Loading...
HomeMy WebLinkAbout2025-422-E-Health Dept-Services Agreement UNC Family Medicine-Services Agreement UNC Family Medicine1 UNC SOM #18-1751.t032 NORTH CAROLINA FY 25-26 ORANGE COUNTY SERVICES AGREEMENT UNC FAMILY MEDICINE July, 2025, by and between Orange County, North Carolina a body politic and corporate of the State of North Carolina (hereinafter, the "County") on behalf of the Orange County Carolina at Chapel Hill (hereinafter, the "Provider") on behalf of its Department of Family Medicine in the School of Medicine, (hereinafter, the "Department"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. General Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to the County for Medical Director Services and Clinical Services identified in Section 3, below. ii) This Agreement also includes clinical supervision for licensed clinical social workers. iii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. 2. Responsibilities of the Provider a. Services to be Provided. The Provider shall provide the County with medical director services and clinical services as set forth limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing the Services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout North Carolina and in accordance with applicable federal, state and local laws and regulations applicable to the performance of the Services. Provider is solely responsible for the professional quality, accuracy and timely completion and/or submission of all work related to the Services. Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 2 UNC SOM #18-1751.t032 ii) Provider shall be responsible for its acts and omissions, in the performance of the Agreement. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or the Services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider in accordance with applicable law. v) Provider agrees that Provider, its employees, agents and its subcontractors, if any, shall be required to comply with all federal, state and local antidiscrimination laws, regulations and policies that relate to the performance of the Services under this Agreement. vi) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it and/or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. Provider agrees that all employees, agents and subcontractors will provide the necessary information to be credentialed with OCHD. 3. Services a. Services. The Services to be rendered pursuant to this Agreement will consist of the following medical director services and clinical services: i) Medical Director Services. The Provider will designate a physician, as set forth in this Agreement and Exhibit A, to serve as Medical Director who will provide the following services in accordance with appropriate medical standards, accepted methods and procedures: 1) Provide consultation, medical expertise, and technical assistance to the OCHD Health Director and OCHD Personal Health Services Director to inical programs and services. 2) Subject to applicable policies of Provider, represent the OCHD, as deemed appropriate by the Health Director, with community relations, including but not limited to, print media, TV and radio. Serve as the OCHD liaison to the medical community at-large, including hospitals and physician practices regarding public health issues. Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 3 UNC SOM #18-1751.t032 3) Provide medical oversight and supervision to the Advanced Practice Practitioners (three point five (3.5) full time equivalent (FTE)) employed by OCHD as required by the NC Board of Medical Examiners. To the maximum practicable extent, OCHD shall include the Medical Director in the hiring process of APPs, including an opportunity to interview and provide input on all candidates. As the hiring authority for the Health Department, the Health Director shall consult the Medical Director prior to any final hiring decisions. Should the Medical schedule not permit participation and/or consultation, the Health Director shall consult with the Chair of Family Medicine. The parties acknowledge that the final hiring decisions of APPs are the sole prerogative of the County. 4) Develop medical policies and protocols, in consultation with the Personal Health Services Director, which conform to standards set by the North Carolina Department of Health and Human Services (DHHS), and the U.S. Department of Health and Human Services. 5) Sign protocols and standing orders that will allow professionals working with OCHD to utilize the optimum range of procedures/medical treatment legally allowed by their Licensure Boards. 6) Provide 24/7 on-call consultation services for OCHD Communicable Disease Programs. 7) Attend OCHD Leadership Team or Board of Health meetings as requested by the Health Director. 8) Provide medical direction to the Communicable Disease Program via meetings, TB Management and Outbreak Management. 9) Provide medical direction to school health programs in both school systems in Orange County and medical consultation to both school and OCHD staff working in or with school health programs. 10) Attend and complete required trainings to include but not limited to, the NC Department of Public Health (DPH) Annual Tuberculosis Symposium, Title X Training, NC DPH Annual STD Update, etc. 11) Other miscellaneous duties as provided for in the Agreement. 12) Discharge the above-described responsibilities through and with prior knowledge of OCHD Health Director. ii) Clinical Services. Provider shall make available physicians and other professionals as set forth in Exhibit A to provide clinical services at OCHD in compliance with State and Federal guidelines, program rules and all OCHD clinical practice guidelines and standards for all Outpatient Clinics conducted by OCHD, including without limitation the following OCHD Outpatient Clinics: Family Planning (FP), Prenatal Care (PNC), Child Health (CH), Adolescent Health (ADOL), Tuberculosis Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 4 UNC SOM #18-1751.t032 (TB), Sexually Transmitted Disease (STD), General Communicable Disease Control (GEN), Adult Health Preventive Services (AH/HP), Primary Care (PC), and Refugee Health (RH). The clinical services provided by the Provider shall include the following: 1) Collaboration with OCHD to ensure high quality standards of care for Outpatient Clinics through routine review of program manuals. For the mutual benefit of the Provider, OCHD, and its prenatal patients, prenatal patients will be managed according to OCHD established protocols. These protocols will be reviewed annually and will be developed in a manner that attempts to be consistent with protocols used at UNC Department of OB/GYN and Family Medicine outlying clinics. 2) Primary medical supervision of the Advanced Practice Practitioners (APPs) who are employees of OCHD to include ongoing monitoring and evaluation of the medical acts performed by the APPs. Meeting with APPs at least once every six (6) months to identify and document clinical problems, progress toward improving outcomes and recommendations for changes in treatment plans. Documentation of clinical issues discussed, and actions taken will be signed, dated, retained by the APP and physician and be available for review. 3) During the first six (6) months of practice, meet with new APPs monthly to discuss practice-relevant clinical issues and quality improvement measures. Documentation of clinical issues discussed, and actions taken will be signed, dated, and retained by the APP and physician and be available for review. 4) Weekly case conference meetings with clinical staff at each site according to an agreed upon schedule to discuss high-risk patient care, treatment changes, and clinical operation issues. 5) working in clinics. This includes orientation, supervision of practice and assurance of compliance with OCHD program and documentation requirements. Advance notice of medical resident and student placement will be made to the Personal Health Director. Medical students are limited to those involved in special projects with the Medical Director. All medical residents and students must be in compliance with OCHD immunization requirements and maintain documentation of such on file at UNC. 6) Provision of routine medical services during scheduled on-site times at OCHD Outpatient Clinics, including documentation of clinical services, follow-up on all labs, patient calls and medication refills for all clinical services provided per established OCHD protocols. 7) Medical consultation to OCHD APPs as needed when the Medical Director is not on-site at OCHD outpatient clinics. 8) Continuing education consultation for OCHD APPs and other OCHD staff to include regular informal consultation and periodic formal sessions as Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 5 UNC SOM #18-1751.t032 appropriate. 9) After- HealthLink program provides initial triage of after-hours calls for all patients with the exception of Prenatal Patients. The Medical Director will provide consultation and supervision to OCHD clinicians ( four (4) APPs) that provide after-hours medical consultation (on a rotating basis) for OCHD clients referred by HealthLink. The Medical Director shall also provide after-hours medical consultation for HealthLink referred OCHD clients on a rotating basis such that each of the five (5) clinicians shall provide such after-hours medical consultation one (1) week, every four to five (4-5) weeks. 10) Discharge the above-described responsibilities through and with the prior knowledge of OCHD Health Director. iii) Designation of a Medical Director. The Provider shall provide, at a minimum, the equivalent of point eight (.80) FTE personnel to carry out the Services described in this Agreement. 1) -up The Medical Director shall be board certified in Family Medicine or an equivalent certification. The Medical Director will report activities and services performed for OCHD as requested by OCHD Health Director. 2) The Chair of the Department shall, concurrent with the execution of this Agreement, designate the name of the Medical Director, and the names of up to five Department physicians on Exhibit A, Designation of Medical Director, attached hereto and incorporated herein by reference, who will rotate as back- u 3) The Department and OCHD shall indicate their mutual agreement to the designation of the Medical Director and designated back-up Department physicians available to be scheduled in the absence of the Medical Director by signing Exhibit A. Any changes in these designations will be mutually agreed to by the Chair of the Department and OCHD Health Director. In the event that the Medical Director or any designated back-up Department physician becomes unwilling or unable to perform the duties required by this Agreement, the Department and OCHD shall attempt to mutually agree upon replacement physician(s). If such mutual agreement is not achieved, then this Agreement shall terminate and any payment due as of the date of termination shall be paid as provided below in this Agreement. 4) Coverage. The Medical Director or designated back-up Department physician shall provide a total of sixteen (16) hours per week of the foregoing clinical services on-site at OCHD Outpatient Clinics or other sites as provided therefor and as agreed by the parties. Days and times and the identity of the person or persons scheduled to be on-site to provide this coverage on behalf of the Provider will be mutually agreed to by the Department and OCHD. Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 6 UNC SOM #18-1751.t032 Although the Provider is not required to provide the attendance of a Medical Director or back-up Department physician on the premises of OCHD outpatient facilities or other sites provided therefor at other times, the Medical Director shall be reasonably available during other days and times as stipulated in this Agreement. 5) Back-Up Coverage. Substitute coverage by a back-up Department physician is expected during vacations and other anticipated absences of the Medical Director or back-up Department physician originally scheduled to be available. The Medical Director or designated back-up Department physician shall be responsible for notifying OCHD of schedule changes. If attendance as scheduled of the Medical Director or designated back-up Department physician is impossible due to unremediable circumstances, phone coverage of a designated back-up Department physician must be provided. In addition to the foregoing described days and hours, at the request of OCHD Health Director and as agreed to by the Provider, the Medical Director or designated back-up Department physician will provide on-site medical supervision at OCHD Outpatient Clinics or other sites as necessary during communicable disease incidents or other public health-related emergencies. 6) Substitutions in the scheduling of the Medical Director or designated back-up Department physician will be the responsibility of the Department in consultation with OCHD Health Director. Vacation leave, continuing education, and other assignments requiring temporary back-up coverage will be mutually agreed upon by the Chair of the Department and OCHD Health Director. iv) The Provider will assure that the Medical Director and designated back-up Department physicians are in, and maintain, compliance with OSHA guidelines regarding bloodborne pathogens including Hepatitis B and TB status as well as documentation of immunization against measles, mumps, rubella and varicella. In the event of a bloodborne pathogen exposure, the Provider will be responsible for providing follow-up according to its policies and procedures governing exposure incidents. v) The Provider will maintain current registration and licensure of the Medical Director and designated back-up Department physicians and shall provide copies to OCHD upon request. vi) Monthly one-on-one clinical supervision by a Mental Health Clinical Supervisor to OCHD Licensed Clinical Social and mental health services to OCHD clients, in order to enhance and support best clinical skills and recommendations for the development of an integrated behavioral health program. The Mental Health Clinical Supervisor shall provide professional support, guidance, and review of LCSW practice and services to clients with issues related to mental health, substance abuse and behavioral health. 4. Duration of Services Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 7 UNC SOM #18-1751.t032 a. Term. The term of this Agreement shall be from July 1, 2025 to June 30, 2026, and shall be renewable annually thereafter upon written notification executed by both parties. b. Scheduling of Services. i) The Provider shall schedule and perform the Services in a timely manner. ii) OCHD Outpatient Clinics are operational during the normal business hours of 8:00 A.M. to 5:00 P.M., Monday through Friday. On Wednesday, the clinics operate from 10:00 A.M. to 5:00 P.M.. In addition, one (1) weekday per site (Tuesday - Hillsborough; Thursday - Chapel Hill) the Outpatient Clinics operate on a flexible evening schedule (i.e., 9:30 A.M. 6:30 P.M.) to provide greater access to care. Outpatient Clinics may run beyond their scheduled time and Medical Director is expected to continue providing the Services in the event Outpatient Clinics run beyond their scheduled time at no additional cost. In addition to the above- described activities during the after-hours program, the Provider is responsible for providing the Services in accordance with this Agreement during the entirety of the hours specified in this paragraph. 5. Compensation a. Compensation for Services. Compensation for Services shall include all compensation due the Provider from the County for all Services under this Agreement except for any authorized Reimbursable Expenses which are defined herein. The maximum amount payable for Services shall not exceed Two Hundred Sixty-Nine Thousand Four Hundred Sixty-Six and 00/100 Dollars ($269,466.00). In addition, County shall pay Provider a five point five percent (5.5%) administrative fee, which shall not exceed Fourteen Thousand Eight Hundred Twenty-One and 00/100 Dollars ($14,821.00). The maximum amount payable under this contract for both Services and the administrative fee shall not exceed Two Hundred Eighty-Four Thousand Two Hundred Eighty-Seven and 00/100 Dollars ($284,287.00) and shall be payable in equal monthly installments of Twenty-Three Thousand Six Hundred Ninety and 59/100 Dollars ($23,690.59). b. Provider shall invoice OCHD on a monthly basis with the first invoice being dated July 1, 2025. c. Payment for Services shall become due and payable within thirty (30) days of Provider properly invoicing the County. Any adjustments to the invoice shall be taken into account in the next invoice or as soon thereafter as reasonably practicable. d. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. The parties will make good faith efforts to resolve any dispute within thirty (30) days. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. e. Additional Services. County shall not be responsible for costs related to any services in Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 8 UNC SOM #18-1751.t032 addition to the Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated, the Health Director, to act as the County's representative with respect to the Services and shall have the authority to render decisions within guidelines established by the County Manager and/or the County Board of Commissioners and shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. b. OCHD agrees to furnish all supplies, equipment, office space and a computer as needed by the Provider to perform the Services; to include the Medical Director in all appropriate conferences, meetings, correspondence and publications necessary to appropriately discharge the Medical Director's duties within budgetary constraints. c. The County shall provide qualified and trained support staff (e.g., nurses, technicians, registration staff) to support the Outpatient Clinics. The parties agree all support staff shall be employees of the County. The County shall provide a medical records system to document Services provided at the Outpatient Clinics. The parties acknowledge that the Outpatient Clinics are clinics operated by the County and the medical records are property of the County. d. OCHD represents and warrants that it will provide such collaborative practice agreements medical oversight and supervision services provided hereunder. 7. Insurance a. General Requirements. The Provider shall provide adequate professional liability self- insurance for its personnel who provide Services described in this Agreement. The insurance limits will be stated in a Confirmation of Insurance submitted at the time this Agreement is commenced. The professional liability insurance shall cover personal injury by the persons designated as Medical Director under this Agreement in the amount of at least $1 million, per occurrence, $2 million aggregate. b. The County will be responsible for the negligence of its employees and agents to the extent permitted by the North Carolina Tort Claims Act, and without waiver of sovereign immunity. The County shall maintain professional liability insurance for its APPs in the minimum amounts of $1 million per claim or occurrence and $2 million annual aggregate. c. Evidence of Insurance. Evidence of such insurance shall be furnished to the County and the Provider, as applicable, upon request of a party. 8. Indemnity a. Indemnity. The Provider will be responsible for the negligence of its employees and agents Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 9 UNC SOM #18-1751.t032 to the extent permitted by the North Carolina Tort Claims Act, and without waiver of sovereign immunity. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. b. The County will be responsible for the negligence of its employees and agents to the extent permitted by the North Carolina Tort Claims Act, and without waiver of sovereign immunity. It is the intent of this provision to require the County to indemnify the University to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Services. Changes in the Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the amendment only after receiving a fully executed amendment from the County. 10. Termination a. Termination for Convenience. Either party may terminate this Agreement at any time, b. This Agreement or its renewals may be terminated upon failure of the parties to agree on a replacement Medical Director or replacement designated back-up Department physician pursuant to paragraph 6 of this Agreement. c. Other Termination. Either party may terminate this Agreement due to a material breach of any term or provision of this Agreement by the other party upon written notice of such breach to the breaching party, and the failure of the breaching party to cure such breach within thirty (30) days of receiving such written notice. However, if such breach is of such character as to reasonably require more than thirty (30) days to cure, this Agreement may only be terminated if the breaching party fails to commence action within such thirty (30) days or, after commencing corrective action, fails to use reasonable diligence to cure the breach. d. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination in accordance with Section 5.c. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any property, electronic data or files relating to the Services. e. Waiver. The payment or receipt of any sums by a party under this Agreement or the failure of a party to require compliance by the other party with any provisions of this Agreement or the waiver by a party of any breach of this Agreement shall not constitute a waiver of any claim for damages by the other party for any breach of this Agreement or a Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 10 UNC SOM #18-1751.t032 waiver of any other required compliance with this Agreement. f. Suspension. County may suspend the Services and this Agreement at any time for fourteen (14 Provider. Upon any suspension by County, Provider shall discontinue work on the Services and shall not resume the Services until notified to proceed by County. c. Additional Provisions a. 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 without the written consent of the other b. 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 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. c. Anti-Discrimination. Provider shall at all times remain in compliance with all applicable local, state and federal laws, rules and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations. Any violation of this requirement is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. d. 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. The parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. e. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. f. Nondiscrimination. OCHD hereby agrees with the Provider that, in their educational and/or employment practices, OCHD and the Provider will comply with such state and federal non-discrimination laws as may be applicable to it in the performance of this Agreement. Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 11 UNC SOM #18-1751.t032 g. Conduct of Service. The Provider shall abide by pertinent rules and regulations of OCHD, Orange County, and the North Carolina Department of Health and Human Services in the conduct of service, provided such rules and regulations are provided to the Provider in advance. h. Confidentiality. The Provider and OCHD shall comply with such 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. i. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the parties. j. Non-Appropriation. Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable and not appropriated for the performance expire without penalty to County immediately upon written notice to Provider of the unavailability and non-appropriation of public funds. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement, but only as an emergency fiscal measure during a substantial fiscal crisis. For purposes of this Agreement, the County represents that sufficient funds have been appropriated. rity, mandate and/or mandated functions, by state and/or federal legislative or regulatory action, which adversely affects authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider k. 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 The University of North Carolina at Attn: Kimberlee Quatrone Chapel Hill School of Medicine 300 West Tryon Street Department of Family Medicine Hillsborough, NC 27278 Attn: Andrew Olsson 590 Manning Drive, CB #7595 Chapel Hill, NC 27599-7595 With a copy which shall not constitute notice to: UNC-CH Office of University Counsel Campus Box #9105 Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 12 UNC SOM #18-1751.t032 123 W. Franklin St., Suite 600A Chapel Hill, NC 27599-9105 Attn: Vice Chancellor and General Counsel l. Signatures. This Agreement may be executed in any number of counterparts, each of which when executed and delivered shall constitute a duplicate original, but all counterparts together shall constitute a single agreement. Counterparts of this Agreement, together with any amendments or modifications, may be executed electronically. All electronic signatures affixed hereto have the same legal force and effect as any wet or ink signatures affixed hereto. All electronic signatures evidence the intent of the parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. m. No Third Party Beneficiaries. This Agreement is made only to benefit the parties hereto. Nothing in this Agreement is intended to create, nor has it created any rights, interests, or benefits for any other parties whatsoever. [SIGNATURE ON FOLLOWING PAGE] Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 13 UNC SOM #18-1751.t032 IN WITNESS WHEREOF, the parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE By: _____________________________ By: ______________________________ Jamezetta Bedford, Chair, Josephine Tetteh, JD Orange County Board of County Director, Office of Professional Commissioners Service Contracts and Affiliations Date: _____________________ Date: ______________________ This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: _____________________________ Date__________________________ Gary Donaldson, Finance Director __________________ ________ By: _____________________________ Quintana Stewart, MPA Health Director Date: _____________________ Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A 7/14/2025 UNC SOM #18-1751.t032 EXHIBIT A Designation of Medical Director Exhibit A to Contract between the Department of Family Medicine, University of North Carolina, School of Medicine and the Orange County Health Department for July 1, 2025 through June 30, 2026. The following clinicians are designated by the Department of Family Medicine to fulfill the terms of the attached contract: Erica Pettigrew, MD Medical Director, Physician Rachel Hughes, MD Physician Ashley Rietz, MD Physician Morgan McEachern, MD Physician Modjulie Moore, MD Physician Sylvia Becker-Dreps MD Physician Linda Myerholtz, PhD Clinical Psychologist, LCSW Supervisor Copies of current registration and licensure for these clinicians are attached. Signed: Margaret Helton, MD, Chair Date Department of Family Medicine Agreed: Quintana Stewart, Health Director Date Orange County Health Department Docusign Envelope ID: 579DB095-5AE0-496E-B369-DA1A2CF55A1A