HomeMy WebLinkAboutAgenda - 08-20-2002 - 8h e
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ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: August 20, 2002
Action Agenda
Item No. ;k
SUBJECT: Adult Day Care Nursing Service Agreement with UNC School of Nursing
DEPARTMENT: Aging & Advisory Board on PUBLIC HEARING: (YIN) No
Aging
ATTACHMENT(S): INFORMATION CONTACT:
Florence Soltys, Chair, Aging Advisory Bd.
Draft UNC-School of Nursing - Service Jeny Passmore, ext. 2009
Agreement TELEPHONE NUMBERS:
Hillsborough 732-8181
Chapel Hill 968.4501
Durham 688-7331
Mebane 336-227-2031
PURPOSE: To authorize the entering into a nursing services contract with UNC-School of
Nursing for the new Central Orange Day Health Care Program.
BACKGROUND: This past fiscal year, the renovation and planning tasks were completed to
establish a new adult day health program at the Meadowlands in Hillsborough, one of the top
priorities (Goal III-i4, cl-3) of the Master Aging Plan for Orange County. For FY 2002-2003, the
Board of County Commissioners set aside $40,000 to implement this adult day health center
initiative along with the commitment of other community partners—specifically UNC Health
Care - $20,000.00, Carol Woods - $18,400.00, Home and Community Block Grant Program -
$9,054.00, and the Friends of the Senior Center covering the day care utilities.
The new Central Orange Adult Day Health Program will provide social and health services to
frail, disabled and isolated older adults. It will also provide respite and education for the
participant's families and caregivers. Before the Adult Day Health Center can open in
September, Orange County is required to have a nurse on site for a minimum of four hours a
day to attend to the health needs of center participants. UNC-Chapel Hill School of Nursing has
agreed to provide this required nursing service under contract from September through June
30, 2003 at an hourly rate of$32.00 and would include pre-admission health assessment and
implementing the care service plan such as medication administration, wound care, feedings,
monitoring participants and collaborating with other health care professionals. The contract
also would provide nursing backup, liability coverage for the registered nurse and the
involvement of the School of Nursing in the Adult Day Health Center as a community teaching
and learning site for their students.
FINANCIAL IMPACT: Funds for the contract have been budgeted for FY 2002-2003. The
projected contact amount of$25,344.00 covers 198 days at$32.00 per hour for a 4 hour daily
minimum. Orange County will pay for actual hours invoiced on a month basis.
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RECOMMENDATION(S): The County Manager recommends that the Board of County
Commissioners approve the contract in substance and authorize the Chair to sign the contract
for the required nursing services of the new Central Orange Adult Day Health Center contingent
upon review and revision of the contract by staff and the County Attorney.
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SERVICE AGREEMENT BETWEEN DR- `� "
ORANGE COUNTY,DEPARTMENT ON AGING
AND
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF NURSING
THIS AGREEMENT is made and entered into as of the I't day of September
2002 by and between THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
for its School of Nursing and ORANGE COUNTY,DEPARTMENT ON AGING.
PURPOSE: The purpose of this Agreement is to set forth the terms and conditions for
the provision of professional nursing services between the UNC AT CHAPEL HILL
SCHOOL OF NURSING and ORANGE COUNTY,DEPARTMENT ON AGING at the
Orange County Adult Day Health Center of 515 Meadowlands Drive, Suite 400,
Hillsborough,NC 27278; to provide a registered nurse to coordinate the delivery of
health care services and participate in care for participants enrolled in the Orange
County Adult Day Health Center as required by the Standards for Certification for Adult
Day Health Services (North Carolina Division of Aging).
RESPONSIBILITIES AND OBLIGATIONS
UNC-CHAPEL HILL SCHOOL OF NURSING
It is agreed that the UNC-CHAPEL HILL SCHOOL OF NURSING shall be
responsible for providing the following:
1. A registered nurse (RN), licensed by the North Carolina Board of Nursing, to
coordinate the delivery of health care services and participate in direct care for
participants enrolled in the Orange County Adult Day Health Center.The RN will fulfill
the nursing responsibilities of the health care coordinator, as outlined in the current North
Carolina Division of Aging's Standards for Certification for Adult Day Health Services.
The RN shall be on-site at the Center mid-day a minimum of four hours each day the
center is open and any additional hours necessary to meet requirements for the provision
of health and personal care services as outlined in the Standards for Certification for
Adult Day Health Services. Orange County Department on Aging Director will approve
additional RN hours according to participant health needs.
2. The nursing responsibilities of health care coordinator, consistent with the
Nursing Practice Act,include but are not limited to:
a) completing preadmission health assessment for initial acceptance into
program, consultation regarding appropriateness of acceptance into
program, and problem-identification and care planning;
b) implementing the health care components of the established service plan
which may include,but are not limited to:
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i. medication administration DRAF
ii. wound care
iii, enteral or parenteral feedings
iv. bowel or bladder training and maintenance programs
v. tracheostomy care and suctioning
vi. delegating appropriate nursing care tasks to qualified unlicensed
personnel;
c) monitoring participant's response to medical treatment plan and nursing
interventions and revising plan of care as necessary;
d) reporting and recording results of the nursing assessment, care rendered,
and participant's response to care, and maintaining integrity of
participant's health care records;
e) collaborating with other health care professionals, staff, caregivers, and
volunteers at the Center regarding provision of participant's health care;
f) educating other staff members to emergency procedures and providing
information to staff and caregivers about health concerns and conditions of
participants;
g) providing first aid treatment as needed.
h) leading activities by team members at the Center for the development of a
holistic approach to participant care
i) providing direct participant health care as needed.
2. Assist with hiring decisions, supervision,and evaluation of certified nursing
assistants or personal care assistants who are employees of the Orange County
Adult Day Health Center in collaboration with the Program Manager.
3. Provide staff education and support through both informal and formal discussions
and seminars.
4. Consult with the Program Manager,Executive Director of Orange County
Department on Aging, and Advisory Board members on health services delivery
(e.g. supplies, documentation,policies, etc.)
5. Liability insurance coverage: The University will assure that the registered nurses
who provide services under this Agreement will obtain and maintain professional self-
insurance liability coverage of up to $1,000,000 per occurrence and$3,000,000 annual
aggregate. Furthermore, the state provides excess liability coverage for State employees
for losses resulting in bodily injury and property damage in the performance of their job.
The limits of liability are $11,000,000 per occurrence.The coverage is subject to policy
terms, conditions, and exclusions, Concerning general liability,the State of North
Carolina claims sovereign immunity and therefore cannot be sued without its permission.
However,by statue (Chapter 143, Article 31), the State has waived its sovereign
immunity against suits for negligence of its employees or agents resulting from bodily
injury or property damage. The State has waived its immunity up to a limit of$500,000
per claim.The North Carolina Industrial Commission has constituted a court for the
purpose of hearing and passing upon tort claims against departments,institutions or
agencies.
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The UNIVERSITY agrees to indemnify and save harmless Orange County and
the Department, their agents and employees from and against any and all loss, cost,
damages, expense and liability caused by the failure of the UNIVERSITY to fully
perform its obligations under this agreement and in accordance with its terms; or by an
accident or other occurrence causing bodily injury, including death, sickness, products or
services rendered under this agreement. The COUNTY will indemnify the UNIVERSITY
to the extent permitted by law and to the extent of insurance policies owned by the
County,for losses,costs, damages, expenses and liability caused by the negligent acts or
omissions of the County in performance of obligations under this agreement.
Performance of the activities described herein will be of benefit to the UNIVERSITY and
will further said UNIVERSITY'S goals of teaching, research, and public service.
ORANGE COUNTY,DEPARTMENT ON AGING
It is agreed that ORANGE COUNTY,DEPARTMENT ON AGING shall be
responsible for providing the following:
1. Examination room space for the Registered Nurse.
2. Basic medical and other supplies necessary for fulfillment of participant
health care services according to the Standards for Certification. All budget
considerations must be approved through normal Adult Day Health Center
protocol.
3. Participant-related,long-distance telephone calls made from the Adult Day
Health Center for participant health care services.
4. General liability insurance and professional liability insurance for all health
care provider employees of ORANGE COUNTY, DEPARTMENT ON
AGING delivering services related to this Agreement.
5. Review and respond to requests for additional RN hours of care if participant
health care needs can not be met with minimum of four hours per day, and
provide written rationale if request is not approved.
6. Incorporate RN recommendations for family involvement in participant care
during hours RN is not working.
7. Reimburses UNIVERSITY for actual hours of RN service per invoices.
AGREEMENTS
The individuals designated by the UNIVERSITY must be acceptable to
ORANGE COUNTY DEPARTMENT ON AGING. In the event mutual agreement
regarding suitable individuals cannot be reached,this Agreement shall terminate. In the
event of such termination, any amounts due shall be pro-rated to the effective date of
termination.
With regard to the services to be performed pursuant to this Agreement by the
UNIVERSITY it is hereby covenanted and greed that ORANGE COUNTY,
DEPARTMENT ON AGING shall not make any use whatsoever of the name of The
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University of North Carolina at Chapel Hill or any of the colleges, schools, or
departments contained therein in any campaign of advertising, or in any other manner
whatsoever, without the express written permission of the UNIVERSITY, which
permission shall not be unreasonably withheld, unless compelled to divulge said name by
force of law. It is also agreed that ORANGE COUNTY,DEPARTMENT ON AGING
shall not attempt to circumvent the intent of this paragraph by the use of descriptive
phrases by which one could identify said UNIVERSITY with reasonable certainty.
COMPENSATION
For the services required by this Agreement, ORANGE COUNTY,
DEPARTMENT ON AGING agrees to pay the UNIVERSITY an hourly rate of$32 per
hour for all services rendered. The UNIVERSITY will invoice ORANGE COUNTY,
DEPARTMENT ON AGING monthly for services rendered during the previous month
and each invoice will be payable within 30 days of the date of ORANGE COUNTY,
DEPARTMENT ON AGING's receipt of such invoice. No other charges or payments are
inclusive of this agreement. Payments shall be payable to THE UNIVERSITY OF
NORTH CAROLINA AT CHAPEL HILL and mailed to:
Brad Volk
Assistant Dean
Office of Administrative Services
School of Nursing
CB#7640,Room 108
University of North Carolina at Chapel Hill
Chapel Hill,NC 27599-7460
CANCELLATION
The terms of this Agreement may be altered, amended or modified only by an
agreement in writing executed by the duly authorized officials of both parties. None of
the work to be performed under this Agreement, which involves the specialized skills or
expertise of the UNIVERSITY, shall be subcontracted.
The term of this Agreement shall be from September 1, 2002 -June 30, 2003 and
shall be renewable for one additional year thereafter with 60-day written notice and
mutual consent by all parties. Either party may terminate this contract upon 60 days prior
written notice to the other party without cause. Upon termination, all participant health
care records and any proprietary information belong to the ORANGE COUNTY,
DEPARTMENT ON AGING shall be delivered to the ORANGE COUNTY ADULT
DAY HEALTH CENTER within 30 days of the effective date of termination. Ally
payment due to the UNIVERSITY for services delivered prior to termination shall be
paid within 30 days of ORANGE COUNTY,DEPARTMENT ON AGING's receipt of a
written invoice for such services.
In agreement with the terms and conditions of this document, we have affixed our
signatures as indicated below:
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FOR AND ON BEHALF OF THE FOR AND BEHALF OF
UNIVERSITY OF NORTH CAROLINA ORANGE COUNTY,
AT CHAPEL HILT. DEPARTMENT ON
AGING
Nancy D. Suttenfield Barry Jacobs
Vice-Chancellor for Chair, Orange County
Finance and Administration Board of Commissioners
Date Date
Linda Cronenwett,PhD, RN,FAAN
Professor and Dean
Date