HomeMy WebLinkAbout2015-311-E DSS - OPT MOU to provide Medicaid transportation to eligible clients DocuSign Envelope ID:0806BD7C-9E5B-4DB8-9CC2-8583BB1 EA400
MEDICAID TRANSPORTATION
MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is entered into this Ol day of S%.1u , 2015,
by and between the Orange County Department of Social Services and Od O am and Public
Transportation(referred to collectively as the "Parties").
WHEREAS, Orange Public Transportation (hereinafter referred to as "OPT") and the
Orange County Department of Social Services (hereinafter referred to as `'OCDSS") are
departments or agencies of Orange County, North Carolina and are ineligible to enter into
binding contractual relationship with one another; and
WHEREAS, the parties desire to enter into this Memorandum of Understanding in order
to establish the mutually agreed upon conditions upon which OPT will provide certain services
for OCDSS in connection with the Orange County Department of Social Services Medicaid
Program; and
WHEREAS, the OCDSS is mandated to provide transportation to Medicaid covered
services when a client does not have access to personal transportation; and
WHEREAS, OPT is a coordinated transit system run by Orange County Government in
Orange County,North Carolina.
NOW, THEREFORE, the parties to this Memorandum hereby agree as follows:
1. OPT will provide transportation services to and from medically necessary appointments
to Medicaid clients at the request of OCDSS.
2. OCDSS will reimburse OPT for services provided under this Memorandum at a rate of
$12.75 per one-way trip. OCDSS will not reimburse OPT for no-shows.
3. OPT agrees that continuation of and/or renewal of this Memorandum is contingent on
meeting the following requirements. OPT agrees to:
A. Provide services to enrolled participants within three days of a request.
B. Provide critical services on short notice when requested.
C. Provide back-up drivers in case the assigned driver is not available.
D. Coordinate maintenance with private vendors to ensure vehicles are in safe operating
order.
E. Review the Transportation Database to ensure client eligibility and verify client
information.
F. Discuss the specific situation, and present evidence of cause, with the Department of
Social Services staff prior to termination of services for any client.
G. Complete the DMA 5124 as part of the annual contract process.
4. OCDSS will reimburse OPT for services described in this Memorandum. For
reimbursement, OPT must submit an original and two copies of an invoice by the fifth of
the month for the preceding month's expenditures to the designated OCDSS
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Administrator. OCDSS will reimburse OPT monthly upon receipt of a complete and
correctly filed report.
5. OPT agrees to use the provided transportation billing codes on invoices to the OCDSS for
reimbursement.
6. OPT agrees to only submit invoices for trips approved by OCDSS. Trips included on
invoices that were not pre-approved by OCDSS will not be reimbursed.
7. OCDSS agrees to receive all client call regarding scheduling.
8. Any change to the client's destination, address, or phone number will be made by
OCDSS.
9. OPT agrees to meet on-time performance standards such that no more than 5% of trips
should be late for client drop-off to his or her appointment per month. Late is defined as
past the client's appointment time.
10. OPT agrees that not more than one quarter of one percent of all trips be missed by the
OPT or any subcontractor during the course of the contract year.
11. OPT agrees to report all no-shows on a daily basis and cancellations on a monthly basis
to OCDSS via email.
12. OPT agrees to record all client complaints which deal with the matters under the control
of OPT, including the date of the complaint, the nature of the complaint, and what steps
were taken to resolve the complaint.
13, OPT agrees to provide names of all owners, managers, management entities, and
subcontractors.
14. OPT agrees to report any changes such as insurance provider, business ownership or
management or exclusion from participation in Medicare.
15. OPT agrees to disclose, at the outset of the contract, upon renewal and upon request, any
criminal convictions or other reasons for disqualifications from participation in Medicare,
Medicaid or Title XX programs.
16. OPT agrees to participate in program, fiscal and administrative monitoring and/or audits,
making records and staff time available to Federal, State and County staff.
17. OPT agrees to allow monitoring of records to ensure that all contract requirements are
met.
18. OPT agrees to take necessary steps for corrective action, as negotiated within a corrective
action plan, for any items found to be out of compliance with Federal, State, and County
laws, regulations, standards and/or terms of this Memorandum.
19. OPT has provided the North Carolina Department of Transportation with certain Annual
Certifications and Assurances as set forth on that certain document entitled "FEDERAL
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(FTA) AND STATE (NCDOT) CERTIFICATIONS AND ASSURANCES FOR
COMMUNITY TRANSPORTATION PROGRAMS FISCAL YEAR 2011-2012." Said
assurances are hereby incorporated into this Memorandum by reference to the same.
20. OPT will ensure that all vehicles transporting clients shall have at least the minimum
level of liability insurance appropriate for the type of vehicle as defined by Article 7,
Rule R2-36 of the North Carolina Utilities Commission;
21. OPT will ensure that all drivers (including employees, contractors, contractor's
employees, and volunteers) shall be at least 18 years of age.
22. OPT will ensure that all drivers (including employees, contractors, contractor's
employees, and volunteers) shall be licensed to operate the specific vehicle used in
transporting clients in accordance with Chapter 20-7 of the General Statutes of North
Carolina and the Division of Motor Vehicle requirements;
23. OPT agrees to maintain records documenting the following:
A. Valid current copies of Driver's Licenses for all drivers;
B. Current valid vehicle registration, for all vehicles transporting clients;
C. Driving records for all drivers for the past three years and with annual updates;
D. Criminal Background checks through North Carolina Law Enforcement or NCIC
prior to employment and every three years thereafter;
E. Alcohol and drug testing program that meets the Federal Transit Authority guidelines
Drug and alcohol testing program will be paid for by OPT.
24. OPT will ensure that all vehicles used in the fulfillment of services under this
Memorandum have a valid State registration and State inspection.
25. Any information, data, instruments, documents, studies or reports given to or prepared or
assembled by OPT under this Memorandum shall be kept as confidential and not
divulged or made available to any individual or organization without the prior written
approval of OCDSS unless the information is required to be disclosed pursuant to the
public records laws of the State of North Carolina or any other applicable law or court
order. OPT acknowledges that in receiving, storing, processing or otherwise dealing with
any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this Memorandum.
26. This Memorandum shall be effective from July 1, 2015 to June 30, 2016.
27. This Memorandum shall be reviewed at least annually, prior to May 1 st and may be
terminated by either parry upon 60 days written notice.
28. The Memorandum contains the entire understanding of the parties and shall not be
altered, amended or modified, except in writing executed by the Department Directors of
both parties.
29. The undersigned represents and warrants that they are authorized to bind their principals to the
terms of this agreement. The Contractor and the County have executed this contract in duplicate
originals, with one original being retained by each party. This Agreement together with any
amendments or modifications may be executed electronically. All electronic signatures affixed
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hereto evidence the intent of the Parties to comply with Article 11 A and Article 40 of North
Carolina General Statute Chapter 66.
IN WITNESS WHEREOF,the parties hereto have caused this Memorandum to be signed by its
Department Director.
FOR AND ON BEHALF OF: FOR AND ON BEHALF OF:
ORANGE PUBLIC TRANSPORTATION ORANGE COUNTY DEPARTMENT OF
SOCIAL SERVICES
EAA ocuSigned by: DocuSigned by:
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Craig Benedict, Director Nancy Coston, Director
DATE: 6/24/2015 DATE: 6/29/2015
E EDocuSigned by'.�l/LI/Ll�., CI GLWtt4q(,�S�,I,i
0637994B755E477... 11
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