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06-07 AGREEMENT Between UNC School of Medicine <br />And Orange County Health Department <br />Page 3 of 9 <br />communicable disease control (GEN), adult health preventive services <br />(AH/HP), and Primary Care (PC). The Clinical Services provided by the <br />Department shall include the following: <br />a. Collaboration with OCHD to develop and approve protocols for <br />Outpatient Clinics. For the mutual benefit of the Department, OCHD, <br />and its prenatal patients, prenatal patients will be managed according <br />to OCHD established protocols. These protocols will be reviewed <br />annually and be consistent with protocols used at UNC Department of <br />OB/GYN and Family Medicine outlying clinics. <br />b. Primary medical supervision of the nurse practitioners who are <br />employees of OCHD to include ongoing monitoring and evaluation of <br />the medical acts performed by the nurse practitioners; Regular <br />individual meetings with the nurse practitioners will occur according to <br />an agreed upon schedule to review records of high-risk or problematic <br />patients; documentation will be recorded in the patient record <br />indicating that a review occurred and noting any recommended <br />changes in the plan of care. <br />c. Co-signing charts of patients seen by new nurse practitioners of OCHD <br />within five (5) working days for at least the first six months of their nurse <br />practitioner practice, and face-to-face consultation on a weekly basis <br />for the first month of their nurse practitioner practice and at least <br />monthly thereafter for the succeeding five months; <br />d. A review of all OCHD prenatal records at 16, 28 and 36 weeks to assure <br />that appropriate medical care is being provided, with a Maternity <br />Chart Review form completed at each interval. <br />e. Weekly group meetings with clinical staff in each site according to an <br />agreed upon schedule to discuss patient care and clinical operation <br />issues. <br />Overall responsibility for medical Residents and medical students <br />working in clinics including orientation, supervision of practice and <br />assurance of compliance with OCHD program and documentation <br />requirements. <br />g. Provision of routine medical services during scheduled on-site times at <br />OCHD Outpatient Clinics, including documentation of Clinical Services <br />provided per established OCHD protocols; <br />h. Medical consultation visits to OCHD patients during on-site scheduled <br />times at Outpatient Clinics; medical consultation to OCHD nurse <br />L:\CONTRACTS\06-07 Contract Drafts\UNC Family Medicine -Medical Director 2006-07.doc <br />