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CHAPEL HILL-CARRBORO CITY SCHOOLS <br />MENTAL HEALTH CLINICAL SERVICES AGREEMENT <br />WITH ORANGE COUNTY HEALTH DEPARTMENT <br />THIS AGREEMENT, made and entered into the Ist day of September, 2005, by and between the Chapel <br />Hill-Cauboro City Schools, hereinafter referred to as "CHCCS" and the Orange County Health <br />Department, hereinafter referred to as "OCHD" that is part of the County of Orange <br />WITNESSETH <br />WHEREAS, OCHD, through its Child and Adolescent Psychosocial Counseling Services, is willing to <br />provide consultation related to child and adolescent Mental Health to CHCCS personnel and to provide <br />direct clinical services related to Mental Health to enrolled students in CHCCS, and is willing to <br />collaborate on programs aimed at the promotion of mental health and the prevention of substance abuse and <br />chemical dependency, <br />AND WHEREAS, CHCCS desires to have such services in their school system, <br />NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereinafter <br />set forth, CHCCS and OCHD agree as follows: <br />Services to be Provided <br />OCHD agrees to assist CHCCS in the identification of students with psychosocial issues that <br />interfere with academic performance and to provide systematic intervention to such students. <br />OCHD agrees to provide consultation to CHCCS staff' with the services of a Mental Health (MH) <br />counselor who will participate on site-based Student Support Teams (SST) and provide clinical <br />treatment services to students enrolled in three CHCCS middle schools (McDougle, Smith and <br />Phillips) and their families in accordance with state and federal laws and CHCCS and OCHD <br />policies. Treatment services include group and individual counseling, mentoring, and consultation. <br />In addition, selected 5"' grade students with psychosocial issues from feeder elementary schools <br />may be served by the OCHD MH counselor to ease potential middle school transition issues. <br />OCHD agrees to report activities, including the number of services rendered, to the CHCCS <br />Health Services Coordinator monthly and agrees to serve on district-wide committees as <br />appropriate. OCHD shall provide supporting documentation and/or data to the CHCCS Health <br />Services Coordinator to assist with written program evaluation at the end of the school year. <br />2. Payments and Documentation <br />CHCCS agrees to reimburse OCHD for clinical Mental Health services provided to middle school <br />students at a rate of $25 per hour for 20 hours per week for 30 weeks of the 2005-2006 school year <br />ending June 10, 2006, The contracted amount for Mental Health services equals $15,000. In <br />addition, CHCCS will compensate OCHD in the amount of $1800 (12% of contracted amount) for <br />administrative overhead The full value of the contract is $16,800 OCHD will invoice CHCCS <br />monthly. <br />School based therapy <br />Students identified by the schools' SSTs would be eligible to be seen by the MH counselor up to <br />five times, These services may include early identification of violence and illegal drug use, <br />counseling about violence and substance abuse, conflict resolution, and mentoring. If additional <br />counseling therapy is deemed necessary and beneficial to the student, the OCHD MH counselor <br />will contact the parent/guaidian(s) regarding ongoing treatment. Community options will be <br />offered, but a parent with a child covered by Medicaid may elect to continue counseling services <br />with the OCHD counselor in the school setting Medicaid billing for ongoing services will be the <br />responsibility of OCHD. Should the student need long term or intense therapeutic mental health <br />services, their parent/guardian(s) would be referred to a provider of their choice.