AFFILIATION_AGREEMENT_WITH_FRANKLIN_PIERCE_UNIVERSITY_-_FINAL.PDF

AFFILIATION AGREEMENT 
Between 
MARICOPA COUNTY  
AND  
FRANKLIN PIERCE UNIVERSITY 
 
 
I. 
PURPOSE: 
 
This Affiliation Agreement shall be effective on the date signed by the Maricopa County Board of 
Supervisors (“BOS”). The parties to this Affiliation Agreement are Franklin Pierce University (“FPU”) and 
Maricopa County  (“County”), a political subdivision of the State of Arizona, to be administered by its 
Department of Correctional Health Services (“CHS”), and other departments the County may designate from 
time to time (together, “Clinical Facility”). 
 
WHEREAS, FPU seeks to provide field training experiences for FPU’s students (“Students”) as part of their 
overall education; and  
 
WHEREAS, County, through its Clinical Facility, is willing to provide field training experiences to FPU’s 
Students; and  
 
WHEREAS, it is to the benefit of both FPU and Clinical Facility to cooperate in the educational preparation 
of Students, so as to promote excellence in patient care, to ensure professional competence, and to provide 
maximum utilization of community resources,  
 
NOW, THEREFORE, IT IS MUTUALLY AGREED that FPU may place selected Students in the Clinical 
Facility for such clinical training experiences (the “Program”) according to the following provisions: 
 
II. 
DEFINITIONS: 
 
As used throughout this Affiliation Agreement, the following terms shall have the meanings set forth below: 
 
A. 
Affiliation Agreement refers to this document and all attachments and amendments hereto. 
 
B. 
Authorized Use refers to Protected Health Information (“PHI”) provided by CHS to FPU that shall 
be used and/or disclosed only as authorized by law including, but not limited to the treatment of 
individuals identified as homeless as needed in order to reduce recidivism. Except when otherwise 
required by law, disclosures of PHI pursuant to this Affiliation Agreement are subject to a minimum 
necessary determination by CHS (45 CFR § 164.502(b)). When reasonable to do so, CHS may rely 
upon the representations of FPU as to what information is the minimum necessary for their lawful 
purpose (45 CFR § 164.514(d) (3) (iii)). Information regarding substance use or abuse shall not be 
disclosed without the express written authorization of the individual. 
 
C. 
CHS refers to the Department of CHS. 
 
D. 
Clinical Facility refers to CHS and other departments the County may designate from time to time. 
 
E. 
County refers to Maricopa County. 
 
F. 
Criminal Justice Information refers to any confidential information collected by criminal justice 
agencies on individuals consisting of identifiable descriptions and notations of arrests, detentions, 
indictments, information, or other formal criminal charges, and any disposition arising therefrom, 
as well as confidential pre-booking or booking personal identifiable information, including date of 
birth, social security number, age, demographic information, projected release dates and release date 
information as defined in 5.U.S.C. § 552 and 5 U.S.C. § 552a. 
 
G. 
Director refers to the Director of CHS. 
 
 
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H. 
Health Insurance Portability and Accountability Act (“HIPAA”) refers collectively to the 
HIPAA of 1996, codified at 42 U.S.C. § 1320d et seq., and the Health Information Technology for 
Economic and Clinical Health Act, enacted as Title XIII of the American Recovery and 
Reinvestment Act of 2009, codified at 42 U.S.C. § 17921 et seq., and any current and future 
regulations promulgated thereunder, including but not limited to 45 C.F.R. Parts 160 and 164.  
 
I. 
PHI shall have the same meaning as defined under HIPAA and includes any information about 
health status, provision of health care or any individually identifiable information including Social 
Security Number, Age, Sex, Date of Birth, Patient Identification Number, Medical Record 
Documentation either paper or electronic, diagnosis, procedural information, and any other 
information directly linked and identifiable to a specific individual under the care, safety, and 
medical supervision of CHS. 
 
J. 
Program refers to clinical training experiences provided by the Clinical Facility to students of FPU. 
 
III. 
PROGRAM DESCRIPTION AND MUTUAL RESPONSIBILITIES OF THE PARTIES.  
 
A. 
Background Clearances and Jail Entry: FPU shall submit required background clearance 
paperwork to Clinical Facility for approval before jail entry access is granted to students. Students 
who do not pass the required background clearances are ineligible to participate in the program. 
FPU shall ensure that its students always bring their government identification to exchange daily 
for a visitor’s badge for jail entry. 
 
B. 
Orientation: Clinical Facility will provide an orientation to FPU’s students regarding security rules, 
regulations, and processes, including, but not limited to, practices related to the HIPAA, infection 
control and standard precautions related to Occupational Safety and Health Administration 
(“OSHA”) regulatory compliance, and other information relevant to student’s participation in the 
program. 
 
C. 
Onboarding Compliance: FPU shall ensure that all participating students remain in compliance 
with the following onboarding documentation:  
1. 
Tuberculosis (TB) results, renewed annually before expiration. 
2. 
Basic Life Support (BLS) certification, renewed annually before expiration.  
3. 
Measles, Mumps, and Rubella (MMR): Completed vaccination series -OR- laboratory 
report for titer testing. 
4. 
Hepatitis B: Completed vaccination series, -OR- laboratory report for titer testing titer 
testing -OR- or Signed Declination statement for any student who refuses. 
5. 
Varicella: Vaccination series -OR- laboratory report for titer testing titer testing -OR- 
Signed Attestation of past chickenpox.  
 
D. 
Scheduling: The parties shall mutually designate points of contact to assist in the scheduling and 
coordination of learning experiences for FPU’s students. The parties shall collaborate to establish 
the number of students eligible for placement in the program and the number of preceptors required 
in advance. The parties shall mutually ensure that preceptors and students arrive timely as scheduled. 
 
E. 
Sites: The Clinical Facility shall provide FPU’s students with access to safe physical facilities to 
support a learning environment as part of the program at the following sites: 
1. 
Fourth Avenue Jail 201 South 4th Avenue, Phoenix, AZ 85003 
2. 
Estrella Jail 2939 West Durango Road, Phoenix, AZ 85009 
3. 
Lower Buckeye Jail 3250 West Lower Buckeye Road, Phoenix, AZ 85009 
4. 
Towers Jail 3127 West Gibson Lane, Phoenix, AZ 85009 
5. 
Watkins Jail 2680 South 28th Drive, Phoenix, AZ 85009 
6. 
Intake, Transfer, Release 2670 South  28th Drive, Phoenix, AZ 85009 
 
F. 
Preceptors, Scope of Practice, and Observation: The Clinical Facility shall designate individuals 
to serve as preceptors to observe FPU’s students while performing duties within their scope of 
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practice as part of the program. The preceptors shall submit resumes for consideration to FPU for 
review and formal approval in advance. Preceptors will provide students with the opportunities to 
fulfill the clinical experience requirements in both observational and supervised hands-on 
experience. The Preceptors will be responsible for instructing, training, and supervising the Students 
at all times during the program, including allowing the Students to observe and assist with patient 
care and in other aspects of clinical professional practice. 
 
G. 
Equipment: FPU shall ensure its students bring a stethoscope, penlight, pen, and paper. The Clinical 
Facility shall provide onsite medical equipment and supplies necessary for the administration of 
care to patients by FPU’s students. FPU’s Faculty and Students are responsible for reimbursing the 
Clinical Facility for the costs associated with any damaged or lost equipment. The Clinical Facility 
shall provide FPU’s students with sufficient Personal Protective Equipment (PPE) to comply with 
all standard precautions pertaining to occupational exposure to bloodborne pathogens as set forth 
by the Occupational Safety and Health Administration (OSHA). 
 
H. 
Injuries: If FPU’s student is injured while onsite as part of the program, the Clinical Facility shall 
provide basic first aid and/or refer the student to the nearest emergency medical care facility. Student 
will be financially responsible for all medical expenses, including future medical expenses, related 
to such injury, illness, or exposure. 
 
IV.  
SPECIAL TERMS AND CONDITIONS: 
 
A. 
FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT (“FERPA”). FPU agrees that for 
purposes of FERPA, Clinical Facility will be considered a FPU official with a legitimate educational 
reason to have access to limited personally identifiable information from student records, hereinafter 
(“Student Information”), as described below. FPU agrees to provide authorized representatives of 
Clinical Facility limited Student Information and only that which is reasonably necessary for 
participation in the affiliation. No other Student Information will be provided. Clinical Facility 
acknowledges and agrees that Student Information provided by the FPU, or others on behalf of FPU, 
that directly relates to any of FPU’s students, including, but without limitation, academic 
information (e.g., coursework, grades, degrees earned, performance in other external rotations); 
professional information, (e.g., licenses obtained, suspension, revocation); training and/or 
certifications,  health and other insurance information and, the results of any criminal background 
check and/or drug testing/treatment information is Student Information and is protected by FERPA. 
Clinical Facility represents and certifies that it will (1) protect the confidentiality of all Student 
Information; and will not, except with the written consent of the student, (2) use Student Information 
for any purpose other than to carry out the purposes of this Affiliation Agreement; or (3) disclose 
Student Information except to authorized individuals within its organization who have a legitimate 
need to know Student Information in order to carry out the purposes of this Affiliation Agreement. 
 
B. 
HIPAA. Students shall be instructed by FPU and/or Clinical Facility before beginning the Program 
concerning the confidentiality of medical information of Clinical Facility’s patients and standard 
precautions. For purposes of compliance with HIPAA, Students shall be considered part of Clinical 
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 Clinical Facility for any other purposes, including by, 
and not limited to tax or employment law. 
 
C. 
POLICIES AND PROCEDURE GOVERNING STUDENTS. In addition to any policies and 
procedures of FPU that govern Students’ conduct, Students shall be subject to and follow Clinical 
Facility’s policies and procedures while participating in the Program, including but not limited to 
security rules to maintain a safe correctional environment. 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 to the Clinical Facility’s employees, including workers’ 
compensation, health insurance or medical benefits, pension, retirement, or vacation or sick pay. 
 
D. 
TERM OF AGREEMENT: This Affiliation Agreement shall begin upon final signature and shall 
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terminate five years thereafter unless otherwise terminated or amended as provided herein.  
 
E. 
TERMINATION: This Affiliation Agreement may be terminated by either party with prior written 
notice to the other party. Such Notice of Termination by FPU shall be effective 30 calendar days 
after mailing by certified mail, return receipt requested, to CHS. CHS may terminate this Affiliation 
Agreement, in whole or in part, immediately upon providing either written or verbal notice to FPU 
when CHS deems the health or welfare of a patient is endangered. Either party may terminate this 
Affiliation Agreement immediately upon providing written or verbal notice when it deems that 
performance would be in violation of the law or order of a court of law. For any other cause, CHS 
may terminate this Affiliation Agreement upon 30 calendar days after mailing by certified mail, 
return receipt requested, to FPU. 
 
F. 
TERMINATION OF STUDENT EXPERIENCE. Upon the reasonable request of the Clinical 
Facility, FPU shall remove a Student from rotation if Clinical Facility deems a Student poses a threat 
or danger to patients; provided, however, Clinical Facility shall provide with such request in writing 
and allow FPU a reasonable time to effectuate such removal. 
 
G. 
AMENDMENTS: Any changes to this Affiliation Agreement shall be in writing and signed by both 
parties.   
 
H. 
FPU’s & CHS’ RESPONSIBILITIES: FPU and CHS shall operate in a professional manner that 
conforms to all local, state, and federal codes and rules and within the standard of practice for the 
scope of each of the parties’ responsibilities. FPU and CHS shall comply with all federal, state, and 
local laws, ordinances, rules, and regulations applicable to each party’s performance under this 
Affiliation Agreement. There are no financial responsibilities assigned by this Affiliation 
Agreement; the Affiliation Agreement is intended to allow FPU and CHS to work together in the 
educational preparation of FPU’s Students. 
 
I. 
RETENTION OF RECORDS: FPU and CHS shall maintain records and other relevant documents 
to this Affiliation Agreement for five years following the termination or expiration of the Affiliation 
Agreement; provided however, if any audit questions are unresolved at the end of that five-year 
period, all records and documents relating to such audit questions shall be maintained until those 
audit questions are resolved. 
 
J. 
NON-DISCRIMINATION: To the extent applicable, FPU, in accordance with A.R.S. § 41-1461, 
et seq., shall provide equal employment opportunities for all persons, regardless of race, color, creed, 
religion, sex, age, national origin, disability or political affiliation. FPU shall comply with the 
Americans with Disabilities Act. 
 
K. 
EMPLOYMENT VERIFICATION: To the extent applicable, the parties shall comply with 
A.R.S. § 41-4401, all Federal immigration laws and regulations relating to its Students and/or 
employees, including compliance with A.R.S. § 23-214, Subsection A. 
 
L. 
GOVERNING LAWS: This Affiliation Agreement shall be governed by the laws of the State of 
Arizona. Any litigation arising from the Affiliation Agreement, or the performance thereof will be 
decided in the federal or state courts of Maricopa County unless otherwise agreed to between the 
Parties. 
 
M. 
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 and Students 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 Affiliation Agreement. Each party’s duty 
to defend, indemnify and hold harmless the other party, its agents, representatives, officers, 
directors, officials, employees, and Students that shall arise in connection with any claim, damage, 
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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 Affiliation Agreement including any 
person for whose acts, errors, omissions or mistakes a party may be legally liable. 
 
N. 
LIABILITY Each party hereto agrees to be responsible for the negligent acts or omissions of its 
officers, employees, Students, and agents, which occur within the line and scope of their 
performance of the services, which are the subject of the Affiliation Agreement. Further, FPU agrees 
to be responsible for the negligent acts or omissions of its students, which arise from the 
performance of their responsibilities arising from the training, which is the subject of this Affiliation 
Agreement. The amount and type of insurance coverage requirements set forth in Section O below 
will in no way be construed as limiting the scope of the liability in this Section. Further, the scope 
of liability does not extend to the sole negligence of either party. 
 
O. 
INSURANCE: FPU, at FPU’s own expense, shall purchase and maintain, at a minimum, the herein 
stipulated insurance from a company or companies duly licensed by the State of Arizona and 
possessing an AM Best, Inc. category rating of B++. In lieu of State of Arizona licensing, the 
stipulated insurance may be purchased from a company or companies, which are authorized to do 
business in the State of Arizona, provided that said insurance companies meet the approval of 
County. The form of any insurance policies and forms must be acceptable to County.  
 
All insurance required herein shall be maintained in full force and effect until all work or service 
required to be performed under the terms of the Affiliation Agreement is satisfactorily completed 
and formally accepted. Failure to do so may, at the sole discretion of County, constitute a material 
breach of this Affiliation Agreement. In the event that the insurance required is written on a claims-
made basis, FPU warrants that any retroactive date under the policy shall precede the effective date 
of this Affiliation Agreement and either continuous coverage will be maintained, or an extended 
discovery period will be exercised for a period of two years beginning at the time work under this 
Affiliation Agreement is completed. FPU’s insurance will be primary insurance as respects County, 
and any insurance or self-insurance maintained by County will not contribute to it.   
 
Any failure to comply with the claim reporting provisions of the insurance policies or any breach of 
an insurance policy warranty shall not affect the County’s right to coverage afforded under the 
insurance policies. The insurance policies may provide coverage that contains deductibles or self-
insured retentions. Such deductible and/or self-insured retentions shall not be applicable with respect 
to the coverage provided to County under such policies. FPU shall be solely responsible for the 
deductible and/or self-insured retention and County, at its option, may require FPU to secure 
payment of such deductibles or self-insured retentions by a surety bond or an irrevocable and 
unconditional letter of credit.  
 
The insurance policies required by this Affiliation Agreement, except Workers’ Compensation and 
Errors and Omissions, shall name County, its agents, representatives, officers, directors, officials, 
Students, and employees as additional insureds. The policies required hereunder, except Workers’ 
Compensation and Errors and Omissions, shall contain a waiver of transfer of rights of recovery 
(subrogation) against County, its agents, representatives, officers, directors, officials, Students, and 
employees for any claims arising out of FPU’s work or service. If available, the insurance policies 
required by this Affiliation Agreement may be combined with Commercial Umbrella Insurance 
policies to meet the minimum limit requirements. If a Commercial Umbrella insurance policy is 
utilized to meet insurance requirements, the Certificate of Insurance shall indicate which lines the 
Commercial Umbrella Insurance covers.   
  
1. 
Commercial General Liability: Commercial General Liability (CGL) insurance and, if 
necessary, Commercial Umbrella insurance with a limit of not less than $1,000,000 for 
each occurrence, $3,000,000 Products/Completed Operations Aggregate, and $3,000,000 
General Aggregate Limit. The policy shall include coverage for premises liability, bodily 
injury, broad form property damage, personal injury, products and completed operations 
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and blanket contractual coverage, and shall not contain any provisions which would serve 
to limit third party action over claims. There shall be no endorsement or modifications of 
the CGL limiting the scope of coverage for liability arising from explosion, collapse, or 
underground property damage.  
 
2. 
Workers’ Compensation: Workers’ Compensation insurance to cover obligations 
imposed by Federal and state statutes having jurisdiction of FPU’s Students engaged in the 
performance of the work or services under this Affiliation Agreement; and Employer’s 
Liability insurance of not less than $1,000,000 for each accident, $1,000,000 disease for 
each Student, and $1,000,000 disease policy limit. FPU, its subcontractors, and sub-
subcontractors waive all rights against this Affiliation Agreement and its agents, officers, 
directors, employees, and Students, for recovery of damages to the extent these damages 
are covered by the Workers’ Compensation and Employer’s Liability, or Commercial 
Umbrella Liability insurance obtained by FPU, its subcontractors, and its sub-
subcontractors pursuant to this Affiliation Agreement.  
 
3. 
Professional Liability Insurance: FPU shall maintain Professional Liability insurance 
which will provide coverage for any and all acts arising out of the work or services 
performed by FPU under the terms of this Affiliation Agreement, with a limit of not less 
than $1,000,000 for each claim, and $3,000,000 aggregate claims.  
 
4. 
Sexual Molestation and Physical Abuse: The policy shall be endorsed to include 
coverage for sexual molestation and physical abuse at limits not less than $1,000,000.00 
per occurrence and $2,000,000.00 aggregate. These limits may be included within a 
General Liability policy, Professional Liability policy or provided by separate endorsement 
with its own limits as required. FPU must provide the following statement on their 
Certificate(s) of Insurance: “Sexual molestation and physical abuse coverage is included.” 
Policies/certificates stating that “Sexual molestation and physical abuse coverage is not 
excluded” do not meet this requirement.  
 
5. 
Certificates of Insurance: Prior to Affiliation Agreement execution, FPU shall furnish the 
County with valid and complete certificates of insurance, or formal endorsements as 
required by the Affiliation Agreement in the form provided by the County, issued by FPU’s 
insurer(s), as evidence that policies providing the required coverage, conditions, and limits 
required by this Affiliation Agreement are in full force and effect. Such certificates shall 
identify this contract number and title. In the event any insurance policy(ies) required by 
this Affiliation Agreement is (are) written on a claims-made basis, coverage shall extend 
for two years past completion and acceptance of FPU’s work or services and as evidenced 
by annual Certificates of Insurance. If a policy does expire during the life of the Affiliation 
Agreement, a renewal certificate must be sent to County 15 calendar days prior to the 
expiration date. Certificates of Insurance shall identify Maricopa County as the additional 
insured/certificate holder as follows:  
  
Maricopa County  
c/o Risk Management  
301 W Jefferson St., Suite 910  
Phoenix, AZ 85003  
  
6. 
Cancellation and Expiration Notice: Applicable to all insurance policies required within 
the insurance requirements of this Affiliation Agreement, FPU’s insurance shall not be 
permitted to expire, be suspended, be canceled, or be materially changed for any reason 
without 30 calendar days prior written notice to Maricopa County. FPU must provide 
notice to Maricopa County, within two business days of receipt, if they receive notice of a 
policy that has been or will be suspended, canceled, materially changed for any reason, has 
expired, or will be expiring. Such notice shall be sent directly to Maricopa County Office 
of Procurement Services and shall be mailed, or hand delivered to 301 W. Jefferson St. 
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Suite 700, Phoenix, AZ 85003.  
  
P. 
EMPLOYMENT: Parties acknowledge that under this Affiliation Agreement, no Student 
participant of FPU is to be considered a County employee, and that no rights of County merit, 
County retirement, or County personnel rules shall accrue to such individual. FPU shall have total 
responsibility for all salaries, wages, bonuses, retirement, withholdings, workman's compensation, 
occupational disease compensation, unemployment compensation, other Student benefits, and all 
taxes and premiums appurtenant thereto concerning such individuals and shall save and hold County 
and CHS harmless with respect thereto. 
 
Q. 
Forced Labor of Ethnic Uyghurs. To the extent applicable under A.R.S. § 35-394, the MCJC 
warrants and certifies that it does not currently, and agrees that it will not use for the duration of this 
Agreement the forced labor, any goods or services produced by the forced labor, or any contractors, 
subcontractors, or suppliers that use the forced labor or any goods or services produced by the forced 
labor of ethnic Uyghurs in the People’s Republic of China. If the MCJC becomes aware that it is 
not in compliance with this paragraph, it shall notify the Town of the noncompliance within five 
business days of becoming aware of it. If the MCJC fails to provide a written certification that it has 
remedied the noncompliance within 180 days after that, this Agreement shall terminate unless the 
termination date of this Agreement occurs before the end of the remedy, in which case this 
Agreement terminates on its termination date. 
 
R. 
NON-JOINT VENTURE: This Affiliation Agreement is not intended to constitute, create, give 
rise to, or otherwise recognize a joint venture Affiliation Agreement, partnership or other formal 
business association or organization of any kind, and the right and obligations of the Parties shall 
be only those expressly set forth in this Affiliation Agreement. 
 
S. 
CONFLICTS OF INTEREST: This Affiliation Agreement is subject to the provisions of A.R.S. 
§ 38-511. 
 
T. 
ARBITRATION: To the extent applicable, the parties, in accordance with A.R.S. §12-1518, agree 
to resolve all disputes arising out of or relating to this Affiliation Agreement through arbitration, 
after exhausting applicable administrative review except as may be required by other applicable 
statutes. This provision does not apply to provider claims disputes or member appeals regarding 
covered services provided by FPU. 
 
U. 
PUBLIC RECORDS: Notwithstanding any other provision of this Affiliation Agreement to the 
contrary, CHS is subject to A.R.S. 39-121 through 39-128 regarding public records. Any provision 
regarding confidentiality is limited to the extent necessary to comply with the provisions of Arizona 
law. The parties acknowledge that FPU is not a public agency subject to public records laws but is 
a private corporation. 
 
V. 
CONFIDENTIALITY OF RECORDS: 
 
1. 
Neither party shall use or disclose any PHI received from the other in any manner that 
would constitute a violation of this Affiliation Agreement or federal or state law. Each 
party shall take reasonable measures to ensure that its directors, officers, Students, 
employees, vendors, contractors, and agents use or disclose PHI received from the other 
party in accordance with the provisions of this Affiliation Agreement and federal and state 
law. Each party shall implement all appropriate safeguards reasonably necessary to 
maintain the confidentiality of the information accessed through the EHR system. 
 
2. 
Information pertaining to substance abuse will only be shared upon obtaining a release of 
information from the individual in compliance with 42 CFR Part 2. 
 
3. 
FPU shall not use or disclose Criminal Justice Information for any other purpose and will 
treat all Criminal Justice Information as confidential as always required by state and federal 
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laws and take reasonable measures to maintain the security and confidentiality of such 
information. FPU shall instruct its staff concerning the confidential nature of Criminal 
Justice Information and the applicable prohibitions against its use and disclosure. 
  
4. 
Reporting of Unauthorized Use or Disclosure of PHI: CHS and FPU shall, within 24 
hours of becoming aware or has reason to believe of an unauthorized use or disclosure of 
PHI by either organization; or any of its Authorized Users, officers, directors, Students, 
employees, vendors, contractors, agents or by a third party. Such notice shall be made to 
the following: 
      
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES (CHS) 
Attn: Business Integration Technology (BIT) 
Title: Unauthorized Use or Disclosure of PHI 
Address: 234 N Central Avenue, Suite 5350 
City, State Zip: Phoenix, AZ 85004 
Phone: (602) 506-0897 
Emails: CHSBIT@maricopa.gov and CHSHIMTeam@maricopa.gov  
 
FRANKLIN PIERCE UNIVERSITY 
Attn: Marci Contreras 
Title: Program Director 
Address: 14455 W. Van Buren St., Bldg. A, Ste. 100 
City, State Zip: Goodyear, AZ 85338 
Phone: 623-925-4907 
Email: contrerasm@franklinpierce.edu 
 
W. 
ASSIGNMENT, DELEGATION, AND EXECUTION: 
 
1. 
Neither party may assign this Affiliation Agreement without the express, written, prior 
consent of both parties, which shall not be unreasonably withheld or delayed. 
 
2. 
This Affiliation Agreement does not imply authority to perform any tasks or accept 
responsibility. 
 
3. 
Sections and other headings contained in this Affiliation Agreement are for reference 
purposes and shall not affect in any way the meaning or interpretation of this Affiliation 
Agreement.  
 
4. 
Provisions Required by Law. Each and every provision of law and any clause required 
by law to be in this Agreement will be read and enforced as though it were included 
herein and, if through mistake or otherwise any such provision is not inserted, or is not 
correctly inserted, then upon the application of either party, this Agreement will promptly 
be physically amended to make such insertion or correction. 
 
5. 
This Affiliation Agreement may be executed in two or more counterparts, each of which 
shall be deemed an original but all of which together shall constitute the same instrument. 
Faxed, copied, digital, and scanned signatures are acceptable as original signatures. 
 
6. 
This Affiliation Agreement contains the entire understanding of the parties hereto with 
respect to the matters covered, and it supersedes all proposals, oral or written, and all other 
documents or communications between the parties relative to the subject matter herein 
covered, unless such documents or communications are specifically included by reference. 
 
7. 
All notices  under  this   Affiliation Agreement  given  by  either  party to the other shall 
be in writing and shall be delivered in person or sent by U.S. Postal Service, postage 
prepaid and addressed to the following individuals: 
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MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES (CHS) 
Attn:  Lisa Struble 
Title:  CHS Department Director 
Address: 234 N. Central Avenue, Suite 5000 
City, State Zip: Phoenix, AZ 85004 
Phone:   (602) 350-1745  
Email: Lisa.Struble@maricopa.gov  
 
FRANKLIN PIERCE UNIVERSITY 
Attn: Marci Contreras   
Title: Program Director 
Address: 14455 W. Van Buren St., Bldg. A, Ste. 100 
City, State Zip: Goodyear, AZ 85338 
Phone: 623-925-4907 
Email: contrerasm@franklinpierce.edu 
 
8. 
Prior to or simultaneously with the execution of this Affiliation Agreement, FPU shall 
provide CHS with proof, satisfactory to the County Attorney, that the individual executing 
this Affiliation Agreement on behalf of FPU is legally authorized to bind FPU. 
  
9. 
Signatures. This Agreement may be executed in two or more counterparts, each of which 
shall be deemed an original but all of which together shall constitute the same instrument.  
E-signed, faxed, copied, and scanned signatures are acceptable as original signatures. 
 
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IN WITNESS WHEREOF, the parties have executed this Agreement as of the respective 
dates written below. 
MARICOPA COUNTY 
BOARD OF SUPERVISORS 
By:  
Name: 
Title: Chairman, Board of Supervisors 
FRANKLIN PIERCE UNIVERSITY 
Authorized Individual: 
By: 
Name: _Marci Contreras, Ed.D., PA-C   
Title: Program Director ________  
Date:   10/12/23
Date:   
ATTEST: 
By:   
 
Name: _____________________________      
Title:  Clerk of the Board  
Date:   
APPROVED AS TO FORM: 
By:  
Name: 
Title: Deputy County Attorney 
Date:   
DocuSign Envelope ID: 31DBBE62-0B1F-424E-B9BA-806A1DDD63CE
10/13/2023
Davina Bressler