HomeMy WebLinkAboutCALIFORNIA PARAMEDIC INST 1-2003INSURANOE NOT ON
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CLERK OF COUNCIL
DATE:
AFFILIATION AGREEMENT
N-2003-t22
THIS AGREEMENT, made and entered into this l ~at~day of A/0VO'~, 2003 by and
between California Paramedic Institute a California Non Profit (hereinafter "("School"),, and the City of
Santa Aha, a charter city and municipal corporation organized and existing under the Constitution and laws
of the State of California (hereinafter "City").
RECITALS
A. School is an approved educational institution which offers a program of instruction
leading to certification or licensure of its students as Emergency Medical Technician, Emergency
Medical Technician- Paramedic and other, similar health care and prehospital providers
(Students);
B. As a part of the licensing and/or certification requirements Students must complete a
course of study including clinical experience (Clinical Experience) on an ambulance
providing the appropriate level of care and operating in normal service;
C. City is a provider of emergency medical service, including both advanced life
support and basic life support prehospital care and transport;
D. City has agreed to assist School by providing limited "Clinical Experience" for
Students, upon certain terms and conditions, so long as its participation in the program does not
jeopardize patient care and/or compromise City's standards of service to its patients and
clients.
NOW, THEREFORE, in consideration of the mutual covenants set forth herein, the
parties agree as follows:
1. TERM.
1.1 Commencement Date. This agreement shall become effective when signed by
all of the parties and completion of the written approval and certification contemplated in
paragraph 2.2, 2.3 and 2.4. and terminate 12 months thereafter unless terminated earlier as
provided. The term of this Agreement may be extended upon a writing executed by the Fire Chief
and the City Attorney
1.2 Termination. This agreement may be terminated by either party, with or
without cause, upon thirty (30) days written notice to the other party as provided herein.
2. RIGHTS AND OBLIGATIONS OF SCHOOL.
2.1 School's Accreditation. School shall maintain a qualified and accredited
educational program for Students designed to provide a smooth transition into
licensure/certification of Students as Emergency Medical Technicians, Emergency Medical
Technician-Paramedics or other similar pre-hospital health care providers. School's program
shall include programming, administration, matriculation, promotion and graduation and shall be
approved or accredited by relevant licensing/certifying agencies in the state(s) and county(ies) in
which School resides and in which the program contemplated herein is to operate.
2.2 Approval by Licensing/Certifying City(ies). School shall secure from all
relevant licensing/certifying agencies written approval for the Clinical Experience program
contemplated herein and shall maintain such approval throughout the course of the program.
School shall provide City with a copy of the written approval and applicable guidelines or
protocols applicable to the program before assigning a Student to the Clinical Experience
program.
2.3 Student Licensure/Certification. School shall ensure that each Student
enrolled in the clinical program has a provisional license/certificate enabling them to participate
in this program. School shall provide City with a copy of the provisional licensnre and or
certification for any Student enrolling in the Clinical Experience before the Student is allowed to
participate in the program unless, the licensing/certifying agencies advise School and City, in '
writing, that provisional licensure/certification is not required and the Clinical Experience
program is approved under all applicable, or potentially applicable, laws and regulations.
2.4 Approval by Doctor or City Having Medical Control. School will secure
from the doctor having medical control in the state(s) or county(ies) in which program will
operate, written approval for the Clinical Experience. Such written approval shall, at a minimum,
define the scope of practice and required supervision of any Student participating in the course of
clinical education. School will provide City with a copy of the approval contemplated in this
paragraph before assigning any Student to the clinical program.
2.5 Records, School will keep and maintain accurate records for all Students
participating in the Clinical Experience. The records will include the Students transcript,
licensnre or certification, temporary license or certification (if applicable), pre-assessment health
record, and record of history/vaccination/immunization as set forth in paragraph 2.8 hereof.
School will maintain the records for a period of at least four (4) years from the date Student
completes, or ceases to participate in, the Clinical Experience contemplated herein.
2.6 List of Participants, Qualifications, Objectives and Representations. School
will notify City at least thirty (30) days prior to the inception ora course of Clinical Experience of
the names, qualifications and performance objectives for each Student scheduled to begin their
Clinical Experience. Inclusion by School of a Student's name on this list is School's representation
that the Student possesses the necessary skills, licensnre/certification and immunizations to
engage in the Clinical Experience.
2.7 City Rules and Regulations. School will use all reasonable efforts to cause
Students to comply with City's policies, procedures, work rules and regulations, including
preservation of the confidentiality of patient care and patient care records. School will, prior to
allowing a Student to participate in the Clinical Experience, review patient confidentiality as well
as the City's policies, procedures, work rules and regulations with
Student and secure Student's agreement to abide by all such roles and regulations.
2.8 Pre-assignment Health Assessment. School will cause Student to
complete a pre-assignment health assessment, at Student's or School's expense, which includes,
but is not limited to: history of communicable diseases and immunizations, proof of tetanus
vaccination or immunization, proof of Hepatitis B vaccination, proof of MMR vaccination,
respiratory certification by a physician and PPD test. School will provide proof of satisfactory
complction/vaccinatiun to City upon request. Inclusion of a Student's name on the list referenced
in paragraph 2.6 is School's representation that Student has completed the preassignment
assessment and is physically able to perform the tasks associated with the program.
2.9 OSHA Compliance. Prior to allowing Student to enroll in the course of
clinical experience, School will educate and train Student in compliance with all relevant and
required OSHA regulations including, but not limited to, Blood-borne Pathogens Standard and
TB Standard.
2.10 Personal Protective Equipment. School shall provide Student with all
necessary personal protective equipment as is, or may be, required by OSHA prior to assignment
to the Clinical Experience. Such equipment includes, but is not limited to: safety glasses and
particulate respirators. School recognizes and will inform Student that this equipment must be in
the possession of the Student as a condition of their participation in the program. Failure to
possess and use the required OSHA equipment will result in Student's dismissal from the program.
2.11 Assistance in Obtaining Signatures and Compliance. School
recognizes that its Students have certain obligations and will be required to execute certain
documentation in order to be eligible to participate in the program. School shall assist City in
obtaining any necessary signatures and ensuring Student compliance with City roles and this
agreement including, but not limited to, those contained in part 3 of this agreement.
2.12 Evaluation of Performance, School is responsible for and shall make
arrangements with City to facilitate, and School is responsible for, evaluating Student's
performance during the clinical program.
2.13 Minimum Age of Participants. School and City will only allow Students that are
at least eighteen (18) years of age to participate in this program. Inclusion of a Student's name on the list
referenced in paragraph 2.6 is School's representation that Student is at least eighteen years of age.
3. STUDENT OBLIGAT/ONS AND REQUIREMENTS.
3.1 Release. Student will, prior to participating in the clinical experience, read,
understand and sign City's internal ride-along waiver releasing City from any and all liability
and/or responsibility arising out of Students participation in the Clinical
Experience. This release of claims must be executed, and on file with the City, prior to Student
participation in the program. The release is a condition precedent to Student's participation in
the clinical experience and no Student will be permitted on a City vehicle without having
signed the release.
3.2 Pre-assignment Health Assessment. Student shall complete a pre
assignment health assessment as set forth in paragraph 2.8 hereof.
3.3 City Rules and Patient Confidentiality. Student shall comply with City's
procedures, policies, rules and regulations, including maintenance of patient and records
confidentiality. Students, while participating in the clinical program, on City property or in a City
vehicle, must meet all standards of appearance and conduct required by City of it's own
employees. Student shall comply with all applicable OSHA rules or regulations. Student shall have
in their possession at all times when on board an City vehicle personal protective equipment and
use such equipment when, as and where designated by City personnel.
3.4 Student Intern Agreement. Student will read and execute the City Student
Intern Agreement. Execution of the Student Intern Agreement is a condition precedent to
participation in the Clinical Experience program. A specimen of the City Student Intern
Agreement is attached to this Affiliation Agreement as exhibit 1.
4. CITY R/GHTS AND OBLIGATIONS.
4.1 City Rules. City requires Students, while participating in the clinical
program, on City property or in a City vehicle, to meet all standards of appearance and conduct
required by City of it's own employees. City reserves the right to refuse to allow any Student to
participate in the clinical program for failure to comply with City standards.
4,2 Student's Skill Level. City reserves the right to discontinue Student's
participation in the program should City, in its sole discretion, determine that Student's skill
level is substandard. City will immediately advise School of any such concerns or situations.
4.3 Orientation Program. City will provide an orientation program designed to
orient Student to City's rules regulations and policies prior to begimxing their Clinical
Experience.
4.4 City's Control of Patient Care. City reserves the right to determine where,
when and if a Student may participate in the provision of care to its patients. City will endeavor
to utilize Student, and allow them to utilize as many of their skills in as many situations as
possible. However, patient care is paramount and Student shall follow City's instructions with
respect to the provision of patient care.
4.5 Right to Control Participation. City reserves the right to refuse to allow any
Student to participate in the provision of care at the scene of an emergency where, in City's sole
discretion, permitting Student to participate would endanger the Student, a patient or an
employee of City or otherwise be inappropriate.
4.6 Student Evaluations. City will cooperate with School in
performing evaluations of Student's clinical experience.
4.7 Provision of Clinical Experience. City will provide a Clinical Experience for
as many of School's Students as possible, in City's sole discretion, in compliance with the
guidelines, protocols, scope of practice provided by the licensing/certifying City and in accord
with the instructions of the Doctor or City having Medical Control.
5.0 INDEMNIFICATION
5.1 Indemnity for Third Party Claims. School will save, defend, indemnify and
hold harmless City, its officers, employees, agents, affiliates and representatives of and from any
and all clams, suits, costs and actions arising out of the provision of this Agreement and/or
Clinical Experience. This indemnity shall survive and remain enforceable after the expiration or
termination of this Affiliation Agreement, provided however, that this indemnity is not intended to
cover claims against City arising solely out of City's own intentional conduct.
5.2 Indemnity for Student Claims. School will save, defend, indenmify and hold
harmless City, its officers, employees, agents, affiliates and representatives of and from any and
all claims, suits, costs and actions brought by any Student, or their heirs, or assignees against City
arising out of their participation in this program or by any patient claiming that the negligence of
Student caused, compounded or exacerbated their injuries. This indemnity shall survive and
remain enforceable after the expiration or termination of this Affiliation Agreement; provided,
however, that this indemnity is not intended to cover claims against City arising solely out of
City's own intentional conduct.
5.3 Scope of Indemnification. School will save defend, indemnify and hold harmless City, its
officers, employees, agents, affiliates and representatives of and from all potential claims,
actions, risks and costs incurred related to, or resulting from, this Agreement and/or the Students'
participation in the Clinical Experience program and Students' exposure to the pre-hospital
environment including actions brought by patients/clients of City where it is alleged that Students
participation adversely impacted a patient/client outcome or condition. The risks include, but are
not limited to, automobile accidents, assault, injui'y from lifting, high speed driving, exposure to
infectious/contagious diseases such as hepatitis, HIV, TB, malpractice and measles. This
indemnity shall survive and remain enforceable after the expiration or termination of this
Affiliation Agreement, provided however, that this indemnity is not intended to cover claims
against City arising solely out of City's own intentional conduct. This indemnity and hold
harmless agreement applies to ail claims for damages, just compensation, restitution, judicial or
equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in
this Section or by reason of the terms of, or effects, arising from this Agreement.
5.4 Defense Obligation. The School further agrees to indemnify, hold harmless,
and pay all costs for the defense of the City, including fees and costs for special counsel to be
selected by the City, regarding any action by a third party challenging the validity of this
Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or
equitable relief due to personal or property rights arises by reason of the terms of, or effects
arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding.
6.0 INSURANCE.
6.1 Professional Medical Liability and General Liability Coverage. School will
maintain Professional Medical Liability and General Liability coverage of not less than one million
dollars ($1, 000,000. 00) per occurrence and three million dollars ($3,000,000) aggregate. Coverage
must specifically cover Students in the Clinical Experience, working under this agreement and
within the course of their training and education during this program. School will name City as an
Additional Insured under the policy and include an indemnification provision, by endorsement, to
be attached to the certificate of insurance. School will provide City with written verification of
coverage in the form of a certificate of insurance which will be attached to this agreement. School
covenants to keep the required insurance in force and effect through the term of this agreement and
maintain tail coverage for five (5) years thereafter if the coverage was a "claims made" policy.
6.2 Endorsement for Student Activities. School assures City that all coverage
of insurance required herein includes specific provisions and/or endorsements to include
Students within School's Medical Liability and General Liability coverage for all activities
conducted under this program.
6.3 Coverage for Student Injuries. School recognizes that Students are NOT covered by
City's Workers Compensation Insurance or Self Insured Program. School represents and warrants that it
will maintain, or ensure that its Students are covered, for bodily injury and disease should any Student be
injured or become ill during the course of their Clinical Experience. School will provide City with a
written verification of insurance coverage in the form of a certificate of insurance which will be attached to
this agreement.
6.4 Amount of Coverage Not a Limitation. The amount of insurance
required hereunder shall not limit School's liability nor relieve School of any obligation
hereunder.
6.5 Minimum Qualifications of Insurer. Any policies of insurance shall be
maintained with insurance companies: (I) holding a "General Policyholder's Rating" of AIV or
better, as set forth in the most current issue of"Best's Insurance Guide," or comparable rating
from reputable rating organizations; (ii) licensed to operate and sell insurance in the state in
which the Clinical Experience will occur; and (iii) in good standing with the state's Department
of Insurance or other similar regulatory City in the state in which the Clinical Experience will
occur.
7.0 NOTICES.
7.1 Notice Complete on Marling. Any notice required or permitted by this agreement
shall be deemed complete when mailed by Certified Mail to:
For School:
Scott C. Arden RN
Program Director
California Paramedic Institute
23141 Lake Center Drive
Lake Forest, California 92630
For City:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
telefacsimile (714) 647-6956
With courtesy copies to:
Fire Chief
1439 S. Broadway
Santa Aha, CA 92702-1988
8.0 MISCELLANEOUS.
8.1 Interpretation. This Agreement has been negotiated between unrelated parties
each of which has either been, or had the opportunity to be, represented by experienced and
knowledgeable counsel. Accordingly, any rule of law, statute, ordinance, or common law
principle or legal decision that would require a legal interpretation of any ambiguities in this
Agreement against the party who has drafted it, is not applicable and is hereby waived. The
provisions of this Agreement shall be interpreted in a reasonable manner to give effect to the
purpose of the parties, and this Agreement shall not be interpreted or construed against any party
to this Agreement because that party, or any attorney who represented that party, drafted this
Agreement.
8.2 Entire Agreement. This agreement constitutes the entire agreement between the
parties pertaining to the subject matter hereof, and is the final, complete, and exclusive expression of the
terms and conditions of the parties agreement. All prior agreements, promises, representations,
negotiations, and understandings of the parties hereto, oral or written, express or implied, are hereby
superseded and merged herein.
8.3 Waiver. The waiver by City of any breech of any term,
condition or covenant herein shall not be deemed to be a waiver of any subsequent breach of the
same or any other term, condition or covenant, nor shall any custom or practice which may grow
up between the parties affect the right of City to insist on the performance by School in strict
accordance with such terms.
8.4 Captions, Number and Gender. The article, title or section headings of the
various provisions of this agreement are intended solely for the conYenience of reference and
shall not in any way amplify, limit, or modify or otherwise be used in the interpretation of any
provision. As used in this agreement, the masculine, feminine or neutral gender and the singular
or plural number shall be deemed to include the other whether the context so indicates or
requires.
8.5 Severability. If any provision of this agreement, as applied to any party or to
any circumstance, shall be adjudged by a court of competent jurisdiction to be void or
unenforceable for any reason, the same shall not affect (to the maximum extent permissible by
la'v) any other provision of this agreement, the application of such provision under circumstances
different fi.om those adjudged by the court, or the validity or enforceability of this agreement as a
whole.
8.6 Amendment. No amendment or addition, modification of, or alteration of any
provision contained in this agreement shall be effective unless fully set forth in writing and signed
by City and School.
IN WITNESS WHEREOF, we have executed this Affiliation Agreement on:
~AV~ ~CITY OF SANTA
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCH, ER
City Attorney
Michael Vigliotta ~
Deputy City Attorney
Acting Fire Chief
Scott C. Arden ~N
Program Director
California Paramedic Institute
I
STUDENT INTERN AGREEMENT
This agreement is entered into on
who lives at
.(" Student") and
,20
between
("City").
Student is enrolled in a course of study at California Paramedic Institute
(School) designed to enable Student become a licensed/certified Emergency Medical
Technician, Emergency Medical Technician-Paramedic or other similar prehospital health care provider.
As part of the cmrieulum, Student has enrolled in the Clinical Experience which is offered through the
School, with City's assistance. The Clinical Experience involves: l) Student's performing acquired
prehospital skills alongside City's personnel; and, 2) accompanying and observing the City's personnel
providing emergency and nonemergency ambulance transport, care and related services.
Student has asked to participate in Clinical Experience knowing that participation will
require Student to accompany City personnel in dangerous and potentially life threatening
situations. Student realizes that City could not, and would not, allow Student to accompany its
personnel without his/her agreement to: (I) release the City fi.om any and all claims for injury or
death which may result fi.om Student's participation in the program; (ii) assume the risk of death or
injury associated with the Clinical Experience; (iii) agree to read, understand and follow City's
policies, procedures and guidelines; (iv) act in a professional and respectable manner at all times;
and follow the instruction/direction of City personnel with respect to patient care, demeanor,
safety, use of personal protective devices, scene control, etc.
Student understands that he or she is exposing himself or herself to certain risks inherent
in the activities associated with the Clinical Experience. Student hereby represents that he or she
AGREES TO ASSUME THE RISKS INHERENT IN THE ACTIVITY. These risks include,
but are not limited to, being hurt or injured: (1) by broken glass (or other scene hazards) including
various cuts about the head, face, eyes, hands, legs, and torso; (2) by exposure to tetanus or
contagious diseases such as the Hepatitis B virus and the Human Immunodeficiency Virus
("HIV"); (3) injury due to gumey lifts and or drops; (4) injury fi.om slip and fall type incidents; (5)
various strains and/or sprains to one and/or all muscle groups; (6) risks associated with "Code 3"
or emergency driving; and (7) risks at the scene of emergencies including assault and battery.
In consideration of City's agreement to provide the Clinical Experience to Student, without
cost, Student agrees to release and forever discharge City and its agents, employees affiliates,
parent corporation, successors and assigns of and from all claims, demands, suits, injuries or
damages of any kind arising in any way out of the participation in this program.
Student further agrees to: (I) follow City's policies, procedures and work rules; (ii) follow
City's instruction and direction with respect to patient care, safety, personal protection; and,
abide by City rules and direction. Student understands that failure to follow the City's direction
may result, in City's sole discretion, in his/her expulsion fi.om the Clinical Experience program.
Student certifies that he/she is at least eighteen (18) years old and is an adult with full
legal authority to execute this release.
By Signing this Document You Acknowledge That You Have Been Advised That There Are
Risks Inherent in this Type of Activity and Have Decided to Assume That Risk and Release the
City of and from All Liability. You Agree to Release the City from Any Claims Associated with the
Event and That You, Not the City, Are Assuming Complete and Total Responsibility for and Any
and All Injuries, Damages or Losses That You May Suffer as a Result of Participating in the
Clinical Experience Program.
I agree to all terms set forth above.
Dated:
Signature of Student
Print Name