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HomeMy WebLinkAboutAgenda - 06-17-2003-8qORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 17, 2003 Action Agenda Item No. ~'t~ SUBJECT• Contract Renewal with UNC Family Medicine and Health Department DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Contract INFORMATION CONTACT: Rosemary Summers, ext 2411 TELEPHONE NUMBERS: Hillsborough 732-8181 Chapel Hill 968-4501 Durham 688-7331 Mebane 336-227-2031 PURPOSE: To consider contract renewal with UNC Family Medicine and Health Department for Physician Services. BACKGROUND: This contract covers all physician services for the health department, including communicable disease consultation, clinic supervision and direct clinical services, mandated oversight of all nurse practitioners, and consultation on protocol development and quality assurance. The contract also includes the oversight of the nurse practitioner at the Orange County Jail. Back-up services are also included in the contract for vacation and sick coverage. There were approximately 10,000 clinic encounters and 5,800 individuals served in 2002-2003. The contract amount is $121,272 for the year, a 5% increase over the previous year. There was no increase last year in the contract. FINANCIAL IMPACT: The contract for FY 2003-2004 is $121,272 and represents .70 FTE of a physician's time including medical back-up. This amount has been included in the department's requested budget for FY 2003-2004. RECOMMENDATION(S): The Manager recommends that the Board approve the contract and authorize the Chair to sign pending approval of the FY 2003-2004 budget and county attorney review. 2 STATE OF NORTH CAROLINA COUNTY OF ORANGE AGREEMENT THIS AGREEMENT, made and entered into this first day of July 2003, by and between The University of North Carolina at Chapel Hill, hereinafter referred to as "The University," for its Department of Family Medicine in the School of Medicine, hereinafter referred to as the "Department" and the Orange County Health Department, hereinafter referred to as the "OCH D." WITNESSETH: WHEREAS, the Department desires to provide Medical Director services and to participate in the provision of medical care for the citizens of the community, and; WHEREAS, the OCHD is the operator of three outpatient facilities known as the Orange County Health Department, located in Chapel Hill and Hillsborough, North Carolina. NOW, THEREFORE, in consideration of the premises and the following mutual covenants and conditions and any sums to be paid, the OCHD and The University agree as follows: I. The Department will render professional consultation as Medical Director. As Medical Director, the Department shall: a. act as the principal advisor to the Health Director and Personal Health Services Director in matters of medical policy; b. advise the Health Director and Personal Health Services Director on the medical implications of alternatives in clinical program functioning and management; c. represent the OCHD in interagency relationships which involve medical expertise at the request of the Health Director; 3 d. advise and interpret the regulatory requirements related to medical aspects of the OCHD'S functions; e. provide coordination for medical components of the clinical programs of the OC H D; f. advise and assist staff in epidemiological investigations; g. be responsive to community public health concerns directly and in consultation with the Health Director and Division Directors; h. assist the Health Director and Personal Health Services Director in establishment of medical procedures and quality/quantity control mechanisms; i. assist in data analysis towards identification of public health concerns; j. work with the Health Director and Division Directors on formulation of responses to public health concerns; k. assist with evaluation of medical programs and services, including recommendations for constructive change; I. maintain close contact and availability through on-site visits and phone consultation to discharge responsibilities at the OCHD; m. participate in Division Head management meetings and Division level meetings when requested and appropriate; n. attend Board of Health meetings when requested; o. provide medical direction to the school health programs in both school systems in the County and medical consultation to both OCHD and school staff working in the school health programs; p. provide medical direction and consultation to the Jail Health Program administered by the OCHD for the Orange County Jail; q. discharge the above listed responsibilities through and with knowledge aforehand of the Health Director; r. other miscellaneous duties as necessary. 4 2. The Department shall provide agreed upon medical direction and clinician services in compliance with State and Federal guidelines and program rules for the following programs: family planning (FP), prenatal care (PNC), child health (CH), adolescent health (ADOL), tuberculosis (TB), sexually transmitted disease (STD), general communicable disease control (GEN), adult health preventive services (AH/HP), and Jail Health (JH). Clinical duties shall include: a. Collaborative development and approval of clinic protocols; for the mutual benefit of the Department, OCHD and its prenatal patients, it is agreed by both parties that prenatal patients will be managed according to OCHD established protocols. These will be reviewed annually and be consistent with protocols used at UNC Department of OB/GYN and Family Medicine outlying clinics. b. Primary medical supervision of the nurse practitioners who are employees of the OC H D; c. Co-signing charts of patients seen by new nurse practitioners of the OCHD within five (5) working days for at least the first six months of their practice, and face-to-face consultation on a weekly basis for the first month after approval and at least monthly for the succeeding five months; d. Routine medical services during scheduled on-site clinic times and Jail Sick Call as requested, including documentation of clinical services per OCHD protocol; Jail Sick Call will be requested only after exhausting all other attempts to staff sick call with regular and temporary FNP personnel. e. Medical consultation visits to OCHD patients during scheduled on-site clinic times; f. Continuing education consultation for nurse practitioners and other staff to include regular informal consultation and periodic formal sessions as appropriate. 3. The Chair of the Department shall designate the name of the Medical Director and the names of any physicians who will provide clinical services. The Medical Director shall be board certified in Family Medicine or an equivalent certification. 5 a. Any changes in these designations will be mutually agreed to by the Chair of the Department and the Health Director. b. The Department and OCHD shall indicate their mutual agreement to the designation of the Medical Director and any other physicians involved as described above by signing the "Designation of MedicaN Director" attachment to this contract. 4. This agreement covers any and all clinics conducted by OCHD in the program areas I fisted i n #2 above. 5. Clinics are operational during the normal business hours of 8:00 a.m. to 5:00 p.m., Monday through Friday. Some clinics may run beyond 5:00 p.m. The Department is responsible for medical activities conducted during the entirety of these hours. 6. On-site physician attendance shall occur for a total of 20 hours per week in the clinical setting. Days and times of this coverage will be mutually agreed to by the Department and OCHD. Although Medical Director or back-up physician attendance is not required on premises at other times, it should be available as stipulated above. At least 8 hours of direct administrative/consultative time shall be available to OCHD staff weekly. On-site back-up coverage is expected during vacations and other anticipated absences. Physicians are responsible for notifying OCHD of schedule changes. If physician attendance is impossible due to unremediable circumstances, physician phone coverage will be provided and nurse practitioner charts will be signed within five (5) working days. 7. The Medical Director or other designated physicians will be available for phone consultation during all business hours and emergency phone consultation shall be available as needed during non-business hours through a pager system. Phone coverage will also be provided for consultation and direction for communicable disease/epidemic 6 control. At the request of the Health Director, the physician will provide on-site medical supervision during communicable disease incidents. 8. The Department agrees to provide the equivalent of .70 FTE to carry out the duties described above. The clinical and administrative services will be provided primarily by the Medical Director, with other designated physicians providing back-up coverage. Substitutions in designated physician back-up will be the responsibility of the Department in consultation with the Health Director. Vacation and continuing education leaves will be mutually agreed upon by the Chair of the Department and the Health Director. The Medical Director will report activities and services performed to OCHD as requested by the Health Director. 9. The Department will maintain current registration and licensure and shall provide copies to the OCHD as appendices to the Designation of Medical Director attachment to this contract. 10. The Department will assure that physicians covered under this agreement are in 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 Department will be responsible for providing follow-up according to its policies and procedures governing exposure incidents. 11. The University will be responsible for the negligence of its employees and agents to the extent of the North Carolina Tort Claims Act. Further, the University will provide adequate professional liability insurance for the University and personnel who provide the services described in the agreement. The insurance limits will be stated in a Confirmation of Insurance submitted at the time the contract is commenced. 12. The Department will offer medical consultation in accord with the accepted methods and procedures. 13. The OCHD agrees to pay the Department in return for the above services equal monthly installments of TEN THOUSAND, ONE HUNDRED SIX DOLLARS ($10,106.00) for a total of $121,272. 14. The University shall bill the OCHD on a monthly basis with the first bill being dated July 1, 2003 and the OCHD shall pay the University within thirty (30) days of receipt of the University's bill. Any adjustments to the billing shall be taken into account in the next succeeding bill or as soon thereafter as reasonably practicable. 15. The OCHD agrees to furnish all supplies, equipment, office space and a computer as needed by the Medical Director; 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. 16. In the event that the Medical Director and back-up physician become unwilling or unable to perform the duties required by this Agreement, The University and OCHD shall attempt to mutually agree upon replacement. 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. 17. This Agreement shall run for a period of TWELVE (12) months, from the 1st day of July, 2003, to the 30th day of June, 2004, and shall be renewable annually thereafter upon written notice executed by both parties. 8 18. This Agreement or its renewals may be terminated at any time without penalty by either party provided that written notice of such termination is furnished to the other party at least ninety (90) days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination. 19. The OCHD hereby agrees with The University that, in its educational and/or employment practices, the OCHD will comply with such non-discrimination law as may be applicable to it in the performance of this Agreement. The Department hereby agrees to abide by pertinent rules and regulations of the OCHD, Orange County, and the North Carolina Department of Health and Human Services in the conduct of service. 20. No provision of this Agreement shall be construed or interpreted as creating a pledge of the faith and credit of the County of Orange or OCHD within the meaning of any constitutional debt limitation. No provision of this Agreement shall be construed or interpreted as creating a delegation of governmental powers nor as a donation by or a lending of the credit of the County of Orange or OCHD within the meaning of the Constitution of the State of North Carolina. This Agreement shall and does not directly or indirectly or contingently obligate the County of Orange or OCHD to make any payments beyond those appropriated in the sole discretion of the County of Orange or OCHD for any fiscal year in which this Agreement shall be in effect. No deficiency judgment may be rendered against the County of Orange or OCHD in any action for breach of a contractual obligation under this Agreement and the taxing power of the County of Orange is not and may 9 not be pledged directly or indirectly or contingently to secure any moneys due under this Agreement. 21. This Agreement contains the entire understanding of the parties and shall not be altered, amended, or modified, except by an agreement in writing executed by the duly authorized officials of both parties. 22. The laws of North Carolina shall govern the validity and interpretation of the provisions, terms, and conditions of the Agreement. 10 IN WITNESS WHEREOF, the parties have hereunto signed this Agreement in their official capacities of the day and year listed below. FOR AND ON BEHALF OF FOR AND ON BEHALF OF ORANGE COUNTY HEALTH DEPARTMENT THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL Rosemary L. Summers, MPH, DrPH Health Director Nancy Suttenfield Vice-Chancellor for Finance and Administration DATE: DATE: Warren P. Newton, MD Chair, Family Medicine DATE: FOR AND ON BEHALF OF THE COUNTY OF ORANGE Margaret Brown, Chair Orange County Board of Commissioners DATE: ORANGE COUNTY FINANCE DIRECTOR: "This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act." Ken Chavious Finance Director DATE: 11 Designation of Medical Director Attachment to Contract between the Department of Family Medicine, University of North Carolina, School of Medicine and the Orange County Health Department for July 1, 2003 through June 30, 2004. The following physicians are designated by the Department of Family Medicine to fulfill the terms of the attached contract: Michael Fisher, MD_ Medical Director Valerie Kind, MD Physician Clark Dennison, MD Physician Andrew Hannipel, MD Physician Margaret Nusbaum, DO Physician Copies of current registration and licensure for these physicians are attached. Signed: Warren Newton, Chai r Department of Family Medicine Agreed: Rosemary Summers, Health Director Orange County Health Department Date Date