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HomeMy WebLinkAbout2022-005-E-CJRD-UNC School of Medicine Department of Psychiatry-Managed Care Psychiatry Sevices and Jail Contract Psychiatry DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 MANAGED CARE (MAINTENANCE OF EFFORT) FUNDS PERFORMANCE AGREEMENT THIS AGREEMENT,made and entered into the first day of July 2021, ("Effective Date")by and between the County of Orange, a political subdivision of the State of North Carolina, Post Office Box 8181, Hillsborough, North Carolina, 27278, ("County") and the University of North Carolina at Chapel Hill, on behalf of its School of Medicine, Department of Psychiatry, a not-for-profit corporation, located at 372 Medical School Wing D CB#7160, Chapel Hill,North Carolina 27599-7160("Provider"). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth,the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2021 to June 30,2022. 2. Scope of Services. a. Provider will provide services to the residents of Orange County, as outlined in the attached Managed Care (Maintenance of Effort) Funds Scope of Work Statement and Program Budget,attached as Exhibit"A,"and incorporated herein by reference. The Scope of Work Statement and the Program Budget may be different based on County appropriation. Any revisions or amendments to this Agreement must be in writing, approved by the County and attached to this Agreement. b. The Provider shall be solely responsible for the means,methods,techniques,sequence,safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. Managed Care Funding. i. Managed Care Funding. The County agrees to appropriate funds for the provision of services described the"Program Services"section of Exhibit A, and may be more particularly outlined in the"Expense Description"section of Exhibit A,the maximum sum of$317,824 in Managed Care Funds. ii. The Provider shall be paid Managed Care Funds in twelve equal monthly installments in the amount of $26,485.33. The first payment is contingent upon receipt of the agency's fully executed performance agreement; the remaining payments are contingent Provider satisfactorily supplying County with receipts for reimbursement with related supporting documentation. Documentation must be supplied to County's satisfaction, County will not unreasonable withhold payment. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds Orange County Managed Care Fund Performance Agreement Revised 612021 Page I of 9 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Work Statement, at the discretion of the County the Provider may be required to repay the funds to the County. c. The County's obligation to make the payments is contingent upon receipt of Progress Reports and requests for reimbursements as provided in Section 4 below, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Work Statement. d. Once Provider has satisfied its obligations as provided in Sections 3 and/or 4 payment will be made within 21 days after receipt of the Progress Report and Request for Reimbursement. e. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Managed Funds Reporting. Provider will provide Orange County a Monthly Progress Report for Managed Care funds that includes a fiscal report and updates on performance measures as outlined in Exhibit A. Progress Reports are due by the 15' of the next month following the month being reported. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services,upon reasonable notice during normal working hours. c. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services,upon reasonable notice during normal working hours. d. Termination for Cause. In the event of any of the circumstances set forth below(hereinafter referred to as"default"),the County may immediately terminate this Agreement,in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination,and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings,be declared insolvent,or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. hi the event that Provider shall fail to render a satisfactory accounting as provided section 4 above,the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to perform satisfactorily any part of the work identified in the Scope of Services,Scope of Work, or to comply with any provision of this Agreement, as determined by the County in its sole discretion. Orange County Managed Care Fund Performance Agreement Page 2 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 v. Failure to adhere to the terms of applicable county,state or federal laws,regulations, or stated public policy. e. In the event of default by the Provider,the county may elect to terminate this Agreement,in whole or in part and/or require the Provider to repay the funds within ten(10)business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. f. Notwithstanding the foregoing,either party may terminate the agreement at any time without penalty;provided 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 and any unused funds shall be returned to the County within 10 days of termination. g. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. h. Waiver. Payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. 5. Responsibilities of the County. Cooperation and Coordination. The County has designated(Caitlin Fenhagen)to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 6. Insurance. a. General Requirements. The Provider shall provide adequate professional liability self- insurance for the Provider and its personnel who provide services described in this Agreement. The professional liability insurance shall cover personal injury by the persons performing services under this Agreement in the amount of at least $1 million, per occurrence, $2 million aggregate. b. Evidence of Insurance.Evidence of such insurance shall be furnished to the County,together with evidence that each policy provides the County with not less than thirty(30) days prior written notice of any cancellation,non-renewal or reduction of coverage. c. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 7. General Provisions. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina.By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Orange County Managed Care Fund Performance Agreement Page 3 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. b. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race,color,gender,national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy, which is incorporated herein by reference and can be viewed at hllp://www.oran_eg coggtync. og v/departments/purchasing division/contracts.php. The County may enforce this provision by an action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. c. 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. d. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The Orange County Living Wage Policy, which is incorporated herein by reference, can be viewed at: http://www.oran eg coggtync. og v/departments/purchasing division/contracts.php. The County's living wage is $ 15.40 per hour. To the extent possible, Orange County recommends that Provider provide a living wage to its employees. e. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. f. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions,boards, and officers,which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. g. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. Orange County Managed Care Fund Performance Agreement Page 4 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 h. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement or the rights to payment to any other party without the written consent of the other. i. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss,liability,claims or expense(including reasonable attorney's fees)arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. j. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 8. Notice. The Parties hereto agree and understand that written notice,mailed or delivered,to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: County: CJRD/Caitlin Fenhagen Provider: UNC School of Medicine, Orange County Department of Psychiatry Post Office Box 8181 Attention: Matthew O'Neal Hillsborough,NC 27278 372 Medical School Wing D Email: CB#7160 cfenhagen@orangecountync.gov Chapel Hill,NC 27599-7160 9. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede,replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms,and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 10. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States,the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part,term or provision held to be invalid. 11. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article I IA and Article 40 of North Carolina General Statute Chapter 66. Orange County Managed Care Fund Performance Agreement Page 5 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For ffgdiq#d$rhatf of the Provider Ma�( u/S 12/18/2021 ac ingWWAN! Wesley Burks,M.D., Dean,UNC School of Medicine Vice Chancellor for Medical Affairs Date For and on behalf of Orange County Government DocuSigned by: (/blil.bUL I�A�Mwtt,V S 11512022 ft tie5 rumrsley, County Manager Date Orange County Managed Care Fund Performance Agreement Page 6 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 ORANGE COUNTY—DEPARTMENT USE ONLY Party/Vendor Name: UNC School of Medicine Department of Psychiatry Party/Vendor Contact Person: Matthew O/neal,Associate Chair of Administration Contact Phone: 919-445-0230 Party/Vendor Address: 372 Medical School Wing D CB#7160 City Chapel Hill State:NC Zip:27599-7160 Department:CJRD Amount:$317,824($292,824 for In-Pt physician services and Out-Pt Crisis and$25,000 for Jail Psychiatry) Purpose: Managed Care Psychiatry Sevices and Jail Contract Psychiatry Budget Code(s): 10420020-710050 Vendor#49882 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 7/1/21 Approved by Board Yes®No❑ Agenda Date: 6/15/21 This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: DocuSigned by: Department Director's Signature �"` V' � Date: 1/3/2022 Agreements for emergency services WHFWsubject to the above affirmation. 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: DocuSigned by: 1 b Office of the Risk Management Office Aura, COVInt Date: 1/3/2022 7FDCF9176800498... Financial Services This instrument has been pre-audited in thgopj �&pquired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Office r Date:1/4/2022 re au�e/smrL 7D4E5181ACC1409... Legal Services This agreement is approved as to le 1 fg9mnd sufficiency: ned by: Office of the County Attorney L_ 079A4D525C0F4FB bi &L, 'V� it, T6S(b Date:1/5/2022 ... 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: Orange County Managed Care Fund Performance Agreement Page 7 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 Exhibit A Managed Care Funds Scope of Work Statement And Program Budget Orange County Managed Care Fund Performance Agreement Page 8 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 ATTACHMENT "A" Orange County Certifications—FY 2021-22 Managed Care Fund Performance Agreement Chief Contact,Administrators,Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name,title,residential address;phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing,with the name,physical address,mailing address and if possible,phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not,please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. DoeuS;9ne„y: Dean,UNC School of Medicine acting for 12/18/2 0 21 Certified by: ALO#"SA.Wesley Burks,MD'Title:Vice Chancellor for Medical Affairs Date: 6rove 6CF93G A4er0fij.s. Signature) Orange County Managed Care Fund Performance Agreement Page 9 of 9 Rev. 912021 DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 Orange County Managed Care Funds Performance Agreement, Exhibit A EXHIBIT"A" Managed Care(Maintenance of Effort)Funds Scope of Work Statement and Program Budget—FY 2021-2022 Agency Name: UNC Dept of Psychiatry Program Name:Center for Excellence in Community Mental Health Funding Award: $25,000 I. Budget. Outline how the agency will spend Orange County's funding award. Please attach additional sheets as necessary to provide detailed budget outline. Expense Description Amount Salary support for clinician providing psychiatric services in Orange Co. Jail $25,000 II. Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2022. • Diagnosic assessments, medication management services for clients in Orange county Jail III. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County,only.If you use percentages,you must also provide the total number of participants within that measure's description or for an earlier performance measure. * Performance Measures Anticipated Results Approximatelt 4-5 visits per week. 200 individuals per year. 200 * Please atta d itio al s / Certified by: Title: ate: ( rovtder's Signature) DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 Orange County Managed Care Funds Performance Agreement, Exhibit A EXHIBIT"A" Managed Care(Maintenance of Effort) Funds Scope of Work Statement and Program Budget FY 202I-2022 Agency Name: UNC-Department of Psychiatry Program Name:Department of Psychiatry Funding Award: $$$ I. Budget. Outline how the agency will spend Orange County's funding award. Please attach additional sheets as necessary to provide detailed budget outline. Expense Description Amount Inpatient mental health and Substance abuse treatment $31,374 $261,450 " Short term outpatient MH and SA treatment 11. Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,20 • Evalauation and mangement of psychiatric inpatients in crisis • Evalaution and managemnt of recently discharged patients prior to connecting with regular service provider II1. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County,only. If yo,i use percentages,you must also provide the total number of participants within that measure's description or for an earlier performance measure.* Performance Measures Anticipated Results Successful tranition from inpatient to outpatient care 600 Decreased ED presentations of recently discharged patients 7-8/month Decreased readmissions of recently discharged patients 7/month l Certified by: Title: � Date: z (Prov'der's ignature) DocuSign Envelope ID: BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 Orange County Managed Care Funds Performance Agreement, Exhibit A * Please attach additional pages as necessary. Certified by: _ Titic; Uatc; (Provider's Signature) DocuSign Envelope ID:BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 (4 MIKE CAUSEY OSFMINSURANCE COMMISSIONER& STATE FIRE MARSHAL NC DEPARTMENT OF' BRIAN TAYLOR,CHIEF STATE FIRE MARSHAL INSURANCE CERTIFICATE OF COVERAGE Certificate Holder: To Whom This May Concern Insurer: State of North Carolina Authorization: Public Officers & Employee Liability Insurance Commission of North Carolina and the General Statutes of North Carolina, Chapter 143, Articles 31 to 31 D, Sections §143-291 to §143-300. Period: February 01, 2021 until February 01, 2022 Coverage: A) Tort Claims against Departments, Agencies, and Employees B) Excess Liability for State Employees BRIT Global Specialty USA- Policy# PK1035819 C) Workers' Compensation Limits A) $1,000,000 for Tort claims against the State B) $2,000,000 per employee/$5,000,000 aggregate for claims against state employees C) Statutory Limits for Workers' Compensation Description: The University of North Carolina at Chapel Hill and its employees, officers, agents, as covered by the Defense of State Employees as per NCGS § 143 300.2. Administrator: Department Insurance - Risk Management Division Public Officers & Employees Liability Insurance Commission 1202 Mail Service Center, Raleigh, NC 27699-1202 Note: This Certificate is for informational purposes only and does not alter any provision of the Tort Claims or Defense of State Employees General Statutes of the State. �i Verified By: Bryan Heckle, CIC, CPCU, CRM Deputy Commissioner of Risk Management UNCCH OFFICE OF STATE FIRE MARSHAL • RISK MANAGEMENT 1202 MAIL SERVICE CENTER I RALEIGH,NC 27699-1202 1 Tel 919.647.0000 1 Fax 919.715.0067 DocuSign Envelope ID:BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 The University of North Carolina Liability Insurance Trust Legal Department Telephone:(984)974-3041 UNIVERSITY OF NORTH CAROLINA HOSPITALS Facsimile:(984)974-6285 101 Manning Drive,2nd Floor,Wing E Chapel Hill,NC 27514 CONFIRMATION OF INSURANCE COVERAGE FOR PROFESSIONAL LIABILITY This Confirmation of Insurance Coverage is being issued specifically to verify professional liability coverage for the referenced insureds while practicing within the scope of their employment responsibilities during the dates of coverage noted. This information should be treated confidentially. INSURED: Jamie Stein Smolko DATES OF COVERAGE: 04/05/2019 — 06/30/2022 NAME OF CARRIER: UNC Liability Insurance Trust Fund AMOUNT OF COVERAGE: 04/05/2019 — 06/30/2022 Covered individuals are subject to a limit of $3 million per medical incident. The total limit of liability per medical incident for all covered parties is $7 million per medical incident. All coverage is limited to medical incidents that occur in the United States of America. CURRENT POLICY TYPE: Occurrence basis POLICY NUMBER: Not applicable CLAIMS HISTORY: None Completed by: &e6t,-it J -_ 11/8/2021 Date: Stephenie Fenton-Wilhelm Vice President of Risk Management, Accreditation & Regulatory Affairs University of North Carolina Hospitals and the School of Medicine of the University of North Carolina at Chapel Hill