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HomeMy WebLinkAbout2025-513-E-Health Dept-Piedmont Health Services-Services and support programs that serve persons with Opioid Use DisorderOrange County Opioid Funding Agency Performance Agreement Revised 07/25 Page 1 of 10 OPIOID FUNDING AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 2025, (“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 Piedmont Health Services, Inc., a non-profit corporation, located at 88 Vilcom Center Drive, Suite 110, Chapel Hill, North Carolina 27514 (“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, 2025 to June 30, 2026. 2. Scope of Services. a. Provider will provide services, as outlined in Exhibit A to NC MOA: High-Impact Opioid Abatement Strategies (“OPTION A” List) - to the residents of Orange County. The Scope of Services and the Program Budget (Exhibit B) may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit C. 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. The County agrees to appropriate for the provision of services described in Exhibit B, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $50,400.00. b. All funds appropriated shall be used for purposes described in Scope of Services. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds 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 Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in four equal installments in the amount of $12,600.00. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports (Attachment A), which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the Scope of Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Orange County Opioid Funding Agency Performance Agreement Page 2 of 10 Rev.07/25 Services. Final payment is contingent upon a final Progress Report as well as the narrative story and accounting of expenditures. e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. • Progress Report dates are: January 10 for reporting months July 1 - December 31 • April 10 for reporting months January 1 - March 31 • July 10 for reporting months April 1 – June 30 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. 5. Termination. a. 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. In 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 satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. 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 Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Orange County Opioid Funding Agency Performance Agreement Page 3 of 10 Rev.07/25 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. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that 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. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. e. Waiver. The 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. 6. Responsibilities of the County. Cooperation and Coordination. The County has designated (Orange County Health Director, Quintana Stewart) 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. 7. Insurance. a. General Requirements. Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by County’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If County’s Risk Manager determines additional insurance coverage is required such additional insurance shall consist of Professional Liability and a Molestation/Sexual Assault rider (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. a. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 8. 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 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 Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Orange County Opioid Funding Agency Performance Agreement Page 4 of 10 Rev.07/25 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 http://www.orangecountync.gov/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. 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. e. 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. f. 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. g. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. h. 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 Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Page 5 of 10 law. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. i.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. j.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. k.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. Modifications may be evidenced by facsimile signatures. l.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 Provider’s Name Piedmont Health Services Attention: Kimberlee Quatrone Attention: Daniella Jaimes-Colina, PHD P.O. Box 8181 Address: 88 Vilcom Center Dr. Suite 220 Hillsborough, NC 27278 Chapel Hill, NC 27514 Email:kquatrone@orangecountync.gov Email: colinad@piedmonthealth.org m.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 11A and Article 40 of North Carolina General Statute Chapter 66. 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 and on behalf of the Provider _______________________ Date ________________________ _____________________________ Daniella Jaimes-Colina PHD, Chief Executive Officer For and on behalf of Orange County Government _______________________________ Travis Myren, County Manager Orange County Opioid Funding Agency Performance Agreement Rev.07/25 Date Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E 8/13/2025 8/20/2025 Orange County Opioid Funding Agency Performance Agreement Page 6 of 10 Rev.07/25 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Piedmont Health Services Vendor Contact Person: Jasmine Fouts Phone: 919-933-8494 Address: 88 Vilcom Center Drive, Suite 110, City Chapel Hill State: NC Zip: 27514 Department: Health Amount: $50,400.00 Purpose: Services and support programs that serve persons with Opioid Use Disorder Budget Code(s): 27411020- 630000-92011 Vendor # 27898 Vendor Status with NCSOS: Current-Active Non-Profit Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 7/1/25 End Date 6/30/26 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: May 20,2025); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation 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. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services 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 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: Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E 8/13/2025 8/18/2025 8/19/2025 8/19/2025 Orange County Opioid Funding Agency Performance Agreement Page 7 of 10 Rev.07/25 Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Exhibits, page 1 EXHIBIT A TO NC MOA: HIGH-IMPACT OPIOID ABATEMENT STRATEGIES (“OPTION A” List) In keeping with the National Settlement Agreement, opioid settlement funds may support programs or services listed below that serve persons with Opioid Use Disorder (OUD) or any co-occurring Substance Use Disorder (SUD) or mental health condition. As used in this list, the words “fund” and “support” are used interchangeably and mean to create, expand, or sustain a program, service, or activity. 1.Collaborative strategic planning. Support collaborative strategic planning to address opioid misuse, addiction, overdose, or related issues, including staff support, facilitation services, or any activity or combination of activities listed in Exhibit C to the MOA (collaborative strategic planning). 2.Evidence-based addiction treatment. Support evidence-based addiction treatment consistent with the American Society of Addiction Medicine’s national practice guidelines for the treatment of opioid use disorder – including Medication-Assisted Treatment (MAT) with any medication approved for this purpose by the U.S. Food and Drug Administration – through Opioid Treatment Programs, qualified providers of Office-Based Opioid Treatment, Federally Qualified Health Centers, treatment offered in conjunction with justice system programs, or other community-based programs offering evidence-based addiction treatment. This may include capital expenditures for facilities that offer evidence-based treatment for OUD. (If only a portion of a facility offers such treatment, then only that portion qualifies for funding, on a pro rata basis.) 3.Recovery support services. Fund evidence-based recovery support services, including peer support specialists or care navigators based in local health departments, social service offices, detention facilities, community-based organizations, or other settings that support people in treatment or recovery, or people who use drugs, in accessing addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need to improve their health or well-being. 4.Recovery housing support. Fund programs offering recovery housing support to people in treatment or recovery, or people who use drugs, such as assistance with rent, move-in deposits, or utilities; or fund recovery housing programs that provide housing to individuals receiving Medication-Assisted Treatment for opioid use disorder. 5.Employment-related services. Fund programs offering employment support services to people in treatment or recovery, or people who use drugs, such as job training, job skills, job placement, interview coaching, resume review, professional attire, relevant courses at community colleges or vocational schools, transportation services or transportation vouchers to facilitate any of these activities, or similar services or supports. 6.Early intervention. Fund programs, services, or training to encourage early identification and intervention for children or adolescents who may be struggling with problematic use of drugs or mental health conditions, including Youth Mental Health Exhibit ADocusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E B.Project Description and Program Sustainability (28 points, page limit: not to exceed 3 pages) PHS plans to use Orange County High Impact Opioid Abatement funds toward Strategy 2: Evidence Based Addictfon Treatment. The following services will be provided at no cost for Medicatfon for Opioid Use Disorder (MOUD) patfents of Orange County: -Visit costs -Lab costs -Medicatfon costs Providing MOUD at no cost is a vital strategy in preventfng overdose deaths; individuals with Opioid Use Disorder (OUD) who partfcipate in an MOUD program receive support in managing cravings, reducing withdrawal symptoms, and ultfmately, preventfng relapse into actfve addictfon. MOUD blocks the effects of opioids and people with access to medicatfons like buprenorphine are less likely to return to illicit opioid use. It is important to note here that illicit opioids are often contaminated with fentanyl or other substances that contribute to a high likelihood of overdose; by preventfng relapse, MOUD prevents overdose deaths. MOUD programs also encourage individuals to engage with much-needed services like counseling, which has been show to improve long-term recovery outcomes. Alleviatfng the cost of visits, labs, and medicatfons for patfents means that tho se financial barriers will not stand in the way of much-needed MOUD services. Providing MOUD at no cost also communicates to patfents that we support them in their process, thereby reducing stfgma. PHS antfcipates using this funding to enroll two new patfents in our MOUD program each month at our Carrboro clinic and one new patfent each month at our Chapel Hill clinic, for a total of three patfents each month, or 36 patfents in one year. PHS engages with community members who may require MOUD services by partnering with community agencies such as the Orange County Emergency Services Post Overdose Response Team (PORT), the NC STAR Network, and the Orange County Health Department, among many others. As a known and trusted presence in Orange County, PHS also partfcipates in Health Fairs, often with our Mobile Health Unit, in order to provide health screenings and spread awareness of our services; occasionally we will receive interest in our MOUD services in-person, either from a person with OUD or from a family member or loved one. Referrals for behavioral health or substance use disorder services come from many places, including positfve screenings from our medical clinics, patfent insurance companies, and other community agencies. This project will advance PHS’s vision of a healthy community in which all people have tfmely access to quality health care. Our hope is that by using this funding to provide services at no cost, we will reach the people who most need MOUD services, and not only provide much- needed care, but also help transitfon patfents into utflizing PHS as a medical home. MOUD is Exhibit B Scope of Services Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E one step toward full recovery; the entfre process requires a lot of support, including care for any medical or behavioral health issues that may have been overlooked or deprioritfzed during actfve addictfon. People who have partfcipated in an MOUD program and experience long-term recovery tend to have improved physical, psychological, and social well-being. Any enhancements, improvements, or increases achieved during the project year will be sustained via communicatfon with Orange County Public Health Department, and will be aided by a pre-existfng streamlined administratfve process. All programmatfc decisions will be based on evaluatfon of program data and patfent survey results; input from community partners will also be solicited and considered. Current funding sources for our MOUD program include Federal and State government, insurance providers, and, in Chatham County, Opioid Settlement Fund dollars. In order to sustain this program, PHS will contfnue to seek diverse funding streams, strengthen community partnerships, and operate efficiently as an agency, with the goal of providing quality services while reducing overhead as much as possible. The current tfmeline for this program is as follows: July 2025: Training of patfent care coordinators and pharmacy staff, begin enrolling patfents August-September 2025: Contfnued implementatfon and streamlining of administratfve process October 2025: Initfal reportfng and reimbursement documentatfon submitted; contfnued implementatfon; nine total patfents enrolled November-December 2025: Contfnued implementatfon January 2026: Reportfng and reimbursement documentatfon submitted; contfnued implementatfon; 18 total patfents enrolled February-March 2026: Contfnued implementatfon April 2026: Reportfng and reimbursement documentatfon submitted; contfnued implementatfon; 27 total patfents enrolled May-June 2026: Contfnued implementatfon July 2026: Final reportfng and reimbursement documentatfon submitted; evaluatfon of program; 36 total patfents enrolled Obstacles to the success of this program may include: -Stfgma, which can affect the ability to sustain funding for MOUD programs, as well as prevent patfents from seeking the services they need; PHS antfcipates that investfng in providing MOUD at no cost to the patfent will counteract stfgma significantly -Transportatfon, which is difficult to find funding for; PHS antfcipates that providing a “one-stop shop” for medical, behavioral, lab, and medicatfon services will be a support as patfents navigate this obstacle Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E -Disruptfons in consistent attendance, which is common for a treatment program; PHS strives to provide compassionate care and flexibility to patfents who may need to reschedule at tfmes, while stfll maintaining boundaries around the best use of staff and clinic resources -Legal and Criminal Justfce issues, which may present a barrier if a patfent becomes involved in the criminal justfce system during MOUD treatment and is unable to communicate with their healthcare providers; PHS will communicate with partners when appropriate, including the Orange County Criminal Justfce Resource Department, in order to stay informed on a patfents’ status and be prepared to coordinate care when necessary, and contfnue care when possible Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Overall Program Budget Agency Piedmont Health Services, Inc. Proposed Program Title Community MOUD for Orange County Project Period Total Revenues:Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Orange County Opioid Settlement Funding $ 50,400.00 $ 57.00 $ 50,400.00 $ - $ - 50,400.00$ Revenues: $ - $ - $ - -$ $ - $ - $ - -$ $ - $ - $ - -$ $ - $ - $ - -$ $ - $ - $ - -$ Total Revenues: $ 50,400.00 $ 57.00 $ 50,400.00 $ - $ - $ - $ - $ - $ - 50,400.00$ Project Period Total Expenses:Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Personnel and Benefits: 20,400.00 57.00 20,457.00 - - 20,457.00 Operations Expenses: 30,000.00 30,000.00 - - 30,000.00 Subcontractor Services: Subcontractor 1 name - - - - - - - Subcontractor 2 name - - - - - - - Subcontractor 3 name - - - - - - - Capital - - - - Administrative/Indirect cost (no more than 10%) - - - - Total Expenses: 50,400.00 57.00 50,457.00 - - - - - - 50,457.00 Total Program Expense Budget 2025 2026 2027 Complete this form for all revenue sources, as well as expense sources other than Opioid Settlement funds. Figures for expenses using Opioid Settlement funds will automatically populate from detail tabs of spreadsheet, except for the administrative/indirect cost line item, which should be filled out in this tab. Add rows as needed. Enter information in yellow shaded cells only. Total Program Revenue Budget 2025 2026 2027 Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Orange-RFA-Budget-Worksheet 080625.xlsx Opioid Settlement Strategies RFA Budget Narrative Agency Piedmont Health Services, Inc Proposed Program Title Community MOUD for Orange County Year 2025 Year Year Direct Personnel and Fringe Benefits Direct Personnel and Fringe Benefits Direct Personnel and Fringe Benefits Other Direct Costs (Non-Personnel)Other Direct Costs (Non-Personnel)Other Direct Costs (Non-Personnel) Subcontractor/Consultant Services Subcontractor/Consultant Services Subcontractor/Consultant Services Administrative Costs Administrative Costs Administrative Costs Visit Cost: $80/visit. Visits are all-inclusive (treatment, labs, diagnostic services, education, screenings, preventive care, etc) except Pharmacy - $80/visit x 12 visits per pt annually = $960 x 25 pts. = $24000 MOUD medications: Burprenorphine: $20/month per pt. x 25 pts. = $500/month x 12 months = $6000 $20,457 is budgeted toward 5% of a Behavioral Health Consultant salary, 2% of a second Behavioral Health Consultant salary, 5% of a Project Director's salary, and 5% of the Behavioral Health Director's salary: The Behavioral Health Consultants will coordinate the clinical aspects of this project, create workflows, and train staff. The Project Director will create workflows, collect and analyze data, as well as coordinate and complete the billing and reporting aspects of this project. The Behavioral Health Director will supervise the Behavioral Health Consultants and the Project Director, as well as oversee all processes, ensuring that grant expenditure and reporting are faithfully completed. This total reflects an average that incorporates a 3% increase in salary each year. Narrative Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Attachment A Start Date: 7/1/2025 End Date: 6/30/2026 Description Count How were efforts supported?Notes Additional Information & Helpful Hints about this Measure # of naloxone kits distributed A naloxone kit contains two doses. # of OTPs that dispense methadone, buprenorphine, and naltrexone # of OTPs that dispense only methadone # of OTP-based medical providers who prescribe methadone for OUD patients A provider may participate in multiple support programs so there may be some duplication of # of providers. # of referrals to opioid treatment programs Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique patients with OUD served at OTP A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). # of office-based clinics offering MOUD within county # of individual OBOT providers who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be some duplication of # of providers. # of buprenorphine prescriptions provided at OBOT # of naltrexone doses provided at OBOT # of referrals to OBOT Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique patients with OUD served at OBOT A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). # of FQHCs offering MOUD within county # of individual FQHC providers who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be some duplication of # of providers. # of buprenorphine prescriptions provided at FQHC # of naltrexone doses provided at FQHC # of referrals to FQHC MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique patients with OUD served at FQHC A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). # of hospitals offering in-patient MOUD within county # of hospitalists who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be some duplication of # of providers. # of buprenorphine prescriptions provided through in-patient services in hospitals 2.Evidence-Based Treatment Insert Start and End Date for this Strategy (MM/DD/YYYY) Process measures answer the question, “How much did you do?”. Please quantify the process measures relevant to your implementation of this strategy. Indicate whether the count represents efforts supported only by opioid settlement funds or efforts supported by multiple funding sources including opioid settlement funds. Process measures should reflect numbers from the current reporting period (fiscal year). STRATEGY-SPECIFIC PROCESS MEASURES Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E # of naltrexone doses provided through in-patient services in hospitals # of referrals to in-patient MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique hospital in-patients with OUD served with MAT A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). # of emergency departments offering MOUD within county # of emergency department providers who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be some duplication of # of providers. # of short-term buprenorphine prescriptions (14 days or less) provided in the ED # of longer-term buprenorphine prescriptions (15 days or more) provided in the ED # of naltrexone doses provided in the emergency department # of referrals from emergency department to community providers Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique emergency department patients with OUD served with MAT A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). # of Local Health Departments (LHD) offering MOUD within county # of individual LHD-based providers who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be some duplication of # of providers. # of buprenorphine prescriptions provided at LHD # of naltrexone doses provided at LHD # of referrals to LHD MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique patients with OUD served at LHD with MAT A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). # of EMS programs offering MOUD within county # of individual EMS providers who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be some duplication of # of providers. # of buprenorphine prescriptions provided through EMS-based MAT programs # of naltrexone doses through EMS-based MAT programs # of referrals to EMS-based MAT programs Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique patients who received pre-hospital buprenorphine treatment from EMS during a non-fatal overdose encounter # of unique patients with OUD served through EMS-based MAT programs # of unique patients with OUD who declined services through EMS- based MAT programs A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E # of Syringe Service Programs (SSPs) offering MOUD within county A provider may participate in multiple support programs so there may be some duplication of # of providers. # of providers who prescribe buprenorphine for patients at/through an SSP # of buprenorphine prescriptions provided through SSPs # of naltrexone doses provided through SSPs # of referrals to SSP-based MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. # of unique patients with OUD served through SSPs with MAT A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). # of patients who are justice-involved that are referred to any MAT program A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Custom, strategy-specific measures may be entered in this row. Custom, strategy-specific measures may be entered in this row. Custom, strategy-specific measures may be entered in this row. Process Measure Count Additional Information & Helpful Hints about this Measure # of unique patients who have OUD, served A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). American Indian/Alaska Native Non-Hispanic Asian Non-Hispanic Black Non-Hispanic Native Hawaiian or Other Pacific Islander Non-Hispanic White Non-Hispanic Hispanic Some Other Race or Multiple Races Unknown Sum total of unique patients served (Autocalculated) Does sum total (C87) match the reported # of unique patients (C77)? (Autocalculated)Yes Description Count Quality Measure Percent (Autocalculated)Notes Additional Information & Helpful Hints about this Measure # of referrals to opioid treatment programs that resulted in 1st appointment attended # of referrals to opioid treatment programs # of referrals to OBOT services that resulted in 1st appointment attended at office-based clinic # of referrals to OBOT services at office-based clinic # of referrals to OBOT services that resulted in 1st appointment attended at FQHC # of referrals to OBOT services at FQHC Notes DEMOGRAPHICS: Provide the following information on race and ethnicity for the # of unique patients who have OUD, served during the current reporting period (fiscal year). STRATEGY-SPECIFIC QUALITY MEASURES Of the # of unique patients who have OUD, served in the count above, how many people identified as: Quality measures answer the question, “How well did you do it?”. Please quantify the quality measures relevant to your implementation of this strategy. Quality measures should reflect numbers from the current reporting period (fiscal year). % of referrals to OTP services that resulted in 1st appointment attended Incomplete % of referrals to OBOT services that resulted in 1st appointment attended at office-based clinic Incomplete % of referrals to OBOT services that resulted in 1st appointment attended at FQHC Incomplete Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E # of referrals to OBOT services that resulted in 1st appointment attended at LHD # of referrals to OBOT services at LHD # of referrals to EMS-based MAT programs that resulted in 1st appointment for treatment attended # of referrals to EMS-based MAT programs # of referrals to SSP-based MAT services that resulted in 1st appointment for treatment attended # of referrals to SSP-based MAT services # of patients who are justice-involved that are referred to any MAT program that resulted in 1st appointment for treatment attended # of patients who are justice-involved that are referred to any MAT program # of unique patients who have OUD, served, who report they are satisfied with services # of unique patients who have OUD, served Description Count Outcome Measure Percent (Autocalculated)Notes Additional Information & Helpful Hints about this Measure # of unique patients with OUD who were connected to treatment and have adhered to treatment at 6 months # of unique patients who have OUD who were connected to treatment (i.e. attended their first appointment) # of patients who have OUD served who report getting the social and emotional support they need # of unique patients who have OUD, served # of community overdose reversals using naloxone # of community overdose reversals using naloxone N/A A community overdose reversal is one where naloxone is administered by a community member who is not EMT or first responder staff. % of referrals to OBOT services that resulted in 1st appointment for treatment attended at LHD Incomplete % of referrals to EMS-based MAT services that resulted in 1st appointment for treatment attended Incomplete % of referrals to SSP-based MAT services that resulted in 1st appointment for treatment attended Incomplete % of referrals from justice system programs that resulted in 1st appointment for treatment attended Incomplete % of patients, who have OUD, who are satisfied w/ services Incomplete A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). STRATEGY-SPECIFIC OUTCOME MEASURES (PROGRAM-LEVEL) Incomplete Custom, strategy-specific measures may be entered in this row. Incomplete Custom, strategy-specific measures may be entered in this row. Incomplete Custom, strategy-specific measures may be entered in this row. Outcome measures answer the question, “Is anyone better off?”. Outcome measures can be at the program- or population-level. Please quantify the outcome measures relevant to your implementation of this strategy. Outcome measures should reflect numbers from the current reporting period (fiscal year). % of patients with OUD who adhere to treatment 6 months after first appointment Incomplete Recommended measure at six months. If measure for adherence is taken at another increment, please describe this in the "Notes" column. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). For recommendations on how to report 6-month adherence, please visit this link. % of patients who report getting the social and emotional support they need Incomplete Consider asking patients the Behavioral Risk Factor Surveillance System question, "How often do you get the social and emotional support you need?" 1. Always 2. Usually 3. Sometimes 4. Rarely 5. Never The # of patients who answer "Always" and "Usually" can be summed to find # of patients who have OUD, served who report getting the social and emotional support they need. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across programs, project, sites, etc., are aggregated for the strategy-specific impact report. A patient may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Description Notes Additional Information & Helpful Hints about this Measure % of residents receiving dispensed buprenorphine prescriptions The North Carolina Overdose Epidemic Data Dashboard can be found here. Use the "Metrics" dropdown to find the "Metric" (i.e., Outcome Measure, Population-Level) and "Place" to find your county. Treatment services rate per 100,000 residents, representing # of uninsured people and Medicaid beneficiaries who received treatment for OUD The North Carolina Overdose Epidemic Data Dashboard can be found here. Use the "Metrics" dropdown to find the "Metric" (i.e., Outcome Measure, Population-Level) and "Place" to find your county. Overdose death rate per 100,000 residents The North Carolina Overdose Epidemic Data Dashboard can be found here. Use the "Metrics" dropdown to find the "Metric" (i.e., Outcome Measure, Population-Level) and "Place" to find your county. Overdose emergency department visits per 100,000 residents The North Carolina Overdose Epidemic Data Dashboard can be found here. Use the "Metrics" dropdown to find the "Metric" (i.e., Outcome Measure, Population-Level) and "Place" to find your county. Custom, strategy-specific measures may be entered in this row. In addition to any program-level outcome measures captured above, population-level data on outcome measures are available from the NC Overdose Epidemic Data Dashboard. Please visit the Data Dashboard and become familiar with what is available. Then indicate if there are population-level outcome measures you are expecting to change as a result of your implementation of this strategy. The NC Overdose Epidemic Data Dashboard provides integration and visualization of state, regional, and county-level metrics for partners across NC to track progress toward reaching common goals. Which metrics are shared on the Dashboard, referred to as outcome measures (population-level) in the Impact Report, may change over time. STRATEGY-SPECIFIC OUTCOME MEASURES (POPULATION-LEVEL) Incomplete Custom, strategy-specific measures may be entered in this row. Incomplete Custom, strategy-specific measures may be entered in this row. Are you expecting to change this measure as a result of implementing this strategy? Incomplete Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E