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DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276 <br /> Exhibit A <br /> • Up to four(4)telephone counseling sessions (one 45 minute session and three 15 minute sessions) <br /> • Eight weeks of nicotine replacement therapy (NRT), based on participation in counseling sessions: <br /> four weeks sent to the Orange County participant home address via UPS upon completion of the <br /> first telephone counseling call (45 min.) and an additional 4 weeks sent via UPS if the Orange County <br /> Health Department participant completes second counseling call. <br /> • An information packet which includes a quit tobacco use guide will be mailed to all participants <br /> completing the screener call. Those who complete the first counseling call and are approved for NRT <br /> will also receive simplified instructions along with the NRT kit. <br /> QuitlineNC orts <br /> The Orange County Health Department will receive the following reports monthly: <br /> • Utilization Report: tracking of participants served and level of services utilized. <br /> • Demographic Report: Demographics including gender, race, age, educational levels etc. of the <br /> Orange County participants by month and year to date. <br /> • How Heard About by County: Report defining how the Orange County participant heard about <br /> the use of QuitlineNC. <br /> Costs for Services, Protocol/Database Changes,Verification,and utc a Evaluation <br /> Alere Wellbeing, Inc. ("Alere") is the prime vendor to QuitlineNC. Alere, while contracted with the TPCB,will <br /> provide QuitlineNC services, including up to 8 weeks of Nicotine Replacement Therapy, at State specific unit <br /> cost rates. This is a cost-sharing agreement,whereby selected services will be paid by the Orange County <br /> Health Department,while other services will be provided by the TPCB at no cost to the Orange County <br /> Health Department, as shown below: <br /> Pricing structure <br /> Nicotine Replacement Unit Costs 1st 4 weeks 2nd 4 weeks <br /> Patches $48.00 per shipment $48.00 $48.00 <br /> Gum $30.00 per box $90.00 $30.00 <br /> Lozenges $38.00 per box $105.00 $38.00 <br /> Combination Therapy - 4 $108.00 $48.00 <br /> wks patches and two boxes <br /> of gum <br /> Combination Therapy - 4 $124.00 $48.00 <br /> wks patches and two boxes <br /> of lozenges <br /> In addition, an Administrative fee equal to 10%of the total contract price will be charged for the cost of <br /> administrative services including the monthly cost and aggregate service reports. <br /> 2 <br />