HomeMy WebLinkAbout5.785 Original Contract
,- .
. '.
.5.7gS
CLINICAL AFFILIATION AGREEMENT
This agreement is made and entered into between Clark County Fire District 5
Northwest Regional Training Center (Training Center) and Port Angeles Fire
Department (Agency). The purpose of this agreement is for Agency, which is
committed to training health care professionals, to provide desirable clinicallearnmg
experiences and facilities for Training Center's Paramedic students In conSideration
of the mutual covenants and agreements herein, Training Center and Agency agree
as follows.
GENERAL PROVISIONS
1. Clinical areas, dates, times and numbers of students shall be mutually agreed
upon at the beginning of each academic term
2. Training Center and Agency will jointly plan the clinical education program and
Jointly evaluate students. Exchange of information will be maintained by on-site
hospital visits when practical and by letter or telephone in other Instances.
3. Training Center and Agency Will instruct their respective faculty, staff and
students participating in the clinical education program, to maintain confidentiality
of student and patient Information as required by law and by the policies and
procedures of Training Center and Agency
4. There will be no payment of charges or fees between Training Center and
Agency.
5. There will be no discrimination against any program participant or applicant
covered under this agreement because of race, color, religion, national origin,
age, handicap, status as a Vietnam era or disabled veteran, sex, or sexual
orientation, nor Will Training Center or Agency engage in such discrimination in
their employment or personnel policies.
TRAINING CENTER'S RESPONSIBILITIES
1. Training Center will provide Information to Agency concerning its curriculum and
the professional and academic credentials of ItS faculty for the students at
Agency Training Center faculty members supervising students will be licensed
to practice where so required in the State of Washington. Training Center will
designate an appropriately qualified and credentialed faculty member to
coordinate and act as the liaison with Agency. Training Center will be
responsible for Instruction and administration of the student's academic
education program Training Center will notify Agency In writing of any change of
its liaison. Training Center Will have the final responsibility for grading students
2. Training Center shall provide Agency with a Handbook for Paramedic Clinical
Preceptors which outlines, among other things, the role of the preceptor, the role
of the student, general rules for conduct by the student, learning styles, safety
precautions to be taken by the student, skills to be performed by the student
under the direction of the preceptor, information taught to students by the
Training Center prior to their beginning a clinical rotation, and documentation
sheets to be completed by the preceptor
3 Faculty of the Training Center and the preceptor will be responsible for selecting
the learning experiences. Responsibilities of the faculty member are to'
. Identify students who meet the criteria for the experience.
. Communicate prior to the clinical experience with the student and preceptor
the role of the Training Center in providing learning experiences for students,
the role and responsibilities of the faculty and preceptor regarding the
experience, and the responsibilities of the student in this experience
. Serve as a resource to the preceptor and the student
. Provide orientation materials, course objectives, forms, evaluation tools, and
policies of the Training Center as needed to preceptor.
. Evaluate student progress and achievement with input from the student and
preceptor according to course and student objectives.
. Be available and respond to concerns or Issues that arise during the clinical
experience
. Provide avenue for ongoing communication to student and preceptor.
. Evaluate preceptor experience In relationship to course objectives.
4. Training Center's faculty will meet as needed with Agency's clinical education
supervlsor(s) and/or preceptor(s) to diSCUSS and evaluate the clinical education
program. These meetings will take place In person If practicable, otherwise by
telephone conference. Training Center is responsible for arranging and planning
the meetings
5. Training Center will provide the names and information pertaining to relevant
education and training for all students enrolled in the clinical education program.
Training Center is responsible for supplying any additional information required
by Agency as set forth in this Agreement, prior to the arrival of students. Training
Center will notify Agency in writing of any change or proposed change In a
student's status. Training Center shall ensure that all students are current on
their immunizations. Immunizations shall include measles (rubeola), mumps,
Rubella (or a positive rubella titer), and chicken pox (varicella). Hepatitis B
Vaccination is encouraged or a signed waiver declining the vaccine Training
Center will provide Information to the Agency regarding student status
concerning the above requirements. In no event shall the Training Center enroll
a student for the clinical experience who the Training Center has reason to
believe has contracted a communicable disease and IS In the communicable
period
6. Training Center will assign to Agency only those students who have satisfactorily
completed the prerequisite didactic portion of the curriculum and who have
evidence of completion of a CPR course based on the American Heart
Association or American Red Cross guidelines and related to the age group(s)
with whom they Will be working.
2
7 Training Center agrees to request a cnminal background check. Training Center
agrees to provide Agency with a copy of the cnminal background check results
provided by the Washington State Patrol pertaining to each student considered
for placement at Agency Training Center acknowledges that placement of each
student at Agency IS contingent upon prOVIsion of background check information
dated less than two years prior to the commencement of the clinical education
placement. Agency acknowledges that Training Center is not responsible for the
accuracy of the information provided through thiS background check and that
Training Center's provision of thiS background check information does not relieve
Agency of any of ItS legal obligations related to these background checks.
Agency understands and agrees that any Information forwarded to it by Training
Center has been procured through this process Training Center does not certify
the veracity of the records provided
8. Training Center shall support and comply with all policies and procedures of
Agency that pertain to students and faculty participating in clinical programs at
Agency. Training Center will notify each student of his/her status and
responsibilities pursuant to thiS Agreement.
9. Training Center Will encourage each student participating in the clinical education
program to acquire comprehensive health and accident insurance that will
provide continuous coverage of such student during his or her participation In the
education program. Training Center will inform students that they are
responsible for their own health needs, health care costs, and health insurance
coverage.
AGENCY'S RESPONSIBILITIES
1. Agency Will provide students with a desirable clinical education experience Within
the scope of health care services provided by the Agency. Agency Will deSignate
staff to act as preceptors, to be responsible for the clinical education program,
and will designate one person as the clinical education Supervisor who Will
maintain contact with the Training Centers designated liaison to assure mutual
participation in and review of the clinical education program and student
progress
2. Agency shall proVide orientation for the students to the clinical areas of the
Agency. Agency reserves the nght to limit access by the student to confidential
information Responsibilities of the preceptor in the Agency.are to:
. Assist the student in processing information that will facilitate meeting
course/learner objectives Within the agency.
. Provide learning experiences and assignments to achieve student and course
objectives.
. Answer student questions
. Be present in the clinical setting and available to the student at all times
during the prescnbed clinical time
. Discuss with the student the Implications of his/her observations within the
(Agency).
"
-'
. Inform the faculty member of problems or issues that are of concern to
preceptor.
. Communicate with the faculty member concerning student's progress
. Provide direct supervision of student(s) within the clinical learning expenence
. Give student feedback on performance.
. Formally evaluate student performance in the clinical area based on course
and student objectives.
. Limit student experiences as necessary for client safety related to client
condition or student concern.
3 Agency will provide students and faculty access to its Medical Library and
access to patient charts according to its standard poliCies and patient's rights.
4. Agency Will provide locker space and conference space as necessary and
available. Agency will make available basIc supplies and equipment necessary
for care of patients/clients and the clinical education program.
5 Agency agrees to follow the outlines of the Handbook for Paramedic Clinical
Preceptors and discuss with Training Center any concerns or deviations that
Agency desires to make
6. Agency retains full responsibility for the care of patient/clients, and will maintain
the quality of patient care without relying on the students' clinical training
activities for staffing purposes.
7 Agency has the right to terminate a student's practicum experience and use of
ItS facIlities, equipment or supplies where flagrant or repeated violations of the
Agency rules, regulations, poliCies or procedures occur Such action will not
normally be taken until the charges against the student have been discussed
with the appropnate representative of the Training Center. However, the
Agency reserves the right to take Immediate action where necessary to preserve
the quality of patient services and to maintain operation of it facilities free from
interruption. The Training Center Will not reassign the individual to the Agency
without prior approval of the Agency, which will not be unreasonably withheld
8. In the event a student or faculty member requires emergency medical care or
first aid for accidents while on the premises of the (AGENCY), the (AGENCY)
will provide such care as needed The cost will be charged to the student or the
faculty member.
STUDENTS' STATUS AND RESPONSIBILITIES
1. Students Will have the status of learners and will not replace Agency Department
personnel Any service rendered by students IS Incidental to the educational
purpose of the clinical education program.
2. Students are required to adhere to the standards, poliCies and regulations of
Agency during their clinical education program.
3. Students Will wear appropnate attire and name tags, and will conform to the
4
,-
standards and practices established by Training Center dUring their clinical
education program at Agency. Students observing in surgery will wear
appropriate surgical attire.
4. Students assigned to Agency will be and will remain Students of Training Center,
and will in no sense be considered employees of Agency. Students will not be
entitled to any monetary or other remuneration for services performed by them at
Agency, nor will Agency otherwise have any monetary obligation to Training
Center or its students by virtue of thiS Agreement.
5 The student will be required to sign the agency's: rider form The student is not
an employee or volunteer member of the agency Agency will not provide
workers compensation for the student
LIABILITY COVERAGE PROVISIONS
1. Training Center shall provide worker's compensation coverage for its staff
members while on Agency premises to the extent such coverage is required by
the State in which the Agency IS located. Agency does not and will not assume
any liability under any law relating to Worker's Compensation on account of any
Training Center student's performing, receiving training, or traveling pursuant to
this Agreement.
2. During the term of this Agreement, Training Center shall keep in full force
professional liability insurance in the amount of $1,000,000 per occurrence and
$3,000,000 In the aggregate which shall extend to the activities contemplated
under this Agreement and undertaken on Agency premises, covering both faculty
and students. Upon request, Training Center will provide proof of coverage.
Notwithstanding anything else in thiS agreement to the contrary, failure by the
Training Center to maintain the required level of insurance coverage continuously
In effect shall be grounds for Immediate termination of this Agreement by
Agency.
3. Training Center agrees to hold Agency harmless from claims or injuries or
damages to persons or property that arise out of any act or omission of the
Training Center or its faculty or students enrolled In the practicum program.
Agency agrees to hold Training Center harmless from claims or injuries or
damages to person or property that arise out of the terms and conditions of thiS
agreement that result from any act or omission of the Agency and ItS employees.
TERM
1 This Agreement will become effective on the last date noted on the signature
page, and remain In effect for two years. This Agreement will be reviewed no
later than two years from ItS effective date, or earlier at the request of either
party. Training Center and Agency will JOintly plan student placement in advance
of each year's beginning taking Into account the needs of the Training Center for
clinical placement, maximum number of students for whom Agency can provide a
desirable clinical education experience, and the needs of other disciplines or
Training Centers requesting clinical placements
5
"
2 This Agreement may be terminated by either party by written notice given to the
other party at least ninety (90) days in advance of such termination. Any
students enrolled in the clinical education program at the time of the notice shall
be allowed to complete his/her practlcum experience.
PROVISIONS REGARDING BLOOD-BORNE PATHOGENS
1. Training Center certifies that it has trained each student it sends to Agency m
universal precautions and transmission of bloodborne pathogens, and that It will
send to Agency only those students who have been trained In and have practiced
using universal precautions. Agency will provide personal protective equipment
that IS appropriate for the tasks assigned to Traming Center's students.
MISCELLANEOUS PROVISIONS
1. Entire Aoreement. This Agreement constitutes the entire Agreement between
the parties, and replaces all oral or written agreements, commitments, or
understandings concerning the matters provided for herem.
2. Amendment. This Agreement may only be modified by a subsequent written
Agreement executed by the parties The provisions in this Agreement may not
be modified by any attachment or letter agreement as described elsewhere In
this Agreement.
3. Governino Law. The parties' rights or obligations under thiS Agreement will be
construed in accordance with, and any claims or dispute relating thereto will be
governed by, the laws of the State of Washington.
4. Notices. Each party may designate a change of address by notice in writing All
notices, demands, requests, or communications that are not hand-delivered will
be deemed received three (3) days after deposit In the U.S. mall, postage
prepaid; or upon confirmation of successful facsimile transmission.
5 Survival. Training Center and Agency expressly intend and agree that the liability
coverage provisions of thiS Agreement will survive the termination of this
Agreement for any reason
6. Inspection. Agency will permit, on reasonable notice and request, the inspection
of clinical and related facilities by agencies charged with responsibility for
accreditation of Training Center.
7. Relationship Between the Parties The parties agree that this agreement is not
intended and shall not be construed to create a relationship of agent, employee,
partnership, joint venture, or association between Training Center and Agency
and any student
6
,
Northwest Regional Training Center
cla~ County Fire :&t 5 ~_
Signature: . ....~ ~_____
//. t? . ~------ '" ,p A \
Print: ~ ~~~
Title: S2rv~ s-'Ef2ViCO .D*c.~
Date: 2-0 -S- ~ <2.-ecA
Port ~nge/es Fire Da;.nt
Signature:
Print:
Dan McKeen
Title:
Fire Chief
Date:
June 15, 2006
7