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DocuSign Envelope ID: C4E78886-164A-49E2-8252-F6D46323E8CC <br /> PHS/OCHD Memo of Agreement <br /> Memorandum of Agreement <br /> Between <br /> Piedmont Health Services, Inc. WIC Program <br /> and <br /> Orange County Health Department <br /> For WIC Program Services <br /> This Memorandum of Agreement made and entered into the 1st day of July 2016 by and between <br /> the Orange County Health Department ("OCHD") and Piedmont Health Services WIC Program <br /> ("PHS"). <br /> WITNESSETH: <br /> WHEREAS, both PHS and OCHD deem it to be of mutual interest to their <br /> patients/clients and their respective organizations to enter into this agreement for certification of <br /> WIC clients at OCHD; and <br /> WHEREAS, both parties desire to reduce the terms of this agreement to writing; <br /> NOW THEREFORE, and in consideration of the mutual promises to the other as <br /> hereinafter set forth, the parties hereby mutually agree as follows: <br /> A. PHS agrees to perform in a manner satisfactory to OCHD the following responsibilities: <br /> 1. Provide WIC services to Maternal and Child Health clinic clients at OCHD in <br /> Hillsborough following the policies, procedures and flow of patients as <br /> established by OCHD. Services will include height and weight assessment, <br /> nutrition assessment and education, WIC certification, food vouchers issuance, <br /> child immunization assessment, and appropriate patient referrals in accordance <br /> with state WIC policies. <br /> 2. Provide the necessary supervision, training and policy guidance to carry out the <br /> tasks identified above in consultation with the designated OCHD liaison. <br /> 3. Provide personnel for coverage during vacations and other approved leave except <br /> PHS scheduled holidays and unavoidable emergencies. Inform the OCHD liaison <br /> when WIC staff will be absent so that OCHD clinic staff can be notified. <br /> 4. Schedule meetings as needed with the OCHD liaison and WIC Director to discuss <br /> problems,procedures, changes in policy and to establish and review objectives. <br /> 5. Reimburse OCHD, on a quarterly basis, Eleven dollars ($11) per client for each <br /> client that is not an OCHD patient, for testing of hemoglobin on WIC clients. <br /> 6. Piedmont Health Services will provide their own interpreter services for clients <br /> receiving WIC services, including laboratory services at the OCHD location in <br /> accordance with Title VI and Title II requirements. <br /> 1 <br />