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DocuSign Envelope ID:5B6FF7D8-5B74-4BD3-BC2C-DDBAEB3C9E82 <br /> Orange County Health Department (hereinafter-r-eferred to as "OCHD") <br /> Additional Terms and Conditions <br /> These are additional terms and conditions to the Agreement between Orange County and the <br /> (PROVIDER) to the Countywide Interpreter Translator Contract of$15,000 or less The additional <br /> terms and conditions shall supersede any terms in the original contract and ate hereby incorporated <br /> as follows: <br /> Add to Section 2. b <br /> v. The Provider will follow the National Code of Ethics and Standards of <br /> Practice outlined by the National Council on Interpreting in Health <br /> Care which can be found at www.ncihc.or a and is hereby incorporated <br /> by reference <br /> vi. the Provider is required to sign the OCHD Conditions of Contract <br /> Statement containing the confidentiality, Iitle X and public health <br /> activities in emergency situations information which is hereby <br /> incorporated by reference. <br /> Add to Section 2 d.i.3 the following sentence: <br /> The Provider should generally instruct clients to call the Health <br /> Depattment front desk staff or the Spanish voicemail line at 644-3350 <br /> (when language appropriate) to schedule an appointment or to inquire <br /> about services <br /> Add Section 2.e. <br /> c Medical Documentation. Prior to beginning work,the Provider is required to: <br /> i Provide proof'of immunity to vaticella, measles,mumps and rubella Proof <br /> of immunity must be one of the following: medical records diagnosing the <br /> disease, laboratory records confirming the disease, laboratory records <br /> documenting positive disease titers, or medical records documenting receipt <br /> of 2 doses of each vaccine (Exception: If the Provider has documentation <br /> of only one dose of vaccine, the Provider must provide documentation of a <br /> second dose within 60 days of'the first day of contract work) <br /> ii Provide proof'of a TB screening and results to OCHD The screening can <br /> be one of the following: <br /> 1. Receipt of a I skin test (IS 1) if the Provider has no history of TB <br /> infection/disease or of a positive IS (Note: If the Provider has not <br /> had an additional I S I within the previous 12 months, a second I S I <br /> will be required one week after the first to establish an accurate <br /> baseline.) <br /> 2 Completion of a TB Screening Form by a medical provider if the <br /> Provider has a history of TB disease or of having a positive TSI. <br /> 6 <br /> Revised 06115 <br />