ࡱ> HJG_ (bjbjJJ 0>(3b(3b PP, ,&88888'''v&x&x&x&x&x&x&$(U+&'''''&88&'88v&'v&!l#8jxnp=.N#*b&&0&x#N ,k@ ,T## ,#'''''''&&'''&'''' ,'''''''''PB : UNIVERSITY OF IDAHO CONTRACT Agreement for Cooperation in a(n) (STATE) Clinical Experience Program XXXX-XXXX Academic Years This contract made and entered into by and between the Board of Regents of the 91av (University) and the INSERT NAME, (Hospital). WITNESSETH: That the University and the Hospital, hereby agree jointly: To cooperate in the development of a clinical experience program in the Hospital, subject to the provisions below; To assign student interns on the basis of criteria mutually agreed upon by the official representatives of the Hospital, and official representative of the University; That the Hospital reserves the right to determine the number of student interns selected for placement in the Hospital during any term; That the University will assign a college faculty member or other approved professional to serve as supervisor of student interns in the Hospital; such person will be responsible for coordinating services of the University including the orienting and advising of cooperating a clinical supervisor regarding the clinical experience program, and the supervision of student interns on a regularly scheduled basis; That the Hospital will assign a clinical supervisor or other approved professional to serve as a liaison of the clinical education program. The Hospital will notify the University in the event of a change in this liaison. That students follow the school calendar during the period of time assigned to internships; That evaluation of the student intern performance for purposes of the college grade and the institutional record shall be made by the University supervisor in consultation with the Hospital; further, that the Hospital provide the University with an evaluation of the performance of the student intern; That University student interns are expected to comply with all rules and regulations of the Hospital while serving in the Hospital; That the University has been authorized by the Professional Educator Standards Board to place candidates in (STATE) Hospitals for field experiences; That the University maintain documentation of student interns health status, proof of current vaccinations and negative tuberculosis immunization status. That the Hospital provide student interns access to emergency medical services in the event of illness or injury during the clinical experience. Emergency care will be provide at the student interns expense. That the Hospital maintains full responsibility for the care of its patients. That the University will provide the student intern with professional liability insurance coverage with limits $1,000,000 / $3,000,000. That student interns are not employees, agents, or assigns of the University or the Hospital. That all patient records shall remain the property of the Hospital. Retention and release shall be in accordance with applicable regulations, policies, and procedures. Access and use of patient information is restricted to only what is necessary to provide the services so noted herein. That the University, its students, employees, agents, and representatives agree to keep confidential from third parties all information which relates to or identifies a particular patient, including, but not limited to name, address, medial 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 of professional ethics. That Subject to the limits of liability specified in Idaho Code 6- 901 through 6-929, known as the Idaho Tort Claims Act, the University shall indemnify and the Hospital and its agents and assigns harmless from and/or against any and all claims, damages, and liabilities (including reasonable attorney's fees) that may be suffered or incurred and that arise as a direct result of and which are caused by the Universitys wrongful acts or omissions in the performance of this Agreement. This indemnification does not apply when such claims, damages, and liabilities are the result of negligent acts, errors, omissions or fault on the part of (i) the Hospital, its agents, or its assigns, (ii) any student, intern, or any other person who is not an employee of the University, or (iii) when the claim or suit is made against the Hospital by the University. The Hospital shall promptly notify the 91av Office of Risk Management, 875 Perimeter Drive MS3162, Moscow, Idaho 83844-3162, of any such claim of which it has knowledge and shall cooperate fully with the Institution or its representatives in the defense of the same. The University's liability coverage is provided through a self-funded liability program administered by the Idaho Bureau of Risk Management. Limits of liability, and this indemnification, are $500,000 Combined Single Limits, which amount is the Institution's limit of liability under the Idaho Tort Claims Act and this Agreement. The Universitys obligations and liabilities hereunder are subject to the appropriation of funds from the State of Idaho, which appropriation shall be in the State of Idahos sole discretion, from revenues legally available to the Institution for the ensuing fiscal year for the purposes of this Agreement. That Subject to the limits of liability specified in Idaho Code 6- 901 through 6-929, known as the Idaho Tort Claims Act, the Hospital shall indemnify and hold the University and its governing board, employees, agents, and assigns harmless from and/or against any and all claims, damages, and liabilities (including reasonable attorney's fees) that may be suffered or incurred and that arise as a direct result of and which are caused by the Hospitals wrongful acts or omissions in the performance of this Agreement. This indemnification does not apply when such claims, damages, and liabilities are the result of negligent acts, errors, omissions or fault on the part of (i) the University and its governing board, employees, agents, or its assigns, (ii) any student, intern, or any other person who is not an employee of the Hospital, or (iii) when the claim or suit is made against the University by the Hospital. The University shall promptly notify the Hospital of any such claim of which it has knowledge and shall cooperate fully with the Hospital or its representatives in the defense of the same. That the Clinical Experience Program each year shall be evaluated under the direction of the official representative of the Hospital and the Director of Clinical Experiences of the University; That the Hospital agrees that it does not discriminate on the basis of race, color, religion, sex, age, sexual orientation, national origin, or handicap. IN WITNESS WHEREOF: The parties have caused this agreement to be executed as required by their respective governing boards. (HOSPITAL NAME) CITY, STATE Date_____________ BY__________________________________________ Signature Please type or print: ____________________________________________________ Name ____________________________________________________ Title Superintendent or President, Board of Education or designated representative 91av, Moscow, Idaho Date_____________ BY__________________________________________ Signature, For the Board of Regents of the 91av Name Title Julia McIlroy Director, Contracts and Purchasing Services The 91av does not discriminate on the basis of race, color, national origin, religion, sex, age, disability, or status as a Vietnam-era veteran, as each of these bases is defined by law, in employment of, in admission to, or the operation of its educational programs and activities, as proscribed by titles VI and VII of the Civil Rights Act of 1964, title IX of the Education Amendments of 1972, Executive Order 11246 as amended, the Rehabilitation Acts of 1973, the Vietnam Era Veterans Readjustment Assistance Act of 1974, the Age of Discrimination Acts of 1974 and 1975, and other federal and state laws and regulations. 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