MAR-298133 MARICOPACOUNTY.OME_MAYOCLINIC.SOM_2022.DOCX

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AFFILIATION AGREEMENT
This Agreement is made by and between the Mayo Clinic through its Mayo Clinic Alix School of Medicine, 
with locations in Rochester, Minnesota, and Scottsdale, Arizona, (hereinafter "Mayo") and Maricopa 
County, administering this Agreement for its Office of the Medical Examiner, d.b.a. Maricopa County 
Office of the Medical Examiner, Forensic Science Center, 701 West Jefferson Street, Phoenix, Arizona 
85007-2908, (hereinafter "OME").
RECITALS
WHEREAS, Mayo wishes to participate with OME in providing coordinated clinical educational 
programs for the education and training of medical students (hereinafter called "Program Participants"); and
WHEREAS, Maricopa County owns and operates OME, and wishes to cooperate in the development 
of settings for coordinated clinical, educational, research and public service programs of interest to Mayo and 
Maricopa County.
THEREFORE, the parties hereby agree as follows:
ARTICLE 1:  TERM
1.1
The Term of this Agreement is entered into October 1, 2022 and shall terminate on September 30, 
2027, subject to the termination provisions in Article 12.
1.2
This Agreement may be extended for up to four (4) additional one (1) year periods or any portions 
therefore, through a duly executed amendment signed by both Mayo and OME.
ARTICLE 2:   AGREEMENT LIMITATION
2.1
Each Party will retain complete control over such programs of its own that are outside of this 
Agreement.
ARTICLE 3:  SCOPE OF WORK
3.1
Program Participants will provide services in their assigned areas as mutually agreed upon between 
OME and Mayo. Notice of any changes will be coordinated with the appropriate OME Professional 
staff.
3.2
Program Participants are not to be considered as ostensible agents, independent health care 
providers, patient advocates, or volunteers, employees or agents of Maricopa County. Furthermore, 
Program Participants are to be considered as individuals participating in training programs while 
providing services pursuant to the terms of this Agreement.
3.3
Nothing in the execution of this Agreement or in its performance shall be construed to establish an 
employer-employee, agency, partnership or joint venture relationship between the Program 
Participants, individually or collectively, and Maricopa County.
3.4
The applicable OME Professional Staff will oversee and modify as necessary the duties of the 
Program Participants, including post mortem procedures, laboratory orders, report preparation, and 
toxicology and histology interpretation, performed in accordance with learning objectives of those 
Program Participants under their supervision.
3.5
Program Participants shall not have ultimate authority for decisions regarding the determination of 
decedent's clinical diagnoses, procedures, and/or dispositions as this authority rests with OME 
Professional staff.

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3.6
This Agreement shall apply to all OME's sites in Maricopa County.
3.7
Accreditation Compliance.  This agreement covers Mayo Clinic College of Medicine. The accreditation 
body ("Accreditation Agency") responsible for the accreditation of the academic program is the Liaison 
Committee on Medical Education (LCME).
ARTICLE 4:   MAYO RESPONSIBILITIES
4.1
Ensure that each Program Participant, if applicable, is appropriately certified and/or licensed pursuant 
to the requirements of the State of Arizona, or shall be deemed exempt from such requirement by the 
appropriate Arizona licensure board, is in good standing in their program, and complies with all 
applicable laws and rules established by the State and Federal Government.
4.2
Provide and coordinate the individual educational and training programs for Program Participants, 
including, but not limited to, recruitment, master schedules, program compliance, curricula 
development, fiscal controls and budgeting, all disciplinary action, and all administrative and overhead 
costs.
4.3
Ensure that Program Participants agree to comply with all applicable policies, procedures, rules and 
regulations of OME, as provided by OME to the Program Participant(s). Upon OME's request, Mayo 
shall remove any Program Participant for unsatisfactory performance or failure to comply with OME's 
administrative, patient care or decedent policies, procedures, rules and regulations, or any applicable 
laws and rules of the State of Arizona.  OME agrees to provide the Mayo a statement in writing of the 
reason(s) for the requested removal of the Program Participant. The withdrawal, dismissal or removal 
of a Program Participant shall not affect continuation of this Agreement or the continued training of 
other Program Participants assigned to OME.
4.4
Provide OME with documentation, upon execution of this Agreement and separate written request, 
that Program Participants have completed:  (a) training in Human Blood and Body Fluid Precautions, 
as set out by Occupational Safety and Health Administration (OSHA) Regulations; (b) immunization 
for Hepatitis B, or signed the OSHA declination; (c) annual Tuberculin skin test, chest x-ray or other 
appropriate health test survey; (d) medical clearance to wear a TB effective respirator, and (e) 
immunization for Measles and Rubella.
4.5
Maintain accreditation by the nationally recognized accreditation entity identified in Section 3.7. 
Provide qualified faculty and a structured educational experience to Program Participants in 
accordance with the accreditation standards of the applicable Accreditation Agency, including 
operating and managing the College and their associated medical student program in accordance 
with applicable accreditation guidelines and standards.
ARTICLE 5:   OME RESPONSIBILITIES
5.1
Ensure the availability of qualified applicable professional and medical staff for the oversight, 
immediate and direct supervision of the medical Program Participants. OME agrees to notify its staff 
of the obligations covered by and agreed to in this Agreement.
5.2
Ensure the supervision of Program Participants as set out within this Agreement and that such 
services shall be performed in a professional manner consistent with like services performed by 
licensed professionals consistent with the applicable accreditation standards and requirements, as 
well as the requirements, policies, procedures, and practices of OME.
5.3
Maintain exclusive control over the contracting, credentialing and oversight of its Medical and 
Professional Staff.
5.4
Notify Professional Staff involved in oversight of Program Participants of its responsibilities as

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supervisory staff, which include, but are not limited to, participation in formal evaluations of Program 
Participants' performance and review of their clinical decisions, diagnoses, treatment and/or 
procedures as applicable.
5.5
Notify Mayo of concerns regarding any Program Participant's safety and/or appropriateness affecting 
his/her ability to carry out the responsibilities set out in this Agreement.
5.6
Provide Program Participants with training in Blood and Body Fluid Precautions pursuant to OME's 
policies and procedures for their facilities and programs.
5.7
OME shall provide to the Program Participants covered by this Agreement emergency medical care 
and treatment in life threatening situations that arise during the Program Participants' training at OME 
to the extent such treatment and care is available at OME; however, since OME does not provide 
Emergency Room care in such facilities, OME shall provide for the prompt and appropriate transfer of 
the Program Participant to such a facility. In such case, all associated expenses for such medical 
care and treatment shall not be the responsibility of OME.
5.8
The administration of didactic and hands on educational services at the facilities of OME shall be the 
sole responsibility of OME.
5.9
Pursuant to paragraph 5.7 and if applicable, OME agrees that, upon report of exposure to an 
infectious agent or hazardous material of Program Participants (i.e. needle stick, inhalation, mucus 
membrane or skin exposure to blood or body fluids or airborne contaminants), OME will provide for 
the prompt and appropriate transfer or referral of the Program Participant to a facility that provides the 
appropriate emergency medical care.  If applicable, OME will immediately make available to the 
affected Program Participant a copy of the decedents’ HIV, HBV and HCV status to the extent 
permitted by law.  Finally, OME will provide copies of all incident reports documenting the 
circumstances of the exposure to:    Mayo Clinic Attn: Kristin Klarkowski 
(Klarkowski.Kristin@mayo.edu).  OME will not be responsible for any post-exposure testing and 
further prophylactic drug treatment.  
5.10
In accordance with accreditation guidelines by the appropriate Accreditation Agency identified in 
Section 3.7, OME will comply with, at a minimum, the following requirements:
i.
Ensure responsibility for the control and operation of OME's facilities and its programs.
ii.
Cooperate with Mayo and acknowledge Mayo's sole authority with respect to academic 
programs.
iii.
Use its best efforts to ensure that its environment promotes the development of appropriate 
professional attributes in the Program Participants assigned thereto.
iv.
Provide the clinical facilities and equipment reasonably necessary for the Program 
Participants' clinical training and allow reasonable use of medical libraries, classrooms and 
conference rooms, as mutually agreed.
ARTICLE 6:   MUTUTAL RESPONSIBILITIES
6.1
The personnel of the OME and the faculty of Mayo assigned to the program will confer at such times 
as may be mutually agreed upon to evaluate the educational program.
6.2
The personnel of the OME and the faculty of Mayo assigned to the program will cooperate in 
providing a sound educational environment.
6.3
The parties may develop special provisions for other programs to be covered by this Agreement.
ARTICLE 7: COMPENSATION/PAYMENT
7.1
All training activities involving OME services rendered involving Program Participants covered by this

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Agreement are considered to be educational in nature, and therefore, OME or the families of the 
deceased of OME shall pay no monetary compensation to the Program Participants. Any salary, 
stipend, and/or benefits, due a Program Participant shall be the sole responsibility of Mayo.
7.2.
For services provided pursuant to this Agreement, no Maricopa County employee may receive directly 
or indirectly any form of compensation from Mayo in addition to the employee's regular Maricopa 
County salary.
ARTICLE 8: CONFIDENTIALITY
8.1
Mayo 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 rotation at OME.  
Additionally, because of Mayo's reliance upon OME for information required by federal, state and 
accreditation requirements, OME agrees to provide Mayo access to that information for those 
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 Agreement.  Mayo 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 OME upon written request.  
Should OME require any additional training, Mayo shall notify Program Participants of such 
requirement and OME shall provide Mayo with records of such attendance.
8.2
OME and Mayo agree to abide by the limitations set forth in the Family Educational Rights and 
Privacy Act (“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.  Both parties agree 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 by law, or as authorized in writing by Student.  
ARTICLE 9:   NON-DISCRIMINATION
9.1
The parties shall comply with all applicable state and federal statutes and regulations governing 
Equal Employment Opportunity, Non-Discrimination and Immigration in the course of carrying out 
duties pursuant to this Contract.  The Parties shall also comply with the provisions of Executive 
Orders 75-5, as amended by Executive Order No. 99-4, which are incorporated into this Contract by 
reference as if set forth in full herein. OME agrees that, if a Program Participant files a complaint 
either with OME or Mayo alleging that s/he has been subjected to unlawful discrimination by OME, 
OME agrees to cooperate with Mayo to investigate and resolve such complaints.
ARTICLE 10: AMERICANS WITH DISABILITIES ACT
10.1
The Parties shall comply with all applicable provisions of the Americans with Disabilities Act (Public 
Law 101-336, 42 U.S.C. 12101-12213) and all applicable federal regulations under the Act, including 
28 CFR Parts 35 and 36.
ARTICLE 11:   INSURANCE
11.1
Each party shall furnish to the other, upon execution of this Agreement and separate written request, 
the following as applicable:  certification of 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; and/or .certification of comprehensive general liability insurance coverage, 
premises liability coverage, and certification of professional errors and omissions liability (professional

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liability) coverage reasonably satisfactory for protection of its employees in amounts of not less than 
$2,000,000 per occurrence and $4,000,000 annual aggregate.
11.2
Each Party shall notify the other thirty (30) days prior 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.
ARTICLE 12: TERMINATION
12.1
Either party may, at any time and without cause, cancel this Agreement by providing the other Party 
with ninety (90) days advance notice. The Parties agree that any such termination shall not become 
effective with respect to the Program Participants then enrolled in a training rotation until the Program 
Participants' scheduled rotation is completed, provided that OME continues to have sufficient staffing 
and other resources to continue the program until that date.
12.2
If, in the judgment of either party to the Agreement, the other party does not perform in accordance 
with the conditions of this Agreement, or is otherwise in default of any provision of this Agreement, 
the party claiming non-performance or default shall give written notice to the other party specifying 
the nature of the non-performance or default. If the non-performance or default is not corrected within 
30 days after receipt of such written notice, or if the non-performing or defaulting party fails to 
diligently pursue remedies for corrections which require more than 30 days to complete, the party 
claiming non-performance or default may terminate this Agreement.
12.3
The OME Chief Medical Examiner or his designee is authorized to provide notice of termination and 
to terminate this Agreement on behalf of OME under the provisions set out in this Agreement.
12.4
Notwithstanding any other provision in this Agreement, this Agreement may be terminated if the 
Maricopa County Board of Supervisors does not appropriate sufficient monies for the purpose of 
maintaining this Agreement. Should Maricopa County fail to appropriate the necessary funds, OME 
may reduce the scope of its involvement in this Agreement, if appropriate, or cancel this Agreement 
without further duty or obligation. OME shall notify Mayo of such action by delivering notice to Mayo 
as soon as it learns of the unavailability of said funds.
12.5
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 either party is at any time while this Agreement or 
any renewal and extension of this Agreement is in effect, an employee or agent in any capacity or a 
consultant to the other party, 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.
ARTICLE 13:  ARBITRATION / LITIGATION
13.1
This Agreement shall be governed by the laws of Arizona and the courts of Arizona shall have 
jurisdiction over any litigation arising from or related to the Agreement.
13.2
The parties shall endeavor in good faith to promptly resolve any dispute arising under this Agreement 
by direct negotiations between supervisors or executives who have authority to resolve the matter.  
Such negotiations shall be conducted in the spirit of collaboration and compromise to address the 
legitimate concerns of the parties, while avoiding more costly dispute resolution procedures.
13.3
The parties agree that pursuant to Arizona Rules of Civil Procedure, any disputes subject to Arizona 
Revised Statutes §12-133 with an amount in controversy less than or equal to amounts set out in 
Arizona Rules for Compulsory Arbitration shall be resolved by arbitration in Maricopa County.
ARTICLE 14: NON-WARRANTY
14.1
The parties do not warrant their respective right or power to enter into this Agreement and if the same

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is declared null and void by court action initiated by third persons, there shall be no liability to the 
other party by reason of such action or by reason of this Agreement.
ARTICLE 15:   COMPLIANCE
15.1
Each Party shall comply with all Federal, State and Local laws, rules, regulations, standards and 
Executive orders, without limitation to those designated within this Agreement. The laws and 
regulations of the State of Arizona shall govern the rights of the parties, the performance of this 
Agreement and any disputes hereunder. Any changes in the governing laws, rules and regulations 
during the terms of this Agreement shall apply, but do not require an amendment.
ARTICLE 16:  REMEDIES
16.1
Either party may pursue any remedies provided by law for the breach of this Agreement. No right or 
remedy is intended to be exclusive of any other right or remedy and each shall be cumulative and in 
addition to any other right or remedy existing at law or at equity or by virtue of this Agreement.
ARTICLE 17: SEVERABILITY
17.1
If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall 
continue valid and enforceable to the full extent permitted by law.
ARTICLE 18: INDEMNITY
18.1
Each party (as 'indemnitor') agrees to indemnify, defend, and hold harmless the other party (as 
'indemnitee') from and against any and all claims, losses, liability, costs, or expenses (including 
reasonable attorney's fees) (hereinafter collectively referred to as 'claims') arising out of bodily injury 
of any person (including death) or property damage, but only to the extent that such claims which 
result in vicarious/derivative liability to the indemnitee are caused by the act, omission, negligence, 
misconduct, or other fault of the indemnitor, its officers, officials, agents, employees, or volunteers.
ARTICLE 19: NOTICES
19.1
Any notice under this Agreement shall be deemed sufficiently given if sent by facsimile, courier, 
electronic transmittal or similar reliable means of delivery, with receipt confirmed. Such notice shall be 
directed as set forth below:
Mayo
OME
Mayo Clinic
Maricopa County OME
Education Business Services
ATTN: Administrative Director
200 First Street SW
701 W. Jefferson Street
Rochester, MN 55905
Phoenix AZ  85007
              EduAffiliations@mayo.edu
ARTICLE 20: USE OF NAME
20.1
Neither party will use the name or trademarks of the other party in any news release, publicity, 
advertising, endorsement, or commercial communication without the prior written approval of the 
other party.  All requests for approval for the use of Mayo’s name pursuant to this Section must be 
submitted to the Mayo Clinic Business Relations Group, at the following email address: 
BusinessRelations@mayo.edu, at least 7 business days prior to the date on which a response is 
needed. The terms of this Section survive the termination, expiration, non-renewal, or rescission of 
this Agreement.
ARTICLE 21: ASSIGNMENT
21.1       No party has the right or the power to assign this Agreement, in whole or in part, without the prior

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written consent of the other parties, and any purported assignment in contravention of this provision 
shall be null and void.
ARTICLE 22:  ENTIRE DOCUMENT
22.1
This Agreement constitutes the entire document, and the understanding among the parties. This 
Agreement may not be modified, amended, altered or extended except through a written amendment 
signed by the parties. 
IN WITNESS WHEREOF, the Parties hereto have executed this Agreement as of the dates 
indicated below.
MARICOPA COUNTY
By:     
Name: 
Title:  Chairman, Board of Supervisors
Date:     
 
ATTEST:
By: 
                                                                    Date
MAYO CLINIC ALIX SCHOOL OF MEDICINE
By:     
Name:  Marcia L. Andresen-Reid, MS
Title:    Administrator
Date:       
MAYO CLINIC 
By:     
Name:  David L. Dahlen, MS
Title:   Administrator, Education
Date:       
DETERMINATION OF COUNSEL
Pursuant to ARS 11-201, the Agreement has been reviewed by the undersigned attorney 
for Maricopa County who has determined that it is in proper form and is within the powers 
and authority granted under the laws of the State of Arizona.
By: 
                                                                    Date
Mayo EBS
Reviewed by:
____________