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Dahlonega Care 2017 ExhibitB Final PDF

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Preview Dahlonega Care 2017 ExhibitB Final

Exhibit 2 AGREEMENT TO PROVIDE PREGNANCY SUPPORT SERVICES, {egancy), serving 35 contract management agency to the ‘Georffa Department of PubIe Heals (OPH) in ecxardancs with O.C.G.A § 31-28-33, hereby contracts with Dahlonega Gare Center Ing (Provider to peavide preganey suppertsenvices io eligible clients 2 foRowe: 1. __ Parties; Third Party Beneficiary. The partes to this contract ate Agency and Providar. OPH 1s an intended hid: party beneficiary of this Agreement 2. Term. This contact shell bagi on December 4, 2017 and shal end on June 30, 2018 untess laminated earier. Agency's obligation to make payment under Paragraph 6, and Providers obligations under Paragraphs 7 and, shell survive the expiration or termination ofthis contract. Definitions, Agency means the enily selected by DPH to sorva as conlracl management agancy in aqaardance wth D.C.GA, § 31-26098, and ts successors, Atonting Physician meana the physician who has primary responsibity atthe time of reference forthe Treatment and care of the feat. Eligible Ctent means a woman who is a resident of Georga, who ks or belloves she may be pragnant Pregnancy Support Services means the folowing: (3) Medical care and information inckiding bu not limited to pregnancy tests, sexually ‘ranemiiag Wfeclon teats nar heal sefeening, ullaeaund service, prema! are, 310 binh classes and planning: (0) Nutridonal services and education; (©) Housing, education, and employment assistance during pregnancy and up ta one year following 8 birt, (2) Adoption education, planning, and services; (6) Chie care sesistence if noteseery for he client fo receive pregnancy support servines; (Parenting education and suppart services for upto ona year following @ bith; (@) Material toms whieh ara eupnrive af pregnancy and edie inckusing, but not lec to, rls, car seats, clothing, formula or obher safely davies: ard (h) Information ragareing neath care banat, Inctulng but notlited Io, available Medical ‘coverage forthe alent for pregnancy caré Ihal provides health caveraga far tha cian's child upon hs or her bith Prograrn means the Positive Allematives far Prognancy and Paraniing PPragram estabished pursuant to O.C.G.A.§ 31-94-31 of sg, 4, Gllent Sereening, Provider shell Implement pracedures to seraen and Identify Elle Cents 5. Services. Provider vill offer any or all elght Pregnancy Suppo Servces to Blgible Gini ‘and provide such services as needed and at no charge ta Eligible Gllants, ether threugh Its own personnel and facies oF rough thire-nary vendors unidar contact to Provide. If Provldarelacts to Drovide Pregnancy Support Services through a tid-parly vendor, then Provider must have 8 vrtien _zgreement far referat in piace vtich provides, at a minimum, tat the vendor shall comply wih the ‘Standards of Conduct set aut in Paragraph 8 below. and that he vendor shall nol charge Eligible CHenis far Prognency Support Services, 6. Billing and Payment. Provider shall invoice and bill according fo Exhibit C Expenditure af Funds and Exhibit D Invaics far Pregnancy Suopart Services which i provides fo Eligible Clients, including Pregnancy Suppor Servos inal are provided through a thkceperty vendor: 7. Aualts. Provider shall have and maintain a sysiom of financial accounlabilty consistant with ‘gonsrally acceptad accountng princlpss, Including an annual budget. Provider shall cooparata with ‘any auilt conducted by of on behalf of Agency oF DPH deemed nacassary lo ver that Provider has ‘complied wit all the reguiterents of the Program, including but not mid to furnishing Information and ‘ocuments upon request by the auditor. 3. Reports, Provider shall maintain aoowats recor and shallrepert data tothe Agency monty 2nd in an Annual Ropar onthe forms provited by OPH. Ata minimum, the month raport wilinelude the folowing monthly and annual aggregate infermation: (8) the undupleated numberof ilibiaCllents who visted Provider (©) the unduplcated number of Eligible Clients who received one a¢ more Pregnancy Suppart Services; (8) the untupicstad numberof Sige Canta ho were detained (abe pragnant nd (2) the unduplostes numberof Elie Gente who |. cared ther pregnancy totem, and chose to kaga the lt i, care ther pregnancy totem, and chase to ale the eld up far adoption: i Ghose to abort the pregnaney; and fy, the number of Bligible Cfenta seen for whom Provider wes unable to verify the timate decision with regard tothe pregnancy. Standards of Conduct. Provider chal abida by the following stendards of conduct wih regard {a all Bllgbla Clants, and shall ensure that any third-party vendars t engage: to provide Pregnancy Support Saricas doas the same: (@) Provider shalt protact the confidentially of Elbe Cllente’ personal heath information In accordance wih HIPAA and AMlachment 9 Business Aesoclate Ageaomant (©) Provider shall provide Ellglle Cllants lth thafr own personal health lafrraaon upon request in accordance wlth MIPAR; (0) Provider shell not provide an EXgibla Clem with an abortion; creel rafar an Elobie ‘Client vo an abortan pravider lor an abanian; ar encourage or afimalively counsel at Eligible Client fo have an aborion, unless the clants attanding physician Cagnoses & Ccoridion which makes such atorton necessary fo prevent har death, @ fo @ @ thy O) @ Pravddor shall not ptemote any religous or polical cause to an Elgbla Clant through ‘ary means, inducing, but not riled lo, counseling or written materials, Tis does nat preclude tha Pravider from having raliglous or poical dlecussians, and providing such ‘ailen mates, ns actif thal ara nal ated to the Program. Provider shall not represent, by suggestion, statement, oF omission, that It provides, ‘sbrion services; Provider chall not employ any namo, eymbol, or stogan thal raprasents, by suggestion, statement, or omission, that It's an abortlon Taciy, Providet chell nol reprasent, by aupgealion, sialement, or omission, thal W provides medical serdcas, unlass Ht employs a Koensad physician or nurse on the premises 10 provide the medical serlcae: Provider shell provide each Ellfbls Ckenl with eccurte information on the developmental characlersles of bebige and of unbom chiifren, Including offering the finled motersls desorbed In Code Section B1-DA-d on fetal development and ‘sssislanca avellle folowing a births, Provider shall provide Infaration regarding the risks and cnneequences of pregnancy, chidbirh, and abortion. Such information shall be accurale, sclentficaly based, and ‘onsiclent with me standards of the American Madicel Associaion and the American Congress of Obstetricians end Gyrecalogis; and Provider shall not use tha DPH name or logo In any manner, Including edverticaments, intgmal pages, or wrtton materials, withoul the express price writen permission of the IDPH Director of Coramunlestiona {0 Termination. Ths cant maybe taminaad by ho Agcy ryt fortes o fo 41. Mon-Discrimination. Provider shel ot deatminate against any cient on the basis of rave, natlonal ogi, gander, age, refglon, cr any aber ground prohiltad By sia or federal aw. 42, Entire Agreement, Tha contract conatuas the entre agrsement between the partion and cupersodes any prior diussions or understandings, k may be amended only By a wring plainly lied "Amendment and signed by bath partis. Provider's rights and ites under this Contract cannot be musi. This 1M. day of Decambst, 2017. AGENCY PROVIDER Kasam Rouben Kenia Tar The: Great Bebivire wr Name: Karen Bowden for Dahlonega Care Conter Title: Executive Director Scanned by CamScanner

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