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~ AFFILIATION AGREEMENT
BSHS
This AFFILIATION AGREEMENT("Agreement")
effective the 23rd day of April,2018 is made and entered by and between The University of Phoenix,
Inc., an Arizona for profit corporation,hereinafter referred to as the"University"and the City of Fort
Worth, an entity domiciled in the State of Texas referred to as the"Agency."
PART 1.
PURPOSE OF AGREEMENT
The purpose of this Agreement is to provide Educational Experiences at the Agency under the
supervision of an Agency Supervisor for Students enrolled in the University's BSHS Programs.
NOW THEREFORE, in consideration of the mutual covenants and agreements contained in this
Agreement,Agency and University agree as follows:
PART II.
DEFINITIONS
1. Agency Supervisor shall mean the designated, qualified agency professional that meets state
and/or industry standards who works for the Agency(as an employee or independent contractor)
and who will mentor and supervise the Student according to the educational guidelines provided
by the University. Supervision must be provided according to guidelines stipulated in the BSHS
Supervision Agreement.
2. University Representative shall mean the member of the University faculty or Administration
designated by the University who coordinates a Student's Educational Experience.
3. University Personnel shall mean employee and other agents of the University, including, but not
limited to, the University's Representative and faculty members associated with evaluation of the
Student's Educational Experience.
4. Student shall mean the individual enrolled in the University's BSHS Program who is participating
in his/her Educational Experience.
5. Client shall mean the individuals to whom Agency provides its services in the course of its
operations.
6. Agency shall mean the human services office or facility where the Student will participate in
his/her Educational Experience under the supervision of the Agency Supervisor.
7. University shall mean the University of Phoenix.
8, Educational Experience shall mean that portion of the BSHS Program in which the Student
receives training under the supervision of the Agency Supervisor.
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BSHS AR Agm t rev 01-16-14
PART III.
RIGHTS AND OBLIGATIONS OF THE UNIVERSITY
1. Responsibility for Educational Experience. University will assume full responsibility for offering
educational programs accredited by appropriate organizations (as applicable); and for
determining standards of education, hours of instruction, learning experiences, administration,
matriculation, promotion, and graduation.
2. Student Placements. University will plan with the Agency, in advance, its schedule of Student
placement to the designated areas, including dates and numbers of Students.
3. Advise Students of Their Agency Obligations. University agrees to inform Students that
Students shall be responsible for following Agency regulations, policies, and procedures.
4. Field Experience Manual. University agrees to provide to Agency a copy of the course
requirements and the Field Experience Manual(if applicable).
5. Health Standards. Participating University Personnel and Students shall be required to comply
with the minimum lawful health standards set forth in writing by the Agency and provided to the
University. The student is required to submit all required documentation to the Agency.
6. Availability of University Personnel. University shall ensure that University Personnel are
reasonably available to the Agency for consultation during a Student Educational Experience in a
manner that is acceptable to both parties. University shall designate a University Representative
and shall give Agency and Agency Supervisor notice of the name of the University
Representative.
PART IV.
RIGHTS AND OBLIGATIONS OF AGENCY
1. Learning Experiences. Agency agrees to cooperate with University in providing learning
experiences for Students that meet applicable Agency standards, that meet the stated objectives
of the University's Educational Experiences, and that effectively facilitate the Students' learning
process.
2. Supervision. Agency agrees that all Educational Experiences will be under the supervision of a
Agency Supervisor.Agency shall provide an Agency Supervisor and other personnel approved by
the Agency to supervise Students. The Agency Supervisor will be the resource person for the
Students in the Agency setting and will: (a) supervise and observe the Agency Educational
Experience of the Student; (b) instruct the Student regarding all applicable Agency policies and
programs; (c) facilitate adequate exchange of information between University Personnel and
Agency staff; and (d) instruct Students regarding changes in Agency regulations, policies and
procedures, University may request the removal and replacement of an Agency Supervisor for
reasonable cause. Agency agrees to remove and replace an Agency Supervisor within five (5)
days of University's written request. Agency Supervisors must meet all state law requirements for
supervision and/or industry standards.
3. Notice of Changes in Health Standards. Agency shall promptly provide to University written
notice of any changes in Agency's minimum health standards for Students participating in
Educational Experiences at the Agency.
4. Compliance with Agency Policy and Procedures. Students are subject to the authority,
policies, and regulations of the University, provided, however, that during the Educational
Experience Students also are subject to applicable Agency regulations, policies and procedures.
Agency agrees to provide to the University Personnel and Students the Agency's policies,
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BSHS Aff Agrrrd rev 01.16.14
procedures and other relevant materials that will allow Students to safely and effectively
participate in appropriate Agency services. Agency policies, procedures, and/or regulations will
govern in the event that such policy, procedure, and/or regulation conflicts with a University
policy, procedure and/or regulation until such time as the parties develop a mutually agreeable
policy, procedure and/or regulation. Agency shall be responsible for providing adequate staffing
necessary to maintain the highest level of quality Client care.
5. Access to Library Facilities.Agency shall permit Students access to library facilities available to
Agency personnel. Students may not remove materials from the Agency without appropriate
approval.
6. Student Activities Expectations: Students in Field Experience must begin with indirect client
contact as an observer to direct client contact under supervision to an independent caseload or
assignment of administrative responsibility. Students are responsible for Agency documents,
Agency dress code,and expectations.
7. Student Activity Limitations. Agency understands and agrees that it is solely responsible for
providing human services for all of its Clients or other service recipients including any Clients that
may become involved directly or indirectly in the Educational Experience with Students. Agency
shall not approve or allow any Student to provide: a) any Agency clinical, medical or counseling
functions; b) any transportation functions for Agency personnel or Clients; or c) any duties that
require some level of professional skill, including, but not limited to, nursing care, nurses' aide
work, administering medication, etc.
8. Non-Liability of University. Agency shall be solely responsible for the services rendered by the
Agency. Agency will assume and maintain complete control and supervision over all its
administrative and staff personnel. University shall not be liable for any claims or damages arising
from Agency activities, whether or not University Personnel or Students have participated in the
services at issue in the claim or suit.
9. Student Progress. Agency agrees to submit to University an evaluation, according to the
guidelines provided by the University, of each Student's performance during the Educational
Experience.
10. Removal from Premises. Agency shall retain the right, in its sole discretion, to request the
removal from Agency premises of any University Personnel or Students and such individuals
shall promptly and without protest leave any area whenever requested to do so by the Agency.
11. Inspection for Quality Assurance.Agency shall, upon reasonable request, permit the University
or its accrediting agencies to inspect Agency facilities, records, and other items pertaining to the
Educational program.
PART V.
TERM OF AGREEMENT
1. Term. This Agreement shall become effective on April 23, 2018, and shall remain in effect until
terminated by either party in accordance with this section. Either party may terminate this
Agreement without cause by giving thirty (30) days prior written notice to the other party of its
intention to terminate. Notwithstanding any such termination, all Students already enrolled in and
participating in the Educational Experience at the time of the notice of termination shall be given a
period of time not to exceed six(6)months from the date of the notice of termination during which
to complete the current course in their Educational Experience at Agency.
2. Request for Withdrawal of Unsatisfactory Students. Agency may request that the University
withdraw from the Educational Experience any Student: (a)whose conduct or appearance inhibits
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BSHS Aff Agrft rev 01-16-14
desirable relationships within Agency, (b) whose health status is a detriment, despite a
reasonable accommodation, to the Student's successful completion of the Educational
Experience, or (c) whose performance after appropriate instruction and counseling continues to
fall below the level required to maintain appropriate practice standards. University agrees to
withdraw such Student at the Agency's request.
PART VI.
RECORDS
1. Confidentiality of Student Records. Agency shall keep confidential and shall not disclose to
any person or entity(a) Student applications; (b) Student health records or reports; and/or(c) any
student records as defined in the Family Educational Rights and Privacy Act, 20 U.S.C. § 123G,
concerning any Student participating in the Educational Experience, unless such disclosure is
authorized by the Student or is ordered by a court of competent jurisdiction. Agency shall adopt
and enforce policies and procedures necessary to protect the confidentiality of Student records as
defined herein.
2. Maintenance of Records. University will maintain documentation on each Student's Educational
Experience for a period of at least six (6) years after said Student has completed his/her
Educational Experience.
3. Confidentiality of Client Records. University shall direct Students and University Personnel to
respect the confidential nature of all health or personnel information relating to the Agency. The
University shall advise all Student and University Personnel of the importance of complying with
all relevant state and federal confidentiality laws, including the Health Insurance Portability and
Accountability Act of 1996("HIPAX),to the extent applicable.
PART VII.
INDEMNIFICATION
1. Indemnification. Each party (the "Indemnifying Party") shall indemnify, hold harmless, and, at
the request of the other party, defend the other party (the "Indemnified Party") from and against
any and all claims, losses, liabilities, costs, and expenses including reasonable attorney's fees,
established by judgment or alternative resolution award, arising from (a) any material breach of
any provision of this Agreement or (b) the negligence or willful misconduct in the performance of
obligations hereunder by the Indemnifying Party or any employee, agent, or other representative
of the Indemnifying Party.
2. Mutual Cooperation. University and Agency shall provide prompt notification to one another and,
to the extent allowed by law, shall reasonably cooperate with one another in the defense of, any
lawsuits, claims, or threatened claims that pertain to services provided pursuant to this
Agreement.
PART Vill.
INSURANCE
1. University and Agency Insurance. University shall maintain, as a minimum, Commercial
General Liability Insurance written on an occurrence basis with insurance companies acceptable
to the other party for limits not less than $1,000,000 per occurrence and $2,000,000 aggregate
and Agency shall maintain, as a minimum, self insurance written on a claims made basis for limits
of not less than $1,000,000 per occurrence and $2,000,000 in aggregate as assurance of
accountability for any such losses, claims, liabilities, or expenses.
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BSHS Aft Agmtl rev 01-10.14
2. Evidence of Coverage. Upon written request, a party shall provide the other party with a
certificate evidencing such insurance coverage.
3. Self Insurance. All insurance required by University to be maintained hereunder may be
provided under; (a) an individual policy; (b) a blanket policy or policies which may include other
liabilities, properties and locations of University or its affiliates; (c) a plan of self-insurance,
provided that University or any guarantor of University's obligations under this Agreement
maintains, during the period of such self-insurance, a net worth of at least Fifty Million Dollars
($50,000,000); or (d) a combination of any of the foregoing insurance programs. To the extent
any deductible is permitted or allowed as a part of any insurance policy carried by University in
compliance with this section, then University shall be deemed to be covering the amount thereof
under an informal plan of self-insurance;
PART IX.
REPRESENTATIONS AND WARRANTIES
1. Each party to this Agreement represents and warrants that(i) it has the full power and authority to
enter into this Agreement and to carry out the transactions contemplated hereby applicable to it;
and (ii) it has taken all action necessary to authorize the execution, delivery and performance of
this Agreement,and this Agreement has been duly executed and delivered to such party.
PART X.
GENERAL TERMS AND CONDITIONS
1. Student and University Personnel Status_ This Agreement is not intended and shall not be
construed to create the relationship of agent, servant, employee, partnership, joint venture,
landlord/tenant, or association between the University and the Agency and their employees,
Students, or agents, but rather is an agreement by and between two independent contractors.
Each Student is placed with the Agency to receive Educational Experience as part of his/her
academic curriculum; duties performed by a Student are not performed as an employee of
Agency but rather in fulfillment of the academic requirements of his/her Educational Experience
and are performed exclusively under direct supervision by Agency personnel. To the extent
allowed under state law, neither the Agency nor the University is required to provide workers'
compensation coverage for the Students participating in the Clinical Educational Experience.
University acknowledges that nothing in this Agreement shall be construed to confer any right
upon the University or University Personnel to participate in, control, or direct operations at the
Agency.
2. Intern Status. Student shall not be considered an employee of Agency at any time during the
term of this Agreement. Student shall neither receive nor be entitled to any remuneration,
compensation, or benefits traditionally reserved for employees. The parties acknowledge that no
work provided by Student is intended to displace the work that paid employees ordinarily provide.
In the event that a Court of Law should determine that Student's employment status has been
misclassified, University shall bear sole financial responsibility for such misclassification.
Please note that during this internship, all work and assignments undertaken by the intern need to
be reasonably related to the intern's coursework/academic program. Failure to ensure that this is
the case can result in the intern being improperly classified,which could result in financial liability
for the City.
3. Employment of Student by Agency. If a Student is also an employee of Agency, such
employment shall be separately negotiated by Agency and each Student. The parties agree that
a Student cannot earn hours toward his/her Educational Experience during the same hours
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BSHS Aft Agrml rev 01-16-14
he/she is working as an Agency employee and must have a different Agency Supervisor during
the Educational Experience.
4. Non-Discrimination. Each party shall be separately responsible for compliance with all laws,
including anti-discrimination laws, which may be applicable to their respective activities during the
Educational Experience.
5. Accreditation, Licensing and Credentials. Each party to this Agreement shall be responsible
for accreditation, licensing, and credentials of its entities and employees, as applicable, and each
party agrees to furnish to the other evidence of such accreditation, licensing and credentials upon
written request by the other.
6. No Compensation for Services Each party shall pay all of its own costs associated with its
participation in the Educational Experience and Agency Supervisors may not charge for their
services.
7. Interpretation. This Agreement constitutes the entire agreement as to the rights and obligations
of the parties hereto and supersedes all prior and contemporaneous agreements and
undertakings of the parties pertaining to the referenced subject matter.
8. Amendment and Assignment. Amendments to this Agreement may be made at any time,
provided, however, that any amendments, modifications or alterations shall be made only in
writing and shall become effective only upon the written approval of both the Agency and the
University. Further, this Agreement may not be assigned by either party without prior written
approval of the other party.
9. Waiver. No waiver of any breach of any term or provision of this Agreement shall be construed to
be, nor shall be, a waiver of any other breach of this Agreement. No waiver shall be binding
unless in writing and signed by the party waiving the breach.
10. Severability. In the event that any provision of this Agreement shall be held void, voidable, or
unenforceable, the remaining provisions of this Agreement shall remain in full force and effect in
accordance with its terms disregarding such unenforceable or invalid provision.
10. No Establishment of Third Party Rights.This Agreement is not intended to create any rights or
interests for any other person or entity other than the Agency or the University.
11. Applicable Law.This Agreement will be governed by the laws of the State of Arizona and shall in
all respects be interpreted, enforced,and governed by Arizona laws.
12. Disputes. In the event any dispute or controversy ('Dispute") arising out of this Agreement
cannot be settled by the parties, such Dispute shall be submitted to arbitration in Phoenix,
Arizona. In the event the parties cannot mutually agree upon an arbitrator and procedure to settle
their Dispute within fifteen (15) days after written demand by one of the parties for arbitration,
then the Dispute shall be arbitrated by a single arbitrator chosen pursuant to the applicable rules
of the American Arbitration Association ("AAA"). The decision of the arbitrator shall be final,
binding and non-appealable for all purposes and judgment to enforce any such binding decision
may be entered in Superior Court, Maricopa County, Arizona (and for this purpose, each party
expressly and irrevocably consents to the jurisdiction of said court) and in any other court of
competent jurisdiction. At the request of either party,arbitration proceedings shall be confidential.
In such case, all documents, testimony, and records shall be received, heard and maintained by
the arbitrator in secrecy, available for inspection only by either party and by their attorneys and
experts, who shall agree in advance and in writing,to maintain all such information in secrecy. In
all other respects, the arbitration shall be conducted pursuant to the then existing rules and
regulations of the AAA to the extent such rules and regulations are not inconsistent with this
Agreement.
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BSHS AR Agrmt rev 01-16-14
13. Counterparts and Electronic Signatures. The Agency and the University may execute this
Agreement in multiple counterparts, each of which constitutes an original, and all of which,
collectively, constitute only one agreement. This Agreement may be executed by facsimile or
PDF. Said facsimile or PDF shall be deemed an original and fully enforceable and admissible in
any legal proceeding. Delivery of an executed counterpart signature page by facsimile or PDF is
as effective as executing and delivering this Agreement in the presence of the other party to this
Agreement. This Agreement is effective upon delivery of one executed counterpart from each
party to the other party(ies). In proving this Agreement, the Agency or the University must
produce or account only for the executed counterpart of the party to be charged.
Notwithstanding the foregoing, the Agency and the University may consent to the use of
electronic signatures for the purpose of executing this Agreement by email or other electronic
means,subject to compliance with any applicable laws, rules or regulations.Any such documents
that are delivered electronically and accepted are deemed to be "in writing" to the same extent
and with the same effect as if the Agreement had been signed manually, In no event will
electronic execution expand such assent to include any terms other than those explicitly set for in
this Agreement.
14. Notices.Any notice given under this Agreement may be given by personal delivery, overnight air
express, or certified United States mail, return receipt requested. Notice shall be deemed to be
given either (a) upon actual receipt, if the notice is by personal delivery or by overnight air
express, or (b) five (5) business days after mailing, if the notice is by United States mail, return
receipt requested. Notice under this Agreement shall be given in writing to the parties at the
following addresses or to such other persons or places as either party may from time to time
designate by written notice to the other party.
If to the University: University of Phoenix
College of Social Sciences
Mailstop: CF-SX07
1625 Fountainhead Parkway
Tempe,AZ 85282
With a copy to: University of Phoenix
Apollo Legal Services
4025 S. Riverpoint Parkway
Mail Stop CF-K612
Phoenix,AZ 85040
If to the Agency Mailing Address:
4200 South Freeway, Ste. 2300
Forth Worth, TX 76115
Agency Physical Address:
4200 South Freeway, Ste. 2300
Forth Worth,TX 76115
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BSHS AN Agrmt rev 01-16-14
Additional Location(s)(If Applicable):
201 S. Sylvania
Fort Worth, TX 76111
IN WITNESS WHEREOF,the parties hereto have executed this Agreement as of the date first subscribed
above.
UNIVERSITY: AGENCY:
{ � .,4
Sig lure Signature
McCeil Johnson or University Representative Femado
Name game(Print or Type)
Dean of Programmatic Accreditation and
Regulatory Compliance E&
Title Title
602-557-2592 817-392-5775
Phone Phone Fax
S/a /moo Mfr s es At
Date Date � � �
mcceil.iohnson(@Dhoenix.edu ��1Me10.eaSf-CL-1 /�
2 d/'�1�watA
E-Mail address E-Mail address a
OVED
AS M FORM AND LEGA t jry
of �, a') '(�t-S _.
FoRN o C ATC Ey
AtteeW br, 9
�XAS Allison r1dwell,Assidwt to the City �r�tr�ty S -
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BSHS All Agrmt rev 01-16-14
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
responsible for the monitoring and
administration of this contract, including
ensuring all performance and reporting req�ts.
By: /
Name: M ' ue i
Title: District Superintendent
Youth Program Provider Agreement 10 of 20