CM-2016-1194 - 9/30/2016AFFILIATION AGREEMENT
This agreement dated September 22, 2016 is between TEXAS STATE UNIVERSITY (TEXAS
STATE), acting through its College of Health Professions, and the City of Round Rock, Parks and
Recreation Department (Facility). In this agreement all clinical training, fellowships, internships,
preceptorships or field experiences will be referred to as "clinical education experiences." In
consideration of the mutual promises herein contained, the parties agree as follows:
1. TERM OF AGREEMENT
1.01 Term: This agreement is for a term of one year and shall commence on December 1, 2016 and
continue until terminated by either party's giving one year's written notice to the other.
1.02 Early Termination: If either party terminates this agreement before the expiration date shown
in the preceding paragraph, the Facility will not be required to provide any clinical education
experiences for students who enroll in a health profession major after the date of the notice of
termination. However, if early termination does occur the Facility agrees to permit students already
assigned for clinical education experiences at the Facility to fully complete the clinical education
experience.
2. DUTIES OF THE FACILITY
2.01 Use of Facilities: In order that students may obtain practical clinical education experiences as a
part of their educational studies at TEXAS STATE, the Facility will permit students enrolled in the
College of Health Professions at TEXAS STATE to use its facilities, equipment, library, and
supplies, within the guidelines and restrictions established by the Facility. The Facility retains the
right to accept or reject any proposed student at any time without cause.
2.02 Duties and Activities: The parties' representatives will work together to determine the specific
clinical education experience that TEXAS STATE students will perform. The parties may add
additional health profession programs to the agreement by revising Addendum A.
2.03 Equipment Provided by Facility: The Facility will provide and maintain (or cause to
be provided and maintained, if appropriate) such facilities, equipment and supplies, as it deems
necessary for the students' performance of their clinical education experience activities under this
agreement.
2.04 Safety Equipment Provided by the Facility: The Facility, as it deems necessary and
proper, shall make available the necessary safety equipment and supplies. The Facility shall also
provide orientation for the students to the Facility.
2.05 Student Health Needs: The Facility is not required to provide health services to
TEXAS STATE students or faculty members who supervise their clinical education experiences
under this agreement except in emergency situations. The student or faculty member requiring
emergency care is responsible for paying the costs associated with providing such care.
2.06 No Employer -Employee Relationship: The TEXAS STATE students subject to
this agreement will perform their clinical education activities as part of their academic requirements
in the College of Health Professions at TEXAS STATE. Consequently, no compensation or payment
of any kind is due such students by the Facility and there is no employer-employee relationship
between the Facility and the student during the clinical education experience. Conversely, the
Facility will not charge such students or TEXAS STATE any fee or other amount for the use of its
facilities, equipment, library or supplies under this agreement.
2.07 Educational Support: The Facility has the option to support the clinical education
activities of TEXAS STATE students through a financial stipend or other types of subsidies for
housing, parking, or meal costs. Such support is for the purpose of supporting the clinical education
and will not constitute an employer-employee relationship between the Facility and the student.
2.08 Student Supervision: The TEXAS STATE students completing clinical education
experiences in the Facility shall be subject to supervision by the Facility's staff at all times. The
supervision will follow the appropriate professional guidelines and jurisdictional regulations
established for the health care profession for which the student has been assigned.
3. DUTIES OF TEXAS STATE
3.01 Supervision: TEXAS STATE will be responsible for assignment, evaluation,
counseling and guidance of students assigned to the Facility. Each Department or Program within the
College of Health Professions will provide a faculty or staff member to supervise the clinical
education experiences for its students and as appropriate for that profession. The Schools,
Departments and Programs, as well as a faculty representative for each are identified in Addendum
A.
3.02 Salaries of Instructors: The salaries and expenses of regular "1'EXAS STATE faculty
members will be paid by TEXAS STATE and there will be no employer-employee relationship
between the Facility and TEXAS STATE faculty members.
3.03 Joint Appointments: The parties agree that employees of the Facility may hold joint
appointment serving as unpaid members of TEXAS STATE faculty. Likewise, employees of TEXAS
STATE may hold unpaid positions with the Facility, as permitted by Facility's policies and
appropriate By -Laws. Consent of the primary employer is required prior to finalizing the joint
appointment.
3.04 Consultant Services: TEXAS STATE faculty members may, at their option, and to the
extent that it does not interfere with their duties at TEXAS STATE, provide in-service education and
serve on committees of the Facility, without charge to the Facility, when requested by the Facility.
The Facility may, at its own discretion, provide payment for consultative services.
3.05 Schedules: TEXAS STATE will provide the Facility with the appropriate schedules
indicating the time period during which the students are expected to perform their clinical education
experience activities at the Facility.
3.06 Students' Records: TEXAS STATE will maintain student records to meet accepted
educational and professional accreditation standards.
3.07 Student Assignment: Ili cooperation with the Facility, TEXAS STATE will arrange
for student assignments at the Facility to complete clinical education experiences required by the
health care profession.
3.08 Policies and Procedures: TEXAS STATE will require students to abide by all policies and
procedures of the College of Health Professions, the School, Department or Program for which they
are completing the clinical education experience, and the Facility. The basic education for
compliance with HIPAA will be the responsibility of the School, Department or Program and will be
completed prior to the student's assignment to the Facility.
3.09 Professional Liability Insurance: TEXAS STATE provides professional liability insurance
under a blanket policy in the minimum amount of $1,000,000 per claim/$5,000,000 in the aggregate
to all students enrolled in a College of Health Professions major participating in clinical education
experiences. This blanket policy will also cover TEXAS STATE faculty members who provide
academic or clinical teaching under this agreement. TEXAS STATE will furnish a copy of this
policy to the Facility upon request.
3.10 Immunization Requirements: TEXAS STATE will require all students participating
in clinical education experiences involving patient contact or exposure to patient specimens to submit
a health report to their appropriate department or program chair. A Licensed Health Care Provider
must complete the health report, which will indicate completion of immunizations for mumps,
measles, rubella, tetanus, diphtheria, pertussis, meningitis, a chest x-ray or TB test (PPD/QFT),
varicella, the Hepatitis B vaccine series (Addendum B), and proof of annual Flu Shot/H1N1, or if
required by Facility, Addendum C for nursing students. TEXAS STATE's department or program
will maintain these records and furnish them to the Facility upon request. The program may be
requested to provide a Health Certificate completed by a licensed health care provider (Addendum
D) by the Facility.
3.11 Infection Control Training: TEXAS STATE agrees to provide those students who
may be involved in patient care with comprehensive infection control training,
including bloodborne pathogens, prior to rotation at the Facility.
3.12 Criminal Background Check: As of September 1, 2005, Texas State will inform
students that the Facility may require criminal background checks for all students, at
the student's expense.
3.13 Drug Testing: As of September 1, 2014, TEXAS STATE will inform students that the Facility
may require drug testing for all students, at the student's expense.
3.14 Employment Verification: As of September 1, 2014, TEXAS STATE will inform students that
the Facility may require employment verification for all students, at the student's expense.
4. INDEMNITY
4.01 Injury to Students: To the extent permitted by Texas law, TEXAS STATE shall hold the
Facility, its officers, agents, representatives and employees harmless from liability resulting from
injury or illness to students except for claims resulting from tortious conduct or gross negligence of
the Facility, its officers, agents, representatives, or employees, or any person or entity not subject to
TEXAS STATE's supervision or control. Notwithstanding any provision of this contract, nothing
herein shall be construed as a waiver by TEXAS STATE of its constitutional, statutory or common
law rights, privileges, immunities or defenses.
S. CASE RECORDS AND HISTORIES
5.01 Property of Facility: All case records, case histories and regular f les concerning
patients at the Facility or parties consulted; interviewed or cared for by the TEXAS STATE students
pursuant to this agreement shall belong to and remain the property of the Facility.
5.02 Confidentiality: All TEXAS STATE students and faculty members will agree to
maintain the confidentiality of client's records to which they might have access, in accordance with
the Facility's policies.
6. MISCELLANEOUS
6.01 Non -Discrimination: No person shall be excluded from participation in, denied the
benefits of, or be subject to discrimination under any program and activity sponsored or conducted
by TEXAS STATE on any basis prohibited by applicable law, including, but not limited to, race,
color, age, national origin, religion, sex, or disability.
Additionally, in their execution of this agreement, all contractors, subcontractors, their respective
employees, and others acting by or through them shall comply with all federal and state policies and
laws prohibiting discrimination, harassment, and sexual misconduct. Any breach of this covenant
may result in termination of this agreement.
6.02 Texas Law to Apply: This Agreement shall be interpreted, construed, and governed
according to the laws of the State of Texas.
6.03 Only Agreement: This Agreement constitutes the sole and only agreement of the
parties hereto and supersedes any prior understanding or written or oral agreements between parties
respecting the within subject matter.
EXECUTED on the day and year first above written.
�Ltut B. LWelbormn, Ph.D.
Dean, College of Health Professions
30.1—W-est-Bagdad-,ve., . 250 —ezt F j%4-';�' V -:Texas State University
Round Rock, TX 78664
Type of rint Name Date
Date
City of Robnd Rock �4 �,L��s` ,
P_adcs-qund acroatiovfl�epartment
�Ltut B. LWelbormn, Ph.D.
Dean, College of Health Professions
30.1—W-est-Bagdad-,ve., . 250 —ezt F j%4-';�' V -:Texas State University
Round Rock, TX 78664
Type of rint Name Date
Date
- City of Round Rock
ROUND ROCK
TEXAS Agenda Item Summary
Agenda Number:
Title: Consider executing an Affiliation Agreement with Texas State University
for use of the BACA Center for a Health Fair.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 9/30/2016
Dept Director: Rick Atkins, Director
Cost: $0.00
Indexes: General Fund
Attachments: LAF Health Fair.pdf, Back-up Health Fair.pdf
Department: Parks and Recreation Department
Text of Legislative File CM -2016-1194
Consider executing an Affiliation Agreement with Texas State University for use of the
BACA Center for a Health Fair.
Texas State University St. David's School of Nursing n Round Rock senior level
Bachelors Science Nursing (BSN) students to conduct a health fair for the members of
the Baca center.
Blood pressure checks and health screening will be provided as a requirement for the
Community -Based Nursing course and participants will learn about community oriented
nursing.
$0.00
General Fund
Department official recommends approval of this item
City of Round Rock Page 1 Printed on 9/3012016