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N 4 --iS-.so , <br /> —Please return this copy to y/ <br /> Clerk to the Board's office for PAF <br /> STATE OF NORTH CAROLINA UNCH#92 <br /> COUNTY OF ORANGE <br /> AGREEMENT BETWEEN <br /> THE UNIVERSITY OF NORTH CAROLINA HOSPITALS <br /> AND <br /> ORANGE COUNTY,NORTH CAROLINA <br /> THIS AGREEMENT, made and entered into this the 1 st day of July, 2010 by and <br /> between Orange County ("County") by and through the Orange County Department of <br /> Social Services ("OCDSS") and The University of North Carolina Hospitals, ("UNCH") <br /> in Orange County,North Carolina. <br /> WITNESSETH: <br /> WHEREAS, the parties have agreed with each other that the County will provide <br /> certain services for The University of North Carolina Jlospitals in connection with the <br /> Orange County Department of Social Services (hereinafter referred to as OCDSS), <br /> Medicaid Program; and <br /> WHEREAS, the UNCH has agreed to pay certain compensation for said service <br /> and the parties desire to execute this contract to delineate their understanding of this <br /> agreement; <br /> NOW, THEREFORE, the parties hereby agree as follows: <br /> 1. Term. The term of this Agreement shall be from July 1, 2010 to June 30, 2011. <br /> 2. The County agrees to the following: <br /> a. Scope of Services: The County agrees to provide UNCH the services of <br /> one full time Income Maintenance Caseworker and one part-time <br /> supervisor providing up to 15 hours of supervision a week. <br /> i. The Income Maintenance Caseworker shall receive all potential <br /> medical assistance applications originating at UNCH. Specifically, <br /> the Income Maintenance Caseworker shall perform intake and <br /> processing functions on MPW and MIC applications for Orange <br /> County and intake functions only for all other applications, <br /> consisting of the following: conducting interviews that initiate an <br /> application; obtaining signatures; obtaining documentation <br /> available at the time of interview; forwarding applications to the <br /> appropriate county for processing; meeting verification <br /> requirements, processing and data entry timeframes, and sending <br /> appropriate notices timely in all processing functions. <br />