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HomeMy WebLinkAbout2008-062 Health Dept - Ginger Mann Dental Preschool Screening STATE OF NORTH CAROLINA COUNTY OF ORANGE 7 ~ AGREEMENT BETWEEN ORANGE COUNTY HEALTH DEPARTMENT AND Ginger Mann (Name of Provider) This Agreement is made effective as of the lstday of July, 2008 by and between Orange County, North Carolina for and on behalf of the Orange County Health Department, hereinafter collectively referred to as "OCHD" and the above named service provider, hereinafter referred to as the "Provider". W I T N E S S E T H: WHEREAS, OCHD desires to contract with the Provider for professional services; in its Dental Preschool Screening Program, and WHEREAS, The Provider desires to provide those services; NOW, THEREFORE, in consideration of the premises and of the following mutual promises, covenants and conditions, OCHD and the Provider agree as follows: 1. The Provider will act as the "Give Kids A Smile/Adopt A Child Care Campaign" (hereafter "Campaign") Coordinator, which includes the following: - Act as a point of contact for Orange County dentists interested in participating in the Campaign. - Agrees to meet regularly with OCPYC staff and Orange County Health Department Dental Services Director regarding the development of the Campaign effort. - Coordinate site screenings between child care providers and private dentists. - Provide any training/consultation requested by private dentists prior to Campaign dental screenings scheduled for January 2009 through February 2009. - Coordinate with Orange County Health Department Dental Services Director regarding acquisition of dental screening materials. - Coordinate distribution of dental screening materials with Orange County Health Department Dental Services Director. - Coordinate and implement referral follow-up on children identified for dental treatment with Orange County Health Department Dental Services Director by June 30, 2009. - Coordinate with OCPYC staff and Orange County Health Department Dental Services Director a follow-up with participating dentists to evaluate the Campaign. - Submit a report of Campaign activities to Orange County Health Department Dental Services Director for inclusion in the year-end project evaluation report by June 30, 2009. -Invoice the OCHD for Campaign services on a regular basis. S:Uvlanagers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann contract 08-09 v.3.doc11/18/200812:23 PM Page 1 of 4 2. The Provider will act as the ~~Smart Start Dental Screening, Education and Referral Project" (hereafter ~~Project") coordinator which includes the following: - Coordinate site screenings between child care providers and dental student teams. - Contacts directors of child care facilities to schedule dental screening. - Mail out to the directors project information and confirmation of the Project. - Conducts calibration to dental student teams. - Evaluates and makes changes to all dental forms used in the Project. - Coordinate and implement referral follow-up on children identified for dental treatment to include (mailing letters to parents and telephone calls) . - Data entries all dental screening forms and information. - Submit a report of Project activities to Orange County Health Department Dental Services Director for inclusion in the year-end project evaluation report by June 30, 2009. - Assist Orange County Health Department Dental Health Service Director in writing of Orange County Partnership for Young Children grant proposal. - Conducts the report out session of the dental student teams. - Assist with developing a transition plan when new Dental Hygienist/Community Dental Care Coordinator position is filled. 3. The Provider will act as the Information Technology Consultant for the Campaign and the Project providing the following: - Selection of appropriate computer equipment and software to accommodate the Campaign and Project data. - Design the software program for the Campaign and Project. - Analyze the data. - Provide computer-programming support for the dental teams during the Campaign and Projects. - Produce the necessary reports from the data to create reports and year-end evaluation reports. - Develop a tracking system to track the children annually. 4. OCHD shall remunerate the Provider in the amount of $14,500.00 for the Smart Start Dental grant period from the 1st day of July 2008, to the 30 day of June 2009. The Provider will submit to OCHD a bill for services rendered by the 1st day of February 2009 for $7,000 and the 1st day of June 2009 for $7,500. OCHD will thereafter submit a request for payment to the Orange County Finance Department. OCHD shall prepare and remit by mail payment to Provider based on the Finance Department's schedule. 5. The Provider hereby agrees to furnish services without regard to race, color, creed, sex or national origin. The Provider hereby agrees to abide by pertinent Rules and Regulations of OCHD, Orange County, and the North Carolina Division of Health Services in the conduct of services. Act as a point of contact for Orange County dentists interested in participating in this Campaign and Project. 6. This Agreement covers childcare centers and homes in Orange County. S:\Managers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann contract 08-09 v.3.doc11/18/200812:23 PM Page 2 of 4 7. This Agreement shall run for a period of one year from the 1st day of July 2008 to the 30th day of June 2009 and shall be renewable upon written notice executed by both parties. Exact days to work shall be prearranged by OCHD and Provider. 8. In connection with Provider's activities as Coordinator of the Campaign and Project, Provider agrees to abide by all applicable federal, state and loca- confidentiality and privacy laws, policies and procedures. Provider will not divulge confidential information to unauthorized persons. Provider understands that if Provider wrongfully discloses such information, Provider may be subject to disciplinary action. Provider further understands that Provider may be liable and subject to litigation for money awards for damages. Provider understands that if Provider should have any questions regarding OCHD's confidentiality policies and procedures, Provider will seek clarification from OHCD Health Director. Provider agrees to abide by and hereby enters into the OCHD's standard Health Insurance Portability and Accountability Act of 1996 (HIPAA) Business Associate Agreement, which is attached hereto and incorporated herein by reference. 9. Independent Contractor. The Provider shall perform all work and services described herein as an independent contractor and not as an officer, agent, servant or employee of Orange County or the OCHD. Provider shall have exclusive control of and the exclusive right to control the details of the services and work performed herewith and all persons performing the same and working herein shall be construed as creating a partnership or joint venture between Orange County or the OCHD and Provider. Provider shall not be considered an officer, agent, servant or employee of Orange County or OCHD, nor shall Provider be entitled to any benefits available or granted to employees of Orange County or OCHD. 10. This Agreement or its renewals may be terminated at any time without Penalty by either party provided that notice of such termination is furnished to the other party in time to properly arrange for professional coverage. 11. 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. 12. The laws of North Carolina shall govern the validity and interpretations of the provisions, terms and conditions of the Agreement. 13. Provider shall obtain, at her sole expense, worker's compensation insurance (to the extent the same is required by North Carolina law) and auto liability insurance in the amounts required by the County's Risk Manager. Such insurance shall name the County as Additional Insured under the Auto Liability policy. -Certificates of insurance shall be provided to the County's Risk Manager prior to Provider performing services under this Agreement. 14. 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 misconduct of the Provider, except to the extent same are caused by the negligence or S:\Managers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann contract 08-09 v.3.docl 1/18/200812:23 PM Page 3 of 4 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 law. In WITNESS WHEREOF, the parties have hereunto signed this Agreement in their official capacities on the day and year listed below. Signature Page: Agreement with Ginger Mann 2008-2009 FOR AND ON BEHALF OF ORANGE CO TY HEALTH DEPARTMENT osemary L. umm rs, Health Director DATE : ~ ~ g FOR AND ON BEHALF OF ORANGE COUNTY ~ / Barry Jacob ,~ air Orange Co ty o is loners Date : /,~(,./~/6~ ORANGE COUNTY FINANCE DIRECTOR "This instrument has been preaudited in the manner required by the Local Government Budget and fiscal Control Act." //,'~ I Finarrd~Director DATE: /I -~l9 "Up FOR AND ON BEHALF OF PROVIDER Ginger ann ~) Date: ~~ ~ ~a S:\Managers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann contract 08-09 v.3.doc11/18/200812:23 PM Page 4 of 4 BUSINESS ASSOCIATE AGREEMENT This Agreement is made effective the 1st of July, 2008, by and between Orange County, hereinafter referred to as "Covered Entity", and Ginger Mann, hereinafter referred to as "Business Associate," (individually, a "Party" and collectively, the "Parties"). WITNESSETH: WHEREAS, Sections 261 through 264 of the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, known as "the Administrative Simplification provisions," direct the Department of Health and Human Services to develop standards to protect the security, confidentiality and integrity of health information; and WHEREAS, pursuant to the Administrative Simplification provisions, the Secretary of Health and Human Services has issued regulations modifying 45 CFR Parts 160 and 164 (the "HIPAA Security and Privacy Rule"); and WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business Associate will provide certain services to Covered Entity, and, pursuant to such arrangement, Business Associate may be considered a "business associate" of Covered Entity as defined in the HIPAA Security and Privacy Rufe (the agreement evidencing such arrangement is entitled Agreement for Services for the "Give Kids aSmile/Adopt a Child Care Campaign" ,dated July 1, 2005, and is hereby referred to as the "Arrangement Agreement"); and WHEREAS, Business Associate may have access to Protected Health Information (as defined below) in fulfilling its responsibilities under such arrangement; THEREFORE, in consideration of the Parties' continuing obligations under the Arrangement Agreement, the Parties agree to the provisions of this Agreement in order to address the requirements of the HIPAA Security and Privacy Rule and to protect the interests of both Parties. DEFINITIONS Except as otherwise defined herein, terms used in this Agreement shall have the same meaning as those terms set forth in the HIPAA Security and Privacy Rule. CONFIDENTIALITY REQUIREMENTS (a) Business Associate shall: (i) use or disclose any protected health information solely as permitted or required by this Agreement, the Arrangement Agreement (if consistent with this Agreement and the HIPAA Security and Privacy Rule), or as required by law. (ii) ensure that its agents, including a subcontractor, to whom it provides protected health information received from or created by Business Associate on behalf of Covered Entity, agrees to the same restrictions and conditions that apply to Business Associate with respect to such information. In addition, Business Associate agrees to take reasonable steps to ensure that its employees' actions or omissions do not cause Business Associate to breach the terms of this Agreement; S:\Managers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann BUSINESS ASSOCIATE AGREEMENT 08-09.doc11/18/200812:24 PM1 (iii) implement appropriate safeguards to prevent use or disclosure of protected health information other than as permitted or required by this Agreement; (iv) permit the Secretary of Health and Human Services to audit Business Associate's records and practices related to use and disclosure of protected health information to ensure Covered Entity's compliance with the terms of the HIPAA Security and Privacy Rule; (v) report to Covered Entity any use or disclosure of protected health information which is not in compliance with the terms of this Agreement of which it becomes aware; (vi) report to Covered Entity any Security Incident of which it becomes aware. For purposes of this Agreement, "Security Incident" means the attempted or successful unauthorized access, use disclosure, modification, or destruction of information or interference with system operations in an information system; and (vii) mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of protected health information by Business Associate in violation of the requirements of this Agreement. (b) Notwithstanding the prohibitions set forth in this Agreement or the Arrangement Agreement, Business Associate may use and disclose protected health information as follows: (i) if necessary, for the proper management and administration of Business Associate or to carry out the legal responsibilities of Business Associate, provided that as to any such disclosure, the following requirements are met: (A) the disclosure is required by law; or (B) Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will be held confidentially and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached; (ii) for data aggregation services, if such services are to be provided by Business Associate for the health care operations of Covered Entity pursuant to any agreements between the Parties evidencing their business relationship. III. AVAILABILITY OF PROTECTED HEALTH INFORMATION Business Associate shall: (a) at the request of Covered Entity, provide access to protected health information in a designated record set to Covered Entity or, as directed by Covered Entity, to an individual, in a time and manner sufficient to permit Covered Entity to comply with the requirements of 45 CFR 164.524. (b) at the request of Covered Entity or an individual, make any amendment(s) to protected health information in a designated record set that are directed by or agreed to by Covered Entity, in a time and manner sufficient to permit Covered Entity to comply with the requirements of 45 CFR 164.526. (c) document disclosures of protected health information and information related to such disclosures in a manner sufficient to permit Covered Entity to respond to a request by an individual for an accounting of disclosures of protected health information in accordance with 45 CFR 164.528 and provide such documentation to Covered Entity or an individual as directed by Covered Entity. S:\Managers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann BUSINESS ASSOCIATE AGREEMENT 08-09.doc11/18/200812:24 PM2 IV. TERMINATION (a) Term: This Agreement terminates when the Arrangement Agreement terminates or as provided in Paragraph IV.b. below (termination for cause). (b) Termination for cause: Upon Covered Entity's knowledge of a material breach by Business Associate, Covered Entity shall either: (i) provide an opportunity for Business Associate to cure the breach or end the violation or, if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity, terminate this Agreement and the Arrangement Agreement; or (ii) immediately terminate this Agreement and the Arrangement Agreement if Business Associate has breached a material term of this Agreement and cure is not possible. (c) Return or destruction of protected health information: At termination of this Agreement, the Arrangement Agreement (or any similar documentation of the business relationship of the Parties), or upon request of Covered Entity, whichever occurs first, Business Associate shall: (i) if feasible, return or destroy all protected health information received from or created or received by Business Associate on behalf of Covered Entity that Business Associate still maintains in any form. Business Associate shall only destroy protected health information with the written approval of Covered Entity. After return or destruction, Business Associate shall retain no copies of such information. (ii) if return or destruction is not feasible, Business Associate will provide Covered Entity with documentation explaining the reason that it is not feasible. If the protected health information is not returned or destroyed, Business Associate will extend the protections of this Agreement to the information and limit further uses and disclosures to those purposes that make the return or destruction of the information not feasible. (d) Survival: The obligations of Business Associate under this Agreement shall survive the expiration, termination, or cancellation of this Agreement, the Arrangement Agreement and/or the business relationship of the parties, and shall continue to bind Business Associate, its agents, employees, contractors, successors, and assigns as set forth herein. V. MISCELLANEOUS (a) All protected health information that is created or received by Covered Entity and disclosed or made available in any form, including paper record, oral communication, audio recording, and electronic display by Covered Entity or its operating units to Business Associate or is created or received by Business Associate on Covered Entity's behalf shall be subject to this Agreement. (b) A reference in this Agreement to a section in the HIPAA Security and Privacy Rule means the section as in effect or as amended. (c) In the event of an inconsistency between the provisions of this Agreement (including definitions) and mandatory provisions of the HIPAA Security and Privacy Rute, as amended, the HIPAA Security and Privacy Rule shall control. Where provisions of this Agreement are different than those S:\Managers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann BUSINESS ASSOCIATE AGREEMENT 08-09.doc11/18/200812:24 PM3 mandated in the HIPAA Security and Privacy Rule, but are nonetheless permitted by the HIPAA Security and Privacy Rule, the provisions of this Agreement shall control. (d) Except as expressly stated herein or the HIPAA Security and Privacy Rule, the parties to this Agreement do not intend to create any rights in any third parties. (e) This Agreement may be amended or modified only in a writing signed by the Parties. No Party may assign its respective rights and obligations under this Agreement without the prior written consent of the other Party. None of the provisions of this Agreement are intended to create, nor will they be deemed to create any relationship between the Parties other than that of independent parties contracting with each other solely for the purposes of effecting the provisions of this Agreement and any other agreements between the Parties evidencing their business relationship. (f) This Agreement will be governed by the laws of the State of North Carolina. (g) No change, waiver or discharge of any liability or obligation hereunder on any one or more occasions shall be deemed a waiver of performance of any continuing or other obligation, or shall prohibit enforcement of any obligation, on any other occasion. (h) The parties agree that, in the event that any documentation of the arrangement pursuant to which Business Associate provides services to Covered Entity contains provisions relating to the use or disclosure of protected health information that are more restrictive than the provisions of this Agreement, the provisions of the more restrictive documentation will control. (i) In the event that any provision of this Agreement is held by a court of competent jurisdiction to be invalid or unenforceable, the remainder of the provisions of this Agreement will remain in full force and effect. (j) The headings in this Agreement are for convenience of reference only and shall not define or limit any of the terms or provisions hereof. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written above. COVERED ENTITY: By: ~ ~~ Title: BUSINESS ASSOCIATE: By: Title: S:\Managers Working Files\Contracts\DENTAL\Smart Start Dental Sub-Contracts\Ginger Mann BUSINESS ASSOCIATE AGREEMENT 08-09.doc11/18/200812:24 PM4