AFFILIATION AGREEMENT WITH COLLEGE OF ST. SCHOLASTICA .PDF

AFFILIATION AGREEMENT
DEPARTMENT OF SOCIAL WORK
Graduate and Undergraduate Programs
AGREEMENT OF INTERNSHIP
This Agreement shall be effective October 1, 2016 (the “Effective Date”). The parties to this
Agreement are the College of St. Scholastica (“School”) and Maricopa County (“County”), a
political subdivision of the State of Arizona, administered by its Human Services, Department,
and other departments the County may designate from time to time (together, “Internship
Facility”).
WHEREAS, School wants to provide internship experiences for the School’s students
(“Students”) as part of their overall education; and
WHEREAS, County, through its Internship Facility, is willing to provide client services
training to School’s Students; and
WHEREAS, it is to the benefit of both School and Internship Facility to cooperate in the
educational preparation of Students, so as to promote excellence in client 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 Internship Facility for such client 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
Internship Facility prior to the start of the rotation and will be subject to Internship Facility’s
acceptance and approval.
1.2 The number of Students accepted into the Program and schedule of Internship
assignments shall be arranged in advance by mutual agreement between Internship Facility and
School. In the event it becomes necessary to cancel a reserved space or change a student
assignment, School will immediately notify Internship Facility.
1.3 School and Internship Facility shall each designate a coordinator who shall be
reasonably available for consultation with the other respective coordinator concerning each
Student’s qualifications, Internship 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 Internship Facility’s
standards of Program admission and participation.
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1.5 Internship Facility assumes full responsibility for the care of its clients. It is
understood that School does not derive direct revenue from client care activity at Internship
Facility.
1.6 As part of their educational experience, Students may be asked to review client
records to help support Internship Facility’s quality assurance projects without necessarily
having the client records de-identified. If any study project requires review and approval from
School’s Institutional Review Board (the “IRB”), the Parties shall work cooperatively and take
all reasonable steps necessary to obtain approval from the IRB.
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 Internship 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 Internship Facility (or its agent). School or Student will be
responsible for the cost of pre-rotation screenings not performed by Internship Facility (including
physical examination and drug test, if applicable). School shall provide Internship 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.
Internship Facility (or its agent) shall review any such documentation to determine if Student is
eligible to have direct contact with Internship Facility clients.
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 Internship Facility
and to maintain confidentiality of client information in accordance with applicable law, as well
as the confidentiality of records and operations of the Internship Facility. Students shall be
required to acknowledge these responsibilities at the start of the Program on a form prepared by
Internship Facility and to grant School and Internship Facility permission to share educational
records necessary to the Program, including written evaluations from Supervising Staff to
School.
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2.4 School shall reimburse Internship Facility for any breakage or damage to
equipment or supplies, provided Internship Facility provides evidence that such breakage or
damage was caused by a Student or School faculty member.
3. Internship Facility’s Responsibilities.
3.1 Internship Facility will determine the locations and assignments for each Student
in the Program and notify School of available assignments.
3.2 Internship Facility agrees (i) to provide direct supervision of Students and
practical instruction while on the assigned premises for the Program at Internship Facility
locations by qualified supervisors who are on staff at the Internship Facility (“Supervising
Staff”); (ii) that all notes or charting concerning a client’s progress, if written by a Student, will
be signed by the Student and countersigned by a Supervising Staff; 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, Internship 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 Internship Facility.
3.4 With respect to any quasi-professional services provided by Students under this
Agreement, Internship 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”). Internship Facility and
School agree to abide by the limitations set forth under FERPA and regulations at 34 CFR 99.33
regarding the protection of educational data. Both parties acknowledge that this Agreement
allows access to educational data, and agree to hold that information in strict confidence and not
to use or disclose educational data received from or on behalf of either institution except as
permitted or required by this Agreement, as otherwise required or allowed by law, or as
authorized in writing by Student.
5. Health Insurance Portability and Accountability Act (“HIPAA”). Students shall be
instructed by School and/or Internship Facility before beginning the Program concerning the
confidentiality of information of Internship Facility’s clients and standard precautions. For
purposes of compliance with HIPAA, Students shall be considered part of Internship 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 Internship 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
Internship Facility’s policies and procedures, including standard precautions, while participating
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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. Internship Facility may terminate the participation
of a Student in the Program if the Student’s work, conduct or health might, in Internship
Facility’s sole discretion, have detrimental effect on its clients, staff, or operations. Internship
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 Internship Facility with the associated expense to be the responsibility of the Student.
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
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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. This Agreement is for a term of one (1) year and will automatically renew for
subsequent one-year terms for a total of five (5) years, unless terminated as described in Section
13 below.
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
Internship 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 Internship Facility:
Jeffery T. Tourdot, Assistant Director
Senior and Adult Services/Special
Initiatives
Maricopa County
Human Services Department
234 N. Central, 3rd Floor
Phoenix, AZ 85004
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 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. 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
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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.
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.
[NAME OF SCHOOL] MARICOPA COUNTY
By: ______________________________ By: ________________________________
Name: ____________________________ Name: ______________________________
Title: Title: Chairman, Board of Supervisors
Date: ____________________________ Date: _______________________________
ATTESTED TO:
By: ________________________________
Name: ______________________________
Title: Clerk of the Board
Date: _______________________________
APPROVED AS TO FORM:
By: ________________________________
Name: ______________________________
Title: Deputy County Attorney
Date: _______________________________
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