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Home My WebLink AboutHome Health Service Contract - Clallam County e " \ I A- Y- 7 J HOME HEALTH SERVICE CONTRACT WHEREAS, on June 1, 1978 the Clallam County Health Department received on behalf of Clallam and Jefferson Counties a grant from the Public Health Service to develop certified Home Health Services in Clallam and Jefferson Counties, to expand the number of staff available to provide Home Health Services, to extend Home Health Services to outlying areas, and to develop the protocols for billing and reporting requirements necessary to meet Medicare and Medicaid requirements; and, WHEREAS, it is necessary to reach an agreement between Clallam and Jefferson Counties on the administration and distribution of services to be provided under the grant from the Public Health Service; It is therefore mutually agreed that: A. The Home Health Service sponsored by the Clallam County Health Department shall: 1. Become certified under the rules of Medicare and Medicaid. 2. Through the assistance of the Public Health Service grant a. Employ a fiscal consultant to advise on and develop all proper and necessary billing practices and procedures to ensure adequate reimbursement for provision of Home Health Services, and, b. Employ an RN Coordinator to develop all necessary Home Health Service policies and procedures and train and supervise the Jefferson County Home Health Service in regard to their use. c. Employ on' a part-time basis an administrator to handle the reporting requirements of the Public Health Service grant, and to oversee other administrative aspects of developing certified Home Health Services in both counties. 3. Provide all appropriate inservice training for nurses and office staff in Jefferson County who will be working with the certified Home Health effort. Specific arrangements for training will be made in conjunction with the Jefferson County Director of Nursing. -1- VOL 4 FAGE 4 4. Provide all billing for certified visits made in Jefferson County upon timely receipt of completed nurses' records. 5. Reimburse Jefferson County for costs associated with certifiable visits made by Jefferson County staff based upon an aggregate unit rate determined in accordance with the fisc 1 computation attached. This rate for the period beginning , 1978 shall be $27.34/visit. Thereafter it will be reviewed quarterly to evaluate its accuracy and adjusted upon written approval of both contracting parties. Reimbursement shall be made to Jefferson County only for visits which Clallam County receives payment from Medicare or Medicaid. Reimbursement shall be made on or before the twentieth day of the month following the month in which the Clallam County Health Department receives payment for those Jefferson County visits. 6. Maintain the original copy of all Jefferson County patient records. B. The Jefferson County Health Department shall: 1. Allow the Clallam County Health Department to exercise certain types of professional control over the arranged services. Specifically: a. The Clallam County Health Officer shall hold ultimate professional responsibility for quality of patient care, for annual review of patient records, and for questionof utilization; and b. The Clallam County Health Department quality controls, professional qualifications and experience levels shall be applied to employees of the Jefferson County Health Department staff working in Home Health Services; c. The Clallam County Health Department admission policies shall be applied by employees of the Jefferson County Health Department in accepting patients for Home Health Services; 2. Maintain a duplicate copy of all Jefferson County patient records. Such records must include diagnosis, medical history, physicians' orders and progress notes relating to all Home .Health services received. -2- VOL 4 FACE 5 3. Maintain liaison with the attending physician with regard to the .progress of the patient to assure that the required plan of treatment is periodically reviewed by the attending physician and to secure from the attending physician the required certification and re-certifications. 4. Adopt the policies, procedures and record forms of the Clallam County Health Department pertaining to Home Health Service. 5. Provide skilled staff for the provision of Home Health Services as defined in the policies of the certified agency, the Clallam County Health Department. 6. Provide transcriber-clerical staff to properly type and prepare reports and patient records. 7. Not charge beneficiaries of Home Health Services for Medicare or Medicaid covered services and items and shall return any money incorrectly collected. 8. Comply with Title VI of the Civil Rights Act. C. Jefferson County will hold the Clallam County Health Department harmless for any negligent actions on the part of its staff in the performance of their duties. In cases of disagreement, where the RN Coordinator disagrees with the Jefferson County Director of Nurses over a substantive issue of patient care like timeliness or adequacy of record keeping, or over an issue of appropriateness of care, where necessary, such disagreements should be forwarded to the administrator of the Clallam County Health Department. It will be this administrator's responsibility to contact the administrator of the Jefferson County Health Department to try to arbitrate the disagreement. Should these measures fail to resolve the difference, the issues will be set out in writing and presented to the Health Officers of the respective parties. Should the Health Officers be unable to resolve the difference, any party may terminate the agreement if it so desires under the provisions of paragraph F below. Until resolution of the disagreement or termination of this agreement, the decision of the Clallam County Health Department shall be controlling. i VOL 4 FACE 8 D. This agreement may only be amended by written consent of both parties attached to and made a part of the original or duplicate copies of the original. E. Upon a breach of any of the above conditions of this contract, written notice must be given by the non-breaching party to the other. If the condition or event causing a breach is not cured within thirty (30) days of the date of the written notice of the breach, then this agreement shall be null and void and all rights hereunder shall be terminated. F. This agreement shall continue and be binding upon both parties until terminated upon ninety (90) days' written notice by either party. Dated this / ' day of ze..."is /c`/ , 1978. JEFFERSON COUNTY CLALLAM COUNTY by JEFFERSON COUNTY COMMISSIONERS by CLALLAM COUNTY COMMISSIONERS 19, * u A. . O'Meara Howard V. Doherty, Jr. Carroll Mercer Dick Lotzg 111 B. G. Brown Ronald N. ichards Attest Approved as to form and legality Be G. Stone Pro cuting Attorney Clerk of the Board -4- VOL 4 FAH 7 OCT. 17/78 COMPUTATION OF JEFFERSON COUNTY HEALTH DEPARTMENT COSTS TO PROVIDE HOME HEALTH CARE BY CONTRACT WITH CLALLAM COUNTY HEALTH DEPARTMENT DIRECT COSTS Salary & Fringes FTE Home Health 12 Months Level Direct Costs Salaries Phyllis Bee - R.N. Supvr. $ 22,409 .5 11,205 Nurse - Field R N 16,185 .85 13,757 Aide - Field 9,886 .2 19,773 Clerical - Office 9,886.5 .75 7,415 Transportation Nurse & Aide Transportation 6,930 .47 3,257 Equipment 3,000 3,000 $ 58,407 INDIRECT COSTS (COSTS DERIVED AS A % OF TOTAL JEFFERSON COUNTY H.DEPT. OPERATIONS) Rental 4,745 Repair & Maintenance 600 Health Officer 5,000 State Examiner 500 Administration 3,000 Insurance 4,000 Communication 2,133 Advertising 500 Printing 700 $ 21,178 X 34% = $7,200 ADD DIRECT & INDIRECT COSTS Direct Total 58,407 Indirect Total 7,200 $ 65,607 AGGREGATE COST/VISIT Total II of visits 2,400 Total Costs 65,607 Aggregate cost/visit $ 27.34 JEFFERSON COUNTY AIDE COST PER VISIT Overhead = 10,200 2,400 = $4.25/visit Super.&Clerical = 18,619 t 2,400 = 7.75/visit Aide Salaries (2) = 19,773 1,680 = 11.76/visit Aide transportation = 3,257 t 2.85 x 2 i 1,680 = $1.36/visit Total Aide Cost per Visit = $25.12 JEFFERSON COUNTY R.N. COST PER VISIT Overhead = 10,200 t 2,400 = $ 4.25/visit Super. & Clerical 18,619 2,400 = 7.75/visit R.N. Salaries (.85) = 13,757 t 720 = 19.10/visit R.N. Transportation 3,257 j 2.85 x .85 i- 720 = $1.34 per visit Total R.N. Cost Per Visit = $ 32.44 4 VOL FAGE