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HomeMy WebLinkAbout2026-181-E-Emergency Svc-Western Caolina University-EMS Educational Affiliation Agreement1 Western Carolina University College of Health and Human Sciences EDUCATIONAL AFFILIATION AGREEMENT THIS EDUCATIONAL AFFILIATION AGREEMENT ("Agreement") is entered into by and between Western Carolina University, herein known as (“University”), a constituent institution of the University of North Carolina, on behalf of its College of Health and Human Sciences, herein know as (“College”) and Orange County Emergency Services, herein known as “Facility” located in Hillsborough, North Carolina. RECITALS WHEREAS University desires to provide students enrolled in any academic program (“Program”) within the College of Health and Human Sciences the opportunity to experience clinical training at the Facility; and WHEREAS, Facility has the expertise to provide such clinical training. NOW, THEREFORE, in consideration of the promises herein contained and for other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the parties agree as follows: I.RESPONSIBILITIES OF THE PARTIES A.SCOPE OF ASSIGNMENT/MUTUAL RESPONSIBILITIES 1.Facility agrees to accept University's students for clinical training under the terms and conditions set forth in this Agreement. University shall recommend only those students who have fulfilled the prerequisites and meet the requirements as outlined in this Agreement. Facility reserves the right to decline or accept any student recommended by the University. 2.The Facility and the University will pre-determine the number and schedule of the students to be assigned to the Facility. The Facility will make the final determination regarding the number of students, dates of assignments, utilization of Facility resources, and location of student rotations. Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 2 3.Withdrawal of a student from an assignment may be requested by either party at any time upon notice to the other party. Notwithstanding the foregoing, Facility retains the right at all times to safeguard the health, safety, and welfare of its patients and the orderly operation of its facilities and shall have the right to immediately remove a student from an assignment when the student's performance is detrimental to a patient's well-being or to the orderly operation of the Facility. 4.University and Facility will plan appropriate consultation conferences to coordinate students' clinical schedules. The Facility will allow faculty/staff members of the University to visit the Facility and students. Such visits shall be on terms mutually agreed upon by the University and the Facility in advance. 5.Each party hereto shall designate an employee to serve as liaison between the University and the Facility. The liaison contact information for each party is as follows: UNIVERSITY: Lori S. Anderson, PhD, RN Dean and Professor College of Health and Human Sciences Western Carolina University 201 HHS Building 3971 Little Savannah Road Cullowhee, NC 28723 FACILITY: Orange County Emergency Services 510 Meadowlands Drive PO BOX 8181 Hillsborough, NC 27278 ATTN: Zachary Gant, EMS Training Officer B.RESPONSIBILITIES OF THE FACILITY 1.Facility will provide supervision of students while participating in the Program and maintain a sufficient level of staff support to carry out normal service functions so that students will not be performing in lieu of staff. Notwithstanding the foregoing, University's Department of Nursing may also assign nursing faculty to supervise students in clinical experiences. Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 3 2.Facility will comply with any state and federal laws and regulations applicable to the provision of healthcare services and the Program, as well as any applicable Program accreditation standards or guidelines. 3.The Facility shall be responsible for coordinating clinical training schedules, supervising the students' clinical training experience, evaluating student performance while at the Facility, and providing a planned and supervised program at Facility. 4.At all times, the Facility shall have sole responsibility for patient care services at the Facility, and the level at which the students participate in such patient care. 5.The Facility will provide appropriate orientation to students assigned to the Facility prior to the commencement of clinical experience. Otherwise, Facility will provide student orientation materials to the University, including copies of pertinent policies and procedures, rules, regulations, student agreements, and confidentiality statements. [attach and incorporate by reference any pertinent documents] 6.The Facility will advise the University at the earliest reasonable time of any changes in its operations, policies, or personnel, which may affect the clinical experience. 7.Facility will provide reasonable first aid assistance for students who experience work related injuries or illnesses, including needle sticks. The cost of any first aid or emergency care provided to the student shall be the responsibility of the student. Additionally, the cost of any follow-up, referrals, x-rays, or laboratory tests as may be necessary shall not be borne by the University or Facility, but shall be the responsibility of the individual student, regardless of whether or not such services are covered by the student’s health insurance. C.RESPONSIBILITIES OF THE UNIVERSITY 1.The University is solely responsible for academic matters, including Program curriculum. 2.University shall (i) determine students' eligibility to participate in the Program, (ii) assign final course grades, and (iii) award course credits. Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 4 3.University shall provide any information reasonably requested by the Facility regarding students’ qualifications for participation in the Program. Such information shall be provided prior to the assignment of a student to the Facility, or otherwise upon request. Access to and disclosure/transmission of student educational records and information shall be made only in accordance with applicable state and federal law. Each party agrees to use best efforts to comply with all applicable federal and state laws regarding the confidentiality of student educational records, including without limitation, the Family Educational Rights and Privacy Act (“FERPA”). 4.University shall advise students who are assigned to the Facility, as well as any supervising faculty members, if applicable, of their responsibility to comply with:(i) the policies and procedures, bylaws, rules, and regulations of the Facility; (ii) any applicable state and federal laws, regulations, and rules; (iii) the standards of the Joint Commission on Accreditation of Healthcare Organizations or other accrediting body(ies); and (iv) the policies and procedures, rules and regulations of the University and Program. 5.University shall provide documentation that each student assigned to the Facility (i) has proof of immunity against communicable diseases, including MMR, DTap, Tdap or TD, and Varicella Zoster, (ii) has been tested for tuberculosis (PPD) within the twelve (12) months prior to the clinical assignment, and (iii) has received a Hepatitis B immunization series or provided a signed refusal of immunization form. Exemption requests will be handled on a case-by-case basis by the Facility. 6.The University agrees that it will not assign students and supervising faculty members, if applicable, to the Facility if, even after accommodation, any disability would prevent them from fulfilling their essential duties and functions during the clinical assignment. The University will furnish other documentation about a student's or faculty member's health status as requested by the Facility, provided that such disclosure is consistent with applicable state and federal law regarding disabilities and the privacy of protected healthcare information. University shall cause each student who participates in a clinical experience at the Facility to submit to a criminal background check, at the student's expense. The Facility shall provide the University liaison with detailed information pertaining to the scope and extent of the background check required by the Facility as set forth in the Facility's personnel policies and procedures. Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 5 The background check will be conducted by a vendor under contract with the University of North Carolina, and the results will be provided directly to the Facility's liaison. The University shall not in any circumstance make the final determination regarding a student's suitability for placement in connection with such criminal background screening. 7.Prior to the start of the clinical experience, University shall provide, or cause students to receive, training pertaining to OSHA Bloodborne Pathogens and such other safety training as requested by the Facility. 8.University shall maintain communication with the Facility on matters pertinent to the clinical experience, including any changes in Program curriculum or Program accreditation standards. II.TERM AND TERMINATION A.This Agreement shall become effective on 8/1/26 and continue in force and effect until terminated or modified by the parties as provided in this Agreement. The parties agree that they shall periodically evaluate the Program and make appropriate modifications to this Agreement in accordance with Section XI below. B.This Agreement may be terminated by either party at any time upon thirty (30) days written notice to the other party; provided, however, that any student participating in the Program at the Facility when notice of termination is given will be permitted to complete his or her clinical experience as scheduled. III.INSURANCE/INDEMNITY A.University shall cause students assigned to the Facility to obtain and maintain occurrence-based professional liability insurance coverage with policy limits of at least $2,000,000 per occurrence/$4,000,000 annual aggregate. Upon request, the University shall provide the Facility with a Certificate of Insurance evincing such coverage. B.University shall cause students assigned to the Facility to obtain health insurance covering students during the term of their assignment at the Facility. Upon request, the University shall provide the Facility with evidence of such coverage. Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 6 C.University will ensure that Facility is provided with notice of any cancellation or significant change of both professional liability insurance and health insurance and health insurance coverages thirty (30) days prior to such cancellation or change. D.The parties understand and agree that the University is an agency of the State of North Carolina, and nothing herein shall constitute a waiver of sovereign immunity or limits of governmental liability that are set forth in the North Carolina Tort Claims Act, NCGS 143- 291 et seq. The University will be responsible for the negligent conduct of its officers, employees, and others for whom the University is legally responsible relating to the performance of this Agreement to the extent permitted by the laws of North Carolina, including the North Carolina Tort Claims Act, the Defense of State Employees Act, and the Excess Liability Policy administered through the North Carolina Department of Insurance, subject to the availability of appropriations and in proportion to and to the extent that such liability for damages is caused by or results from the acts of the University, its officers or employees. E.Facility shall obtain and maintain in full force and affect such policies of insurance as may be required by law and as are customary for Facility’s business and operations. IV.NOTIFICATION OF CLAIMS Each party agrees to notify the other party as soon as possible in writing of any incident, occurrence, or claim arising out of or in connection with this Agreement. Further, the notified party shall have the right to investigate such incident or occurrence, and the notifying party will cooperate in this investigation to the fullest extent permitted by applicable state or federal law. V.CONFIDENTIALITY A.The parties agree to keep confidential from third parties all information which relates to or identifies a particular patient, including but not limited to the name, address, medical treatment or condition, financial status, or any other personal information which is deemed to be confidential in accordance with applicable state and federal law and standards, including the Health Insurance Portability and Accountability Act of 1996 and its Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 7 implementing regulations ("HIP AA"), and will require that their respective employees, contractors, subcontractors, agents, and representatives comply with the same. The requirements of this confidentiality section shall survive the termination or expiration of this Agreement. B.University shall inform students of the confidentiality requirements set forth above and shall further inform students that any breach of confidentiality may result in their removal from the Facility and disciplinary action, up to and including dismissal from the Program. VI.NOTICES All notices or other communication provided for in this Agreement shall be given to the parties addressed as follows: UNIVERSITY: Lori S. Anderson, PhD, RN Dean and Professor College of Health and Human Sciences Western Carolina University 201 HHS Building 3971 Little Savannah Road Cullowhee, NC 28723 FACILITY: Orange County Emergency Services 510 Meadowlands Drive PO BOX 8181 Hillsborough, NC 27278 ATTN: Kirby Saunders, Emergency Services Director In Compliance with federal Law, Including the provisions of Title IX of the Education Amendments of 1972, Sections 503 and 504 of the Rehabilitation Act of 1973, the Age Discrimination in Employment Act of 1967 and 1975 and the Americans with Disabilities Act of 1990, and Title VI of the Civil Rights Act of 1964, each party hereto will not discriminate on the basis of race, sex, religion, color, national or ethnic origin, age, disability, or military service in its administration of its policies, including admissions policies, employment, programs or activities. Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 8 VII.ASSIGNMENT AND BINDING EFFECT Neither party shall assign, subcontract, or transfer any of its rights or obligations under this Agreement to a third party without the prior written consent of the other party. If an assignment, subcontract, or transfer of rights does occur in accordance with this Agreement, this Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective successors or assigns. VIII.INDEPENDENT CONTRACTORS It is expressly acknowledged by the parties hereto that they are independent contractors and nothing in this Agreement is intended or shall be construed to create an employer/employee relationship, partnership or a joint venture relationship so as to allow one party to exercise control or direction over the manner or method by which the other party performs the services which are the subject matter of this Agreement. Neither party is authorized or empowered to act as agent for the other for any purpose and shall not on behalf of the other enter into any contract, warranty, or representation as to any matter. Neither party shall be bound by the acts or conduct of the other party. Neither party, nor any other person performing services on behalf of such party pursuant to this Agreement shall have any right or claim against the other party for Social Security benefits, workers' compensation benefits, disability benefits, unemployment insurance benefits, health insurance benefits, paid time off, or any other employee benefit. IX.STUDENTS' STATUS Students are not employees of either the University or the Facility. Students are considered to be and shall be treated as trainees who have no expectation of receiving compensation, benefits, or future employment from either the University or the Facility. X.ENTIRE AGREEMENT/AMENDMENTS This Agreement contains the entire understanding between the parties hereto and supersedes any and all prior agreements, understandings, and arrangements between the parties relating to the subject matter hereof. No amendment, change, modification or alteration of the terms and conditions hereof shall be binding unless evidenced by a writing signed by the parties hereto. Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 9 XI.SECTION HEADINGS/CONSTRUCTION Section headings contained in this Agreement are for convenience only and are not intended to affect the interpretation of this Agreement. The word "including" shall mean "including without limitation". The Agreement shall be construed as if drafted jointly by the parties and no presumption of burden of proof shall arise favoring or disfavoring any party by virtue of the authorship of any provision in this Agreement. All words in this Agreement shall be construed to be of such gender or number as the circumstances require. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their duly authorized representatives on the last signature date specified below. FACILITY Signature: Title: Printed Name: Date: WESTERN CAROLINA UNIVERSITY Signature: Title: Dean and Professor, College of Health and Human Sciences Printed Name: Lori S. Anderson, PhD, RN Date: Director Kirby Saunders Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 5/5/2026 CERTIFICATE OF COVERAGE Certificate Holder: Jackson County Parks & Recreation Department 88 Cullowhee Mountain Road Cullowhee, NC 28723 Insurer: State of North Carolina Authorization: North Carolina General Statute Sections 143-291 to 143-300.1A, commonly referred to as the State Tort Claims Act. Coverage: Tort Claims against Departments, Agencies, and Employees must be filed in the North Carolina Industrial Commission and a legal defense is provided by the State. Limits: $1,000,000 statutory damage to any one person arising out of any one occurrence. NCGS § 143-299.2 Description: Western Carolina University and its employees, officers, agents, as covered by the Defense of State Employees as per NCGS § 143 300.2. The State Tort does not expire. Administrator: Office of State Fire Marshal Risk Management Division 1202 Mail Service Center, Raleigh, NC 27699-1202 Note: This Certificate is for informational purposes only and does not alter any provision of the Tort Claims or Defense of State Employees General Statutes of the State. Verified By: Latarsha Y. Silver, CRM, TRA Division Chief – Risk Management Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD Re: NC State Tort The State of North Carolina, being self-insured and holding sovereign immunity, is not susceptible to legal action without its explicit permission. Consequently, we do not procure liability insurance. However, pursuant to statute (Chapter 143, Article 31), the State has chosen to waive its sovereign immunity concerning suits related to the negligence of its employees or agents, leading to injuries. The indemnity extends up to a maximum of $1,000,000 for any single individual arising from a singular incident (NCGS § 143-299.2). The North Carolina Industrial Commission is constituted as a court for the purpose of hearing and passing upon tort claims against departments, institutions, or agencies. The State tort is not attached to a policy, therefore does not expire, or require an expiration date to be placed on the certificate of coverage. We trust that the above information provides the necessary certification needed by your organization. If you have any questions or need additional information, please let us know. Sincerely, Latarsha Y. Silver, CRM Division Chief of Risk Management Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD Revised 01/24 1 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Western Caolina University Vendor Contact Person: Evelyn Wilson Phone: (828) 227-3519 Address: 3971 Little Savannah Road City: Cullowhee State: NC Zip: 28723 Department: Emergency Services Amount: NA Purpose: EMS Educational Affiliation Agreement Budget Code(s): NA Vendor # NA Vendor Status with NCSOS: 0040832 Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 8/1/2026 End Date Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. This agreement is approved as to technical form and content. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ Docusign Envelope ID: 7571D164-E14D-8622-8214-03FD551071CD 5/5/2026 5/11/2026 5/14/2026