HomeMy WebLinkAbout2025-731-E-Health Dept-Piedmont Health Services-Reimbursement for WIC Hemoglobin Testing and use of facilitiesPHS/OCHD Memo of Agreement
Revised 11/2025
Memorandum of Agreement
Between
Piedmont Health Services, Inc. WIC Program
and
Orange County Health Department
For WIC Program Services
This Memorandum of Agreement made and entered into the 1st day of July 2025 by and between
the Orange County Health Department (“OCHD”) and Piedmont Health Services WIC Program
(“PHS”).
WITNESSETH:
WHEREAS, both PHS and OCHD deem it to be of mutual interest to their patients/clients and
their respective organizations to enter into this agreement for certification of WIC clients at
OCHD; and
WHEREAS, both parties desire to reduce the terms of this agreement to writing;
NOW THEREFORE, and in consideration of the mutual promises to the other as hereinafter set
forth, the parties hereby mutually agree as follows:
A. PHS agrees to perform in a manner satisfactory to OCHD the following responsibilities:
1. Provide WIC services to Maternal and Child Health clinic clients at OCHD in
Hillsborough following the policies, procedures and flow of patients as established
by OCHD. Services will include height and weight assessment, nutrition
assessment and education, WIC certification, food vouchers issuance, child
immunization assessment, and appropriate patient referrals in accordance with state
WIC policies.
2. Provide the necessary supervision, training and policy guidance to carry out the
tasks identified above in consultation with the designated OCHD liaison.
3. Provide personnel for coverage during vacations and other approved leave except
PHS scheduled holidays and unavoidable emergencies. Inform the OCHD liaison
when WIC staff will be absent so that OCHD clinic staff can be notified.
4. Schedule meetings as needed with the OCHD liaison and WIC Director to discuss
problems, procedures, changes in policy and to establish and review objectives.
5. Reimburse OCHD, on a quarterly basis, eleven dollars ($11) per client for each
client that is not an OCHD patient, for testing of hemoglobin on WIC clients. This
fee is the fee charged to non-insured patients according to OCHD’s fee schedule.
6. Piedmont Health Services will provide their own interpreter services for clients
receiving WIC services, including laboratory services at the OCHD location in
accordance with Title VI and Title II requirements.
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PHS/OCHD Memo of Agreement
Revised 11/2025
B. OCHD agrees to perform in a manner satisfactory to PHS the following responsibilities:
1. Provide reasonable working space and equipment necessary for carrying out WIC
responsibilities in the Hillsborough office.
2. Provide reasonable working space in the Chapel Hill office for WIC staff to meet
with clients referred by Orange County Health Department.
3. Assist WIC employees with gaining read -only access to OCHD patient medical
records through current University of North Carolina read-only platform. The
parties agree to comply with the Business Associate Agreement attached hereto as
Exhibit 1.
4. Through its liaison, OCHD shall be responsible for the following:
a. Meet, as needed, with the PHS WIC Director to discuss problems, procedures,
changes in policy and to establish and review objectives.
b. Inform WIC staff of OCHD holidays, closings, clinic changes, and staff
absences, which may affect the delivery of WIC services.
5. Perform hemoglobin testing for all WIC clients served at the Hillsborough OCHD
site and submit invoices on a quarterly basis to Piedmont Health Services, Inc. for
non-OCHD clients.
6. OCHD will send patient referrals to WIC utilizing The NC Department of Health
and Human Services link https://www.ncdhhs.gov/ncwicreferral.
C. Term. This agreement is for the performance of services rendered during the period
beginning July 1, 2025 and ending June 30, 2026.
D. Termination. Either party may terminate this agreement by giving 90 days written notice
to the other party.
E. Non-Appropriation. It is understood and agreed between PHS and OCHD that continuation
or any renewal or extension thereof, is dependent upon and subject to the allocation or
appropriation of funds to PHS and/or to OCHD for the purposes set forth in this agreement.
It is also understood and agreed that either party shall involve the other in significant
scheduling or program changes, which may affect services.
F. Access to Records. OCHD agrees that the State of North Carolina, United States
Department of Agriculture, the Controller General of the United States, or any of their duly
authorized representatives, shall have access to any books, documents, papers and records
of OCHD which are directly pertinent to this specific agreement, for the purposes of audit,
making excerpts and transcriptions.
G. Governing Law and Priority. This Agreement and the duties, responsibilities, obligations
and rights of respective parties hereunder shall be governed by the laws of the State of
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PHS/OCHD Memo of Agreement
Revised 11/2025
North Carolina. Provider shall at all times remain in compliance with all applicable local,
state, and federal laws, rules, and regulations and the Orange County Non-Discrimination
Policy and Orange County Living Wage Policy (each policy is incorporated herein by
reference and may be viewed at,
http://www.orangecountync.gov/departments/purchasing_division/contracts.php). 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. 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, 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. In determining the basic services to be
provided, should any documents be referenced in or attached to this Agreement, the terms
herein shall have priority in any conflict between the terms of referenced documents and
the terms of this Agreement.
H. Confidentiality of Patient Records. All parties agree to abide by all laws and regulations
governing the confidentiality of patient information, including HIPAA privacy rules and
further agree to vigorously safeguard privileged information, in accordance with the terms
and conditions of the BAA attached hereto.
I. Non-discrimination. All activities under this contract will be conducted in accordance with
Title VI of the Civil Rights Act of 1964 (42 U.S.C.2000d et seq.), Title IX of the Education
Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of
1973 (29 U.S.C.794), Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.); Title II
and Title III of the Americans with Disabilities Act (ADA) of 1990 as amended by the
ADA Amendment Act of 2008 (42 U.S.C. 12131-12189) as implemented by Department
of Justice regulations at (28 CFR Parts 35 and 36); Executive Order 13166, "Improving
Access to Services for Persons with Limited English Proficiency." (August 11, 2000), all
provisions required by the implementing regulations of the U.S. Department of Agriculture
(7 CFR Part 15 et seq); and FNS directives and guidelines to the effect that no person shall,
on the ground of race, color, national origin, age, sex (including gender identity and sexual
orientation), or disability, be excluded from participation in, be denied the benefits of, or
otherwise be subjected to discrimination under any program or activity for which Federal
financial assistance is received for the administration of the WIC Program; and hereby
gives assurances that it will immediately take measures necessary to effectuate this
agreement. By providing this assurance, the contractor agrees to compile data, maintain
records and submit records and reports as requested by the Community Nutrition Services
Section to permit effective enforcement of the nondiscrimination laws, and to permit the
Community Nutrition Services Section personnel during normal working hours to review
and copy such records, books and accounts, access such facilities, and interview such
personnel as needed to ascertain compliance with the non-discrimination laws. If there are
any violations of this assurance, the Community Nutrition Services Section shall have the
right to seek judicial enforcement of this assurance. This assurance is given in
consideration of and for the purpose of obtaining any and all Federal financial assistance,
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PHS/OCHD Memo of Agreement
Revised 11/2025
grants, and loans of Federal funds, reimbursable expenditures, grant, or donation of Federal
property and interest in property, the detail of Federal personnel, the sale and lease of, and
the permission to use Federal property or interest in such property or the furnishing of
services without consideration, or at a consideration that is reduced for the purpose of
assisting the recipient, or any improvements made with Federal financial assistance
extended to the Program applicant by USDA. This includes any Federal agreement,
arrangement, or other contract that has as one of its purposes the provision of cash
assistance for the purchase of food, and cash assistance for the purchase or rental of food
service equipment or any other financial assistance extended in reliance on the
representations and agreement made in this assurance.
J. Renewal of Agreement. This agreement may be renewed upon the mutual agreement of
both parties. Any renewal shall be negotiated 30 days prior to the beginning date of the
new contract period.
K. Amendment. This agreement may be amended upon the mutual agreement of the parties.
All amendments shall be in writing and signed by both parties to the agreement.
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 Health Department Piedmont Health Services, Inc.
Attention: Kimberlee Quatrone Attention: Daniella Jaimes-Colina, PhD
300 West Tryon Street 88 Vilcom Cntr. Dr., Ste. 110
Hillsborough, NC 27278 Chapel Hill, NC 27514
l. 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 Parties, by and through their authorized agents, have hereunder set
their hands and seal, all as of the day and year first above written.
_______________________________________ ____________
Daniella Jaimes-Colina, PhD, Chief Executive Director Date
Piedmont Health Services, Inc.
______________________________________ ____________
Travis Myren, County Manager Date
Orange County
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ORANGE COUNTY—INTERNAL USE ONLY
______________________________________________________________________________
Finance Information
Vendor Name: Piedmont Health Services Vendor Contact Person: Ashley Brewer Phone: 336-382-0242 Address:
88 Vilcom Center Drive City Chapel Hill State: NC Zip: 27514 Department: Health Amount: $3,000 Purpose:
Reimbursement for WIC Hemoglobin Testing and use of facilities Budget Code(s): 10414001-476020-71403 – This
is a contract for Piedmont to pay us. Vendor # 27898
Vendor Status with NCSOS: Current-Active 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 60-30-26 Notice Date (Notice Purpose )
Award
Approved by Board (Agenda Date: 6-17-25); 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.
This agreement is approved as to technical form and content. 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:
Received for record retention:
Office of the Clerk to the Board __________________________________________Date:_________
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Exhibit 1
THIS BUSINESS ASSOCIATE AGREEMENT (this “Agreement”) is made as of the 1st
day of July, 2025 (the “Effective Date”), by and between Orange County Health Department
(“Covered Entity”) and Piedmont Health Services, Inc (“Business Associate”), each
individually a “Party” and together the “Parties.”
BACKGROUND STATEMENTS
A. Purpose. The purpose of this Agreement is to comply with the requirements of the
Health Insurance Portability and Accountability Act of 1996 and the associated regulations
(45 C.F.R. parts 160-164, as may be amended, including the “Privacy Rule” and the “Security
Rule”) (“HIPAA”) and the Health Information Technology for Economic and Clinical Health
Act and the associated regulations, as may be amended (“HITECH”). “HIPAA” and “HITECH”
are collectively referred to in this Agreement as “HIPAA.” Unless otherwise defined in this
Agreement, capitalized terms have the meanings given in HIPAA, as applicable. HIPAA
requires Business Associate to provide reasonable assurances to Covered Entity that the
Business Associate will appropriately safeguard Protected Health Information (“PHI”).
B. Relationship. Covered Entity and Business Associate have entered into an
agreement (the “Services Agreement”) pursuant to which Business Associate may receive,
use, obtain, access, maintain, transmit, and/or create PHI from or on behal f of Covered
Entity in the course of providing certain services (the “Services”) for Covered Entity.
AGREEMENT
The Parties hereby agree as follows:
Section 1. Permitted Uses and Disclosures.
Business Associate may use and/or disclose PHI only as permitted or required
by this Agreement or as otherwise required by Law. Business Associate may disclose PHI to,
and permit the use of PHI by, its employees, contractors, agents, or other representati ves
only to the extent directly related to and necessary for the performance of the Services.
Business Associate will request from Covered Entity no more than the minimum PHI
necessary to perform the Services. Business Associate will request, use and disclose only
PHI that constitutes a Limited Data Set, if practicable, and will otherwise limit any request,
use or disclosure of PHI to the minimum necessary for the intended purpose of the request,
use or disclosure. Business Associate will not use or disclose PHI in a manner (i) inconsistent
with Covered Entity’s obligations under HIPAA, or (ii) that would violate HIPAA if disclosed
or used in such a manner by Covered Entity.
Business Associate will comply with the Privacy Rule requirements applicable to
Covered Entity if and to the extent Business Associate’s performance of the Services involves
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carrying out Covered Entity’s Privacy Rule obligations. Business Associate will also comply
with its own direct obligations under HIPAA. Business Associate will not engage in
marketing or fundraising that involves the use or disclosure of PHI and will not otherwise
receive direct or indirect remuneration for PHI, except as expressly permitted in writing by
Covered Entity in connection with the provision of the Services.
Section 2. Safeguards for the Protection of PHI.
Business Associate will implement and maintain commercially appropriate
administrative, physical, and technical security safeguards to ensure that PHI obtained by or
on behalf of Covered Entity is not used or disclosed by Business Associate in violation of this
Agreement. Such safeguards will be designed to protect the confidentiality and integrity of
such PHI obtained, accessed, created, maintained, or transmitted from or on behalf of
Covered Entity. Business Associate will comply with the applicable requirements of the
Security Rule. Upon request by Covered Entity, Business Associate will provide a written
description of such safeguards.
Section 3. Reporting and Mitigating the Effect of Unauthorized Uses and
Disclosures.
Business Associate will report without unreasonable delay and in no case later
than sixty (60) calendar days , upon discovery, in writing and in accordance with Section
10.6, any Security Incident or Breach (as defined below) by it or any of its employees,
directors, officers, agents, subcontractors or representatives concerning the use or
disclosure of PHI. For purposes of this Agreement, “Breach” means any acquisition, access,
use or disclosure of PHI under this Agreement that is (a) in violation of HIPAA or (b) not
permitted under this Agreement. Business Associate will be deemed to have discovered a
Breach as of the first day on which the Breach is, or should reasonably have been, known to
(a) Business Associate or (b) any employee, officer, or other agent of Business Associate
other than the individual committing the Breach. Business Associate further will investigate
the Breach and provide to Covered Entity, as soon as possible all information Covered Entity
may require to make notifications of the Breach to Individuals and/or other persons or
entities (“Notifications”). Business Associate will cooperate with Covered Entity in
addressing the Breach. Business Associate will not notify Individuals or other persons or
entities of the Breach without the express written consent of Covered Entity, unless required
by applicable law. Covered Entity may direct Business Associate to make the Notifications
and implement other mitigation steps, in a reasonable form and manner, and within
reasonable timeframes directed by Covered Entity, consistent with Covered Entity’s legal
obligations. Business Associate will be responsible for the reasonable costs of required
notifications and mitigation directly resulting from such Breach to the extent the Breach is
determined to have resulted from the negligence, wrongful acts, or omissions of Business
Associate or its employees or agents. Nothing in this Agreement shall be construed to waive
Business Associate’s governmental immunities or defenses under North Carolina law
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Business Associate will establish and implement procedures and other
reasonable efforts for mitigating, to the greatest extent possible, any harmful effe cts arising
from any improper use and/or disclosure of PHI.
Section 4. Use and Disclosure of PHI by Subcontractors, Agents, and
Representatives.
Business Associate will require any subcontractor, agent, or other
representative that is authorized to receive, use, maintain, transmit, or have access to PHI
obtained or created under the Agreement, to agree, in writing, to (1) adhere to the same
restrictions, conditions and requirements regarding the use and/or disclosure of PHI and
safeguarding of PHI that apply to Business Associate under this Agreement; and (2) comply
with the applicable requirements of the Security Rule.
Section 5. Individual Rights.
Business Associate will comply with the following Individual rights
requirements as applicable to PHI used or maintained by Business Associate:
5.1 Right of Access. Business Associate agrees to provide access to PHI, at
the request of Covered Entity, as necessary to satisfy Covered Entity’s obligations with
regard to the individual access requirements under the Privacy Rule. Business Associate will
otherwise comply with its obligations regarding an Individual’s right of access to PHI under
HIPAA.
5.2 Right of Amendment. Business Associate agrees to make any
amendment(s) to PHI as necessary to meet the amendment requirements under HIPAA.
5.3 Right to Accounting of Disclosures. Business Associate agrees to
document such disclosures of PHI as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of PHI in accordance with HIPAA,
and to provide all such documentation to Covered Entity or, to an Individual, as necessary to
satisfy Covered Entity’s obligations with regard to an Individual’s right to an accounting of
disclosures. Business Associate will otherwise comply with its obligations regarding an
Individual’s right to an accounting of disclosures under HIPAA.
Section 6. Use and Disclosure for Business Associate’s Purposes.
6.1 Use. Except as otherwise limited in this Agreement, Business Associate
may use PHI for the proper management and administration of Business Associate or to
carry out the legal responsibilities of Business Associate.
6.2 Disclosure. Except as otherwise limited in this Agreement, Business
Associate may disclose PHI for the proper management and administration of Business
Associate, provided the disclosures are Required by Law, or Business Associate obtains
reasonable assurances from the person to whom the PHI is disclosed that the PHI will remain
confidential and be used or further disclosed only as Required by Law or for the purpose for
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which it was disclosed to the person, and the person notifies Business Associate immediately
upon discovery of any instances in which the confidentiality of the PHI has been Breached,
as defined and described in Section 3 of this Agreement.
Section 7. Audit and Inspection.
With reasonable notice, Covered Entity may audit Business Associate to monitor
compliance with this Agreement. Business Associate will promptly correct any violation of
this Agreement found by Covered Entity and will certify in writing that the correction has
been made. Covered Entity’s failure to conduct an audit or, if an audit is conducted, to detect
any unsatisfactory practice, does not constitute acceptance of the practice or a waiver of
Covered Entity’s rights under this Agreement.
Business Associate will make its internal practices, books, records, and policies and
procedures relating to the use and disclosure of PHI received from, or created or received by
Business Associate on behalf of Covered Entity, available to the federal Department of Health
and Human Services (“HHS”), the Office for Civil Rights (“OCR”), or their agents and to
Covered Entity for purposes of monitoring compliance with HIPAA.
Section 8. Term and Termination
8.1 Term. This Agreement will become effective on the Effective Date.
Unless terminated sooner pursuant to Section 8.2, this Agreement will remain in effect for
the duration of all Services provided by Business Associate and for so long as Business
Associate will remain in possession of any PHI received from, or created or received by
Business Associate on behalf of Covered Entity.
8.2 Termination. In the event of a material breach of this Agreement, the
non-breaching Party may immediately terminate the Services Agreement and this
Agreement. Alternatively, in the non-breaching Party’s sole discretion, the non-breaching
Party may provide the breaching Party with written notice of the existence of the material
breach and afford the breaching Party thirty (30) days to cure the material breach. In the
event the breaching Party fails to cure the material breach within such time period, the non-
breaching Party may immediately terminate the Services Agreement and this Agreement.
8.3 Effect of Termination. Upon termination of the Services Agreement and
this Agreement, Business Associate will recover any PHI relating to this Agreement in the
possession of its subcontractors, agents or representatives. Business Associate will return
to Covered Entity or destroy all such PHI plus all other PHI relating to this Agreement in its
possession, and will retain no copies. If Business Associate cannot feasibly return or destroy
the PHI, Business Associate will ensure that any and all protections, requirements and
restrictions contained in this Agreement will be extended to any PHI retained after the
termination of this Agreement, and that any further uses and/or disclosures will be limited
to the purposes that make the return or destruction of the PHI infeasible.
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Section 9. Responsibility for Compliance.
Each party shall be responsible for its own acts and omissions and for compliance
with its respective obligations under this Agreement and applicable law. Nothing in this
Agreement shall be construed to require either party to indemnify the other or to waive any
governmental immunities or defenses available under North Carolina law.
Section 10. Miscellaneous.
10.1 Survival. The respective rights and obligations of the Parties under
Sections 7 (Audit and Inspection), 8.3 (Effect of Termination), 9 (Indemnification) and 10
(Miscellaneous) will survive termination of this Agreement indefinitely.
10.2 Amendments. This Agreement constitutes the entire agreement
between the Parties with respect to its subject matter. It may not be modified, nor will any
provision be waived or amended, except in a writing duly signed by authorized
representatives of the Parties. Notwithstanding the foregoing, Covered Entity may amend
this Agreement upon written notice to Business Associate if the amendment is necessary to
comply with a statutory or regulatory requirement.
10.3 Waiver. A waiver with respect to one event will not be construed as
continuing, or as a bar to or waiver of any right or remedy as to subsequent events.
10.4 Compliance with HIPAA. Any ambiguity in this Agreement will be
resolved in favor of a meaning that permits the Parties to comply with HIPAA. The Parties
agree to amend this Agreement from time to time as necessary for the Parties to comply with
the requirements of HIPAA.
10.5 No Third Party Beneficiaries. Nothing express or implied in this
Agreement is intended to confer, nor will anything herein confer, upon any person other than
the Parties and their respective successors and permitted assigns, any rights, remedies,
obligations or liabilities whatsoever.
10.6 Notices. Any notice to be given under this Agreement to a Party will be
made via U.S. Mail, commercial courier or hand delivery to such Party at its address given
below, and/or via facsimile to the facsimile telephone number listed below, or to such other
address or facsimile number as will hereafter be specified by notice from the Party. Any such
notice will be deemed given when so delivered to or received at the proper address.
If to Business Associate, to: If to Covered Entity to:
Piedmont Health Services, Corporate Office Orange County Health Dept.
88 Vilcom Center Dr., Ste 110 PO Box 8181, 300 W. Tryon St.
Chapel Hill, NC 27514 Hillsborough, NC 27278
Attention: Daniella Jaimes-Colina, PhD Attention: Ashley Rawlinson
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10.7 Relationship between Parties: The relationship of the Parties is that
of independent contractors, and nothing in this Agreement will be construed to render
either Party a partner, employee or agent of the other, nor will either Party have authority
to bind the other in any respect, it being intended that each Party will remain solely
responsible for its own actions. No employee or agent of one Party to this Agreement will
be considered an employee or agent of the other Party.
IN WITNESS WHEREOF, each of the Parties has caused this Agreement to be
executed in its name and on its behalf as of the Effective Date.
COVERED ENTITY BUSINESS ASSOCIATE
Sign: ______________________________ Sign: _____________________________
Orange County Health Department Piedmont Health Services, Inc.
Print Name: __Quintana Stewart Print Name: Daniella Jaimes-Colina, PhD__
Title: _Health Director__________ Title: Chief Executive Director_____________
Date: ______________________________ Date: ____________________________
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