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HomeMy WebLinkAboutAgenda - 06-27-2006-5eORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 27, 2006 Action Agenda Item No. _ SUBJECT: Contract with UNC School of Dentistry and Health Department for Services of a Dentist DEPARTMENT: Health PUBt_IC 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 .lohnson 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 ttrnover of dentists as there was no individual commitment to the clinics or the patients, When a dentist left, clinics were often 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. Recnaitment of a dentist has been difficult because of the competitive private practice salaries of dentists, The current dentist, Dr. Stephanie Rodriguez, is returning to Texas (her home state) at the end of June, after one year of service with the Health Department. The Health Department, with the assistance of the Personnel Department, began recruitment for this position in January, immediately upon notice that Dr. Rodriguez was vacating the position. The Department has explored all qualified candidates and made offers to at least two dentists who have accepted other positions at either higher salaries or with a loan repayment package that is currently not available to Orange County. The Health Department is currently discussing the development of a loan repayment option for the dentist position with Personnel, Finance, and the County Attorney. That process may take some time to develop and, in the meantime, the Health Department must be able to cover the services for County residents, One of the graduate residents that rotated through the Health Department from the School of Dentistry, Dr. Mike Zaritsky, is completing residency at the end of June. Dr. Zaritsky has indicated that he would be interested in a one-year commitment to provide dental services to the Health Department. Dr. Zaritsky holds a Canadian dental license and successfully completed his graduate dental residency at UNC this June; however, because he does not hold a North Carolina dental license, he cannot practice dentistry in North Carolina unless he is a faculty member at the UNC School of Dentistry and providing dental education. The UNC School of Dentistry is offering Dr. Zaritsky a position as a Visiting Clinical Professor and is willing to contract with the Health Department to provide clinical dental services for fiscal year 2006-2007. The dentist under this contract arrangement would also be supervising the Graduate Dental Resident that typically provides services to the Health Department and would supervise all dental students, dental hygiene students, and dental assisting students currently rotating through the Health Department. This one-year arrangement would give the Department time to work through the details on a loan repayment option and still provide services to County residents. FINANCIAL IMPACT: Funds to support this contract would come from cone-year transfer from the Health Department's personnel line to professional contract services. The total amount of funds allocated for the salary and benefits far this position is $102,410, The contract amount is for a total of $102,291 and includes salary, benefits (at the university rate), and renewal license fee. The total is currently part of the proposed 2006-2007 fiscal year budget for the Health Department. RECOMMENDATION(S): The Manager recommends that the Board approve the contract and authorize the Chair to sign. 3 STATE OF NORTH CAROLINA COiJNTY OF ORANGE AGREL•.MENT 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 ls` day of.Iuly 2006, 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 Visiting Clinical Assistant Professor to provide direct clinical services for clients of the Dental Health Service of the Orange County Health Department for the fiscal year 2006-2007; WHEREAS, The Health Department desires to reimburse The School of Dentistry for the salary plus fringe of one Visiting Clinical Assistant Professor; WHEREAS, The School of Dentistry wishes to provide the services of one Visiting Clinical Assistant Professor to the Flealth Department; NOW, THE.RE.FORE, 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 '/a the total salary and fringe: $25,572.75 for a total of $102,291. As part of the total annual salary $1,600 has been included to pay for the renewal fee for the Canadian Dental License. The Visiting Clinical Assistant Professor will submit to the UNC School of Dentistry the renewal form in December 2006 for its payment January 2007. 2. The School of Dentistry will provide the services of one Visiting Clinical Assistant Professor to The Health Department for the purpose of rendering comprehensive clinical dental services for .32 hours per week (.8 FTE) in the Dental Health Services Division of the Health Department. Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page 2 of 6 3. The School of Dentistry, will provide the services of one Visiting Clinical Assistant Professor to The Health Department for the purpose of providing attending dentist supervision for dental residents and students who provide services through the UNC School of Dentistry under this agreement. 4. School of Dentistry will bill The Health Department $25,572.75 at the close of each quarter for the salary/fringe of one Visiting Clinical Assistant Professor,. 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 Visiting Clinical Assistant 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. 7. The Health Department will allow ten vacation days and ten sick days for .8 FTE Clinical Assistant Professor at the Health Department for the fiscal year 2006-2007.. The vacation request must be submitted to the Health Department Dental Division Director at least two months in advance. 8. The Visiting Clinical Assistant Professor shall provide the following services to the Health Department: A. Provide dental care for adults and children within the scope of the OCHD Dental Health Services Standards of Care: 1, Meets daily production standard of $2,500 to $3,000 per day. 2. Assures that all clinical staff is meeting production standards. B. Use professional,judgment to facilitate the accomplishment of the following: 1. Provide our patients with quality care. 2. Deliver that care in a timely and compassionate manner.. 3. Perform a clinical exam (limited or comprehensive) in order to observe and record pertinent information regarding the physical condition and dental needs of the patient. 4. Based on the results of the examination, a diagnosis and proposed treatment plan will be developed. 5. Presentation of treatment plan to the patient will relate to the patient's need and desires. 6 Treatment plan alternatives, when appropriate, will be developed and presented to each patient. 7. Amalgam and composite restorations. 8. Simple extractions and those extractions that become surgical. 9. Pulpotomies, stainless steel crowns, sealants, prophylaxis, periodontal scaling, fluoride. 10. Performs emergency dental treatment for relief of pain and/or infection. 1 I . Triage dental emergency patients appointments daily.. 12. Assess the client's dental needs and makes referrals to appropriate specialist. 13. Prescribes appropriate medications to treat or prepare a patient for treatment. Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page .3 of 6 14, Accurately documents treatment rendered in dental patient records to manage risk, provide continuity of care and assure quality of care. I5. Reads and co-signs all entries in the dental patient record for every visit except when the pediatric dentist is the attending in the clinic. 16. Review medical and dental histories of all dental patients. 17, Treat medically compromised patients consistent with their educational training and experience. 18, Assure that necessary precautions are taken for each patient to reduce the risk of medical and dental complications. 19. All treatment procedures performed should be of such a level of quality that favorable, predictable results will routinely occur. C. Supervise the clinical treatment services performed by all staff in the OCHD Denta] Health Service to a culturally diverse population. I. 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 Standards 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/Attending Quarterly Meetings. 2, Participates in the GPR recruitment process.. 3, Responsible for the resident's and student's behavior while at the OCHD (late arrival, leaving early, production, patient care). E. Serves as a preceptor for students from UNC School of Dentistry. Holds a Clinical Assistant Professor appointment in the Department of Dental Ecology, LTNC School of Dentistry. 1. Follows L1NC 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 the Health Department. 3. As preceptor, adheres to Che 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 CINC to function as a preceptor for dental hygiene students on rotation at the Health Department. 5. Fills out all evaluation forms for students and residents. 6. Is accessible and interacts with residents and students, 7. Answers questions and provides training for residents and students. F. Meets Health Departrnent Quality Assurance Protocols,. 1. Follows general dentistry Standards of Care. 2, Participates in a carefully stnrcrirred, active peer review of dental operators through regularly scheduled, rotating chart audits conducted by the Health Department 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. 6 Between The University of North Carolina School of Dentistry for its Department of Dental Ecology And OCHD Page 4 of 6 G. Adheres to the following work schedule I . 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 can be taken at the discretion of the Dental Health Services Division Director. 10. This Agreement shall run for a period of one year, from the ]s` day of.July 2006 to the .30°i day of.lune 2007, and shall be renewable thereafter.. 1 1. 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.. 12. In compliance with 42 U.S.C. I395x (v)(1)(I) and implementing regulations, The School of Dentistry and The Health Department agree, until the expiration of four years 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 Deparimenf 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 I-luman Services and the Comptroller General shall have access to such subcontract and to the books, documents and records of tine subcontractor necessary to verify the nature and extent of the costs of such subcontract.. 13. 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. I4 The School of Dentistry will be responsible for training its Visiting Clinical Assistant Professor to follow the OSHA Blood-borne Pathogens Standard, assuring that its Visiting Clinical Assistant Professor comply with the health requirements established by North Carolina state regulations and the School of Dentistry. 7 Between The University of North Carolina School of Dentistry for its Depardnent of Dental Ecology And OCHD Page 5 of 6 15. The School of Dentistry will maintain proper records of its Visiting Clinical Assistant 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. 16. 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 Assistant 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 Visiting Clinical Assistant Professor will be required to return to the UNC Schoo] of Dentistry Employee Health for post-incident testing and counseling if feasible. In the event the Visiting Clinical Assistant Professor is unable to do so in a timely manner, the Health Department will provide access to testing and counseling for the Visiting Clinical Assistant Professor. The Visiting Clinical Assistant Professor will be responsible for the payment of services. 17. The Health Department will not be responsible for damages arising from personal injury to the Clinical Assistant Professor of the School of Dentistry while the Visiting Clinical Assistant 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. 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 Norih 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: THE ORANGE COUNTY HEALTH CAROLINA DEPARTMENT Rosemary L. Summers, MPH, DrPH Date Health Director 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 Barry Jacobs Date FOR AND ON BEHALF OF THE UNIVERSITY OF NORTH AT CHAPEL HILL Dr..Tohn Williams, DMD, MBA Date Professor and Dean, School of Dentistry Nancy Suttenfield Date Vice Chancellor for Finance and Administration Orange County Board of Commissioners