UNIVERSITY OF ALABAMA - AFFILIATION AGREEMENT .PDF

AFFILIATION AGREEMENT
st , 7) Y Between
ied | MARICOPA COUNTY by and through the
|
oxi DEPARTMENT OF CORRECTIONAL HEALTH SERVICES
AND THE BOARD OF TRUSTEES OF THE UNIVERSITY
OF ALABAMA FOR THE UNIVERSITY OF ALABAMA AT
BIRMINGHAM
This Agreement shall be effective on the date this Agreement is signed by the Maricopa
County Board of Supervisors (the Effective
5	1	6	1	2	7	1270	909	143	47	96.495743	Date). The parties of this Agreement are
The Board of Trustees of the University of Alabama for the University of Alabama at
Birmingham ("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
4	1	6	1	7	0	331	1208	206	48	-1	
5	1	6	1	7	1	331	1208	206	48	95.322426	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:
lL. 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.
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
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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,
3

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.
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.
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.
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.
Student Health Insurance and Emergency Medical Care. Students shall be
4

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.
Liability. Each party hereto agrees to 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 patty shall endeavor to
provide thirty (30) calendar days prior written notice to the other party of any
modification or termination of required insurance.
IL. 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 patty 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
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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:
UAB School of Nursing Maricopa County Board of Supervisors
Attn: Clinical Placement Office Attn: Clerk of the Board
1720 2"4 Ave S. NB 203B 301 West Jefferson Street, 10th Floor
Birmingham, Alabama 32394 Phoenix, Arizona 85003
Copy to Clinical Facility: Education
Supervisor Maricopa County
Correctional Health Services
3250 W. Lower Buckeye Rd.
Suite 2100
Phoenix, AZ 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 patty, or another patty's employee or agent in any publicity or advertising
material without such 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 patty shall assign all nor part of this Agreement without the
prior written consent of the other patty which consent shall not be unreasonably
withheld; provided, however, that this Agreement may be assigned by either patty
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 patty 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 patty may enter into similar agreements with
other training institutions, provided that such agreements do not materially
interfere with the ability of each patty 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 patties 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
patties with respect to the subject matter hereof, and supersedes all prior
agreements and representations.
23. Authority. The persons signing this Agreement warrant that they have full
authority to do so and that their signatures shall bind the patties for which they
sign.
24, Cancellation: This Amendment is subject to cancellation pursuant to A.R.S. § 38-
S11.
[Signature Page to Follow]

IN WITNESS WHEREOF, the patties have executed this Agreement as of the
respective dates written below.
THE BOARD OF TRUSTEES OF THE MARICOPA COUNTY
UNIVERSITY OF ALABAMA FOR THE
UNIVERSITY OF ALABAMA AT
BIRMINGHAM
BA by — Electronically signed by:
By: ater Feb 12, 2021 15:46 CST By:
Name: Bernard Mays, Jr. Name:
Title: Assistant Vice President/Controller Title: Chairman, Board of Supervisors
Date: 02/12/2021
Date:
Electronically signed — by:
. Dn Aw Linda Moneyham 5.
By: Data: Feb 08 CST ATTESTED BY
By:
Name: Linda D. Moneyham, PhD, RN FAAN
Name:
Title: Senior Associate Dean, Academic Affairs
Title: Clerk of the Board
UAB School of Nursing
Date:
Date: 02/05/2021
APPROVEDAS O FORM:
By: Z-
A497 TJ: FEck
Name:
Title: Deputy (60 ty Allete Pp “gf
Date: 3/+ [02S