HomeMy WebLinkAbout2019-432-E DSS - OPT Medicaid transportation MOU DocuSign Envelope ID:431 01 1 1 6-0328-4364-BE8C-46E75760A1F2
MEDICAID TRANSPORTATION
MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is entered into this 20th day of May, 2019, by and
between the Orange County Department of Social Services and Orange County Public
Transportation(referred to collectively as the "Parties").
WHEREAS, Orange County Public Transportation (hereinafter referred to as "OCPV"
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 OCPT 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, OCPT 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. OCPT will provide non-emergency medical transportation services to and from medically
necessary appointments to Medicaid clients at the request of OCDSS.
2. OCDSS will reimburse OCPT for services provided under this Memorandum at a rate of
$26.75per one-way trip. OCDSS will not reimburse OCPT for no-shows.
3. OCPT agrees that continuation of and/or renewal of this Memorandum is contingent on
meeting the following requirements. OCPT agrees to;
A. Transport approved, authorized clients to specific destinations within and outside of
Orange County within a 30 mile radius of the clients' pickup location.
B. Provide services to enrolled participants within two days of a request.
C. Provide transportation for critical services, including dialysis, on short notice when
requested.
D. Provide back-up drivers in case the assigned driver is not available.
E. Coordinate maintenance to ensure vehicles are in safe operating order.
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. Clients may be
suspended for thirty (30) days for three no-shows without good cause within a three-
month period.
G. Complete the DMA 5124 as part of the annual contract process.
1
DocuSign Envelope ID:431 01 1 1 6-0328-4364-BE8C-46E75760A1F2
4. OCPT agrees to use the NC Tracks system per the State's Division of Medical Assistance
{DMA} guidelines to invoice trips approved by OCDSS. All reimbursement will be
received from DMA not OCDSS.
5. OCPT agrees to use the provided transportation billing codes on invoices to the OCDSS
for reimbursement.
6. OCPT 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. OCPT 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. 00PT agrees that not more than one quarter of one percent of all trips be missed by the
OCPT or any subcontractor during the course of the contract year.
11. OCPT agrees to report all no-shows on a daily basis and cancellations on a monthly basis
to OCDSS via email.
12. OCPT agrees to record all client complaints which deal with the matters under the control
of OCPT, including the date of the complaint, the nature of the complaint, and what steps
were taken to resolve the complaint.
13. 00PT agrees to provide names of all owners, managers, management entities, and
subcontractors.
14. OCPT agrees to report any changes such as insurance provider, business ownership or
management or exclusion from participation in Medicare.
15. OCPT 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. 00PT 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. OCPT agrees to allow monitoring of records to ensure that all contract requirements are
met.
18. OCPT 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_
2
DocuSign Envelope ID:431 01 1 1 6-0328-4364-BE8C-46E75760A1F2
19. OCPT has provided the North Carolina Department of Transportation with certain
Annual Certifications and Assurances as set forth on that certain document entitled
"FEDERAL (FTA) AND STATE (NCDOT) CERTIFICATIONS AND ASSURANCES
FOR COMMUNITY TRANSPORTATION PROGRAMS FOR THE CURRENT
FISCAL YEAR." Said assurances are hereby incorporated into this Memorandum by
reference to the same.
20. OCPT 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. 00PT will ensure that all drivers (including employees, contractors, contractor's
employees,and volunteers) shall be at least 18 years of age.
22. 00PT 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. OCPT 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.
Payment for the drug and alcohol testing program will be the responsibility of OPT.
24. 00PT 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 OCPT 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. OCPT 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 duly 1, 2019 to June 30, 2020.
27. This Memorandum shall be reviewed at least annually, prior to May 1st and may be
terminated by either party 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. Signatures. This Agreement together with any amendments or modifications may be
executed electronically. All electronic signatures affixed hereto evidence the consent of
3
DocuSign Envelope ID:43101116-0328-4364-BE8C-46E75760A1 F2
the Parties to utilize electronic signatures and the intent of the Parties to comply with
Article I IA and Article 40 of North Carolina General Statute Chapter 66.
30. Notices. Any notice required by this Agreement shall be in writing and delivered by
certified or registered mail,return receipt requested to the following:
Orange County PT Orange County DSS
Attention: Theo Letman Attention: Nancy Coston
P.O. Box 8181 P.O. Box 8181
Hillsborough,NC 27278 Hillsborough,NC 27278
IN WITNESS WHEREOF,the parties hereto have caused this Memorandum to be signed by
their respective Department Directors.
FOR AND ON BEHALF OF: FOR AND ON BEHALF OF:
ORANGE COUNTY
PUBLIC TRANSPORTATION ORANGE COUNTY DEPARTMENT OF
Docu Signed by, SOCIAL SERVICES
_ DocuSigned by:
DAE
722E5DC•OAB25490 .
Theo Letman, Director Trou Uy'u►��uii,u rector
DATE: 6/26/2019 DATE: 7/9/2019
4