2016-514-E DSS - OPT MOU to provide medical transportation to eligible Medicaid clients

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DocuSign Envelope ID: D843B726-9091-416C-B6AC-7EA85FE2894E MEDICAID TRANSPORTATION MEMORANDUM OF UNDERSTANDING This Memorandum of Understanding is entered into this 0 day of t 2016, by and between the Orange County Department of Social Services and Oran e Public Transportation (referred to collectively as the "Parties"). WHEREAS, Orange Public Transportation (hereinafter referred to as "OPT") and the Orange County Department of Social Services (hereinafter referred to as "OCDSS") are departments or agencies of Orange County, North Carolina and are ineligible to enter into binding contractual relationship with one another; and WHEREAS, the parties desire to enter into this Memorandum of Understanding in order to establish the mutually agreed upon conditions upon which OPT will provide certain services for OCDSS in connection with the Orange County Department of Social Services Medicaid Program; and WHEREAS, the OCDSS is mandated to provide transportation to Medicaid covered services when a client does not have access to personal transportation; and WHEREAS, OPT is a coordinated transit system run by Orange County Government in Orange County, North Carolina. NOW, THEREFORE, the parties to this Memorandum hereby agree as follows: I. OPT will provide non-emergency medical transportation services to and from medically necessary appointments to Medicaid clients at the request of OCDSS. 2. OCDSS will reimburse OPT for services provided under this Memorandum at a rate of $15.65 per one-way trip. OCDSS will not reimburse OPT for no-shows. 3. OPT agrees that continuation of and/or renewal of this Memorandum is contingent on meeting the following requirements. OPT agrees to: A. Provide services to enrolled participants within two days of a request. B. Provide critical services, including dialysis, on short notice when requested. C. Provide back-up drivers in case the assigned driver is not available. D. Coordinate maintenance to ensure vehicles are in safe operating order. E. Review the Transportation Database to verify client eligibility and information. Refer any discrepancies to OCDSS for investigation. F. Discuss the specific situation, and present evidence of cause, with the Department of Social Services staff prior to termination of services for any client. Clients may be suspended for thirty (30) days for three no-shows without good cause within a three- month period. G. Complete the DMA 5124 as part of the annual contract process.