AFFILIATION AGREEMENT AZ COLLEGE OF NURSING-CMPDF.PDF

AFFILIATION AGREEMENT
Between
MARICOPA COUNTY
by and through the
DEPARTMENT OF CORRECTIONAL HEALTH SERVICES
AND ARIZONA COLLEGE OF NURSING
This Agreement shall be effective on the date this Agreement is signed by the Maricopa
County Board of Supervisors (the "Effective Date"). The parties to this Agreement are the
Arizona College of Nursing ("School") and Maricopa County ("County"), a political
subdivision of the State of Arizona, administered by its Department of Correctional Health
Services, and other departments the County may designate from time to time (together,
"Clinical Facility").
WHEREAS, School wants to provide field experiences for the School's students
("Students") as part of their overall education; and
WHEREAS, County, through its Clinical Facility, is willing to provide field training to
School's Students; and
WHEREAS, it is to the benefit of both School and Clinical Facility to cooperate in the
educational preparation of Students, so as to promote excellence in patient care, to ensure
professional competence, and to provide maximum utilization of community resources,
NOW, THEREFORE, IT IS MUTUALLY AGREED that School may place selected
Students in the Clinical Facility for such clinical experiences (the "Program") according to
the following terms and conditions:
1. Program Description and Mutual Responsibilities of the Parties.
1.1. School shall retain full control and responsibility for the academic education of the
Students. Any educational goals and objectives for a rotation must be provided by
School to Clinical Facility prior to the start of the rotation and will be subject to
Clinical Facility's acceptance and approval.
1.2. The number of Students accepted into the Program and schedule of field assignments
shall be arranged in advance by mutual agreement between Clinical Facility and
School. In the event it becomes necessary to cancel a reserved space or change a
student assignment, School will immediately notify Clinical Facility.
1.3. School and Clinical Facility shall each designate a coordinator who shall be
reasonably available for consultation with the other respective coordinator

concerning each Student's qualifications, field experience performance, and the
curriculum of the Program.
1.4. School agrees to designate for participation in the Program only Students who have
completed the necessary training, appropriate prerequisites, and didactic work for the
Program and who are in good standing. All Students shall be subject to Clinical
Facility's standards of Program admission and participation.
1.5. Clinical Facility assumes full responsibility for the care of its patients. It is
understood that School does not derive direct revenue from patient care activity at
Clinical Facility.
1.6. At all times during the term of this Agreement, all services shall be performed in
accordance with all applicable standards established by law or ordinance, or
established by the rules and regulations of any federal, state, or local agency,
department, commission, association, or other pertinent governing, accrediting, or
advisory body having the authority to set standards for offices maintained by health
care providers.
1.7. Clinical Facility and School agree to cooperate with each other and share
information, to the extent allowed by law, in the event of any investigation, audit,
peer review matter, disciplinary action or third party liability claim arising out of the
Program or any services provided under this Agreement or any adverse event that
may result in liability to the other party in connection with their performance under
this Agreement.
2. School's Responsibilities.
2.1. School shall advise all Students that they may be required to pass a physical
examination and drug screening when appropriate for the specific rotation; will be
required to have up-to-date immunizations including a hepatitis B series; and will be
required to complete a criminal background check by the Clinical Facility (or its
agent). Student will be responsible for the cost of pre-rotation screenings not
performed by Clinical Facility (including physical examination and drug test, if
applicable). School shall provide Clinical Facility with documentation upon request
establishing that each Student has undergone the appropriate pre-screening and any
necessary documentation to perform the requisite background check. Clinical
Facility (or its agent) shall review any such documentation to determine if Student is
eligible to have direct contact with Clinical Facility patients.
2.2. School shall maintain all personnel and academic records relating to Students.

2.3. School shall require all Students and any other personnel furnished by School to
comply with all applicable rules, regulations, policies and procedures of the Clinical
Facility and to maintain confidentiality of patient information in accordance with
applicable law, as well as the confidentiality of records and operations of the Clinical
Facility. Students shall be required to acknowledge these responsibilities at the start
of the Program on a form prepared by Clinical Facility and to grant School and
Clinical Facility permission to share educational records necessary to the Program,
including written evaluations from Supervising Clinicians to School.
3. Clinical Facility's Responsibilities.
3.1. Clinical Facility will determine the locations and assignments for each Student in the
Program and notify School of available assignments.
3.2. Clinical Facility agrees (i) to provide direct supervision of Students and practical
instruction while on the assigned premises for the Program at Clinical Facility
locations by qualified clinicians who are on staff at the Clinical Facility
("Supervising Clinicians"); (ii) that all notes or charting concerning a patient's
treatment or progress, if written by a Student, will be signed by the Student and
countersigned by a Supervising Clinician; and (iii) to complete written evaluations
on each Student on forms provided by School.
3.3. At all times during the term of this Agreement and any renewal or extension hereof,
Clinical Facility shall, at its own expense, comply with applicable state and federal
laws and regulations including but not limited to OSHA standards pertaining to
Occupational Exposure to Bloodborne Pathogens with respect to each of School's
employees, agents and Students present at the Clinical Facility.
3.4. With respect to any quasi-professional services provided by Students under this
Agreement, Clinical Facility shall notify School and its Program Director(s) as soon
as possible of the initiation of any investigation of a Student or School faculty
member.
4. Family Educational Rights and Privacy Act ("FERPA"). School agrees that for
purposes of Family Educational Rights and Privacy Act (FERPA), Facility will be
considered a School official with a legitimate educational reason to have access to
limited personally identifiable information from student records, hereinafter
("Student Information"), as described below. School agrees to provide authorized
representatives of Facility limited Student Information and only that which is
reasonably necessary for participation in the affiliation. No other Student
Information will be provided. Facility acknowledges and agrees that Student
Information provided by the School, or others on behalf of the School, that directly
relates to any School student, including, but without limitation, academic

information (e.g., coursework, grades, degrees earned, performance in other external
rotations); professional information, (e.g., licenses obtained, suspension,
revocation); training and/or certifications (e.g., CPR, OSHA/Bloodborne pathogen);
health information (e.g., Hepatitis, TB Testing); health and other insurance
information and, the results of any criminal background check and/or drug
testing/treatment information is Student Information and is protected by FERPA.
Facility represents and certifies that it will (1) protect the confidentiality of all
Student Information; and will not, except with the written consent of the student, (2)
use Student Information for any purpose other than to carry out the purposes of this
agreement; or (3) disclose Student Information except to authorized individuals
within its organization who have a legitimate need to know Student Information in
order to carry out the purposes of this agreement.
5. Health Insurance Portability and Accountability Act (“HIPAA"). Students shall be
instructed by School and/or Clinical Facility before beginning the Program
concerning the confidentiality of medical information of Clinical Facility's patients
and standard precautions. For purposes of compliance with HIPAA, Students shall
be considered part of Clinical Facility's work force as that term is defined in HIPAA
to include trainees and students. Students are not considered work force or employees
of Clinical Facility for any other purposes, including by, and not limited to tax or
employment law.
6. Policies and Procedure Governing Students. In addition to any policies and
procedures of School that govern Students' conduct, Students shall be subject to and
follow Clinical Facility's policies and procedures, including standard precautions,
while participating in the Program. Notwithstanding any provision to the contrary,
Students shall not be entitled to any defense or indemnity by the County, or to any
stipends, benefits, terms or rights that are afforded County employees, including
workers' compensation, health insurance or medical benefits, pension, retirement, or
vacation or sick pay.
7. Termination of Student Experience. Clinical Facility may terminate the participation
of a Student in the Program if the Student's work, conduct or health might, in Clinical
Facility's sole discretion, have detrimental effect on its patients, staff, or operations.
Clinical Facility shall not be arbitrary or discriminatory in the exercise of this right.
8. Student Health Insurance and Emergency Medical Care. Students shall be
responsible for maintaining health insurance throughout the entire term of their
participation in the Program. Students may be furnished emergency medical care and
treatment, if needed, while on duty at Clinical Facility with the associated expense
to be the responsibility of the Student.

9. Liability. Each party hereto agrees to be responsible for the negligent acts or
omissions of its officers, employees, and agents, which occur within the line and
scope of their performance of the services, which are the subject of the Agreement.
Further, School agrees to be responsible for the negligent acts or omissions of its
students, which arise from the performance of their responsibilities arising from the
training, which is the subject of this Agreement The amount and type of insurance
coverage requirements set forth in Section 10 below will in no way be construed as
limiting the scope of the liability in this Section. Further, the scope of liability does
not extend to the sole negligence of either party.
10. Insurance. Both parties shall maintain insurance or funded self-insurance as follows:
(i) commercial general liability insurance coverage with minimum limits of
$1,000,000 per occurrence and $3,000,000 annual aggregate; (ii) professional
liability insurance coverage with minimum limits of $1,000,000 per claim and
$3,000,000 annual aggregate; and (iii) workers' compensation insurance or a similar
self-funded program to cover obligations imposed by federal and state statutes
applicable to the respective party's employees engaged in the Program. Upon written
request, a party shall provide to the other party a certificate of insurance evidencing
such insurance coverage. Each party shall endeavor to provide thirty (30) calendar
days prior written notice to the other party of any modification or termination of
required insurance.
11. Relationship of the Parties. Each party is a separate and independent institution, and
this Agreement shall not be deemed to create a relationship of agency, employment,
or partnership between or among them. Each party understands and agrees that this
Agreement establishes a bona fide training relationship and that the agents, Students,
and employees of each respective party are not employees or agents of the other
party.
12. Term. Unless terminated earlier as described in Section 13 below, the term of this
Agreement shall begin the date the Agreement is executed by the Maricopa County
Board of Supervisors and expire in five (5) years. The County may, at its option and
with the agreement of the School, renew the term of this Agreement for additional
terms up to a maximum of five (5) years.
13. Termination. This Agreement may be terminated by either party upon thirty (30)
days prior written notice to the other party; provided, however, Students participating
in an ongoing clinical experience at the time shall be given the opportunity to
complete their participation. In such event, all applicable provisions of this
Agreement shall remain in force during the extension period from the effective date
of termination, until the end of the academic term in which the Students are enrolled.

14. Notices. Communications regarding the Program shall go through the parties'
designated coordinators. Any legal notice that is required or permitted to be given by
a party to the other shall be deemed to have been sufficiently given if personally
delivered or deposited in the U.S. Mail in a properly stamped envelope, addressed
to:
For School: For County:
Arizona College of Nursing Maricopa County Board of Supervisors
Attn: Ami Patel Attn: Clerk of the Board
2510 West Dunlap Avenue 301 West Jefferson Street, 10th Floor
Phoenix, Arizona 85021 Phoenix, Arizona 85003
Copy to: Copy to:
Elizabeth Serva Clinical Facility: Education Supervisor
Arizona College of Nursing Maricopa County
Clinical Coordinator Correctional Health Services
1620 West Fountainhead Parkway 3250 W. Lower Buckeye Road
4th Floor Suite 2100
Tempe, Arizona 85282 Phoenix, Arizona 85009
15. Amendments. This Agreement may be amended from time to time only by written
agreement of the parties.
16. Use of Names. No party shall use the name, trademark, logo, or likeness of another
party, or another party's employee or agent in any publicity or advertising material
without other party's express prior written consent; however, the existence and scope
of the Program available via this Agreement may be made known to Students as a
means of assistance in completing their training requirements.
17. Assignment. Neither party shall assign all nor part of this Agreement without the
prior written consent of the other party which consent shall not be unreasonably
withheld; provided, however, that this Agreement may be assigned by either party
without consent of the other to an affiliate or to any third party who succeeds to
substantially all of its businesses or assets. In the event of a valid assignment, this
Agreement will inure to the benefit of and be binding upon each party and its
respective successors and permitted assigns.
18. Enforceability and Waiver. The invalidity or unenforceability of any term or
provision of this Agreement shall in no way affect the validity or enforceability of
any other term or provision. The waiver by a party of a breach of any provision of
this Agreement shall not operate as or be construed as a waiver of any subsequent
breach thereof.

19. Non-exclusive Agreement. Each party may enter into similar agreements with other
training institutions, provided that such agreements do not materially interfere with
the ability of each party to carry out its obligations hereunder.
20. Compliance with Laws. Each party shall, to the extent such provisions apply, comply
with all applicable federal and state laws, ordinances, Executive Orders, rules,
regulations, standards, and codes whether or not specifically referenced herein,
including, but not limited to: Title VI and VII of the Federal Civil Rights Act; the
Federal Rehabilitation Act; the Age Discrimination in Employment Act; the
Americans With Disabilities Act, as amended; the Immigration Reform and Control
Act of 1986 (IRCA); and Arizona Executive Order 2009-9, which mandates that all
persons shall have equal access to employment opportunities. Unless exempted
under Federal law, the parties shall not discriminate against any employee or
applicant for employment because of race, age, disability, color, religion, sex, or
national origin.
21. Counterparts. This Agreement may be executed in multiple counterparts, each of
which shall be deemed an original, and all of which together shall constitute one and
the same instrument.
22. Entire Agreement. This Agreement represents the entire agreement between the
parties with respect to the subject matter hereof and supersedes all prior agreements
and representations.
23. Authority. Each party has provided the other with proof that the person executing
this Agreement has been authorized to do so.
24. Cancellation: This Amendment is subject to cancellation pursuant to A.R.S. § 38-
511.
~Signature Page to Follow~

IN WITNESS WHEREOF, the parties have executed this Agreement as of the respective
dates written below.
ARIZONA COLLEGE OF NURSING MARICOPA COUNTY
BY: _______________________ BY: _______________________
Name: Ami Patel Name:
Title: National Clinical Development Manager Title:
Date: _____________________ 5/14/2021 Date: _____________________
ATTESTED BY:
BY: _______________________
Name:
Title:
Date: _____________________
APPROVED AS TO FORM:
BY: _______________________
Name: Wayne J. Peck
Title: Deputy County Attorney
Date: June _____________________ 4, 2021