PCH RESIDENT AGREEMENT (002).DOCX

PHOENIX CHILDREN’S HOSPITAL
RESIDENT ROTATION RESIDENCY AGREEMENT
This Off-Site preceptor Resident Rotation Residency Agreement (“Agreement”)
sets forth the terms of the rotation of Residents from Phoenix Children’s Hospital (“PCH”),
Inc., an Arizona nonprofit corporation whose principal office is located at 1919 E. Thomas
Rd., Phoenix, AZ 85016 to Maricopa County, by and through its Department of Public
Health (“MCDPH”), whose principal office is located at 4041 N. Central Ave., Ste. 1400,
Phoenix, AZ 85012 for educational Residency and experience.
1. Rotation Goals and Objectives
A. The educational goals and objectives for any rotation will be provided by PCH to
the applicable MCDPH preceptor prior to the start of the rotation. If these goals
and objectives are acceptable to MCDPH, the MCDPH preceptor will sign a
statement agreeing to meet the goals and objectives of the rotation and will return
a copy to PCH.
B. The Program Director of the applicable Residency Program at PCH shall retain
full control and responsibility for the overall education of the Residents.
2. Responsibilities of PCH for Rotations
A. Use proper administrative procedures acceptable to MCDPH in planning for
observation and practical experience.
B. Provide for supervision and instruction as agreed upon by both parties.
C. Ensure that Residents participating in the program along with any faculty
observers at MCDPH adhere to existing rules and regulations of MCDPH.
D. Ensure each Resident participating in the program at MCDPH meets the same
health standards that are required of all employees at MCDPH. MCDPH may
request upon reasonable notice a physical examination and/or laboratory or other
diagnostic tests for any Resident. The Resident and PCH shall have the option to
either agree to such physical examinations, labs, and tests or to withdraw the
Resident from MCDPH. MCDPH shall not be responsible for any cost or charges
incurred for such physical examinations, labs, or tests.
E. Prohibit Residents or PCH staff members from releasing any material relative to
practical experiences that has not been approved by MCDPH for release for
publication or to third parties, or that is confidential by law.
F. Ensure that Resident dress and grooming shall be appropriate for MCDPH and
for health care workers. Residents will comply with the MCDPH dress code.
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G. Notwithstanding any provision to the contrary, PCH agrees that the faculty
observers and Residents enrolled at MCDPH shall not be employees or agents of
MCDPH or Maricopa County, and shall not be entitled to any defense or indemnity
under Maricopa County’s Declaration of Trust for Maricopa County, Arizona, Self-
Insured Risk Trust Fund, stipends, benefits, conditions, terms or rights of MCDPH
employees including workers’ compensation, medical or hospitalization insurance
or benefits, pension, retirement or vacation pay, credit or other benefits or rights
of MCDPH employees. MCDPH employees employed by PCH as faculty
members on their own time (non-MCDPH pay status) will be subject to the same
restrictions.
H. Provide professional and either general liability insurance coverage or self-
insurance coverage to each individual rotating Resident for the duration of the
assigned rotation, to include commercial general liability insurance of $2,000,000
each occurrence and $4,000,000 general aggregate, and professional liability
insurance of $2,000,000 per claim and a $4,000,000 aggregate. In the event any
insurance policies required are written on a claims made basis, coverage shall
extend for two years past the Agreement’s completion as evidenced by annual
Certificates of Insurance. PCH will provide proof of such coverage in the form of
Certificates of Insurance to MCDPH.
I. Remove from MCDPH any Resident or PCH faculty observer identified for any
reason as unacceptable by MCDPH.
J. Reimburse MCDPH for damage to equipment or supplies, provided MCDPH
provides evidence that such damage was caused by Residents or faculty
observers.
K. Designate a person or persons to assist in the coordination of Resident learning
experiences, including planning with MCDPH staff to assign Residents to specific
learning experiences that are appropriate for the program(s).
L. Provide a 30-day advance notice for Residents assigned to a rotation.
3. Responsibilities of MCDPH for Rotations
A. Provide Residency experiences and make available the related facilities at
MCDPH for Residents enrolled in any program.
B. MCDPH staff will teach and supervise Residents while assigned to MCDPH
experiences. Any client services provided by Residents shall be under the direct
and exclusive supervision of qualified staff employed by MCDPH.
C. MCDPH shall designate, after consultation with PCH, a member of its Medical
Staff to coordinate the Residents’ schedules and educational activities at MCDPH
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(“Program Coordinator”). The Program Coordinator shall act as liaison with PCH,
and will assume administrative responsibility for the Residents while on rotation.
In addition, the Program Coordinator shall execute an addendum to this
Agreement with the PCH Program Director, for each participating residency
program governed by this Agreement, to be described in an attached Addendum
as mutually executed by the parties. Any future addenda are incorporated herein
by reference. A sample of the addendum is attached hereto as Attachment A. The
term for all Resident rotations at MCDPH shall be the same as this Agreement
term unless terminated by either party as provided herein.
D. Keep PCH informed of changes in policy that affect Residents and faculty
observers.
4. Mutual Responsibilities of MCDPH and PCH
A. The personnel of MCDPH and the faculty of PCH assigned to the program will
confer at such times as may be mutually agreed upon to evaluate the educational
program.
B. The personnel of MCDPH and the faculty of PCH assigned to the program shall
cooperate in providing a sound educational environment.
C. Residents are assigned for practical Residency experiences in the appropriate
MCDPH unit. Both parties shall mutually agree upon the number of Residents and
the appropriate MCDPH unit for training.
D. Upon request, each party will complete program evaluation forms for Residents,
faculty, or learning experiences.
5. Term and Termination
A. The term of this Agreement shall be from January 1, 2024, through June 30, 2033.
The Agreement may be renewed for additional terms by the mutual consent of
both parties.
B. This Agreement may be terminated by either party upon 30 days prior written
notice to the other party; provided, however, Residents participating at MCDPH
at the time of termination shall be given an opportunity to complete their
participation.
6. Miscellaneous
A. PCH and MCDPH shall not discriminate against any individual on the basis of
race, color, sex, pregnancy, childbirth or medical conditions related to pregnancy
or childbirth, political or religious affiliation or ideas, culture, creed, social origin or
condition, genetic information, sexual orientation, gender identity or expression,
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national origin, ancestry, age, disability, military service or veteran status, or
marital status, whether as to employees, applicants for employment, Residents,
faculty, or clients. To the extent applicable to this Agreement, both parties agree
to comply with all state and federal employment laws, rules, regulations, and
executive orders, including Executive Order 2009-09 as amended by Executive
Order 2023-01, relating to equal employment opportunity and non-discrimination.
B. Nothing in this Agreement shall be deemed or construed as creating a
relationship of principal and agent or of partnership or of joint venture between
the parties. Residents shall not be considered servants, agents, or employees of
MCDPH.
C. This Agreement shall be construed and enforced 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 will be in the state or
federal courts sitting in Phoenix, Arizona.
D. This Agreement shall be binding upon and shall inure to the benefit of both parties
and their respective successors, heirs, assigns and legal representatives. This
Agreement may not be assigned in part or whole without the prior written consent
of both parties.
E. Individuals executing this Agreement on behalf of the parties represent and
warrant that they have been authorized to do so.
F. This Agreement contains the entire understanding of the parties relating to the
subject matter of this Agreement. Any prior agreements, promises, negotiations
or representations between the parties, either oral or written, relating to the
subject matter of this Agreement that are not expressly included are of no force
or effect. Any modifications or amendments must be agreed to by both parties in
writing.
G. During the term of this Agreement, the parties shall take such actions, including
revising this Agreement, as necessary or advisable to comply fully with all laws,
rules, and regulations applicable to the performance of this Agreement, including
without limitation the Health Insurance Portability and Accountability Act and the
Family Educational Records and Privacy Act.
H. To the fullest extent permitted by law, each party (as “Indemnitor”) agrees to
indemnify, defend, and hold harmless the other its agents, representatives,
officers, directors, officials, and employees (as “Indemnitee”) from and against all
claims, damages, losses, and expenses (including, but not limited to attorneys'
fees, court costs, expert witness fees, and the costs and attorneys' fees for
appellate proceedings) arising out of, or alleged to have resulted from the
negligent acts, errors, omissions, or mistakes of Indemnitor, a subcontractor, any
one directly or indirectly employed by them, relating to the performance of this
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Agreement.
i. Each party’s duty to defend, indemnify, and hold harmless the other, 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 of, or destruction of tangible property, including loss of use
resulting therefrom, caused by negligent acts, errors, omissions, or
mistakes in the performance of this Agreement, but only to the extent
caused by the negligent acts or omissions of the Indemnitor, a
subcontractor, any one directly or indirectly employed by them, regardless
of whether or not such claim, damage, loss, or expense is caused in part
by a party indemnified hereunder.
ii. The amount and type of insurance coverage requirements set forth herein
will in no way be construed as limiting the scope of the indemnity in this
paragraph.
I. PCH warrants and certifies that it does not currently, and agrees for the duration
of the Agreement that it will not, use:
i. The forced labor of ethnic Uyghurs in the People’s Republic of China.
ii. Any goods or services produced by the forced labor of ethnic Uyghurs in
the People's Republic of China.
iii. Any contractors, subcontractors or suppliers that use the forced labor or
any goods or services produced by the forced labor of ethnic Uyghurs in
the People's Republic of China.
If PCH becomes aware during the term of the Agreement that PCH is not in
compliance with this paragraph, PCH shall notify MCDPH within five business
days after becoming aware of the noncompliance. Failure of PCH to provide a
written certification that PCH has remedied the noncompliance within 180 days
after notifying MCDPH of its noncompliance shall result in the termination of this
Agreement unless the Term of this Agreement shall end prior to said 180-day
period.
J. Compliance Requirements for A.R.S. § 41-4401, Government Procurement; E-
Verify Requirement:
i. PCH warrants compliance with all federal immigration laws and regulations
relating to employees and warrants its compliance with A.R.S. § 23-214(A),
which states, “After December 31, 2007, every employer, after hiring an
employee, shall verify the employment eligibility of the employee through
the e-verify program and shall keep a record of the verification for the
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duration of the employee’s employment or at least three years, whichever
is longer”.
ii. A breach of warranty regarding compliance with immigration laws and
regulations shall be deemed a material breach of this Agreement and PCH
may be subject to penalties up to and including termination of the contract.
iii. Failure to comply with a state audit process to randomly verify the
employment records of contractors and subcontractors shall be deemed a
material breach of this Agreement and PCH may be subject to penalties
up to and including termination of the Agreement.
iv. The State of Arizona retains the legal right to inspect the papers of any
employee who works on this Agreement to ensure that the contractor or
subcontractor is complying with the warranty under Paragraph i.
v. For questions about E-Verify PCH should visit the following web site:
http://www.uscis.gov.
K. This Agreement may be cancelled in accordance with A.R.S. § 38-511.
IN WITNESS WHEREOF, MCDPH and PCH have executed this Agreement.
MARICOPA COUNTY PHOENIX CHILDREN’S HOSPITAL
Acting for and on behalf of
the Department of Public Health
By: By:
Chairman, Date
Maricopa County Board of
Supervisors Name:
Title:
Attest:
Clerk of the Board Date
Director, MCDPH Date
Approved as to Form Date
Deputy County Attorney
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Attachment A
Sample Program Letter of Agreement
Program Letter of Agreement for Graduate Medical Education
Between
Maricopa County, by and for its Department of Public Health
and
Phoenix Children’s Hospital, Inc.
This Program Letter of Agreement for Graduate Medical Education (“PLA”) is
between Maricopa County, by and for its Department of Public Health (“MCDPH”) and
Phoenix Children’s Hospital, Inc., an Arizona nonprofit corporation (“PCH”), referred to
individually as “Party” and collectively as “Parties”. This PLA is effective for the same term
as the Parties’ Resident Rotation Residency Agreement.
1. Rotation Description and Duration
This is a (name of) rotation for PCH’s (Resident type) (referred to herein individually as
“Resident” and collectively as “Residents”) to rotate at MCDPH.
The rotational assignment for Residents would be such that X Residents would rotate for
X-Y weeks at MCDPH.
2. Persons Responsible for Education and Supervision
At PCH: (name) (“Program Director”).
At MCDPH: (name) (“Site Director”).
The above-mentioned people are responsible for the education and supervision of the
Residents while rotating at MCDPH.
3. Responsibilities
The faculty at MCDPH must provide appropriate supervision of Residents in patient care
activities and maintain a learning environment conducive to educating the Residents in
the Accreditation Council of Graduate Medical Education (“ACGME”) competency areas.
The faculty must evaluate each Resident’s performance in a timely manner during each
rotation or similar educational assignment and document this evaluation at completion of
the assignment.
4. Content of the Educational Experiences
The contents of the educational experiences have been developed according to ACGME
Residency/Fellowship Program Requirements, and include the following goals and
objectives set forth in Paragraph 9 of this PLA.
In cooperation with Program Director, Site Director and the faculty at MCDPH are
responsible for the day-to-day activities of the Residents to ensure that the outlined goals
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and objectives are met during the course of the educational experiences at Participating
Institution.
5. Policies and Procedures Governing Resident Education
Residents will be governed in accordance with the policies and procedures of MCDPH
and PCH.
6. Stipend and Additional Costs
The stipend, medical benefits, transportation costs, housing costs, and medical licensure
or registration arrangements and costs for the Residents would continue to be borne by
PCH pursuant to its applicable policies and procedures.
7. Notices.
All notices required under this PLA shall be deemed to have been fully given when made
in writing and deposited in the United States mail, postage prepaid, certified mail, return
receipt requested, and addressed as follows:
To: MCDPH: Maricopa County Department of Public Health
4041 N. Central Ave. Ste. 1400
Phoenix, AZ 85012
ATTN: Specialized Services Supervisor
To: PCH: Phoenix Children’s Hospital, Inc.
1919 E Thomas Road
Phoenix, AZ 85016
ATTN: Medical Education
Copy to: Phoenix Children’s Hospital, Inc.
1919 E Thomas Road
Phoenix, AZ 85016
ATTN: Office of General Counsel
8. Records.
All records documenting the services provided by MCDPH pursuant to this PLA shall be
retained by MCDPH for a period of three (3) years from the date the record is made.
MCDPH shall, upon reasonable notice, give PCH or its authorized representative the
privilege at a reasonable time of inspecting, examining, and auditing, during normal
business hours, such of MCDPH’s business records which are relevant to any
governmental or intermediary investigation or audit of PCH. The cost of such inspection,
examination, and audit will be at the sole expense of PCH and, unless otherwise
mandated by a governmental entity or fiscal intermediary, such inspection, examination,
and audit shall be conducted where said records are normally maintained.
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9. Program/Rotation Goals and Objectives
MCDPH and PCH shall cooperate to achieve the following goals and objectives for this
Rotation:


IN WITNESS WHEREOF, the parties have caused this PLA to be executed by
their duly authorized officers or representatives, as of the day and year indicated below.
MARICOPA COUNTY, by and for its PHOENIX CHILDRENS HOSPITAL,
Department of Public Health INC., an Arizona nonprofit corporation
(“PCH”)
Joel W. Kodicek Vasudha L. Bhavaraju, MD
Specialized Services Supervisor Designated Institutional Official
Date Date
Site Director: Site Director:
Renuka Khurana, MD, MPH Wassim Ballan, MD
Site Director Program Director
Date Date
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