Orange County NC Website
DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276 <br /> Exhibit A <br /> Cost Sharing Agreement for QuitlineNC Comprehensive Services <br /> Introduction <br /> The North Carolina tobacco and Prevention and Control Branch (TPCB") of the North Carolina Division of <br /> Public Health in the North Carolina Department of Health and Human Services ("DHHS") works with diverse <br /> communities to reduce tobacco disease, death and health care costs. The North Carolina Tobacco-Use <br /> Quitline ("QuitlineNC"), funded by TCPB, employs scientific evidence-based methods to help tobacco users <br /> quit smoking. The North Carolina Public Health Association ("NCPHA") has entered into a Memorandum of <br /> Agreement with TPCB to enable third-parties to enter into cost-sharing agreements with the NCPHA for <br /> Quitline services. The Orange County Health Department has expressed interest in becoming a third party <br /> payer to expand the sources of payment for purchase Nicotine Replacement Therapy for Orange County <br /> residents enrolled in the QuitlineNC. The following represents a proposal for service delivery between the <br /> Orange County Health Department and the NC Public Health Association (NCPHA). <br /> General Demographic Information <br /> The Orange County Health Department requests Quitline NC provide Nicotine Replacement Therapy for <br /> residents of Orange County, North Carolina. There are approximately 133,800 residents, of which <br /> approximately [16% (n=21,408)] are tobacco users. Based on historical trends in 2015 and 2016, the projected <br /> "reach" or number of residents expected to call the QuitlineNC for services is 120 per year. Eligible service <br /> users are Orange County residents who are 18 years or older. <br /> Cessation Service for Orange County Residents <br /> During the period July 1, 2017—June 30, 2018, Orange County residents that enroll in the Quitline will receive <br /> telephone-based and integrated web-based counseling or web only counseling and free Nicotine <br /> Replacement Therapy (NRT) as follows: an initial telephone screening call, four or eight of weeks of free <br /> nicotine patches, gum, lozenges or combination therapy, up to four counseling calls per member, mailed <br /> materials, and unlimited courtesy calls to the Orange County participant for additional Quitline support. <br /> QuitlineNC participants must speak with a coach to receive free NRT. The Orange County Health Department <br /> will also be able to take advantage of any statewide or nationwide promotion of 1-800-QuitNow. <br /> Per the Memorandum of Agreement between NCPHA and the DHHS (see Contract Number 00030671, Scope <br /> of Services), specific service delivery protocol by QuitlineNC will be as follows: <br /> • Initial screening to determine Orange County participant smoking status, provide service explanation <br /> and offer counseling; initial counseling call may be completed "on the spot" if a counselor is available; <br /> otherwise an appointment will be made for a date and time selected by the Orange County <br /> participant. QuitlineNC will initiate the counseling call at the scheduled <br /> time. If the Orange County participant is not reached within a total of four (4) call backs, other <br /> attempts will be made to try to reach the Orange County participant to complete the engagement. <br /> 1 <br />