MARICOPA SPECIAL HEALTH CARE DISTRICT DBA MARICOPA INTEGRATED HEALTH SYSTEM.PDF

[CLINICAL EDUCATION AGREEMENT
This Agreement shall be effective October 1, 2017 (the "Effective Date"). The parties to
this Agreement are Maricopa Special Health Care District dba Maricopa Integrated Health
System, Maricopa Medical Center ("MIHS") and Maricopa County ("County"), a political
subdivision of the State of Arizona, administered by its Department of Correctional Health
Services, Department of Public Health, and other departments the County may designate from
time to time (together, "Clinical Facility").
WHEREAS, MIHS wants to provide clinical experiences for the MIHS 's Residents
("Residents") as part of their overall education; and
WHEREAS, County, through its Clinical Facility, is willing to provide clinical training
to MIHS 's Residents; and
WHEREAS, it is to the benefit of both MIHS and Clinical Facility to cooperate in the
educational preparation of Residents, 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 MIHS may place selected
Residents 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 MIHS shall retain full control and responsibility for the academic education of the
Residents. Any educational goals and objectives for a rotation must be provided by MIHS to
Clinical Facility prior to the start of the rotation and will be subject to Clinical Facility's
acceptance and approval. Goals and objectives for rotations are identified in the Program Letter
of Agreement (PLA) addendum attached to this Agreement.
1.2 The number of Residents accepted into the Program and schedule of clinical
assignments shall be arranged in advance by mutual agreement between Clinical Facility and
MIHS. In the event it becomes necessary to cancel a reserved space or change a Resident
assignment, MIHS will immediately notify Clinical Facility.
1.3 MIHS and Clinical Facility shall each designate a coordinator who shall be
reasonably available for consultation with the other respective coordinator concerning each
Resident's qualifications, clinical experience performance, and the curriculum of the Program.
1.4 MIHS agrees to designate for participation in the Program only Residents who
have completed the necessary training, appropriate prerequisites and didactic work for the
Program and who are in good standing. All Residents 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 MIHS does not derive direct revenue from patient care activity at Clinical
Facility.
1.6 As part of their educational experience, Residents may be asked to review patient
records to help support Clinical Facility's quality assurance projects without necessarily having
the patient records de-identified. If any study project requires review and approval from MIHS 's
Institutional Review Board (the "IRB"), the Parties shall work cooperatively and take all
reasonable steps necessary to obtain approval from the 1RB.
1.7 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.
1.8 Clinical Facility and MIHS 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. IVIIHS's Responsibilities.
2.1 MIHS shall advise all Residents 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). MIHS or Resident will be
responsible for the cost of pre-rotation screenings not performed by Clinical Facility (including
physical examination and drug test, if applicable). MIHS shall provide Clinical Facility with
documentation upon request establishing that each Resident 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 Resident is eligible to
have direct contact with Clinical Facility patients.
2.2 MIHS shall maintain all personnel and academic records relating to Residents.
2.3 MIHS shall require all Residents and any other personnel furnished by MIHS 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. Residents shall be required
to acknowledge these responsibilities at the start of the Program on a form prepared by Clinical
Facility and to grant MIHS and Clinical Facility permission to share educational records
necessary to the Program, including written evaluations from Supervising Clinicians to MIHS.
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2.4 MIHS shall reimburse Clinical Facility for any breakage or damage to equipment
or supplies, provided Clinical Facility provides evidence that such breakage or damage was
caused by a Resident or MIHS faculty member.
3. Clinical Facility's Responsibilities.
3.1 Clinical Facility will determine the locations and assignments for each Resident in
the Program and notify MIHS of available assignments.
3.2 Clinical Facility agrees (i) to provide direct supervision of Residents 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 Resident, will be
signed by the Resident and countersigned by a Supervising Clinician; and (iii) to complete
written evaluations on each Resident on forms provided by MIHS.
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 Blood borne Pathogens with respect to each of MIHS 's employees, agents and
Residents present at the Clinical Facility.
3.4 With respect to any quasi-professional services provided by Residents under this
Agreement, Clinical Facility shall notify MIHS and its Program Director(s) as soon as possible
of the initiation of any investigation of a Resident or MIHS faculty member.
4. Intentionally Left Blank
5. Health Insurance Portability and Accountability Act ("HIPAA"). Residents shall be
instructed by MIHS 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, Residents shall be considered part of Clinical
Facility's work force as that term is defined in HIPAA to include trainees and Residents.
Residents 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 Residents. In addition to any policies and
procedures of MIHS that govern Residents' conduct, Residents 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, Residents 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 Resident Experience. Clinical Facility may terminate the participation
of a Resident in the Program if the Resident's work, conduct or health might, in Clinical
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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. Resident Health Insurance and Emergency Medical Care. Residents shall be
responsible for maintaining health insurance throughout the entire term of their participation in
the Program. Residents 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
Resident.
9. Indemnification. To the fullest extent permitted by law, each party shall defend,
indemnify, and hold harmless the other party, its agents, representatives, officers, directors,
officials, and employees for, from and against all claims, damages, losses and expenses,
including, but not limited to, attorneys' fees, court costs, expert witness fees, and the cost of
appellate proceedings, relating to, arising out of, or alleged to have resulted from the negligent
acts, errors, omissions or mistakes relating to the performance of this Agreement. Each party's
duty to defend, indemnify and hold harmless the other party, its agents, representatives, officers,
directors, officials, and employees shall arise in connection with any claim, damage, loss or
expense that is attributable to bodily injury, sickness, disease, death, or injury to, impairment, or
destruction of property, including loss of use resulting therefrom, caused by any negligent acts,
errors, omissions or mistakes in the party's performance of this Agreement including any person
for whose acts, errors, omissions or mistakes a party may be legally liable.
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 indemnity in this Section. Further, the
scope of indemnification 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 $2,000,000 per
occurrence and $4,000,000 annual aggregate; (ii) professional liability insurance coverage with
minimum limits of $1,000,000 per occurrence and $3,000,000 annual aggregate; and
(iii) workers' compensation insurance 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, Residents, 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 be from 10/01/2017 through 09/01/2022. The County may, at its option and
with the agreement of the MIHS, renew the term of this Agreement for additional terms up to a
maximum of five (5) years.
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13. Termination. This Agreement may be terminated by either party upon thirty (30) days
prior written notice to the other party; provided, however, Residents 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
Residents 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 MIHS For County:
Maricopa County Board of Supervisors
Chandrika Shankar, MD. Attn: Clerk of the Board
Director Psychiatry Residency Program 301 West Jefferson Street, 10th Floor
Maricopa Integrated Health System (MIHS) Phoenix, Arizona 85003
Desert Vista Behavioral Health
570 W. Brown Rd.
Mesa, AZ 85201
Phone: 480 344 2023
Fax: 480 344 2157
chandrika_shankar@dmgaz.org
Copy to Clinical Facility:
Jim Carl Education Manager
GME Contract Coordinator Maricopa County
Maricopa Integrated Health System Correctional Health Services
Academic Affairs, Administration LL 3250 W. Lower Buckeye Rd.
2601 E. Roosevelt St. Suite 2100
Phoenix, AZ 85008 Phoenix, AZ 85009
Phone: 602 344 1870
Fax: 602 344 1185
Jim.carl@mihs org
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 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 Residents as a means of assistance in
completing their training requirements.
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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. Governing Law and Venue. This Agreement shall be construed in accordance with the
laws of the State of Arizona. Exclusive venue and jurisdiction for any actions or proceedings
related to or stemming from this Agreement shall be in the state or federal courts sitting in
Phoenix, Arizona.
19. Conflict of Interest. The County's participation in this Agreement is subject to A.R.S. §
38-511, which provides that this Agreement may be cancelled if any person significantly
involved in initiating, negotiating, securing, drafting or creating this Agreement on behalf of the
County is, at any time while this Agreement, or any extension thereof, is in effect, an employee
or agent of the other party to this Agreement in any capacity or consultant of the other party with
respect to the subject matter of this Agreement.
20. 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.
21. 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.
22. Compliance with Laws. Each party shall, to the extent such provisions apply, comply
with all 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.
23. 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.
24. 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.
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25. Authority. The persons signing this Agreement warrant that they have full authority to
do so and that their signatures shall bind the parties for which they sign.
[Signature Page to Follow]
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IN WITNESS WHEREOF, the parties have executed this Agreement as of the respective
dates written below.
MIHS MARICOPA COUNTY
By:
Title: Chief Medical Officer Title: Chairman, Board of Supervisors
Date: Date:
ATTESTED TO:
By:
Name: Elizabeth Ferguson, M.D. Name:
Title: Designated Institutional Official Title: Clerk of the Board
Date: Date:
APPROVED AS TO FORM:
By:
Name:
Title: Deputy County Attorney
Date:
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PROGRAM LETTER OF AGREEMENT
ADDENDUM TO THE CLINICAL EDUCATION AGREEMENT
BETWEEN
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
d.b.a.
MARICOPA INTEGRATED HEALTH SYSTEM,
1VIARICOPA MEDICAL CENTER
("MIHS")
AND
MARICOPA COUNTY DEPARTMENT OF CORRECTIONAL HEALTH SERVICES,
DEPARTMENT OF PUBLIC HEALTH
("Clinical Facility")
The following Addendum is added to the above-referenced Agreement:
1. Programs/Rotation
MIHS Psychiatry Residents rotate to Clinical Facility in Administrative Psychiatry
("Program).
2. Rotation Description/Length
This rotation involves MIHS and its Participants. The rotational assignment would be
such that:
One resident, at
- PGY 4 level, will rotate to Clinical Facility
for 1-1.5 days per week
for clinical experience in Program
- located at Maricopa County Correctional Health Services, Phoenix, AZ.
3. Rotation Purpose
The purpose of this rotation is to provide MIHS Participants with exposure to an
educational experience, including diverse pathology in Program. Goals of the rotation are
to provide Program Participants with an educational setting to:
• Resident will discuss guidelines for integrating mental health care (example -
substance use disorders, suicide risk) in the Correctional System
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Resident will describe the operational aspects of Correctional system and attend
Justice related meetings as well as mental health unit staffing.
• . Resident will identify administrative systems and legal issues that guide clinical
practice in correctional settings
• . Resident at the end of the rotation will select a project of his/her interest and
then prepare a brief report based on their experiences at DOC.
4. Teaching Faculty
Dawn Noggle, PhD, CCHP who is a member of Clinical Facility, will be responsible for
the instruction, supervision and evaluation of the MIHS Program Participant(s). This
rotation will not involve patient care.
5. Stipend and Additional Costs
The stipend, medical benefits, transportation costs, housing costs, and medical licensure
or registration arrangements and costs for MIHS Program Participants will be borne by
MIHS pursuant to its applicable policies and procedures.
6. Evaluation
MIHS Program Director shall provide appropriate evaluation documents and instruction
for use by the supervising faculty at Clinical Facility.
7. Policies Governing Resident Education
Participants shall be governed in accordance with established MIHS, the Residency Training
Program and Clinical Facility policies and procedures. The Program Director shall retain full
control and responsibility for the overall education of the Participant(s) including
appointment of the Teaching Faculty responsible for the supervision and evaluation of the
resident.
8. Effective Date and Term
This agreement term begins October 1, 2017 and continues up to five years or the
termination of the Agreement whichever occurs first.
IN WITNESS WHEREOF, the parties hereto have executed this Addendum to the Agreement as
of the respective dates written below.
[Signatures are on next page]
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MARICOPA COUNTY DEPARTMENT MARICOPA COUNTY SPECIAL HEALTH
OF CORRECTIONAL HEALTH CARE DISTRICT, d.b.a.
SERVICES, DEPARTMENT OF PUBLIC MARICOPA INTEGRATED HEALTH
HEALTH SYSTEM,
("Clinical Facility") MARICOPA MEDICAL CENTER
("MIHS")
By:
By: Name: ergLigot1/2, M.D.
Name: Title: Des' Institutional Official
Title: Date:
Date:
By:
By: Name: Chanilrika Shankar, M.D.
Name: Title: Program ector, Psychiatry
Title: Date:
Date:
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