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Home My WebLink About2021-405-E-Health-Granville Vance Public Health-Funding to implement InCK model in Orange County Page 1 of 4 Memorandum of Agreement between Granville-Vance District Health Department (dba Granville Vance Public Health) and Orange County, by and through its Health Department Background The goal of the North Carolina Integrated Care for Kids Model (NC InCK ) is to provide efficient, optimal physical and behavioral healthcare for children ages birth to 21 who receive services through North Carolina’s Medicaid or CHIP program. Children must live in one of five NC counties to enroll in NC InCK: Alamance, Durham, Granville, Orange or Vance. Funding for the InCK program is provided by the Centers for Medicare and Medicaid Services to Duke University, as a pass-through entity. Duke University contracts with Granville Vance Public Health as a subrecipient. I. Purpose of the Agreement This Memorandum of Agreement (MOA) sets out the terms by which Granville Vance Public Health and Orange County Health Department will work together to implement the InCK Model within Orange County. This agreement will remain in effect from July 1, 2021 to June 30, 2022. For this project, Kelsey Dickman, Health Promotion & Wellness Supervisor, will be the key contact for Granville Vance Public Health. Quintana Stewart, MPA will be the key contact for Orange County Health Department. These individuals are responsible for ensuring the conduct of the activities listed below. Through this agreement, Granville Vance Public Health agrees to partner with Orange County Health Department to implement the NC InCK Model among eligible and interested community members. II. Roles and Responsibilities Responsibilities of Granville Vance Public Health and Orange County Health Department 1. Granville Vance Public Health will provide funding not to exceed $25,962 to Orange County Health Department to cover the costs associated with providing an employee to implement the InCK Model, including salary and benefits. DocuSign Envelope ID: 33686AC2-BCA9-42EA-883D-3ABB4D4F0269 Page 2 of 4 2. Granville Vance Public Health will provide a public health educator to oversee the five- county implementation. This public health educator will provide guidance and support to the Orange County Health Department public health educator identified for this program. 3. The Orange County Health Department will provide a public health educator to manage and implement the InCK Model in Orange County. Responsibilities include: a. Coordinate with Granville Vance Public Health employees who manage and oversee the five-county implementation. b. Provide regular reports as requested by Granville Vance Public Health. c. Be available for virtual meetings with Granville Vance Public Health. d. Attend available training sessions to understand and implement NC InCK. 4. The State of North Carolina has the right to audit records pertaining to this agreement both during performance and after completion. 5. Both parties agree to abide by all laws and regulations governing the confidentiality of patient information, and further agree to vigorously safeguard privileged information. 6. Both parties agree to assure that no person, solely on the grounds of race, color, age, religion, sex or gender, national origin or ancestry, veteran status or physical or mental disability status is excluded from participation in, is denied the benefits of, or is subject to discrimination under any program or activity covered by this agreement. III. Payment Schedule Granville Vance Public Health will compensate Orange County Health Department upon receipt of invoice. IV. Relationship of Parties Both parties enter into this Agreement as independent contractors and will secure all personnel required in performing services under this Agreement. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized or permitted under state and local law to perform this work. It its further agreed, by both Parties, that they s hall obey all state and federal statutes, rules, and regulations that are applicable to provision of the services called for herein. V. Governing Law The parties acknowledge that this Agreement shall be governed by the laws of the State of North Carolina. VI. Entire Agreement The terms and provisions herein contained constitute the entire agreement by and between Granville Vance Public Health and Orange County Health Department and shall supersede all previous communications, representations or agreements, either oral or written between the parties hereto with respect to the subject matter hereof. Any future amendments to this agreement shall be made in writing. Both parties agree that either party may terminate this agreement by giving thirty (30) days wr itten notice to the other party. DocuSign Envelope ID: 33686AC2-BCA9-42EA-883D-3ABB4D4F0269 Page 3 of 4 VII. Severability If any provision of this Agreement shall be determined to be unenforceable by a court of competent jurisdiction, such determination will not affect any other provision of this Agreement. VIII. Certification Regarding Lobbying (2 CFR 200.450) By signing this agreement, the authorized officials certify that to the best of their knowledge, no Federal appropriated funds will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement in accordance with 2 CFR 200.450. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or intending to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an emplo yee of a Member of Congress in connection with this Federal contract, grant, long, or cooperative agreement, the Orange County Health Department shall complete and submit Standard Form -LLL, “Disclosure Form to Report Lobbying” to Granville Vance Public Health. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. IX. Debarment, Suspension, and Other Responsibility Matters (2 CFR 200.214 and 2 CFR 180) By signing this MOA, the Orange County Health Department authorized official certifies, to the best of his/her knowledge and belief, that neither the Orange County Health Department not its principals are presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from participation in this transaction by any federal department or agency, in accordance with 2 CFR 200.213 and 2 CFR 180. X. Audit and Access to Records Orange County Health Department certifies that it will provide Granville Vance Public Health with notice of any adverse findings which impact this Subaward. Orange County Health Department certifies compliance with applicable provisions of 2 CFR 200.501-200.521. If Orange County Health Department is not required to have a Single Audit as defined by 200.501, Granville Vance Public Health requirements, or the Single Audit Act, then Orange County Health Department will provide notice of the completion of any required audits and will provide access to such audits upon request. Orange County Health Department will provide access to records as required by parts 2 CFR 200.337 and 200.338 as applicable. DocuSign Envelope ID: 33686AC2-BCA9-42EA-883D-3ABB4D4F0269 Page 4 of 4 XI. Program for Enhancement of Contractor Employee Protections (41 U.S.C. 4712) Orange County Health Department is hereby notified that they are required to: inform their employees working on any federal award that they are subject to the whistleblower rights and remedies of the program; inform their employees in writing of employee whistleblower protections under 41 U.S.C. 4712 in the predominant native language of the workforce; and include such requirements in any agreement made with a subcontractor subgrantee. This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. ____________________________________________________ Finance Officer, Granville Vance Public Health This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. ____________________________________________________ Finance Officer, Orange County ___________________________________ ___________________________________ Bonnie Hammersley Lisa M. Harrison, MPH County Manager Health Director Orange County Granville-Vance District Health Department 300 West Tryon Street P.O. Box 367 Hillsborough, N.C. 27278 Oxford, N.C. 27565 ___________________________________ ___________________________________ Date Date DocuSign Envelope ID: 33686AC2-BCA9-42EA-883D-3ABB4D4F0269 7/21/20217/22/2021 Revised 06/21 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: Granville Vance Public Health Party/Vendor Contact Person: June Manning Contact Phone: 919-690-2100 Party/Vendor Address: 101 Hunt Drive City Oxford State: NC Zip: 27565 Department: Health Amount: To Us $25,962 Purpose: Funding to implement InCK model in Orange County Budget Code(s): 10411005-443110 Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 7/23/21 Approved by Board Yes No Agenda Date: --- For Section XIV. c. contracts only, Approved by Board in Current FY Budget Yes No This agreement is approved as to technical form and content and I as Department Director affirmatively state wo rk on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmatio n. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 33686AC2-BCA9-42EA-883D-3ABB4D4F0269 7/21/2021 7/21/2021 7/22/2021 7/22/2021