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HomeMy WebLinkAbout065593 - General - Contract - Texas Health Resources (THR)Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 RESTATED AFFILIATION AGREEMENT BETWEEN TEXAS HEALTH RESOURCES AND CSC No. 65593 THE CITY OF FORT WORTH This Restated Affiliation Agreement ("Agreement"), is entered into by and between The City of Fort Worth C'City"), a Texas home -rule municipality, and Texas Health Resources, a Texas non-profit corporation ("THR"). CITY and THR agree to the following: PURPOSE THR is a non-profit health care system with hospitals and medical clinics located in north Texas. One or more of the THR hospitals and medical clinical facilities are willing to provide students of City with clinical experience, and such Facilities are listed on Exhibit D which is attached hereto and incorporated herein (individually, the "Facility" and collectively, the Facilities"). CITY has various programs through which City provides its student's academic and clinical experience. CITY and THR agree that Facilities will provide academic and clinical experiences to students enrolled in the programs listed on Exhibit A ("Program"). On 10/18/2024 the Parties entered into an affiliation agreement that inadvertently listed the Fort Worth Fire/ /Department as the responsible legal party for the City (the "Original Agreement"). Accordingly, the Original Agreement is hereby amended and restated in its entirety to read as set forth herein. This Agreement supersedes the Original Agreement in all respects, and the Original Agreement shall be of no further force or effect from and after the date hereof. Restated Terms. The terms of the Agreement between the Parties shall henceforth be as follows: 1.0 RESPONSIBILITIES OF CITY City shall: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX a) plan the educational activities for the Program's clinical experience at Facility after consultation with and approval by Facility; b) provide qualified teachers at City to teach the pre -requisite core curriculum and support courses in the Program; c) provide administrative functions for each student in the Program; d) provide a faculty member to be available for consultation at all times students are at Facility. e) instruct students to abide by Facility's patient care policies and guidelines, and regulatory and accreditation standards. Information regarding Facility's applicable policies and guidelines will be available at the time of student orientation at Facility; f) require students to comply with all current immunization requirements of THR and any additional immunization requirements that may be instituted by THR/Facility during students' clinical rotations THR's current immunization requirements are listed on Exhibit B. City must submit to THR a letter attesting that each student assigned to a Facility meets the immunization requirements listed on Exhibit Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 B. THR/Facility will provide a reasonable amount of advance notice of any new or additional requirements to City and students. g) confirm and attest that students have passed a drug test in accordance with THR's Drug Free Workplace policy prior to assignment at THR, which, at a minimum, has conducted a panel screening for presence of the following: amphetamine, cocaine metabolites, marijuana metabolites, opiates, MDA-analogues, oxycodones, barbiturates, benzodiazepines, and phencyclidine. Each Student shall be subject to such policy while assigned to THR. h) inform students that THR will require students, at their own expense, to undergo a background evaluation and criminal background history in all fifty (50) states prior to commencing any assignment at Facility. For purposes of this Agreement, a background evaluation shall include the following: i) Social Security Number Verification (and trace to verify the individual correlates with the SSN); ii) Criminal background search for a minimum of seven (7) years and of all counties in and outside of Texas in which the Employee has resided or been employed; iii) Employment verification to include reason for separation and eligibility for rehire; iv) Sex Offender Registry; v) OIG List of Excluded Individuals/Entities; vi) GSA List of Parties Excluded from Federal Programs (with a negative finding); vii) U.S. Treasury Terrorist List (with a negative finding); viii) Applicable State Exclusion List (Medicaid); ix) Office of Foreign Assets Control (OFAC); x) Previous Address Locator; City will ensure appropriate individualized screening of any student whose criminal background report reflects any felonies, misdemeanors, and the underlying behaviors or conduct of charges, pending charges, deferred adjudications, and arrests ("Negative Findings"). The process should include a review of 1) Self reporting of convictions or charges by the candidate or employee in accordance with City application and ongoing reporting requirements, 2) Nature or gravity of offense or conduct, 3) Nature of the assignment within Facility and 4) Amount of time passed from the offense, conviction and/or completion of sentence. The process must yield an analysis of the information and a determination of whether the nexus of the offense or conduct with the nature and duties of the assignment at Facility creates an unacceptable level of risk unmitigated by the amount of time passed since the offense, conduct or completion of sentence. City must disclose to Facility any assigned student whose criminal background report includes any Negative Findings falling within this section, including the circumstances and results of their internal review. Facility will have the opportunity to review the Negative Findings and the City results and may, in its sole and absolute discretion, agree to the assignment, based upon the nature, severity, and number of Negative Findings, and job applicability of the assigned student. i) confirm that the name of any assigned students do not appear on either the Health and Human Services (HHS) — Office of Inspector General (OIG) List of Excluded Individuals/Entities, or the General Services Administration List of Excluded Parties or the Texas Medicaid OIG Sanctions List. Facility reserves the right to re -screen students who have access or will be granted Access to protected health information of Facility's patients or confidential information, as determined to be required by Texas Health Resources or Facility based on the circumstances; Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 j) confirm students have been instructed in Standard Precautions recommended by the Centers for Disease Control and Prevention (CDC) and completed an American Heart Association Basic Life Support ("BLS") 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; k) confirm that City is basically a self -funded entity, and, as such, it does not maintain a commercial liability insurance policy, and damages for which City would ultimately be found liable would be paid directly and primarily by City. 1) provide to Facility at least two (2) weeks prior to commencement of the Program a letter outlining the needs of students, days and hours students will be on patient units or service areas, names of students, and names and registration numbers of any supervising faculty members who will work onsite at the Facility (if applicable) m) consider promptly any complaints made by Facility against a student and participate in joint problem solving. Facility, in its sole discretion, may require permanent withdrawal of any student from Facility at any time for cause; n) confirm that each student is aware of and complies with the Employee Health policies and procedures of Facility; o) 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 students or agents or any student under this Agreement for which a final judicial or other determination is made that the City, its students or agents or any student is responsible for such a claim; p) remove any student upon THR's request in THR's sole discretion; q) confirm that each student(s) is age 16 years or older. 2.0 RESPONSIBILITIES OF THR THR shall: a) provide suitable clinical experiences and assist with clinical teaching and supervision of students; b) provide equipment and supplies which are necessary for clinical instruction at Facility; c) provide meeting space for students in the Program if meeting space is available at the Facility; d) upon request by City, formally evaluate performance of students in the Program using the form provided by City; e) retain responsibility for patient care; f) 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 THR's negligence or gross misconduct; and Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 g) 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. 3.0 RESPONSIBILITIES OF CITY AND THR City and each THR shall: a) 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; Any Facility may decline to accept students in a given semester. b) mutually agree, schedule, and provide an orientation of faculty and students to Facility and assigned units; c) understand there will be no exchange of monies between the City and the THR for this Program; d) revise or modify this Agreement in writing if both parties agree to the revisions or modifications; and e) comply with all applicable federal and state laws, rules and regulations. 4.0 TERM AND TERMINATION This Agreement shall remain in effect for three (3) years beginning 10/16/2024 and ending 10/16/2027 unless sooner terminated as provided herein. This Agreement may be terminated by either parry upon ninety (90) days written notice to the other parry by certified mail, return receipt requested. 5.0 NOTICE Any notice, request or other communication required to be delivered under this Agreement shall be in writing and shall be deemed to have been given or made if delivered personally, by overnight delivery service, by United States mail, to the parties at the following addresses, or at such other addresses as shall be specified in writing by either of the parties to the other in accordance with the terms and conditions of this subsection: If to THR: Texas Health Resources THR University Attn: Contract Specialist 600 E. Lamar Blvd., Suite 232 Arlington, Texas 76011 Email: THRAffiliationAgreements(a�texashealth.org If to City: Fort Worth Fire Department Attn: Gina Nix, EMS Education 505 W. Felix St. Fort Worth, TX 76115 Email: gina.nix(�i),fortworthtexas.gov Phone: (817) 392-6874 With copy to: City Attorney's Office 100 Fort Worth Trail Fort Worth, Texas 76102 Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 6.0 STATUS OF STUDENTS City and Facility understand and agree that while faculty and students are participating in the Program, faculty and students are not employees of Facility and are not entitled to any rights or benefits of employees. Nothing herein shall be construed as creating a partnership or joint venture between City and THR, its officers, agents, employees and subcontractors, and doctrine of respondent superior has no application as between City and THR. 7.0 MISCELLANEOUS 7.1 Prior Agreements. This Agreement supersedes any prior clinical affiliation agreements between City and any THR Facility. 7.2 Adding Additional Clinical Programs. In the event that City and THR agree to include additional programs under this Agreement, the parties shall sign a written amendment reflecting updates to Exhibit A. 7.3 Non -Discrimination. City and Facility shall not unlawfully discriminate in their respective performance of this Agreement. 7.4 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. 7.5 Governing Law and Venue. This Agreement shall be governed by, construed and enforced in accordance with the substantive laws of the State of Texas (but not including its conflict of laws rules if and to the extent such rules would apply the substantive laws of another jurisdiction). Venue for litigation of any dispute arising under this agreement or any lawsuit to enforce or interpret this Agreement shall be in an appropriate court located in the county in which Facility is located. The parties agree that the county in which Facility is located is the county in which performance of this Agreement shall take place. 7.6 Severability. Should any clause or provision of this Agreement be held or ruled unenforceable or ineffective by a court of law, such a ruling will in no way affect the validity or the enforceability of any other clause or provision contained herein. 7.7 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. 7.8 Confidentiality. City acknowledges that the intent of federal and state privacy laws and Texas Health Resources' ("THR") and Facility policies, is to assure that Confidential Information, as described in Exhibit C, will remain confidential and will be used only by those with appropriate authority as necessary to fulfill the purpose of this Agreement. City acknowledges that students, faculty and other City representatives may access Confidential Information during the performance of their function under this Agreement. As such, City shall ensure that each student executes the Texas Health Resources Student Confidentiality Agreement (see Exhibit C), prior to arrival at the Facility; and represents and warrants that its agents, employees and representatives (collectively 5 Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 hereinafter "Representatives") will maintain such information as confidential and will not disclose such information to third parties or other Representatives of City, who do not require the information in order to fulfill this Agreement, except as permitted by law or order of the court. Should City, through its Representatives, for any reason otherwise disclose the information, City will immediately notify Facility. City warrants that it will train all Representatives concerning this provision of the Agreement. 7.9 Multiple Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original and all of which shall together constitute one and the same instrument. Facsimile and electronic (pdf) signatures shall be treated as if they are original signatures. [SIGNATURE PAGE FOLLOWS.] 1.1 Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date(s) set forth below. THE CITY OF FORT WORTH Printed Name: William Johnson Title: Assistant City Manager TEXAS HEALTH RESOURCES Docu Signed by: By: nnri�FRFaF�neFr Printed Name: Mark Morales Title: VP Chief Talent Officer For City of Fort Worth internal processes: Approval Recommended: By: Name: Raymond Hill Title: Fire Chief Attest: By: Name Title: Jannette Goodall City Secretary Contract Authorization: M&C: N/A Date M&C Approved: N/A Form 1295: N/A 07/30/2026 Date 7/24/2026 Date 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 requirements. bvvop 4Q FonrnIl>: Gina Nix (Jul 29, 2026 07:43:04 CDT) oA F,,000 0�0By: d Name: Brenda Ray Pvo o=p Title: Purchasing Manager Fire aaan��aa5aaa Approved as to Form and Legality: By: Name Title: :5 /71� 5� : Taylor Paris Senior Assistant City Attorney OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 EXHIBIT A PROGRAMS THR and City agree that this Clinical Affiliation Agreement shall apply to the following programs of City: (List agreed upon programs) NOTE: Any added programs require approval by THR Leadership which may cause a delay in the process. EMS FWPD Tactical Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 EXHIBIT B THR IMMUNIZATION REQUIREMENTS Each assigned to a Facility shall meet the requirements and qualifications described herein at the personal expense of the student. Hepatitis B vaccine. Each Student shall have completed the full Hepatitis B vaccine schedule prior to placement. Flu vaccinations. Student must have a flu vaccine within one (1) year of commencement of working at THR and annually if continuing to work at THR. Flu vaccinations may also be required during outbreak of influenza in the community or when designated by THR. TB testing. Each Student will have been tested for tuberculosis within one year of commencement working at THR. IGRA testing may be utilized in lieu of TB skin testing. If the Student's documentation indicates positive IGRA or TST, the Student may provide evidence of negative chest x-ray (conducted within previous year) and documentation of no symptoms of active TB must be provided. Medical clearance indicating Student is safe to work in hospital environment must be provided at time of assignment for positive TB test or positive IGRA results even if x-rays result are negative. MMR, TDAP, and varicella vaccinations. Each student shall have documentation of the current Centers for Disease Control recommendations for Healthcare Workers for MMR, TDAP, and varicella vaccinations or has the existence of sufficient titers for MMR and/or varicella. Other vaccines. Each student provided to THR in the following departments: childcare centers, psychiatric departments or facility and nutritional services are required to have Hepatitis A vaccine series. Hepatitis A and B combined vaccine may be given, if indicated. Students working in the microbiology lab must have documentation showing that the Meningococcal vaccine has been administered. I Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 EXHIBIT C TEXAS HEALTH RESOURCES STUDENT CONFIDENTIALITY AGREEMENT I understand that while I am participating in an educational program at a Texas Health Resources ("THR") facility, I may have access to Confidential Information. Confidential Information is valuable and sensitive and is protected by law and by THR Policy. The intent of federal and state privacy laws and THR policies is to assure that Confidential Information will remain confidential and will be used only by those with appropriate authority as necessary to accomplish THR's mission. Confidential Information is information about patients, participants of THR benefit plans and programs, customers, physicians on the medical staff of a THR hospital, credentialing, peer review, quality review, committee records, personnel records, payroll records, salary and compensation information, logon and password information, employee health information, or information related to operations about THR that is not generally available to the public. I may learn of or have access to some or all of this Confidential Information orally, through a computer system or through documents. If I need access to THR's or Facility's computer system I will be assigned a unique logon ID and password, as well as other access control devices such as cards or tokens. I agree that I will keep these logon IDs, passwords, and other access control devices assigned for any purpose secure and confidential. I acknowledge the unique logon ID and password are equivalent to a legal signature. I will be held accountable for any access utilizing my unique logon ID. Access cards and other facility security devices will be kept secure. Access to Confidential Information is permitted only as authorized and as required for legitimate purposes in the performance of my student role. I understand that patient information will be available for educational purposes to authorized students enrolled in educational programs affiliated with the THR facility for use within the department maintaining those records. Removal of any part of the patient's medical record or information that identifies a patient is prohibited. Requests for access for formal research purposes require a waiver from the facility's Institutional Review Board. In order to access and compile data for educational studies, I understand I must present a written request and consent of my instructor. Students are prohibited from removing information that identifies a patient from the THR facility. I understand the above requirements and I agree to abide by these requirements. I understand that my violation of this Agreement may result in my being terminated from my participation in the program at a THR facility. Printed Student's Name Student's Signature Date 10 Docusign Envelope ID: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 EXHIBIT D THR PARTICIPATING FACILITIES HOSPITALS Q THA - Texas Health Presbyterian Hospital Q THFW - Texas Health Harris Methodist Allen Hospital Fort Worth Q THAL - Texas Health Harris Methodist Q THHEB — Texas Health Harris Methodist Hospital Alliance Hos ital Hurst -Euless -Bedford Q THAM - Texas Health Arlington Memorial Q THK - Texas Health Presbyterian Hospital Hospital Kaufman Q THAZ - Texas Health Harris Methodist Q THP - Texas Health Presbyterian Hospital Hospital Azle Plano Q THC - Texas Health Harris Methodist Q Hospital Cleburne THRW -Texas Health Hospital Rockwall Q THCDS — Texas Health Center for Q THS - Texas Health Harris Methodist Hospital Diagnostics & Surgery Plano Stephenville Q THCF - Texas Health Hospital Clearfork Q THSH - Texas Health Specialty Hospital Fort Worth Q THD - Texas Health Presbyterian Hospital Q THSL - Texas Health Harris Methodist Dallas Hospital Southlake Q THDN - Texas Health Presbyterian Hospital Q THSW - Texas Health Harris Methodist Denton Hospital Southwest Fort Worth Q THE - Texas Health Hospital Frisco Q THUC — Texas Health Breeze Urgent Care Q THFM - Texas Health Presbyterian Hospital Flower Mound BEHAVIORAL HEALTH Q Q THRWC - Texas Health Recovery & Wellness THBHS - Texas Health Seay Behavioral (Mansfield — Addiction Recovery Center by Health Plano Texas Health Q THBHSP - Texas Health Springwood Behavioral Health HEB NEIGHBORHOOD CARE & WELLNESS Q THB - Texas Health Neighborhood Care & Q THWP - Texas Health Neighborhood Care & Wellness Burleson Wellness Willow Park Q THPS - Texas Health Neighborhood Care & Q Wellness Prosper THVCC —Texas Health Virtual Care Channel THPG Q THPG - Texas Health Physicians Group SYSTEM Q THR — System Services 11 a docusign Certificate Of Completion Envelope Id: 24FB45E8-BD89-8D67-83AF-F6B80C20C780 Subject: Signature Requested: 2024 - 2027 CAA between THR & City of Fort Worth PT#:: PSPC #:: Source Envelope: Document Pages: 11 Signatures: 1 Certificate Pages: 2 Initials: 0 AutoNav: Enabled Envelopeld Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) Record Tracking Status: Original 7/24/2026 9:00:49 AM Signer Events Mark Morales markmorales@texashealth.org Chief Talent Officer Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via Docusign In Person Signer Events Editor Delivery Events Agent Delivery Events Intermediary Delivery Events Certified Delivery Events Carbon Copy Events Chekesha Jackson chekeshajackson@texashealth.org Chief Talent Officer Texas Health Resources Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via Docusign Holder: Mark Morales ChekeshaJackson@texashealth.org Signature CDollligned by: � ODC17FBFAFAF74d5C... Signature Adoption: Drawn on Device Using IP Address: 12.50.9.2 Signature Status Status Status Status Status PIED Gina Nix O PI E D gina.nix@fortworthtexas.gov Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via Docusign Status: Completed Envelope Originator: Mark Morales 612 E Lamar Blvd Ste 190 Arlington, TX 76011-4131 ChekeshaJackson@texashealth.org IP Address: 12.50.9.2 Location: DocuSign Timestamp Sent: 7/24/2026 9:05:15 AM Viewed: 7/24/2026 9:09:35 AM Signed: 7/24/2026 9:09:49 AM Timestamp Timestamp Timestamp Timestamp Timestamp Timestamp Sent: 7/24/2026 9:09:50 AM Resent: 7/24/2026 9:09:52 AM Sent: 7/24/2026 9:09:50 AM Viewed: 7/24/2026 10:43:26 AM Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/24/2026 9:05:15 AM Certified Delivered Security Checked 7/24/2026 9:09:35 AM Signing Complete Security Checked 7/24/2026 9:09:49 AM Completed Security Checked 7/24/2026 9:09:50 AM Payment Events Status Timestamps Signature:5� Email: allison.tidwell@fortworthtexas.gov FORT WORTH. City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: Retated Affiliation Agreement Subject of the Agreement: experience CITY has various programs which provides students academic and clinical M&C Approved by the Council? * Yes ❑ No M If so, the M&C must be attached to the contract. Is this an Amendment to an Existing contract? Yes ❑ No 0 If so, provide the original contract number and the amendment number. Is the Contract "Permanent"? *Yes 0 No ❑ If unsure, see backpage for permanent contract listing. Is this entire contract Confidential? *Yes ❑ No 0 If only specific information is Confidential, please list what information is Confidential and the page it is located. Effective Date: If different from the approval date. Expiration Date: If applicable. Is a 1295 Form required? * Yes ❑ No ED *If so, please ensure it is attached to the approving M&C or attached to the contract. Project Number: If applicable. *Did you include a Text field on the contract to add the City Secretary Contract (CSC) number? Yes 0 No ❑ Contracts need to be routed for CSO processing in the followingorder: rder: 1. Katherine Cenicola (Approver) 2. Jannette S. Goodall (Signer) 3. Allison Tidwell (Form Filler) *Indicates the information is required and if the information is not provided, the contract will be returned to the department.