HomeMy WebLinkAboutContract 30637 C;TY `+-C'9ETARY
CT NO. �uz
TEXAS CHRISTIAN UNIVERSITY
AND
CITY OF FORT WORTH
Educational Affiliation Agreement for Student Internships and Clinical Experiences
THIS AGREEMENT is made between Texas Christian University ("TCU") and the City of Fort
Worth ("City"), a municipal corporation located in Tarrant County, Texas, by and through their duly
authorized representatives.
RECITALS
A. TCU has established an approved program of professional education entitled the
Department of Nutritional Sciences (the"Program");
B. The Program requires relationships with facilities where students can obtain the clinical
learning experience required in the curriculum;
C. City, through the Public Health Department has the clinical setting and equipment needed
by TCU students participating in the Program ("Program Participants") as part of their practical learning
experience; and
D. TCU and City agree that it will be to their mutual interest and advantage for students and
faculty of TCU to be given the opportunity to utilize the City for educational purposes as part of the
Program.
In consideration of the mutual promises and conditions in this Agreement and for good and
valuable consideration, TCU and City agree as follows:
1.0 Obli ations of City.
1.1 City, to the extent as is reasonable practicable and allowable by City regulations, will
make available its facilities and personnel in order to provide a quality and suitable clinical learning
experience and supervision consistent with the Program's curriculum and objectives for Program
Participants in accordance with TCU's academic calendar.
1.2 City and TCU shall work together to establish direction and coordination for the Program,
including assigning students to specific clinical experiences, providing opportunities for Program
Participants to participate in selected conferences, clinics, courses and programs conducted by or under
the direction of City, and providing evaluations of Program Participants' performance at the City. To the
extent as reasonably possible, City shall provide to TCU conference and classroom areas for Program
Participants as City deems necessary, as well as locker space and lounge areas, while Program
Participants are assigned to the City.
1.3 It is understood that in no case shall Program Participants replace regular staff and that
City retains full responsibility, authority and accountability for its sole actions and will not rely on the
Program Participant's training activities for staffing purposes.
1.4 City will permit the inspection of clinical and related facilities by agencies charged with
responsibility for accreditation of TCU upon ten (10)days written notice and request by TCU.
1.5 City may take immediate action, including removal of a Program Participant from the
City's program, to correct a situation where a Program Participant's actions endanger the care of City's
patients and or employees. City shall give written notice to TCU for the withdrawal of a Program
Participant from participation in the Program if: (1) the achievement, progress, adjustment or health of the
Program Participant does not warrant continuation at Facility, (2) the behavior of the Program Participant
fails to conform to the applicable regulations of City, (3) the Program Participant's clinical performance is
unsatisfactory to City, or (4) the Program Participant's behavior, in the City's sole discretion, is disruptive
or detrimental to City and/or its patients or employees. In any such event, the Program Participant's
participation in the Program at the City shall immediately cease; however, in such situations, all final
resolutions of the Program Participant's academic status and/or continuing participation in the Program
will be made solely by TCU. Only TCU may remove or dismiss a student from the TCU Educational
Program.
CRP 08.19.040 rOFFMAL ROD
cFy. IN
TEXAS CHRISTIAN UNIVERSITY
Department of Nutritional Sciences
City of Fort Worth, Tarrant County, Texas
1.6 City shall provide all equipment and supplies needed for clinical instruction at City, to the
extent practicable.
1.7 City shall provide emergency care, at student's expense, in case of illness or accident to
any participating student.
1.8 City will provide an orientation and training to familiarize Program Participants and faculty
of TCU with City's procedures, policies, standards, code of ethics and to meet OSHA(Occupational Safety
Health Administration) and JCAHO (Joint Commission on the Accreditation of Health Care Organization)
requirements. TCU will instruct Program Participants that they must attend such orientation and comply
with the regulations of City or otherwise be removed from the City Program.
1.9 It is understood that in no case shalt there be any direct expense to City under this
agreement beyond the normal operating costs of City.
2.0 Obligations of TCU.
2.1 TCU shall send to City for clinical experience students who have completed a substantial
segment of their academic curriculum.
2.2 TCU shall provide and maintain the academic records and reports necessary for
conducting the Program Participants' clinical learning experience.
2.3 TCU shall assign a specific number of faculty to work directly with City staff in furthering of
the Program Participants'clinical [earning experience and in resolving any problems which may arise.
2.4 TCU shall maintain confidentiality of any material relative to the clinical learning
experience.
2.5 TCU, through the Department of Nutritional Sciences, after consultation with City, shall
plan and oversee the educational program for student clinical experiences.
2.6 TCU shall provide City with a description of the program, curriculum and objectives to be
achieved at City, and the academic calendar of TCU.
2.7 TCU shall provide to City, upon request, verification of current State of Texas licensure for
faculty who are licensed.
2.8 TCU shall provide, upon request, written verification of immunizations required by
applicable regulatory agencies and City's policies, including Hepatitis B (or waiver) and current PPD and
provide evidence of immunity to chicken pox, measles and rubella.
2.9 If requested by City, TCU will assign to City only those Program Participants that have: (1)
been instructed in Standard Precautions recommended by the Centers for Disease Control and
Prevention (CDC); and (2) completed a cardiopulmonary resuscitation and first aid course.
2.10 Upon City's written request, TCU shall, with the Program Participant's consent, prescreen
Program Participants in compliance with the Dallas-Fort Worth Hospital Council Community Standard for
Drug Screening and Background Checks adopted November 2000, subject to restrictions of HIPAA and
FERPA. If such prescreening is requested by the City, the City shall notify the TCU faculty coordinator of
such requirements prior to accepting Program Participants.
3.0 Joint Obligations.
3.1 The specific areas of Program Participant assignment and the number and distribution of
Program Participants between units of the City shall be mutually agreed upon each academic semester by
TCU and City.
3.2 TCU and City shall adhere to all requirements of local, state and federal laws, ordinances
and regulations.
3.3 TCU and City shall provide a safe working environment in compliance with applicable
safety laws, policies and procedures governing the City.
CRP 08.19.003 0 �71"
My
T .!�?
TEXAS CHRISTIAN UNIVERSITY
Department of Nutritional Sciences
City of Fort Worth, Tarrant County, Texas
4.0 Term.
4.1 This Agreement shall be for a term of three (3) years, beginning on August 1, 2004, and
ending without further notice on July 31, 2007.
4.2 This Agreement may be renewed for two (2) additional 1-year terms by written agreement
of both parties. All terms and conditions as specified herein shall apply to the renewal unless otherwise
specifically contained in the written agreement for the renewal.
4.3 Notwithstanding anything to the contrary herein, either party may terminate this
Agreement at any time upon at least thirty(30) days written notice, provided that such termination shall not
become effective for the Program Participants then enrolled in the Program at the City if such termination
prevents completion of their requirements for completion of the Program.
4.4 Notwithstanding anything to the contrary herein, either party may terminate the Agreement
upon ten (10) days notice for lack of funding or by City Council direction, effective upon the conclusion of
the then current semester of TCU.
5.0 Application of City's Rules.
Program Participants, during clinical experience at City, shall follow all City rules as they
reasonably relate to Program Participants. TCU students will be expected to conduct themselves in a
professional manner such that their attire and their appearance conform to the accepted standards of City.
6.0 Reservation of Rights; Placement.
TCU and City each reserve the absolute right to withhold placement of Program Participants
depending upon the availability of facilities and personnel to adequately provide a satisfactory clinical
experience and upon direction from City Council.
7.0 Insurance-, Harmless.
7.1 TCU agrees to tender certificates of liability insurance to City indicating coverage of TCU
and its agents, employees and Program Participants training in a clinical setting for their acts, failure to act
or negligence arising out of or caused by the activity which is the subject of this Agreement. TCU will not
list City as additional insured. TCU will provide "occurrence type" professional liability insurance for its
students training in a clinical setting in the amount of$200,000 per occurrence and $600,000 per annum.
7.2 Program Participants shall be required to sign separate release of liability agreements
attached as Exhibit "B".
8.0 Laws, Rules and Regulations,• on-Discrimination.
8.1 City and TCU agree that neither will discriminate against any individual on the basis of
age, sex, race, creed, color, religious belief, national origin, disability, status as a disabled veteran, or
veteran of the Vietnam era, and that City agrees to comply with all non-discriminatory laws and policies
that TCU promulgates and to which TCU is subject.
8.2 City agrees that all records governed by The Family Educational Rights and Privacy Act
(FERPA) regulations shall be treated as confidential and secured in a locked receptacle to the extent the
City is the custodian of those records.
9.0 Remuneration.
9.1 Program Participants shall not be paid for the services they render.
CRP 08.19,04v3 r ,
f flt � UQ �
Ciffp� ��p � F1'
TEXAS CHRISTIAN UNIVERSITY
Department of Nutritional Sciences
City of Fort Worth, Tarrant County, Texas
9.2 City will not provide remuneration either in the form of pay or in kind to any employees of
TCU for any services performed or activity required in connection with matters associated with this
Agreement.
10.0 Use of Name; Advertising.
Neither party shall use the other's name or any corporate or business name which is reasonably
likely to suggest that the two parties are related, without first obtaining the written consent of the other
party.
11.0 Non-AssISLnment and Subcontracting.
Each party shall not assign, transfer or contract for the furnishing of services to be performed
under this Agreement without the written approval of the other party.
12.0 Entire Agreement; Modification.
This Agreement (and its attachments, if any) constitutes the entire understanding between the
parties with respect to the subject matter hereof, supersedes any prior agreements between TCU and City
on the subject matter hereof, and may be modified only by a writing signed by both parties. Any such
requests for changes or written notice to terminate must be sent to the following:
Texas Christian University City of Fort Worth
Ann C. Sewell, Assistant Provost Director for the Public Health Department
TCU Box 297042 Dan Reimer
Fort Worth, TX 76129 1800 University Drive
FAX: (817)257-7503 Fort Worth, TX 76107
FAX: (817)871-8903
13.0 Governing ZawNenve.
This Agreement shall be governed by and construed under the laws of the State of Texas.
Tarrant County, Texas shall be the exclusive forum for any lawsuit arising from or incident to this
Agreement.
14.0 Consideration.
Under the terms of this Agreement, neither TCU nor City are obligated to make any payments of
any kind to the other party.
15.0 Severability.
In the event one or more clauses of this Agreement are declared illegal, void or unenforceable,
that shall not affect the validity of the remaining portions of this Agreement.
16.0 Waiver.
The failure of either party to exercise any of its rights under this Agreement for a breach thereof
shall not be deemed to be a waiver of such rights, and no waiver by either party, whether written or oral,
express or implied, of any rights under or arising from the Agreement shall be binding on any subsequent
occasion; and no concession by either party shall be treated as an implied modification of the Agreement
unless specifically agreed in writing.
CRP 08.19.04v3 N
OFFC ��I
1 t �Mn.F�� Y�Z10
TEXAS CHRISTIAN UNIVERSITY
Department of Nutritional Sciences
City of Fort Worth, Tarrant County, Texas
17.0 Relationship Between the Parties.
Nothing herein shall be construed to create an employer/employee, partnership, joint venture or
principallagent relationship between TCU and City or between the City's employees and TCU's employees
and Program Participants. Neither party has any express or implied authority to assume any obligation or
responsibility on behalf of or in the name of the other party. With independent management of each, they
will maintain an effective liaison incorporation. If a dispute arises related to the obligation or performance
of either party in this Agreement, representatives of the parties will meet in good faith in attempt to resolve
the dispute.
18.0 Governmental Powers.
It is understood that by execution of this Agreement, the City does not waive or surrender any of it
governmental powers or immunities.
19.0 CONFIDENTIALITY and HIPAA.
19,1 School and its agents, Program Participants, faculty representatives and employees
agree to keep strictly confidential all information, as required by HIPAA, of City and/or its patients and not
disclose or reveal any confidential information to any third party without the express prior written consent
of City. City may ask Program Participants to sign an additional Confidentiality Statement which if required
is made a part of this agreement and an example is so attached as "Exhibit A."
19.2 TCU shall direct Program Participants to comply with the policies and procedures of the
City, including those governing the use and disclosure of protected health information under Federal law,
specifically 45 CFR parts 160 and 164. City agrees to provide any training as deemed necessary by the
City to orient Program Participant to the City's specific policies and procedures governing use and
disclosure of protected health information. Program Participants are not, and shall not be considered to
be employees of the City.
20.0 Healthcare Facilities.
If City is a healthcare provider then the following special provisions shall apply:
(a) The City will establish a protocol related to post-exposure of bloodborne pathogens and
shall train Program Participants in the use and practice of such protocols;
(b) Program Participants and TCU faculty assigned to the City shall meet all reasonable
health standards imposed by applicable laws and regulations or reasonably imposed by
the City. A copy of the City's standards will be provided to TCU for dissemination to its
students and faculty involved in the Program.
(c) TCU and its agents will abide by, and instruct the Program Participants to abide by, the
written administrative, clinical and all other policies or procedures of the City while using
its facilities including but not limited to the consistent performance of patient care
processes according to the Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) standards, as well as other regulatory agencies that oversee
hospital operations.
CRP 08.19.040
OFFICIFIA ROD
Of SICIETAIRY
TEXAS CHRISTIAN UNIVERSITY
Department of Nutritional Sciences
City of Fort Worth, Tarrant County, Texas
IN WITNESS��W..HEREOF the authorized representatives of the parties have executed this
Agreement on this day , 2004.
TCU: CITY:
Texas Christian University City of t worth
By: [�' ( By:
Ann C. Sewell, Ph.D. Libby Wa n
Assistant City Manager
Assistant Provost
B : 1 Approved as to form and legality:
Y g ty:
Michael McCracken, Ph.D
Dean AssistanOtty Attorney
By: 1 Attest:
Anne Van Beber, Ph.D., RD, LD f��OAC-,h
Program Director Marty Hendrix, 'ty Secretary
NO M&C REQUIRED
CRP 08.19.003
OFFICIAL WORD
CITY SECKEY
FT, WORTH, fix.
TEXAS CHRISTIAN UNIVERSITY
Department of Nutritional Sciences
City of Fort Worth, Tarrant County, Texas
EXHIBIT A"CONFIDENTIALITY AGREEMENT"
INTENTIONALLY BLANK
CRP 08.19 043 ra
OFFI JAL CON
cIff RIMY
. MUST Ex.
TEXAS CHRISTIAN UNIVERSITY
Department of Nutritional Sciences
City of Fort Worth, Tarrant County, Texas
EXHIBIT S "RELEASE AND HOLD HARMLESS FORM"
CRP 08.19-04v3 OFFIORRECO M
C" SICIETARY
�Y► ITH, TEX.
ATTACHMENT B
RELEASE,HOLD HARMLESS AND INDEMNIFICATION OF LIABILITY AGREEMENT FOR
PARTICIPATION IN THE CITY OF FORT WORTH PUBLIC HEALTH DEPARTMENT
NUTRITIONAL SCIENCES PROGRAM
in consideration of the opportunity to participate an
educational clinical nursing program through TCU, fully recognize and appreciate certain inherent risks, including, but not
limited to, working in and around Cite-owned or leased facilities, do, on my own behalf, as well as my assigns, successors,
administrators, and heirs, hereby FULLY AND FOREVER WAIVE AND RELINQUISH, COVENANT NOT TO SUE,
RELEASE,HOLD HARMLESS, DISCHARGE AND INDF,MNIFY the City of Fort Worth, its officers,agents,employees,
affiliates, volunteers and attorneys, from any and all actions, lawsuits,debts,demands, damages, claims, judgments or liabilities
of any nature, whether known or unknown,which I individually have or may have against the City of Fort Worth,its officers,
agents or employees for property loss, or damage; for any and all medical, hospital or pharmaceutical expenses, doctor bills or
nurses' expenses; and,damages for personal injury, including death,Sustained by myself;or, any other damage of any kind or
character and any other ty pe of damage which I may hereinafter incur, arising out of, resulting from directly or indirectly
attributable circumstances related to my participation in the Nursing Program.
I hereby assume all responsibility and liability for such damages or injuries sustained by myself, and understand and
acknowledge the significance and consequences of this release and this agreement. I hereby acknowledge that I am fully
aware of any risks which may be associated with my participation in these activities, and knowingly assume all risks of personal
injury and property damage in connection with same. I certify that I have no physical defects or other conditions, medical or
otherwise, which would prevent or hinder my participation in the Nursing Program. I further certify that I am not an officer,
agent, servant or employee of the City of Fort Worth. Neither the City of Fort Worth, nor its officers, agents, employees, or
affiliates, are responsible for any injury or damages to me or to my personal property that I may sustain while participating in
the aforesaid activities.
THIS RELEASE AND INDEMNIFICATION SHALL BE CONSTRUED AS EXPRESSLY
INCLUDING, BUT NOT LIMITED TO, ALLEGED ACTS, OMMISSIONS, NEGLIGENCE,
MISCONDUCT, MATERIALS OR TRAINING, EQUIPMENT, SERVICES OR THE MANNER OF
PERFORMANCE OF SERVICES OF OR BY THE CITY OF FORT WORTH, ITS OFFICERS,
AGENTS, EMPLOYEES, AFFILIATES, VOLUNTEERS AND ATTORNEYS, ACTING OFFICIALLY
OR OTHERWISE.
I have read this Release,Hold Harmless and Indemnification waiver and fully understand its terms and conditions. I
have not been influenced in anv way by any representation or statement not contained in this Agreement.
Participant's Signature Date
Printed Name
Witness Date
If Program Participant is a minor, the signature of a patent or legal guardian is also required.
Parent/legal guardian A�� UN�T Date
i tuft
i WORTH, 111