SCOTTSDALE HEALTHCARE DI AGREEMENT 3.DOCX

AFFILIATION AGREEMENT
BETWEEN
MARICOPA COUNTY
by and through its
Department of Public Health
AND
SCOTTSDALE HEALTHCARE
FOR
DIETETIC INTERNSHIP PROGRAM
IN THE
OFFICE OF NUTRITION SERVICES
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THIS AGREEMENT is entered into by and between Maricopa County, acting by and through its
Department of Public Health (hereinafter referred to as COUNTY), whose principal office is
located at 4041 N. Central Ave., Ste. 1400, Phoenix, AZ 85012 and Scottsdale Healthcare
Hospitals (hereinafter referred to as THE AFFILIATE), an Arizona nonprofit corporation whose
principal office is located at 8125 N. Hayden Rd., Scottsdale, AZ 85258.
WITNESSETH:
WHEREAS, the purpose of the Agreement is to establish a program of cooperative interaction
between COUNTY and THE AFFILIATE to provide dietetic interns with a dietetic internship
practicum approved by the American Dietetic Association, in an off-campus setting, in the areas
of clinical, community, food management, and administrative dietetics; and
WHEREAS, it is in the mutual interest and advantage of the parties that the interns be given the
opportunity to utilize THE AFFILIATE'S facilities for educational and supervisory experience
purposes; and
WHEREAS, it is acknowledged by the parties to this Agreement that the dietetic interns who
participate in the dietetic internship program contemplated by this Agreement are performing
duties for a program which is sponsored by COUNTY, and that said dietetic interns will be
supervised by both COUNTY and THE AFFILIATE while they are performing duties in the
dietetic internship program contemplated by this Agreement; and
WHEREAS, the dietetic internship program of COUNTY is currently granted approval status by
The American Dietetic Association Council on Education Division of Education
Accreditation/Approval, a specialized accrediting body recognized by the Council on
Postsecondary Accreditation and the United States Department of Education; and
NOW, THEREFORE, upon the mutual promises and covenants contained herein, COUNTY and
THE AFFILIATE agree as follows:
1. RESPONSIBILITIES OF COUNTY
COUNTY agrees that during the term of this Agreement, it shall:
a. Designate in writing a Dietetic Internship Program Director who will be
available for consultation with THE AFFILIATE on all matters of the
operation of the program to include the qualification, preparation, grading,
and working hours of the interns placed in the program;
b. Select for potential placement in the program at THE AFFILIATE interns
whose previous academic and practical experience has properly prepared
them for the activities and responsibilities required by the program;
c. All interns and on-site faculty must comply with the health standards
applied to employees of THE AFFILIATE. Pre-admittance requirements
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for immunizations, certifications, tuberculosis (TB) screening, substance
abuse testing, and background checks for on-site program faculty and
interns shall be in keeping with the policies applicable to employees of
THE AFFILIATE. This includes the following:
A. A statement of good health to participate from a medical provider,
B. Membership in ADA and the Arizona Dietetic Association – Central,
C. Health insurance,
D. Automobile insurance
E. Driver's License
F. Signed verification statement of the Didactic Program in Dietetics
G. Proof of immunity by documentation of one of the following for each
disease:
Measles a) documentation of two live doses of vaccine (given at least 28 days apart) and given on
or after the student's first birthday
b) lab titer indicating immunity
c) birth before 1957
Rubella a) documentation of one live dose given on or after their first birthday;
b) lab titer indicating immunity
c) birth before 1957
Mumps a) documentation of one live dose given on or after their first birthday
b) lab titer indicating immunity
c) documentation of physician-diagnosed case of disease, if born before 1957
Varicella a) verbal history of disease
b) lab test indicating immunity
c) 2 doses of varicella vaccine
Hepatitis B a) immunizations
b) titers OR
c) signed waiver/declination
Tuberculosis (TB) screening would include 2-step TB testing via Mantoux method, given
7-10 days apart (only one needs to be given if they have documentation of negative TB
skin test within last year); if positive reaction (equal to or greater than 10mm
INDURATION), chest x-ray is to be performed, with no evidence of active disease in
order to begin learning experiences; if history of positive reaction, no TB test is given but
should have no current signs and symptoms of TB, with documentation of negative chest
x-ray within six months. If faculty or student currently has signs and symptoms of TB, a
current and negative chest x-ray will be required prior to beginning the assigned rotation,
internship, or externship.
A drug panel 154 urine drug screen must be completed with negative results within 30
days prior to intern start date, with interpretation by a medical review officer as
necessary. This drug screen will include testing for nicotine (cotinine). Existing on-site
faculty and interns who have been continuously employed or enrolled by the COUNTY
will not require a repeat drug screen. Only new on-site faculty or interns, those screened
for cause, or those returning from leaves of absence will require a screen that includes
nicotine (cotinine). A listing of all current health and safety requirements can be found at
http://www.shc.org/studentreqs. Acquisition of all pre-admittance requirements (drug
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screening, fingerprint clearance cards, immunizations, and certifications) will not be the
responsibility of THE AFFILIATE. Results of all testing will be kept on-file by the
COUNTY. Interns or faculty who do not comply with THE AFFILIATE’S policy in all
above requirements will not utilize THE AFFILIATE for rotations, internships,
externships, or other learning opportunities. Falsification or misrepresentation may result
in termination of this Agreement.
H. Fingerprint Clearance Card: All students and faculty assigned to
Scottsdale Healthcare are required to obtain a current fingerprint
clearance card from the Arizona Department of Public Safety (DPS).
I. Current Level C CPR card or Basic Life Support (BLS) for healthcare
providers certification. This fingerprint clearance card must
encompass state and federal checks for criminal and sex offender
offenses. If either an on-site instructor or student commits a criminal
offense while assigned to HOSPITAL, SCHOOL will notify
HOSPITAL of this offense.
J. Flu shot: All students and faculty assigned to Scottsdale Healthcare are
required to demonstrate receipt of an influenza vaccine once per year.
If the vaccine is refused, documentation of this declination must be
kept on-file at the educational institution.
K. Appropriate level of education required for the Students’ participation
concerning OSHA, Bloodborne Pathogen Regulations, and Universal
Blood and Body Fluids Precautions.
Acquisition of all pre-admittance requirements (drug screening, fingerprint
clearance cards, immunizations, and certifications) will not be the
responsibility of THE AFFILIATE. Results of all testing will be kept on-
file at the educational institution for a minimum of five (5) years from the
date the on-site faculty and/or student began participating in the program.
Students or faculty who do not comply with THE AFFILIATE policy in
all above requirements will not utilize THE AFFILIATE for rotations,
internships, or externships. Falsification or misrepresentation of the
required health and safety requirements may result in termination of this
contractual relationship.
COUNTY must submit documentation to AFFILIATE’S student programs
specialist verifying completion of the required health and safety
requirements prior to on-site arrival. This documentation must be in a
format acceptable to AFFILIATE student programs specialist and must be
received two to four weeks prior to the student's first day at AFFILIATE.
d. Instruct and advise the selected interns of their obligations to THE
AFFILIATE while participating in the program as those obligations are set
forth in writing by THE AFFILIATE, and to comply with all written rules,
regulations and policies of THE AFFILIATE while they participate in the
program. THE AFFILIATE may remove a student from the clinical
experience if he/she is incompatible with THE AFFILIATE or whose
personal characteristics prevent desirable relationships within THE
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AFFILIATE; negatively impacts the welfare of patients; or whose
performance, after appropriate instruction and counseling, continues to fall
below the level required to maintain practice standard;
e. Provide such supervision and instruction, in addition to that made
available by THE AFFILIATE at its facilities, as may be agreed upon by
COUNTY and THE AFFILIATE;
f. Provide THE AFFILIATE'S Registered Dietitian Site Director with a
written copy of the policies and rules of the Dietetic Internship Program
that affect the interns and are related to their participation in the program,
and keep THE AFFILIATE’S Registered Dietitian Site Director informed
of any changes in said policies and rules;
g. The faculty and interns agree to comply with all applicable Federal and
State laws and policies and regulations of the AFFILIATE. THE
AFFILIATE retains the ultimate control for all aspects of patient care;
h. Provide THE AFFILIATE'S Registered Dietitian Site Director all the
rights and privileges of an adjunct faculty member; and
i. Advise THE AFFILIATE in writing at least thirty (30) days prior to the
arrival of interns at THE AFFILIATE of the date anticipated for
commencement of their participation in the program.
j. AFFILIATE agrees that on-site instructors and assigned students will
complete an approved orientation prior to arrival at the assigned
HOSPITAL areas. This orientation must be completed at least two weeks
in-advance to rotation, internship, or externship start dates. HOSPITAL
reserves the right to either cancel or to delay the supervisory or learning
assignment if the orientation is not completed by the aforementioned
deadline.
k. AFFILIATE agrees to make all arrangements for consultation and
assistance with/for its students regarding tuition, housing, transportation,
etc.
l. COUNTY agrees to meet all deadlines set forth by AFFILIATE. Failure
to meet deadlines may result in possible agreement termination.
2. RESPONSIBILITIES OF THE AFFILIATE
THE AFFILIATE agrees that during the term of this Agreement it shall:
a. Provide the necessary facilities and supervisory personnel to establish and
carry out the requirements of the dietetic internship program that will give
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the dietetic interns educational and supervisory experiences in dietetics at
THE AFFILIATE site(s).
b. Designate a Registered Dietitian Site Director who shall be responsible for
the interns and act as the dietetic internship program coordinator with
COUNTY.
c. Provide to the Dietetic Internship Program Director evaluation of the
interns’ performance and other such information as may be requested
concerning the interns’ participation at THE AFFILIATE site(s).
d. Provide such training aids and data relating to the various phases of the
program as may be reasonably necessary;
e. Allow interns to utilize library and cafeteria facilities if available;
f. Provide the Dietetic Internship Program Director with a copy of the
written rules, regulations and policies of THE AFFILIATE as it applies to
the dietetic internship programmatic activities.
3. MUTUAL RESPONSIBILITIES OF COUNTY AND THE AFFILIATE
Both parties agree:
a. That faculty of COUNTY, and faculty of THE AFFILIATE shall confer at
such times as may be mutually agreed upon to evaluate the progress of the
dietetic internship program and the interns;
b. To cooperate to provide a sound educational environment to the interns
and quality services to all clients of COUNTY and THE AFFILIATE; and
c. That any and all material and/or programs developed by the interns during
their participation in the dietetic internship program at COUNTY shall
become the joint property of COUNTY and THE AFFILIATE.
4. COMPENSATION
Interns will not receive financial compensation from either COUNTY or the AFFILIATE
under the terms of this agreement.
5. WORK STATEMENT
To complete program graduation requirements, the interns will meet the 47 Core
Competencies and 10 Community Competencies for the Supervised Practice Components
of entry level dietitians as listed in the Commission on Accreditation for Dietetic
Education Accreditation Handbook, © 2002, pages 32-35. All interns will receive a copy
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of these competencies.
No on-site instructor or student from COUNTY shall be deemed to be employees or
agents of AFFILIATE for purposes of compensation, fringe benefits, workers’
compensation, unemployment compensation, minimum wage laws, income tax
withholding, social security, health insurance, professional liability insurance, or any
other purpose, because of their participation in the PROGRAM. Each student is placed
within the AFFILIATE to receive clinical experience as a part of his or her academic
curriculum only, and each on-site instructor, if any, is placed within the AFFILIATE to
aid in such student clinical experience. The foregoing notwithstanding, the parties
acknowledge that, as part of the PROGRAM at AFFILIATE, students and on-site
instructors will receive “protected health information,” as defined in HIPAA, and because
they will function in a capacity that would otherwise be filled by a paid employee of
AFFILIATE, students and on-site instructors will be deemed to function as part of
AFFILIATE’s “workforce,” as defined in HIPAA.
AFFILIATE may remove a student from the learning experience who is disruptive or
otherwise unprofessional, dangerous to the life, health, and/or safety of the HOSPITALS’
patients, influenced by the ingestion of alcohol or other intoxicating drugs or substances,
is determined to be in violation of any state or federal law or regulation or who negatively
impacts the welfare of patients or whose performance, after appropriate instruction and
counseling, continues to fall below the level required to maintain practice standards.
6. NONDISCRIMINATION
The parties hereto mutually agree that at no time shall race, creed, color, gender, or other
prohibited criteria be employed by either COUNTY, OR THE AFFILIATE for the
purpose of discrimination, whether as to employees, applicants for employment, interns
or clients. To the extent applicable to this Agreement, both parties hereto agree to
comply with all state and Federal laws, rules, regulations, and executive orders as to
equal employment opportunity, non-discrimination and affirmative action including
Arizona Executive Order No. 2009-09.
7. INSURANCE
A. Each party shall have in effect at all times during the term of this Agreement
insurance or comparable self-insurance which is adequate to protect the other party,
its officers and employees, participants and equipment against such losses as are set
forth below.
B. THE AFFILIATE shall provide COUNTY, upon request, with a current Certificate
of Insurance or a certified copy of the insurance policy naming Maricopa County as
an additional insured under THE AFFILIATE’S commercial general liability and
commercial automobile liability insurance; or, if THE AFFILIATE is self-insured,
shall provide the COUNTY with current documentation of self-insurance coverage
by furnishing a letter indicating such.
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C. The following types and amounts of insurance are required as minimums:
1. Workers’ Compensation as required by Arizona law, and Employer’s Liability
Insurance of $1,000,000 each accident, $1,000,000 disease and $1,000,000
disease policy limits.
2. Unemployment Insurance as required by Arizona law.
3. Commercial general liability insurance with a minimum of $1,000,000 each
occurrence, $3,000,000 general aggregate and $3,000,000 products/completed
operations aggregate. The policy shall include coverage for public liability,
bodily injury, and property damage, personal injury (including coverage for
contractual and employee acts) and blanket contractual.
4. Standard minimum deductible amounts are allowable. Any losses applied
against insurance deductibles are the sole responsibility of THE AFFILIATE.
5. Professional Liability Insurance with a minimum combined single limit of
$1,000,000 for each claim and $3,000,000 aggregate.
6. Commercial Automobile Liability Insurance with a combined single limit of
$1,000,000.
D. THE AFFILIATE will immediately inform the Dietetic Internship Program Director
of any cancellation of its insurance or any decrease in its lines of coverage at least
thirty (30) days before such action takes place.
8. PROFESSIONAL LIABILITY
A. Under this Agreement, all Dietetic Interns shall have in effect at all times during
their participation in the dietetic internship program professional liability insurance
with a minimum of combined single limit of $1,000,000 for each claim, $3,000,000
aggregate.
B. The Dietetic Interns, while providing health care, medical or professional services
shall be deemed agents of the COUNTY for purposes of determining professional
liability for acts rising out of the performance of this Agreement. Such professional
liability coverage shall be enforced for services performed in COUNTY programs as
specified in the Work Statement and in support of this Agreement.
C. The scope of the COUNTY'S responsibility to the dietetic interns while providing
health care, medical or professional services is pursuant to A.R.S. §11-981, and
governed, defined and controlled by the terms of the Revised Restated Declaration of
Trust for Maricopa County, Arizona Self-Insured Risk Trust Fund, approved by the
Maricopa County Board of Supervisors maintained and administered by the Maricopa
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County Risk Management Department.
9. NON-LIABILITY
Maricopa County and its officers and employees shall not be liable for any act or
omission by THE AFFILIATE or any subcontractor, employee, officer, agent or
representative of Contractor or subcontractors occurring outside the scope and duties of
this Contract. THE AFFILIATE and its officers and employees shall not be liable for any
act or omission by the COUNTY or any of its employees, agents or representatives
occurring outside the scope of duties of this Contract.
10. RECIPROCAL INDEMNITY
Each party (as “indemnitor”) agrees to indemnify, defend, and hold harmless the other
party (as “indemnitee”) from and against any and all claims, losses, damages and
expenses (including reasonable attorney’s fees), hereinafter collectively referred to as
“claims,” arising out of the negligent acts, misconduct or omissions of the indemnitor, its
agents, or employees.
11. APPLICABLE LAW
This agreement shall be construed under the laws of the State of Arizona, and is subject
to the provisions of A.R.S. § 38-511. 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.
12. COMPLIANCE REQUIREMENTS FOR A.R.S. § 41-4401, GOVERNMENT
PROCUREMENT; E-VERIFY REQUIREMENT
A. THE AFFILIATE warrants compliance with all federal immigration laws and
regulations relating to employees and warrants its compliance with A.R.S. § 23-
214, Subsection A (that subsection reads: “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 duration of the employee’s employment or at least three years, whichever is
longer”).
B. A breach of warranty regarding compliance with immigration laws and regulations
shall be deemed a material breach of this Agreement and THE AFFILIATE may be
subject to penalties up to and including termination of the Agreement.
C. 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 THE AFFILIATE may be subject to penalties up to and including
termination of the Agreement.
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D. 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 12.A.
E. For questions about E-Verify THE AFFILIATE should visit the following web site:
http://www.uscis.gov/portal/site/uscis.
13. TERMS OF AGREEMENT
A. This Agreement supersedes all previous agreements between the parties, and
constitutes the entire binding Agreement upon the parties and their respective
successors. Any amendment or modification to this Agreement shall be made in
writing addressed to the designated officer of AFFILATE and COUNTY as set forth
below.
B. The term of this Agreement shall be from January 1, 2014 through December 31,
2014. The Agreement may be renewed for additional terms by the mutual consent
of both parties.
C. Either party may terminate this Agreement at any time upon thirty (30) days prior
written notice to the other party. Neither expiration of the Agreement nor termination
based on a 30-day notice shall affect students currently enrolled in a clinical
experience at the Hospital, except as otherwise provided for in this Agreement.
14. SIGNATURE AUTHORIZATION
Any individual executing this Agreement on behalf of THE AFFILIATE represents and
warrants to COUNTY that they are duly authorized to execute this Agreement on behalf
of THE AFFILIATE, and that upon their signature this Agreement shall be binding upon
THE AFFILIATE.
(signature page follows)
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IN WITNESS WHEREOF, COUNTY and THE AFFILIATE have executed this Agreement.
MARICOPA COUNTY THE AFFILIATE
Acting by and through its Department of
Public Health
By: By:
Chairman, Date
Maricopa County Board of Supervisors Name:
Title: Senior Vice President of Human
Resources/Chief Talent Officer
Attest:
Clerk of the Board Date
Director, MCDPH Date
Approved as to Form Date
Deputy County Attorney
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