HomeMy WebLinkAboutE-04. AGREEMENT APU SCHOOL OF NURSING SEPT 2016CONSENT ITEM
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TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
VIA: TROY L. BUTZLAFF, ICMA-CM, CITY MANAGER
FROM: JOE JACOBS, DIRECTOR OF RECREATION AND FAMILY SERVICES
DATE: SEPTEMBER 19, 2016
SUBJECT: APPROVAL OF EXTENSION OF THE CLINICAL AFFILIATION AGREEMENT
BETWEEN AZUSA PACIFIC UNIVERSITY SCHOOL OF NURSING AND THE
AZUSA SENIOR CENTER
SUMMARY:
On January 26, 1996, the City of Azusa Senior Center entered into a partnership with Azusa Pacific
University’s School of Nursing. This was done in an effort to provide instructional and clinical
experience to the students of nursing, as well as to offer valuable health care resources to the seniors of
the community who visit the Azusa Senior Center. The agreement with Azusa Pacific University will
expire at the end of September 2016. The proposed action extends the agreement for an additional three
(3) years.
RECOMMENDATION:
Staff recommends that the City Council take the following actions:
1) Approve the extension of the Clinical Affiliation Agreement with Azusa Pacific University’s
School of Nursing for an additional three (3) years ; and
2) Authorize the City Manager to execute, in a form acceptable to the City Attorney, the agreement
on behalf of the City.
DISCUSSION:
On January 26, 1996, the City of Azusa Senior Center entered into a partnership with Azusa Pacific
University’s School of Nursing. This was done in an effort to provide instructional and clinical
experience to the students of nursing as well as to offer valuable health care resources to the seniors of
the community who visit the Azusa Senior Center; The previous extension was approved on September
16, 2013. The Azusa Senior Center together with Azusa Pacific University wishes to continue these
collaborative efforts for an additional three years as per the attached agreement.
Approved
Council Meeting
9/19/2016
Approval of Extension to Clinical Affiliation Agreement with Azusa Pacific University
September 19, 2016
Page Two
FISCAL IMPACT:
There is no fiscal impact associated with the recommended actions.
Prepared by: Reviewed and Approved:
Lenore Gonzales Joe Jacobs
Recreation Supervisor, Senior Services Director of Recreation and Family Services
Reviewed and Approved: Reviewed and Approved:
Louie F. Lacasella Troy L. Butzlaff, ICMA-CM
Management Analyst City Manager
Attachment:
1) Clinical Affiliation Agreement Between Azusa Pacific University School
of Nursing and the Azusa Senior Center
Attachment 1
CLINICAL AFFILIATION AGREEMENT BETWEEN
AZUSA PACIFIC UNIVERSITY
SCHOOL OF NURSING
and
AZUSA SENIOR CENTER
Azusa Pacific University, domiciled in the City of Azusa, State of California (hereinafter
called “UNIVERSITY”) and Azusa Senior Center, domiciled in the City of Azusa, State of
California (hereinafter called “FACILITY”), hereby agree:
RECITALS
UNIVERSITY is an institution of higher learning, which presently offers Bachelor’s,
Master’s and Doctorate Degrees in various disciplines, fully accredited by the Western
Association of School and Colleges, and the Commission on Collegiate Nursing Education
(CCNE). FACILITY is an institution, which offers health services and facilities, and maintains
appropriate state licensure.
UNIVERSITY and FACILITY desire to assist and cooperate with each other in providing
instruction and clinical experience to students of nursing, which leads to the awarding of elective
credit toward a Bachelor’s, Master’s or Doctorate degree, and/or continuing education units,
from Azusa Pacific University.
UNIVERSITY has determined that its utilization of FACILITY comports with the
requirements of section 1427 of title 16 of the California Code of Regulations.
TERMS OF AGREEMENT
1. ACCREDITATION:
FACILITY shall undertake to maintain standards of care and all other requirements
necessary to insure continued Medi-Cal and/or Medicare certification and appropriate state
licensure. It is recognized that UNIVERSITY is under the jurisdiction of various accrediting
agencies with whose standards it must comply if UNIVERSITY is to maintain accreditation, and
it is therefore agreed that UNIVERSITY will administer the Degree Program, and that
UNIVERSITY will prescribe curriculum and courses of study. It is agreed that the Program is
the responsibility of UNIVERSITY, and that UNIVERSITY is in authority of the administration
of the same. UNIVERSITY personnel recognize the responsibility to plan and work
collaboratively and cooperatively with FACILITY, in providing student learning and patient
care. Appropriate representatives of UNIVERSITY and FACILITY will meet as needed for the
purpose of interpreting, discussing and evaluating students’ clinical experience at the
FACILITY.
Upon failure of either party to this AGREEMENT to obtain or maintain its certification or
accreditation, the party hereto which has certification or accreditation, at its election, may
terminate this AGREEMENT at the end of the academic year of the UNIVERSITY by giving at
least one semester’s written notice thereof to the party that does not have its said certification or
accreditation and thereupon, this AGREEMENT shall terminate without further liability
hereunder by either party to the other, except as provided for in Section 7 of this AGREEMENT.
The term semester as used herein, means one half of a regular school year as now conducted by
UNIVERSITY or its then equivalent.
2. TRANSPORTATION OF NURSING STUDENTS BETWEEN UNIVERSITY AND
FACILITY:
Neither UNIVERSITY nor FACILITY will provide transportation for nursing students
between campus of UNIVERSITY and FACILITY. Each nursing student shall be responsible
for his or her transportation between UNIVERSITY campus and FACILITY.
3. INSURANCE:
(a) Worker’s Compensation Insurance and Employer’s Liability Insurance: FACILITY
shall maintain minimum insurance coverage for Worker’s Compensation, including
Employer’s Liability, covering its employees. UNIVERSITY shall maintain
minimum insurance coverage for Worker’s Compensation, including Employer’s
Liability, covering its employees and students.
(b) Professional Liability Insurance: FACILITY shall carry professional liability
insurance coverage in the amount of $1,000,000 per limit and $3,000,000 in the
aggregate, for its employees and agents. UNIVERSITY shall carry professional
liability insurance coverage in the amount of $1,000,000 per limit and $3,000,000 in
the aggregate, for its employees, agents, and students.
(c) General Liability Insurance: FACILITY shall maintain general liability insurance
coverage in the amount of $1,000,000 per incident and $3,000,000 in the aggregate,
covering its employees and agents. UNIVERSITY shall maintain general liability
insurance coverage in the amount of $1,000,000 per incident and $3,000,000 in the
aggregate, covering its employees, agents, and students.
(d) UNIVERSITY maintains proof of all insurance coverage and will provide said proof
to FACILITY upon request. Further, in the event of any modification, termination,
expiration, non-renewal or cancellation of any insurance coverage required by this
Agreement, UNIVERSITY shall give written notice thereof to FACILITY not more
than ten (10) days following the date of UNIVERSITY’S receipt of such notification.
(e) FACILITY maintains proof of all insurance coverage and will provide said proof to
UNIVERSITY upon request.
4. CONFIDENTIALITY:
All verbal and written information exchanges, as well as proprietary information relating to
business practices, procedures or methods of the FACILITY or the project shall remain strictly
confidential and shall not be disclosed without consent of the FACILITY.
The University shall notify students that they are responsible for respecting and maintaining
the confidentiality of all Health Information with respect to all patients of the FACILITY,
including without limitation, all Health Information regarding a patient’s: 1) Medical treatment
and condition; 2) Psychiatric and Mental Health; and 3) Substance abuse and Chemical
dependency, which the student may receive pursuant to this Agreement. The student agrees to
comply with the terms and conditions of the: (i) Confidentiality of Medical Information Act of
1981, California Civil Code Section 56 et seq. (General Patient Medical Records); (ii) California
Welfare & Institutions Code §5328.6 and §5328.7 (Mental Health Records); and (iii) 42 U.S.C.
§§290dd-2; (iv) Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the
Regulations promulgated thereunder (42 U.S.C. Sections 1320d-2 and 1320d-4; 45 C.F.R.
Subtitle A, Subchapter C, Parts 160 – 164), as amended from time to time.
5. STUDENT AGENCY ASSIGNMENT:
The assignment of nursing students within the FACILITY shall be made by the
UNIVERSITY, or UNIVERSITY faculty assigned to the facility (if any), in accordance with
students’ educational needs as determined by the curriculum of the UNIVERSITY’S program.
Physical facilities of FACILITY for such assignments will be made available therefore by
FACILITY, and FACILITY will adhere to the placement objectives set forth by the
UNIVERSITY.
The student will be officially enrolled in a nursing course of study at Azusa Pacific
University.
The student will work with a FACILITY preceptor(s) agreed upon by FACILITY,
UNIVERSITY and student.
The UNIVERSITY and/or student will prepare objectives for the clinical experience
with the approval of UNIVERSITY faculty and FACILITY preceptor(s), and
FACILITY’S preceptor(s) shall instruct students in their clinical training at
FACILITY in accordance with those objectives.
The clinical hours to meet the student’s learning needs will be jointly arranged by the
UNIVERSITY, FACILITY, and student.
Student evaluations will be the responsibility of the UNIVERSITY faculty with input
from the FACILITY preceptor(s).
The student will meet all time obligations or otherwise notify the FACILITY
preceptor(s) of alterations in advance.
The UNIVERSITY shall notify students that they are responsible for following the
internal protocols, policies, procedures, rules and regulations established by
FACILITY; and all requirements of the Joint Commission on Accreditation of
Healthcare Organizations (“Joint Commission” or “JCAHO”), as may be revised
from time to time.
6. RESERVATION OF RIGHTS:
FACILITY reserves the right for its Administrator to exercise exclusive control over the
administration, operation, maintenance and management of FACILITY, and faculty and students
while students are in residence at the FACILITY and subject thereto. UNIVERSITY reserves
the right to exercise control and supervision over the operation, curriculum, faculty and students
of the School of Nursing within the prescribed framework.
7. TERMINATION AND TERM LENGTH OF THIS AGREEMENT:
The AGREEMENT may be terminated by either party thereto by delivery of thirty (30)
days prior written notice of termination to the other party hereof, and delivery of a copy of said
notice to the Board of Directors or Trustees, or the organization having jurisdiction over either of
the parties hereto, or of which either party hereto is a member, and whose laws, rules or
regulations require that such notice be given to such Board or organization. In the event such
notice of termination is given for any reason including for loss of certification or accreditation as
provided for in Section 1 hereof, the UNIVERSITY and FACILITY will continue to discharge
their obligations as expressed herein to each other as to the nursing students then enrolled. This
AGREEMENT is for the term of three (3) years, unless earlier terminated pursuant to the terms
of this Agreement.
8. MISCELLANEOUS:
(a) Patient Care: The FACILITY shall remain in charge of and provide appropriate
supervisory personnel for patient care. FACILITY is at all times responsible for care
and supervision of its patients, and FACILITY warrants that FACILITY has adequate
staffing to ensure safe and continuous health care services to FACILITY’S patients,
and that students shall not be substituted for FACILITY staff necessary for reasonable
coverage.
(b) Orientation: The FACILITY will provide for the UNIVERSITY and its nursing
students and faculty appropriate orientation prior to and, if required, during each
semester. Orientation shall include familiarization with relevant FACILITY purpose,
policies, procedures and facilities.
(c) Hepatitis B: UNIVERSITY requires the hepatitis B vaccine and vaccination series for
all of its health care students who have occupational exposure. UNIVERSITY also
follows up with all students who have had an exposure incident at no cost to them,
once the student has received the required training and within ten working days of
initial assignment. All students are assured that if the hepatitis B vaccination has
previously been declined (for which a signed declaration has been obtained) that the
vaccination series is still available to such student.
(d) Universal Precautions: The UNIVERSITY nursing curriculum contains Universal
Precautionary Practices, which include a general explanation of the epidemiology and
systems of blood borne disease, modes of transmission, and information on the
hepatitis B vaccination, as well as other pertinent information.
(e) Health Clearance: The UNIVERSITY assumes responsibility for maintaining a
current (within a year) certification of health clearance, including verification of a titer
test proving immunity to rubella and measles or proof of two (2) immunizations,
Quantiferon Gold or two-step PPD Test followed by annual renewals or chest x-ray
and tuberculosis questionnaire showing no active tuberculosis, two (2) immunizations
or positive titer for Varicella-zoster virus (chicken pox), proof of immunization, three
(3)-series, against hepatitis B (heptavac) or positive titer, and evidence of a Tetanus,
Diphtheria, Pertussis, (Tdap) vaccination. UNIVERSITY shall ensure compliance
with this Paragraph and shall maintain files of all health examinations of students
assigned to FACILITY.
(f) Background Check: The UNIVERSITY shall require each assigned student to submit
to a complete background check as a condition of participation in the Program. The
background check will be considered “completed” if it includes all of the following
elements: (1) 7 year criminal background check in current and previous counties of
residence and employment; (2) confirmation that the assigned student is not listed as
sexual offender and, if requested by the FACILITY, in any child abuse registry;
(3) evidence that the assigned student is eligible to participate in all federal and state
health programs and verification that the student is not on the OIG or GSA exclusion
list.
9. MUTUAL INDEMNIFICATION:
(a) UNIVERSITY shall indemnify, save and hold harmless FACILITY, its officers,
directors, agents and employees from and against all obligations, claims and liabilities
of any kind under state or federal law (including costs and attorneys fees) that may
arise out of negligent acts or omissions of UNIVERSITY officers, directors, agents,
and employees during the course and scope of a UNIVERSITY’s student’s clinical
training.
(b) FACILITY shall indemnify, save and hold harmless UNIVERSITY, its officers,
directors, agents and employees from and against all obligations, claims and liabilities
of any kind under state or federal law (including costs and attorneys fees) that may
arise out of negligent acts or omissions of FACILITY officers, directors, agents or
employees during the course and scope of a UNIVERSITY’s student’s clinical
training.
10. AMENDMENTS:
This AGREEMENT and each of their terms and provision hereof may be amended from
time to time by the parties hereto by written amendment only and executed by the parties hereto.
11. STATUS OF STUDENTS: The employment status of students and the responsibility for
insurance coverage for student activities depends upon the status of the students as set forth
below:
(a) Students Participating in Unpaid Internship not at Student’s Place of
Employment: It is understood by the parties that the UNIVERSITY’s students are
fulfilling specific requirements for clinical experiences as part of a degree
requirement, and therefore, the UNIVERSITY’s students do not thereby become
employees or agents of UNIVERSITY by virtue of their clinical training. The
UNIVERSITY shall be responsible for providing general liability, professional
liability, and workers’ compensation coverage for such students, pursuant to Section 3
(Insurance) of this Agreement.
(b) Students Participating in Unpaid Internship at Student’s Place of
Employment: It is understood by the parties that the UNIVERSITY and FACILITY
shall keep the clinical training and work duties of the UNIVERSITY’s students strictly
separate. The UNIVERSITY shall be responsible for providing general liability,
professional liability, and workers’ compensation coverage for such students’ clinical
training, pursuant to Section 3 (Insurance) of this Agreement, and the FACILITY shall
be responsible for providing insurance coverage for such students’ activities as an
employee.
(c) Students Participating in Paid Internship: If the UNIVERSITY’s students are
provided with a nominal stipend from the FACILITY intended to reimburse them for
estimated expenses related to their clinical training, the UNIVERSITY’s students do
not thereby become employees or agents of FACILITY, and UNIVERSITY shall be
responsible for providing general liability, professional liability, and workers’
compensation coverage for such students pursuant to Section 3 (Insurance) of this
Agreement; however, FACILITY shall be responsible for issuing a Form 1099
reporting the stipend to the Internal Revenue Service. If, however, the
UNIVERSITY’s students are paid by the FACILITY for their services, then they
become employees of the FACILITY, and FACILITY is responsible for all employee
obligations and for insuring the activities of such students, notwithstanding Section 3
(Insurance) of this Agreement; in addition, Section 9 (Mutual Indemnification) shall
not apply to either party.
IN WITNESS WHEREOF, the Parties to this AGREEMENT have hereunto set their hands in
duplicate, this ________ day of _________________________, 2016.
AZUSA SENIOR CENTER
740 N. Dalton Avenue
Azusa, CA 91702
626-812-5204 Phone
626-969-5611 Fax
By_________________________________
Lenore Gonzales
Recreation Supervisor/Senior Services
AZUSA PACIFIC UNIVERSITY
701 E. Foothill Blvd./ PO Box 7000
Azusa, CA 91702-7000
626-815-5386 Phone
626-470-9644 Fax
By___________________________________
Aja Tulleners Lesh, PhD, RN
Dean, School of Nursing