AHSC AGREEMENT -.PDF

Maricopa County — Formal (2025-01-24)

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HOLD FOR BASKET PICK-UP MARICOPA COUNTY RECORDER
CLERK OF THE BOARD 2004-1250445 10736704 10:00
10 OF 12

DELROSSOR

INTERGOVERNMENTAL AGREEMENT

BETWEEN

MARICOPA COUNTY

AND

ARIZONA BOARD OF REGENTS/UNIVERSITY OF ARIZONA

FOR EDUCATIONAL AFFILIATION AGREEMENT

C 86 05 4722

APPROVED BY
THE MARICOPA COUNTY BOARD OF SUPERVISORS

ON

OCTOBER 29, 2004

DO NOT REMOVE
This is part of the official document

NTERGOVERNMENTAL AGREE? ‘NT
MARICOPA COUNTY
by and through the
DEPARTMENT OF PUBLIC HEALTH
1845 East Roosevelt Street, Phoenix, Arizona 85006

Non-Financial
1. Agreement No: _ (4 (9 05 “W742. 2. Agreement Type: Affiliation Agreement
3. Agreement Amount: __-0- 4. Purpose: Collaboration with and development of

Education and Research in Preventive Medicine through a
partnership with the University of Arizona College of Medicine.
5. Start Date: July 1, 2005 6. Expiration date: June 30, 2006
This Agreement is entered into by and between the Arizona Board of Regents for and on behaif of University of Arizona,
College of Medicine, referred to hereinafter as “University” and Maricopa County Department of Public Health, referred to
hereinafter as “Affilate”. University, for and in consideration of the covenants and conditions set forth herein, shall provide and

perform the services as set forth below. All rights and obligations of the parties shall be governed by the terms of this document, its
Exhibits, Attachments and Appendices, including any Subcontracts or Amendments as set forth herein and in:

Section | - General Provisions Section H - Special Provisions

This Agreement contains all the terms and conditions agreed to by the parties. No other understanding, oral or otherwise,
regarding the subject matter of this Agreement shall be deemed to exist or to bind any of the parties hereto. Nothing in this
Agreement shall be construed as consent to any suit or waiver of any defense in a suit brought against Maricopa County, or
the University, in any State or Federal Court.

Legal Notice under this Agreement shall be given by personal delivery or by registered or certified mail to the addresses set forth
below and shall be effective upon receipt by the party to whom addressed unless otherwise indicated in said notice.

Notice to University: AHSC Contracts Administrator Phone: (520) 626-6070
Address: 1501 N, Campbell Avenue, Room 1104, Tucson, Arizona 85724-5171
tice to Department: Contracts Administrator Phone: (602) 506-6603

dress: 1845 E. Roosevelt Street, Phoenix, AZ 85006-3642
IN WITNESS WHEREOF, the parties enter into this Agreement:
ARIZONA BOARD OF REGENTS on behalf of THE MARICOP. 470 NP OF SUPERVISORS
UNIVERSITY, OF ARIZONA

Jul ls Eo, a
BY: 15/4/04 BY: tolzolou
Judy/L. McElroy Date Andrew GaSe Date
AHSGontracts Administrator Chairman
Maricopa County Board of Supervisors

Pursuant to A.R.S. 211-952, the Maricopa County Attorney's Oftice has ATES

determined frat this Intergovernmental Agreement is in proper form and a)

is within the powers and authority granted the under the laws of the State J

of Arzong aoe Du Be om

i td fer . Bik of the Board cae
ff LMdp dale o- fe 2g. ea

Signa ie “e ° Datel

Susan Nicholas, Deputy County Attorney

Print Name

Pursuant to A.R.S. 11-952, the undersigned public agency attorney has RESERVE R R TA

determined that this Intergovernmental Agreement is in proper form and

is wif the powers and authority granted the under the jaws of the State

Laub Ellrd __sfufok

fz

(Dat
Upaanrrenty tiny °

Page | of 10

INTERGOVERNMENTAL AFFILIATION AGREEMENT

This Affiliation Agreement (“Agreement”) is made by and between the ARIZONA BOARD OF REGENTS
acting on behalf of The University of Arizona, Arizona Health Sciences Center (Colleges of Medicine,
Nursing, Pharmacy and Public Health), Tucson, Arizona 85724, (hereinafter referred to as "University"),
pursuant to Arizona Revised Statutes Title 15, Chapter 13, Article 2, Section 1625.B.2, and MARICOPA
COUNTY, on behalf of its Departments of Public Health, Environmental Health Services, and
Correctional Health Services, Phoenix, Arizona 85006-3642, pursuant to A.R.S. §11-951 et. seq., and its
professional staffs as employees, agents and independent contractors, individually and collectively, (hereinafter
referred to as "Affiliate"), WITNESSETH:

WHEREAS, the University wishes to participate with the Affiliate in providing coordinated clinical
educational programs for the education and training of health sciences students classified as either externs,
interns, residents and/or fellows from the University, (hereinafter called "Program Participants"); and

WHEREAS, the Affiliate wishes to cooperate in the development of settings for coordinated clinical
educational programs of interest to the University.

NOW, THEREFORE, UNLESS AN EXCEPTION IS SPECIFIED IN THE ATTACHED SPECIAL

PROVISIONS, IT IS AGREED THAT:

1. Each Party will retain complete control over such programs of its own that are outside of this
Agreement,
2. The Term of this Agreement shall be from July 1, 2005 through June 30, 2006, and thereafter

shall automatically be renewed and extended each year, except that either Party may, at any time, with or without
cause, cancel this Agreement, or any renewal and extension thereof, by providing the other Party with ninety
(90) days advance notice in writing. Should Agreement be terminated, any Program Participant rotating through
Affiliate shall be allowed to complete their rotation.

3. The Parties recognize that the performance by the Arizona Board of Regents for and on behalf

of the University of Arizona may be dependent upon the appropriation of funds by the Legislature of the State of

Page 2 of 10

Arizona, Should this Legislature fail to appropriate the necessary funds or if the University's appropriation is
reduced during the term of this Agreement, the Arizona Board of Regents may reduce the scope of the
University's involvement in this Agreement, if appropriate, or cancel this Agreement without further duty or
obligation by delivering written notice to the Affiliate as soon as reasonably possible after the unavailability of
said funds comes to the Board's attention.

4. By signing this Agreement, the Affiliate is not obligated to accept Program Participants on a
continuous basis or more than one Program Participant at any time. Scheduling of Program Participants’ training
rotations are subject to approval of the Affiliate and the appropriate University program director, This
Agreement shall apply to all Affiliate’s sites in the State of Arizona.

5. This Agreement may be canceled pursuant to Arizona Revised Statutes § 38-511 as amended,
without penalty or further obligation, if any person significantly involved in initiating, negotiating, creating,
drafting, or obtaining this Agreement on behalf of the Arizona Board of Regents is at any time while this
Agreement or any renewal and extension of this Agreement is in effect, an employee or agent of the Affiliate in
any capacity or a consultant to the Affiliate with respect to the subject matter of this Agreement. Cancellation
shall be effective when written notice is received, unless the notice specifies a later time.

6. To catry out the programs covered by this Agreement, the responsibility for selecting and
designating competent site personnel to serve as supervisors, liaisons, program coordinators, ete, will be assumed
by the Affiliate. The immediate and direct supervision of all Program Participants assigned to the Affiliate and
its affiliated institutions is the responsibility of the Affiliate and its medical staff. Affiliate agrees to notify its
staff of the obligations covered by and agreed to in this Agreement. However, upon mutual consent, and in
certain circumstances, University may provide its own supervision.

7. The administration of all clinical services at the facilities of the Affiliate shall be the sole
responsibility of, and under the complete and immediate direction, control and professional supervision of, the
appropriate staff and authorized agents and consultants of the Affiliate. Acceptable schedules and training
assignments for the Program Participants will be developed jointly to ensure non-interference with the primary

mission of the Affiliate.

Page 3 of 10

8. The University agrees to furnish the Affiliate, upon execution of this Agreement and written
request, certification of worker's compensation coverage for eligible University Program Participants who are
University employees, University also agrees fo provide Affiliate with documentation, upon execution of this
Agreement and written request, that the Program Participants have completed: (a) All OSHA related training as
outlined in OSHA regulations, e.g. blood-borme pathogen standards; (b) immunization for Hepatitis B or have
signed the OSHA declination; (c) an annual Tuberculosis skin test, chest x-ray or other appropriate health test or
survey; (d)immunization for Measles and Rubella; and, (e) per OSHA standards, evidence of medical
evaluation and fit-testing all Participants with a Particulate Respirator with Safety Seal (Correctional Health will
provide said respirator while participant is working in a CHS facility). Affiliate agrees to provide Program
Participants with training in Human Blood and Body Fluid Precautions as pertains to the Affiliate's facilities and
programs.

9, Services rendered by Program Participants covered by this Agreement will be within the
established and written requirements of the degree, certification, or training being pursued and as required of
every candidate for that degree, or certification, if applicable. Services rendered by Program Participants covered
by this Agreement are considered to be educational in nature, and, therefore, no monetary compensation shall be
paid to the Program Participants by the Affiliate or the patients of the Affiliate. Any salary, stipend, and/or
benefits, due a Program Participant shall be the sole responsibility of the University.

10, Program Participants shall not have implied, presumptive or apparent authority or independent
health care responsibilities for Affiliate’s patients and are not to be considered as ostensible agents, independent
health care providers, patient's advocates, Affiliate's employees or agents, or individuals practicing in an
extended role while providing health care pursuant to the terms of this Agreement. All patient orders and staff
instructions, methods, techniques and procedures initiated and/or performed by Program Participants shall be
subject to prior review, approval and counter signature by appropriate Affiliate medical personnel. Affiliate,
together with its patient care staff, agrees to maintain exclusive control over Affiliate's patients’ care and be the
responsible party for initiating all decisions related to such health care and treatment. Under the provisions of

this Agreement, Affiliate, together with its patient care staff, has complete and total authority and ri ght to control

Page 4 of 10

the details and means for the patient care training activities and to provide each Program Participant with
immediate and direct supervision of such activities. Program Participants shall not share in either the allocation
of the duty of care responsibilities, determination of service utilization, or establishment of criteria for standard
of care for Affiliate's patients. Each patient’s attending physician shall maintain control of his/her patient
admissions, clinical diagnoses, treatment and prescriptions, and patient disposition, as well as patient informed
consents. Personnel of the Affiliate shall be proactive in informing Affiliate’s patients, customers and others
concerning the training role of the Program Participants in order to prevent any mistaken impression by the
patients or others.

Ll. Nothing in the execution of this Agreement, or im its performance, shall be construed to
establish an employer-employee, an agency, a partnership or a joint venture relationship between the Program
Participants, individually or collectively, and the Affiliate or between the Parties of this Agreement,

12. Patients shall not be billed for services rendered to the patients of the Affiliate when rendered
either solely by the Program Participants or for their assisting services with the Affiliate's attending medical
personnel. Program Participant's involvement in the patient care activities of the Affiliate shall not result in
increased costs to the patients or third-party payors, in any over-utilization of services or procedures, or impact
on the patient's quality of care, freedom of choice and informed consent, or affect competition in amy manner.
Assurance of proper billing practice is solely the duty of the Affiliate.

13, In keeping with all federal and state rules and regulations regarding patient confidentiality,
the University shall notify the Program Participants that they are responsible for maintaining the
confidentiality of patient information. Program Participants shall not have access to, or have the right to
review, any medical record, except where necessary in the regular course of the training program covered by
this Agreement or in furtherance of any litigation arising out of Program Participant's affiliation.
Additionally, the Affiliate agrees to allow University access to those pertinent medical records as may be
required by federal, state and accreditation purposes. The discussion, transmission, or narration, in any form,
by Program Participants of any patient information of a personal nature, medical or otherwise, obtained by

the Program Participants is forbidden except as a necessary part of the training program covered by this

Page 5 of 10

Agreement. University shall affirm that all Program Participants have received all mandatory training
required by Federal Rules and Regulations for the protection of patients’ protected health information (PHI)
and that departmental records of completion of such training shall be available to Affilate upon written
request. Should Affiliate require any additional training, University shall notify Program Participants of such
requirement and Affiliate shall provide University with records of such attendance.

14, The University shall ensure that the Program Participants agree to comply with all applicable
policies, procedures, rules and regulations of Affiliate. Upon Affiliate’s request, the University shall remove
any Program Participant from the training program covered by this Agreement for unsatisfactory
performance or failure to follow Affiliate's administrative and patient care policies, procedures, rules and
regulations, or any applicable laws of the State of Arizona. Affiliate agrees to provide the University a
statement in writing of the reason, or reasons, for the requested removal of the Program Participant following
such withdrawal. The withdrawal, dismissal or removal of a Program Participant, in accordance with the
provisions of this Agreement, shall not affect continuation of this Agreement or the continued training of
other Program Participants.

15. The Program Participants covered by this Agreement shall be furnished emergency medical
care and treatment in a life-threatening situation, while in training at the facilities of the Affiliate; however, if the
Affiliate does not provide Emergency Room care in such facilities, the Affiliate shall provide for the transfer of
the Program Participant to such a facility. All associated expenses for such medical treatment, including costs of
transfer and further treatment, shall be the personal responsibility of the Program Participant and his or her
personal health insurance coverage or, if a University employee, worker's compensation as provided by the
University, if applicable.

16, Affiliate acknowledges that it is has received a written copy from University outlining the
Arizona Health Sciences Center current policy on student exposure to blood/body fluids. Additionally, Affiliate
agrees that, upon receipt of a report of such exposure by a Program Participant, Affiliate shall immediately
contact University Physicians, Inc. Infectious Disease physician on call and shall either institute initial

prophylactic treatment as instructed by that physician within the time limits articulated or make such treatment

Page 6 of 10

available. Additionally Affiliate shall provide copies of all records of such treatment to the UPI Infectious
Disease physician,-as well as whatever follow up information is available regarding the HIV status of the source
to the extent permitted by law. The University of Arizona College of Medicine agrees that it will reimburse
Affiliate for the cost of providing such prophylactic treatment, upon reasonable demand for payment.

17. The right is reserved by each Party to request any additional features to be included in the
programs covered by this Agreement which such Party may deem necessary, provided that such additional
features are consistent with the policies of both Parties. Both Parties hereby agree to give reasonable
consideration to all requests, but no additional feature shall be added until mutually approved in writing, by
authorized signatories for both Parties. In addition and as a matter of record, both Parties agree that all
understandings, interpretations, decisions and acts arising or resulting from, or in the performance of, this
Agreement shall be construed, governed and settled on the basis of the provisions of this integrated Agreement.

18. Each Program Participant shall be (1) duly certified and/or licensed pursuant to requirements of
the State of Arizona, or shall be deemed exempt from such requirement by the Arizona State Board of Medical
Examiners, and (2) shall comply with all applicable laws and rules established by the State of Arizona, the
United States of America, and any such state or federal agency governing the medical profession.

19. Neither Party to this Agreement agrees to indemmify the other Party or hold harmless the
other Party from liability hereunder. However, if Arizona law provides for either a right to indemmity and/or a
right to contribution to any Party to this Agreement, then the right to pursue one or both of these remedies is
preserved.

20. The University shall furnish the Affiliate, upon execution of this Agreement and separate
written request, certification of comprehensive general liability insurance coverage and certification of
professional errors and omissions liability (professional liability) coverage reasonably satisfactory for protection
of assigned Program Participants as established in accordance with Arizona Revised Statutes § 41-621 et seq.,
(State of Arizona Self-Insured Program), or amendments thereof, or other pertinent statutes. Provision of such
proof of insurance coverage shall not constitute acceptance of Affiliate’s tender of defense of allegations of

negligence against Program Participants to the University. Each party shall notify the other thirty (30) days prior

Page 7 of 10

to any discontinuance of such insurance coverage. Upon either party’s notice of the other’s discontinuation of
insurance coverage the other party shall then have the right to immediate termination of the Agreement. Proof of
said insurance coverage does not designate Affiliate as an additional insured. It is also understood and agreed
upon that said insurance coverage is excess over any other available and collectible insurance from any other
source.

21. The Parties agree to be bound by applicable state and federal rules governing Equal
Employment Opportunity and Non-Discrimination.

22, The parties agree that any dispute arising under this Agreement, involving the sum of
$50,000 or less in money damages only, shall be resolved by arbitration pursuant to the Arizona Rules of
Civil Procedure, Rules for Compulsory Arbitration. Any such arbitration shall take place in Pima County.
The decision of the arbitrator(s) shall be final.

23, The attached Special Provisions, which may set forth additional particular responsibilities of
the Parties hereto, are, by this reference, made for all purposes a part of this Agreement.
The persons executing this Agreement represent and warrant that they have the full power and authority to enter

into this Agreement on behalf of the entities they are signing on behalf of. IN WITNESS HEREOF, the parties
hereto have executed this Agreement in triplicate by proper persons thereunto duly authorized.

Page 8 of 10

Special Provisions - Effective July 1, 2005 — Department of Public Health

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These Specia! Provisions are intended to cover, but not be limited to, the post-graduate medical training
of Preventive Medicine Residents from the Department of Family and Community Medicine in the
College of Medicine, University of Arizona while they are at Maricopa County Department of Public

Health.

Items of Agreement

A.

Designation of Residency Program Director is Doug Campos-Outcalt, MD, MPA. The Program
Director has responsibility for the general administration of the program, including those activities
related to the recruitment, selection, instruction, supervision, counseling, evaluation, discipline
and advancement of residents and the maintenance of records related to program accreditation.

Supervisory Attending Staff (on-site) (name and title):

Larry Sands, D.O., M.P.H., Director, Chronic Disease and Tobacco Control

Sarah Santana, Director, Division of Epidemiology Services

Jonathan Weisbuch, M.D., M.P.H., Director, Maricopa County Department of Public Health
Any Sorenson, M.D., M.S., Medical Director, TB Program

Educational Goals and Objectives

To provide residents a supervised experience in:

e TB, STD, infectious disease epidemiology and control.
e Chronic disease epidemiology and control

Public health preparedness and emergency response.
Maternal and child health public health activities.

The homeless clinic.

Assignment. of Residents. Each resident will spend a minimum of 38 weeks at the following sites:
Division of Clinical Services - TB program and clinic, STD program and clinic, Homeless Clinic.
Division of Biodefense Preparedness and Response,

Division of Maternal, Child and Family Health

Division of Community Development and Minority Health

Resident Evaluation, Supervision and Teaching

The Program Director shall ensure that residents shall be taught and supervised by attending
faculty physicians, whose responsibility shall include evaluating residents on a regular schedule,
per relevant RRC requirements, and to communicate to each resident that evaluation of the
knowledge, skills, and professional growth of the resident, using appropriate criteria and
procedures in a timely fashion and provide an opportunity for these residents to participate
actively in the evaluation process.

Due Process

In compliance with the Essentials of Accredited Residencies of the Accreditation Council for
Graduate Medical Education, the College of Medicine has developed policies and procedures
that provide residents with exclusive due process protections, These policies and procedures, as
set forth in the Graduate Medical Education Policy and Procedure Manual, are the exclusive
procedures governing such disciplinary matters,

These Special Provisions are not intended to limit the Parties to this Agreement from developing special
provisions for other programs covered by this Agreement.

If a conflict arises between these Special Provisions and the General Provisions of this Agreement, the
General provisions shall govern.

Page 9 of 10

Special Provisions - Effective July 1, 2005 — Department of Environmental Health Services

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These Special Provisions are intended to cover, but not be limited to, the post-graduate medical training
Preventive Medicine Residents from the Department of Family and Community Medicine in the
College of Medicine, University of Arizona while they are at Maricopa County Department of
Environmental Health Services.

Items of Agreement

A.

Designation of Residency Program Director is Doug Campos-Outcalt, MD, MPA. The Program
Director has responsibility for the general administration of the program, in including those
activities related to the recruitment, selection, instruction, supervision, counseling, evaluation,
discipline and advancement of residents and the maintenance of records related to program
accreditation.

Supervisory Attending Staff (on-site) (name and title):
Albert F. Brown, Director, Maricopa County Department of Environmental Health Services

Educational Goals and Objectives

To provide residents a supervised experience with public health inspections, monitoring and
control of environmental disease exposure through water, solid waste, air pollution and food
preparation.

Assignment of Residents
Department of Environmental Health: Air Quality, Water and Waste Management, and
Environmental Health Services, not to exceed a two-week rotation per Resident.

Resident Evaluation, Supervision and Teaching

The Program Director shall ensure that residents shall be taught and supervised by attending
faculty physicians, whose responsibility shall include evaluating residents on a regular schedule,
per relevant RRC requirements, and to communicate to each resident that evaluation of the
knowledge, skills, and professional growth of the resident, using appropriate criteria and
procedures in a timely fashion and provide an opportunity for these residents to participate
actively in the evaluation process.

Due Process

In compliance with the Essentials of Accredited Residencies of the Accreditation Council for
Graduate Medical Education, the College of Medicine has developed policies and procedures
that provide residents with exclusive due process protections. These policies and procedures, as
set forth in the Graduate Medical Education Policy and Procedure Manual, are the exclusive
procedures governing such disciplinary matters.

These Special Provisions are not intended to limit the Parties to this Agreement from developing
special provisions for other programs covered by this Agreement.

If a conflict arises between these Special Provisions and the General Provisions of this Agreement,
the General provisions shall govern.

Page 10 of 10

Special Provisions - Effective July 1, 2005 — Department of Correctional Health Services

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These Special Provisions are intended to cover, but not be limited to, the post-graduate medical
training of Preventive Medicine Residents from the Department of Family and Community Medicine

in the College of Medicine, University of Arizona while they are at Maricopa County Correctional
Health Services.

Items of Agreement

A.

Designation of Residency Program Director is Doug Campos-Outcalt, MD, MPA. The Program
Director has responsibility for the general administration of the program, including those activities
related to the recruitment, selection, instruction, supervision, counseling, evaluation, discipline and
advancement of residents and the maintenance of records related to program accreditation.

Supervisory Attending Staff (on-site) (name and title):
Gail Steinhauser, M.D., Medical Director

Educational Goals and Objectives
To provide residents supervised disease control activities among the jail population.

Assignment of Residents
Length of rotation at the Madison Street Jail will be upon mutual agreement.

Resident Evaluation, Supervision and Teaching

The Program Director shall ensure that residents shall be taught and supervised by attending
faculty physicians, whose responsibility shall include evaluating residents on a regular
schedule, per relevant RRC requirements, and to communicate to each resident that evaluation
of the knowledge, skills, and professional growth of the resident, using appropriate criteria and
procedures in a timely fashion and provide an opportunity for these residents to participate
actively in the evaluation process.

Due Process

In compliance with the Essentials of Accredited Residencies of the Accreditation Council for
Graduate Medical Education, the College of Medicine has developed policies and procedures
that provide residents with exclusive due process protections. These policies and procedures, as
set forth in the Graduate Medical Education Policy and Procedure Manual, are the exclusive
procedures governing such disciplinary matters.

These Special Provisions are not intended to limit the Parties to this Agreement from developing
special provisions for other programs covered by this Agreement.

If a conflict arises between these Special Provisions and the General Provisions of this Agreement, the
General Provisions shall govern.