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PHS/OCHD Memo of Agreement <br />Revised 06/23 <br /> <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 /> <br /> <br />This Memorandum of Agreement made and entered into the 1st day of July 2024 by and between <br />the Orange County Health Department (“OCHD”) and Piedmont Health Services WIC Program <br />(“PHS”). <br /> <br />WITNESSETH: <br /> <br />WHEREAS, both PHS and OCHD deem it to be of mutual interest to their patients/clients <br />and their respective organizations to enter into this agreement for certification of WIC clients at <br />OCHD; and <br /> <br />WHEREAS, both parties desire to reduce the terms of this agreement to writing; <br /> <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 /> <br />A. PHS agrees to perform in a manner satisfactory to OCHD the following responsibilities: <br /> <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 established <br />by OCHD. Services will include height and weight assessment, nutrition <br />assessment and education, WIC certification, food vouchers issuance, child <br />immunization assessment, and appropriate patient referrals in accordance with state <br />WIC policies. <br /> <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 /> <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 /> <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 /> <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. This <br />fee is the fee charged to non-insured patients according to OCHD’s fee schedule. <br /> <br />Docusign Envelope ID: 63CECEA1-D8BB-4086-B7BA-20666284B037