occurrence
Each Wrongful Act LP-NC-456-17 July 1,2017 July 1,2018
X Law Enforcement Liability,
Each Occurrence LP-NC-456-17 July 1,2017 July 1,2018
$1,000,000 aggregate
Cyber Liability LP-NC-456-17 July 1,2017 July 1,2018 Claims Made
Excess Liability
LP-NC-456-17 July 1,2017 July 1,2018
Automobile Liability
All Owned Autos,
X Each Accident
LP-NC-456-17 July 1,2017 July 1,2018
Hired Autos,
X Each Accident $2,000,000 occurrence
LP-NC-456-17 July 1,2017 July 1,2018
Excess Auto Liability for
X Non-Owned Autos
LP-NC-456-17 July 1,2017 July 1,2018
Automobile Physical Damage
Scheduled Vehicles
X Actual Cash Value at the time of
LP-NC-456-17 July 1,2017 July 1,2018 the Loss,unless otherwise
Hired Autos(if coverage is not specified in the Coverage
X purchased elsewhere) Document;Deductible Applies
LP-NC-456-17 July 1,2017 July 1,2018
Property—Risks of Direct Physical Loss, Limit Deductible
Blanket Limit LP-NC-456-17 July 1,2017 July 1,2018 $51,514 I $1,000
Additional Information:
Evidence of coverage.
CERTIFICATE HOLDER:
Cancellation: Should any of the described coverage documents herein be
NCPHA cancelled before the expiration date shown, the NCACC Pools will endeavor to
222 N.Person St. mail written notice to the Certificate Holder named herein,but failure to mail such
Raleigh,NC 27601 notice shall impose no obligation or liability of any kind upon the NCACC Pools,
its agents or representatives,or the issuer of this certificate.
By:Collin Klein,Underwriting
Technician for the NCACC C, . ;',4 6/30/2017
Certificate Mailed/E-Mailed or Faxed to:
NCPHA
222 N. Person St.
Raleigh, NC 27601
DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
As!soctm row 0F,Coutiwy 4 r0,ymmrsstt9sous
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WORKERS COMPENSATION COVERAGE CERTIFICATE
COVERAGE PROVIDER:
NCACC Liability and Property Pool
215 North Dawson Street This certificate is provided by the NCACC Workers'Compensation Pool
Raleigh,NC 27603 and is issued as a matter of information only. This certificate confers no
MEMBER: rights upon the certificate holder other than those provided in the
coverage document. This certificate does not amend,extend,or alter the
North Carolina Alliance of Public Health Agencies coverage afforded by the coverage documents listed herein.
222 N. Person Street,Suite 208
Raleigh,NC 27601
COVERAGES
Type of Coverage Coverage Effective Expiration
Contract# Date Date Limits
Coverage A:
WORKERS'COMPENSATION
WC-NC-456-17 July 1,2017 July 1,2018 Statutory
Coverage B:
EMPLOYERS'LIABILITY
WC-NC-456-17 July 1,2017 July 1,2018 $2,000,000
Coverage C:
OTHER STATES
WC-NC-456-17 July 1,2017 July 1,2018 Statutory
Additional Information:
Evidence of coverage.
CERTIFICATE HOLDER: Cancellation: Should any of the described coverage documents herein be cancelled before
NCPHA the expiration date shown, the NCACC Pools will endeavor to mail written notice to the
Certificate Holder named herein,but failure to mail such notice shall impose no obligation
222 N. Person St. or liability of any kind upon the NCACC Pools, its agents or representatives,or the issuer of
Raleigh,NC 27601 this certificate.
By: Collin Klein, Underwriting
Technician for the NCACC 1. i.A"".• 4 J/U 6/30/2017
Certificate Mailed/E-Mailed or Faxed to:
NCPHA
222 N. Person St.
Raleigh, NC 27601