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DocuSign Envelope ID:0806BD7C-9E5B-4DB8-9CC2-8583BB1 EA400 <br /> MEDICAID TRANSPORTATION <br /> MEMORANDUM OF UNDERSTANDING <br /> This Memorandum of Understanding is entered into this Ol day of S%.1u , 2015, <br /> by and between the Orange County Department of Social Services and Od O am and Public <br /> Transportation(referred to collectively as the "Parties"). <br /> WHEREAS, Orange Public Transportation (hereinafter referred to as "OPT") and the <br /> Orange County Department of Social Services (hereinafter referred to as `'OCDSS") are <br /> departments or agencies of Orange County, North Carolina and are ineligible to enter into <br /> binding contractual relationship with one another; and <br /> WHEREAS, the parties desire to enter into this Memorandum of Understanding in order <br /> to establish the mutually agreed upon conditions upon which OPT will provide certain services <br /> for OCDSS in connection with the Orange County Department of Social Services Medicaid <br /> Program; and <br /> WHEREAS, the OCDSS is mandated to provide transportation to Medicaid covered <br /> services when a client does not have access to personal transportation; and <br /> WHEREAS, OPT is a coordinated transit system run by Orange County Government in <br /> Orange County,North Carolina. <br /> NOW, THEREFORE, the parties to this Memorandum hereby agree as follows: <br /> 1. OPT will provide transportation services to and from medically necessary appointments <br /> to Medicaid clients at the request of OCDSS. <br /> 2. OCDSS will reimburse OPT for services provided under this Memorandum at a rate of <br /> $12.75 per one-way trip. OCDSS will not reimburse OPT for no-shows. <br /> 3. OPT agrees that continuation of and/or renewal of this Memorandum is contingent on <br /> meeting the following requirements. OPT agrees to: <br /> A. Provide services to enrolled participants within three days of a request. <br /> B. Provide critical services on short notice when requested. <br /> C. Provide back-up drivers in case the assigned driver is not available. <br /> D. Coordinate maintenance with private vendors to ensure vehicles are in safe operating <br /> order. <br /> E. Review the Transportation Database to ensure client eligibility and verify client <br /> information. <br /> F. Discuss the specific situation, and present evidence of cause, with the Department of <br /> Social Services staff prior to termination of services for any client. <br /> G. Complete the DMA 5124 as part of the annual contract process. <br /> 4. OCDSS will reimburse OPT for services described in this Memorandum. For <br /> reimbursement, OPT must submit an original and two copies of an invoice by the fifth of <br /> the month for the preceding month's expenditures to the designated OCDSS <br /> Contract Rev.(06115) 1 <br />