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DocuSign Envelope ID:2D2D4024-9587-4AD4-BF9B-91 E3244EA302 <br /> Orange County Health Department (hereinafter referred 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 fntexpreter Translator Contract of'$15,000 or less. The additional <br /> terms and conditions shall supersede any terms in the original contract and are 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.org 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, Title 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 /> Department front desk staff or the Spanish voicemail line at 644-3350 <br /> (when language appropriate) to schedule an appointment or to inquixe <br /> about services. <br /> Add Section 2 e. <br /> e Medical Documentation Prior to beginning work,the Provider is required to: <br /> i. Provide proof of immunity to varieella, 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 ISI (Note: If the Provider has not <br /> had an additional I S I within the pi evious 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 IB Screening Form by a medical provider if the <br /> Provider has a history of TB disease or of having a positive TST. <br /> 6 <br /> Revised 06115 <br />