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DocuSign Envelope ID: CE675105-630E-49DD-B392-DE8C1 F83FA54 <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 Interpreter 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.ncilic.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 inquire <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 varicella, 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 /> i <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 TB skin test (TST) if the Provider has no history of TB <br /> infection/disease or of a positive TST(Note: If the Provider has not <br /> had an additional TST within the previous 12 months, a second TST <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 TST. <br /> 6 <br /> Revised 06/16 <br />