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STATE OF NORTH CAROLINA <br />COUNTY OF ORANGE <br />UNCH #92 <br />AGREEMENT BETWEEN THE UNIVERSITY OF NORTH CAROLINA HOSPITALS <br />AND ORANGE COUNTY, NORTH CAROLINA <br />THIS AGREEMENT, made and entered into this the 1st day of July, 2012 by and <br />between Orange County ( "County ") by and through the Orange County Department of Social <br />Services ( "OCDSS ") and The University of North Carolina Hospitals, ( "UNCH ") in Orange <br />County, North Carolina. <br />WITNESSETH: <br />WHEREAS, the parties have agreed with each other that the County will provide certain <br />services for The University of North Carolina Hospitals in connection with the Orange County <br />Department of Social Services (hereinafter referred to as OCDSS), Medicaid Program; and <br />WHEREAS, the UNCH has agreed to pay certain compensation for said service and the <br />parties desire to execute this contract to delineate their understanding of this agreement; <br />NOW, THEREFORE, the parties hereby agree as follows: <br />1. Term. The term of this Agreement shall be from July 1, 2012 to June 30, 2013. <br />2. The County agrees to the following: <br />a. Scope of Services: The County agrees to provide UNCH the services of one full <br />time Income Maintenance Caseworker and one part -time supervisor providing up <br />to 10 hours of supervision a week. <br />i. The Income Maintenance Caseworker shall receive all potential medical <br />assistance applications originating at UNCH. Specifically, the Income <br />Maintenance Caseworker shall perform intake and processing functions <br />on MPW and MIC applications for Orange County and intake functions <br />only for all other applications, consisting of the following: conducting <br />interviews that initiate an application; obtaining signatures; obtaining <br />documentation available at the time of interview; forwarding applications <br />to the appropriate county for processing; meeting verification <br />requirements, processing and data entry timeframes, and sending <br />appropriate notices timely in all processing functions. <br />ii. The Income Maintenance Caseworker shall be assisted by UNCH staff in <br />obtaining information and documentation required to complete the <br />application process. <br />iii. The Income Maintenance Caseworker shall work cooperatively with <br />UNCH staff and the staff of any Department of Social Services to make <br />appropriate referrals of patients and family members with problems not <br />related to eligibility determination. <br />