HomeMy WebLinkAboutContract 56365 CLINICAL AFFILIATION AGREEMENT BETWEEN
CSC No.56365
CITY OF FORT WORTH AND
METROPOLITAN AREA EMS AUTHORITY
This Clinical Affiliation Agreement("Agreement''),is entered into,effective this 1st day of October,2021,
by and between the City of Fort Worth ("City") and Metropolitan Area EMS Authority dba Medstar Mobile
Healthcare, a governmental agency created under the provisions of Section 773.051 of the Texas Health and
Safety Code and the provisions of Chapter 791 of the Texas Government Code, which operates an emergency
medical services ("EMS")agency located at 2900 Alta Mere Fort Worth,TX("Facility"). City and Facility agree
to the following:
WHEREAS,Fort Worth Fire Department, a department of City("Department")has an Emergency Medical
Technology Program ("Program") through which City provides Department trainees (hereinafter referred to as
"Students" or individually as "Student") academic and clinical experience.
WHEREAS,City desires for Facility to provide Students with clinical experience through Facility's clinical
facilities, and Facility is willing to provide such experience.
ARTICLE 1. RESPONSIBILITIES OF CITY
City shall:
I.I. Plan the educational activities for the Students' clinical experience at Facility after consultation with and
approval by Facility.
1.2. provide qualified teachers from Department to teach the pre-requisite core curriculum and support courses
in the Program;
1.3. Provide administrative functions for each Student in the Program.
1.4. Provide a faculty member at Facility to be available for consultation at all times Students are at Facility to
supervise Students participating in the Program.
1.5. Instruct Students to abide by Facility's patient care policies and guidelines. Information regarding Facility's
applicable policies and guidelines will be available at the time of student orientation at Facility.
1.6. If applicable, provide Facility with the appropriate forms to be used in evaluating the performance of
Students in the Program.
1.7. Require Students to comply with the regulatory and accreditation standards provided by the Facility at the
time of student orientation at Facility.
1.8. Provide information to each Student regarding the Hepatitis B vaccine, its efficacy, safety, method of
administration and benefits of being vaccinated and suggest that Students be vaccinated for Hepatitis B.
1.9. Confirm Students have been tested for tuberculosis within one (1) year of commencement of the Program
and are tested at least annually while participating in the Program and provide evidence of such testing and
the results to Facility prior to commencement of the Program or upon request of Facility thereafter.
1.10. Ensure each student has current immunizations,including: Influenza,Hepatitis B,MMR,TDAP,Varicella
(or titer), and a Negative TB test, and provide MedStar proof if requested.
1.11. Confirm Students have been instructed in Standard Precautions, as recommended and defined by the
Centers for Disease Control and Prevention (CDC), and completed a Basic Life Support cardiopulmonary
resuscitation course prior to the beginning of the Program and provide evidence of such confirmation to
Facility prior to commencement of the Program or upon request of Facility thereafter.
1.12. Confirm that City is a self-insured entity and as such, generally, does not maintain a commercial liability
insurance policy and that damages for which City could ultimately be found liable would be paid directly
and primarily by City and not by a commercial insurance company.
OFFICIAL RECORD
CITY SECRETARY
1 FT. WORTH, TX
1.13.At least two (2) weeks prior to commencement of the Program, provide a letter to Facility outlining the
needs of Students,days and hours Students will be on patient units or service areas,names of Students and
supervising faculty members, and length and dates of clinical experience.
1.14. Consider promptly any complaints made by Facility against a Student and participate in joint problem
solving. Patient safety and welfare shall be the primary concern. Student issues will be documented by the
Facility and communicated to the designated Faculty member and/or other representative of City. Facility
may require permanent withdrawal of any Student from clinical training at or through Facility at any time
for cause, as determined by Facility in its sole discretion.
1.15. Comply with Facility's substance abuse policies and, at Facility's request, remove any Student or faculty
member from the Program if there is reasonable suspicion that the Student or faculty member has violated
Facility's substance abuse policies.
1.16. Verify that a background evaluation, including a criminal background history in all fifty (50) states, has
been performed on each Student, and verify that there are no negative findings for each Student prior to
commencing any assignment at Facility. For purposes of this Agreement, a criminal background history
shall include any felony conviction within the last ten (10) years. For purposes of this Agreement, a
background evaluation shall include the last ten (10)years and all counties (in Texas and outside of Texas)
in which the Student has been a resident of or employed in.\
1.17. To the extent allowed by law, City shall hold Facility harmless for all claims, damages, losses, and
expenses, including attorney fees, arising out of any claim for negligence resulting from the action or
inaction of City, its employees, agents or Students under this Agreement for which a final judicial or other
determination is made that the City, its employees agents, or Student(s) or is responsible; and
1.18.Ensure that each Student and faculty member wears a name tag, badge, or other identifying label at all
times while at Facility that clearly identifies the Student or faculty members and the City.
ARTICLE 2. RESPONSIBILITIES OF FACILITY
Facility shall:
2.1. Provide cooperation to promote success of the Program;
2.2. Provide equipment and supplies which are necessary for clinical instruction at Facility;
2.3. Provide meeting space for Students in the Program;
2.4. Provide suitable clinical experience situations as prescribed by the curriculum provided by City;
2.5. Assist with clinical teaching and supervision of agreed upon number of Students in the Program;
2.6. Upon request by City, formally evaluate performance of Students in the Program using the form provided
by City;
2.7. Retain responsibility for patient care;
2.8. Reserve the right to determine the manner in which its equipment shall be operated;
2.9. To the extent allowed by law, assume no professional or financial liability for injury to Students or faculty
except that which might occur as a member of the public, unless due to Facility's negligence or gross
misconduct; and
2.10.Provide access to acute emergency care at Student's expense in the event of an accident or injury to a
student on Facility's campus.
ARTICLE 3. RESPONSIBILITIES OF CITY AND FACILITY
City and Facility shall:
3.1. Agree upon the number of Students to be placed in Facility for clinical rotations prior to the beginning of
each semester in which Students are assigned to and accepted by Facility.
3.2. Mutually plan, schedule and provide an orientation of faculty and Students to Facility and assigned units.
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3.3. Understand there will be no exchange of monies between City and Facility for this Program.
3.4. Revise or modify this Agreement in writing if both parties agree to the revisions or modifications.
3.5. Comply with all applicable federal, state, and local laws,rules,regulations, and ordinances.
ARTICLE 4. TERM AND TERMINATION
4.1. This Agreement shall remain in effect for two (2) years beginning October 1st, 2021 ("Effective Date")
and ending on September 30th, 2023, unless sooner terminated as provided herein. This Agreement may
be terminated by either party upon ninety (90) days written notice in accordance with Section 5.1 below.
The termination shall not take effect until Students who are enrolled at the time such notice is given have
completed the courses in which they are enrolled.
ARTICLE 5. NOTICE
5.1. Notices. All notices provided for by this Agreement shall be made in writing either (a) by actual delivery
(e.g., personally, by commercial courier service, or by confirmed telefacsimile) of the notice, or(b)by the
mailing of the notice by United States Postal Service certified or registered mail,return receipt requested,
and addressed to the Party to be notified at the address set forth below(or at such other address as may be
given by notice by a Party). The notice shall be deemed to be received (i) if by actual delivery, on the date
of its receipt by the Party, or (ii) if by mail, on the second day on which mail is delivered following the
date of deposit in the United States Postal Service.
If to Facility: MedStar Mobile Healthcare
Attention: General Counsel
2900 Alta Mere
Fort Worth, Texas 76116
If to City: Fort Worth Fire Department
Attention: EMS Division
509 W. Felix St.
Fort Worth, Texas 76115
ARTICLE 6. STATUS OF STUDENTS
6.1. City and Facility understand and agree that while faculty and Students are participating in the Program,
faculty and students are not employees of Facility. Accordingly, faculty and Students are not entitled to
any of the rights or benefits established for Facility's employees, such as salary, vacation, sick leave with
pay, paid holidays, insurance, and/or worker's compensation coverage. Further, nothing herein shall be
construed as creating a partnership or joint venture between City and Facility, its officers, agents,
employees and subcontractors, and doctrine of respondeat superior has no application as between the City
and Facility.
ARTICLE 7. MISCELLANEOUS
7.1. Non-discrimination. City and Facility shall not unlawfully discriminate in their respective performance
of this Agreement against any person because of age, disability, race, color, religion, sex, sexual
orientation, national origin, gender expression, gender identity, transgender, familial status, or protected
legal status.
7.2. Entire Agreement. This Agreement constitutes the entire agreement between the Parties, and supersedes
any and all prior and contemporaneous oral or written understandings. This Agreement may not be altered,
amended, or modified except by a written document executed by both parties.
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7.3. Governing Law,Jurisdiction and Venue. This Agreement shall be governed by the laws of the State of
Texas without regard to its conflict of laws provisions. The venue of any litigation arising from this
Agreement will be in the United States District Courts, Fort Worth Division of the Northern District of
Texas if the litigation arises in Federal Court or in the District Courts of Tarrant County, Texas if the
litigation arises in State Court. The venue of any dispute resolution activity shall be in Fort Worth,Tarrant
County, Texas.
7.4. Severability. Should any part, term, or provision of this Agreement be declared to be invalid, void, or
unenforceable, all remaining parts, terms, and provisions hereof shall remain in full force and effect, and
shall in no way be invalidated, impaired, or affected thereby. Each invalid provision shall be revised only
to the extent necessary to bring it within the requirements of such law or regulation.
7.5. No Waiver. No waiver by City or Facility of any breach of any term, provision or condition contained in
this Agreement, or the failure to insist upon strict performance thereof shall be deemed to be a waiver of
such term, provision or condition as to any subsequent breach thereof or a waiver of any other term,
provision or condition contained in this Agreement. The exercise of any right or remedy hereunder shall
not be deemed to preclude or affect the exercise of any other right or remedy provided herein.
7.6. HIPAA Obligations. Both Parties acknowledge that they have obligations "under the Health Insurance
Portability and Accountability Act of 1996 (42 U.S.C. § 1320(d) ("HIPAA") and its implementing
regulations, including 45 C.F.R. parts 160 and 164, subparts A and E ("Privacy Rule") and 45 C.F.R.parts
160 and 164, subparts A and C ("Security Rule), and agree to comply with the Health Information
Technology for Economic and Clinical Health Act of 2009 (42 U.S.C. 17921-53) and its implementing
regulations.
7.7. Subject Headings.The subject headings of the sections,paragraphs, and subparagraphs of this Agreement
are included herein solely for the purposes of convenience and reference, and shall not be deemed to
explain, modify, limit, amplify, or aid in the meaning, construction, or interpretation of any of the
provisions of this Agreement.
This Agreement is effective as of the Effective Date set forth above and is executed by and between
City and Facility through their duly authorized officers,thereby binding themselves,their successors and
assigns and representatives for the faithful and full performance of the terms and provision of this
Agreement.
[signatures on next page]
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CITY OF FORT WORTH:
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
By. Valerie Washington(Sep 24,202117:02 CDT) reporting requirements.
Name: Valerie Washington
Title: Assistant City Manage
Date: Sep 24, 2021 By: Marksc�her(Sep 23,202115:02 CDT)
Name: Mark Rauscher
APPROVAL RECOMMENDED: Title: Assistant Director Fire
APPROVED AS TO FORM AND LEGALITY:
By:
J6Afs Davis(Sep 24,2021 16:11 CDT)
Name: James Davis
Title: Fire Chief pF*0 .0-0
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0 1.° 0��� Name: Christopher Austria
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ATTEST: tag '� Title: Assistant City Attorne0
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By. M&C: N/A
Name: Ronald P. Gonzales_ (1295): N/A
Title: City Secretary
FACILITY:
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By: Kenneth J Simpson(Sep 23,20 110:43 CDT) By:
J Kenneth J. Simpson J Veer D. Vithalani,M.D.
Interim Chief Executive Officer System Medical Director
Chief Operations Officer Chief Medical Officer
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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