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HomeMy WebLinkAbout1 - Original Submission_ City of Bremerton AAAffiliation Agreement Page 1 AFFILIATION AGREEMENT BETWEEN CENTRAL WASHINGTON UNIVERSITY AND CITY OF BREMERTON This Agreement is made and entered into between Central Washington University (“School”), located at 400 E. University Way, Ellensburg, Washington, 98926-7480, and City of Bremerton (“Training Site”), located at 911 Park Avenue, Bremerton, WA 98337. The purpose of this Agreement is for Training Site to provide desirable learning experiences (“the education program”) for School’s students who are enrolled in School’s educational/clinical programs. In consideration of the mutual covenants and agreements contained herein, School and Training Site agree as follows: I. GENERAL PROVISIONS A.School and Training Site agree that contemporaneous with or following executionof this Agreement and within the scope of its provisions, School may develop letter agreements with Training Site to formalize operational details of the education program. These details include, but are not limited to, the following: •Beginning dates and length of experience (to be mutually agreed upon at least one monthbefore the beginning of the education program); •Number of students eligible to participate in the education program; •Specific days, hours and locations for the education program; •Specific learning objectives and performance expectations for students; •Specific allocation of responsibilities for the faculty Liaison, education Supervisor, andPreceptors, if any, referenced elsewhere in this Agreement; •Deadlines and format for student progress reports and evaluation forms. Any such letter agreements will be considered to be attachments to this Agreement, will be binding when signed by authorized representatives of each party, and may be modified by subsequent letter agreements signed by authorized representatives of each party. B.School and Training Site will jointly plan the education program and jointlyevaluate students. Exchange of information will be maintained by on-site visits when practical and by letter or telephone in other instances. C.School and Training Site will instruct their respective faculty, staff, and studentsparticipating in the education program to maintain confidentiality of student and patient information as required by law and by the policies and procedures of School and Training Site. D.There will be no payment of charges or fees between School and Training Site. 15177 DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Affiliation Agreement Page 2 E.There will be no discrimination against any program participant or applicantcovered under this Agreement because of race, color, religion, national origin, age, handicap, status as a Vietnam era or disabled veteran, sex, or sexual orientation, nor will School or Training Site engage in such discrimination in their employment or personnel policies. II. SCHOOL’S RESPONSIBILITIES A.School will provide information to Training Site concerning its curriculum and the professional and academic credentials of its faculty for the students at Training Site. School will designate an appropriately qualified and credentialed faculty member to coordinate and act as the Liaison with Training Site. School will be responsible for instruction and administration of the students’ academic education program. School will notify Training Site in writing of any change or proposed change of its Liaison. School will have the final responsibility for grading students. B.School’s faculty will meet with the Training Site education Supervisor Preceptors,if any, at the beginning and end of the education program to discuss and evaluate the education program. These meetings will take place in person if practicable, otherwise by telephone conference. School is responsible for arranging and planning the meetings. C.School will provide the names and information pertaining to relevant educationand training for all students enrolled in the education program at least four weeks before the beginning date of the education program. School is responsible for supplying any additional information required by Training Site as set forth in this Agreement, prior to the arrival of students. School will notify Training Site in writing of any change or proposed change in a student’s status. D.School will obtain evidence of current immunizations against diphtheria, tetanus, poliomyelitis, measles (rubeola), mumps, rubella (or a positive rubella titer), and of hepatitis B immunity status, documented by a protective titer, for those students who will be in contact with patients/clients. For each student born after 1956, School will maintain on file records of positive titer or of post-1967 immunization for rubella and rubeola. At the time of immunization, students with no history of exposure to chickenpox will be advised to get an immune titer. School will require yearly PPD testing or follow-up as recommended if the students are PPD-positive or have had BCG. School will provide information to Training Site regarding student status concerning the above requirements. E.School will assign to Training Site only those students who have satisfactorily completed the prerequisite didactic portion of the curriculum and who have evidence of completion of a CPR course based on American Heart Association or American Red Cross guidelines and related to the age group(s) with whom they will be working. F.School shall ask each student who may be placed in Training Site to obtain his/her criminal history background record from the Washington State Patrol, pursuant to RCW DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Affiliation Agreement Page 3 43.43.834 and RCW 43.43.838, to release a copy of that record to the School, and to authorize the School to transmit that record or copy thereof to Training Site. Before the start of training, School will provide Training Site with the names of any students who have failed to provide the requested records, or who refuse to authorize the release of records to Training Site. The students will be informed that, whether or not they agree to obtain the record and agree to release it to School and Training Site, Training Site may conduct the background inquiry directly and the Training Site may refuse placement of a student who does not provide the requested records or who has a record of prior criminal conduct. Training Site understands and agrees that any information forwarded to it by School has been procured through this process. School does not certify the veracity of the records provided and, furthermore, the obligation to conduct appropriate background checks and the liability for non-compliance therewith remains the responsibility of Training Site. G.School will comply with and ensure to the extent possible that students complywith the policies and procedures established by Training Site. School will notify each student of his/her status and responsibilities pursuant to this Agreement. H.School will encourage each student participating in the education program toacquire comprehensive health and accident insurance that will provide continuous coverage of such student during his or her participation in the education program. School will inform students that they are responsible for their own health needs, health care costs, and health insurance coverage. III.TRAINING SITE’S RESPONSIBILITIES A.Training Site will provide students with a desirable education experience withinthe scope of services provided by Training Site. Training Site will designate in writing Preceptors, if any, to be responsible for the education program, and will designate in writing one person as the education Supervisor, who will maintain contact with the School-designated Liaison to assure mutual participation in and review of the education program and student progress. Training Site will submit in writing to School the professional and academic credentials for the Preceptors and education Supervisor. Training Site will notify School in writing of any change or proposed change of the Preceptors or education Supervisor. B.Training Site will provide students with access to sources of informationnecessary for the education program, within Training Site’s policies and procedures and commensurate with patients’ rights, including library resources and reference materials. C.Training Site will make available to students basic supplies and equipmentnecessary for care of patients/clients and the education program. Within the limitation of facilities, Training Site will make available office and conference space for students and, if applicable, School faculty. DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Affiliation Agreement Page 4 D.Training Site will submit required reports on each student’s performance and willprovide an evaluation to School on forms provided by School. E.Training Site retains full responsibility for the care of patients/clients, and willmaintain the quality of patient care without relying on the students’ training activities for staffing purposes. F.Training Site will have the right to take immediate temporary action to correct a situation where a student’s actions endanger patient care. As soon as possible thereafter, Training Site’s education Supervisor will notify School of the action taken. All final resolutions of the student’s academic status in such situations will be made solely by School after reviewing the matter and considering whatever written factual information Training Site provides for School; however, Training Site reserves the right to terminate the use of its facilities by a particular student where necessary to maintain its operation free of disruption and to ensure quality of patient care. G.On any day when a student is participating in the education program at itsfacilities, Training Site will provide to such student necessary emergency health care or first aid for accidents occurring in its facilities. The student will be responsible for the costs of any and all care. H.Except as provided in this Agreement, Training Site will have no obligation to furnish medical or surgical care to any student. IV.STUDENTS’ STATUS AND RESPONSIBILITIES A.Students will have the status of learners and will not replace Training Sitepersonnel. Any service rendered by students is incidental to the educational purpose of the education program. B.Students are required to adhere to the standards, policies, and regulations ofTraining Site during their education program. C.Students will wear appropriate attire and name tags, and will conform to thestandards and practices established by School during their education program at Training Site. D.Students assigned to Training Site will be and will remain students of School, andwill in no sense be considered employees of Training Site. Training Site does not and will not assume any liability under any law relating to Worker’s Compensation on account of any School student’s performing, receiving training, or traveling pursuant to this Agreement. Students will not be entitled to any monetary or other remuneration for services performed by them at Training Site, nor will Training Site otherwise have any monetary obligation to School or its students by virtue of this Agreement. DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Affiliation Agreement Page 5 V.LIABILITY COVERAGE PROVISIONS A.Each party to this Agreement shall be responsible for its own acts or omissions and for those of its officers, employees, and agents. Neither party shall be responsible for the acts or omissions of persons or entities not a party to this Agreement. B.School, an agency of the State of Washington, warrants that it is self-insured against liability claims in accordance with the risk management and tort claims statutes, including chapter 4.92 RCW and RCW 43.19.760 et seq. The tort claims procedure, RCW 4.92.100 et seq., provides the fundamental remedy for all tort liability claims against School and its officers, employees, and agents acting as such, and all such claims must be filed and processed as provided therein. School shall make general liability insurance and medical professional liability coverage available for purchase by its students. School shall provide students who purchase insurance through it with proof of insurance. In addition, the limits of the liability policy shall be at the minimum of One Million Dollars ($1,000,000) per occurrence and Three Million Dollars ($3,000,000) in the aggregate per school annual aggregate. Students shall provide Clinical Facility with proof of insurance prior to placement. Students will not be accepted without proof of required insurance. C.Training Site maintains commercial general liability insurance coverage with aminimum of $1,000,000 per occurrence. Through that coverage, Training Site provides liability coverage for its employees, officers, and agents in the performance of this Agreement, and further provides the means for defense and payment of claims that may arise against such individuals. VI.TERM A.This Agreement shall be effective as of the latest date shown below (Effective Date) for a term of three (3) years ("Initial Term”), and shall renew every three years commencing from the Effective Date; PROVIDED THAT the parties review this Agreement and memorialize their intent to renew the Agreement for a subsequent three year period – such renewal being memorialized prior to the expiration of the current three year term. There shall be a maximum of two renewal periods. The Initial Term and any Renewal Term will be collectively referred to herein as “Term”. School and Company will jointly plan student placement in advance of each year’s beginning, taking into account the needs of the school for clinical placement, maximum number of students for whom Company can provide a desirable clinical education experience, and the needs of other disciplines or schools requesting clinical placements. B.This agreement may be canceled by written notice 60 days prior to termination;however, such termination shall not become effective for the students then enrolled in the education program if such termination prevents completion of their requirements for completion of the education program. DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Affiliation Agreement Page 6 VII. PROVISIONS REGARDING BLOOD-BORNE PATHOGENS A.School certifies that it has trained each student it sends to Training Site in universal precautions and transmission of blood-borne pathogens and that it will send to Training Site only students who have been trained in and have practiced using universal precautions. School has recommended the Hepatitis B (HBV) screening to all education program students before assignment to Training Site. Students may waive the HBV series, but are required to have a TB screening and be up-to-date on all other immunizations. Training Site will provide personal protection equipment that is appropriate for the tasks assigned to School’s students. B.In the event a student sustains a needle-stick injury or other substantial exposure to bodily fluids of another or other potentially infectious material while participating in the education program at Training Site, Training Site agrees to provide the following services: •Emergency medical care following the injury; •Initiation of HBV, Hepatitis C (HCV) and HIV protocol; •HIV counseling and appropriate testing. The student will be responsible for the costs of any and all care, testing, counseling, and obtaining necessary follow-up care. C.The source patient’s HBV, HCV and HIV status will be determined by TrainingSite in the usual manner to the extent possible. VIII.MISCELLANEOUS PROVISIONS A.Entire Agreement. This Agreement constitutes the entire agreement between theparties, and supersedes all prior oral or written agreements, commitments, or understandings concerning the matters provided for herein. B.Amendment. This Agreement may be modified only by a subsequent writtenAgreement executed by the parties. The provisions in this Agreement may not be modified by any attachment or letter agreement as described elsewhere in this Agreement. C.Order of Precedence. Any conflict or inconsistency in this Agreement and itsattachments will be resolved by giving the documents precedence in the following order: 1.This Agreement;2.Attachments to this Agreement in reverse chronological order. D.Governing Law. The parties’ rights or obligations under this Agreement will beconstrued in accordance with, and any claim or dispute relating thereto will be governed by, the laws of the State of Washington. DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Affiliation Agreement Page 7 E.Notices. All notices, demands, requests, or other communications required to begiven or sent by School or Training Site, will be in writing and will be mailed by first-class mail, postage prepaid, or transmitted by hand delivery or facsimile, addressed as follows: (a)To School:Central Washington University 400 E. University Way Ellensburg, WA 98926-7480 (b)To Training Site:City of Bremerton 911 Park Avenue Bremerton, WA 98337 Each party may designate a change of address by notice in writing. All notices, demands, requests, or communications that are not hand-delivered will be deemed received three (3) days after deposit in the U.S. mail, postage prepaid; or upon confirmation of successful facsimile transmission. F.Survival. School and Training Site expressly intend and agree that the liabilitycoverage provisions of this Agreement will survive the termination of this Agreement for any reason. G.Severability. If any provision of this Agreement, or of any other agreement,document or writing pursuant to or in connection with this Agreement, shall be held to be wholly or partially invalid or unenforceable under applicable law, said provision will be ineffective to that extent only, without in any way affecting the remaining parts or provisions of said agreement. H.Waiver. Neither the waiver by any of the parties hereto of a breach of or adefault under any of the provisions of this Agreement, nor the failure of either of the parties, on one or more occasions, to enforce any of the provisions of this Agreement or to exercise any right or privilege hereunder, will thereafter be construed as a waiver of any subsequent breach or default of a similar nature, or as a waiver of any of such provisions, rights or privileges hereunder. I.Inspection. Training Site will permit, on reasonable notice and request, the inspection of clinical and related facilities by agencies charged with responsibility for accreditation of School. DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Affiliation Agreement Page 8 J.HIPAA. School voluntarily provides students with training on the requirements of theHealth Insurance Portability and Accountability Act (HIPAA). Training Site will provide additional training on Training Site’s specific HIPAA policies and procedures. School will direct its students and faculty to comply with the policies and procedures of Training Site. Noprotected healthcare information (PHI) is anticipated to be exchanged between Training Siteand School. Solely for the purpose of defining students’ role in relation to the use anddisclosure of Training Site’s PHI, students acting pursuant to this Agreement are defined as members of Training Site’s workforce. However, School’s students and faculty shall not be considered to be employees of Training Site. CENTRAL WASHINGTON UNIVERSITY CITY OF BREMERTON By: By: Title: Title: Date: Date: LH 6/1/21DocuSign Envelope ID: ACA25BD8-A710-4BEF-AC36-03BB43BBC909 Interim Dean Heidi Henschel Pellett 6/21/2021 6/21/2021 Greg Wheeler Mayor