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HomeMy WebLinkAbout10-0816 NIU . j lo-01S16 AFFILIATION AGREEMENT This Agreement is hereby made and entered into this [t day of Az/ttst , 2010, by and between the City of Elgin, Illinois, a municipal corporation (hereinafter referred to as the "INTERNSHIP SITE" or "SITE"), and the Board of Trustees of Northern Illinois University, a body politic and corporate of the State of Illinois(hereinafter referred to as the"UNIVERSITY"). WITNESSETH: WHEREAS, the UNIVERSITY is currently conducting a program granting undergraduate and graduate degrees in Public Health (B.S., M.P.H.) and desires to obtain the assistance of the INTERNSHIP SITE in furthering its educational objectives; and WHEREAS, the INTERNSHIP SITE provides capability for learning experiences and recognizes the societal benefits of assisting in the education of UNIVERSITY students and is interested in providing assistance to the UNIVERSITY in its curriculum; and WHEREAS, the parties hereto agree that, for the mutual benefit of each as independent contractors and not as partners or joint venturers, formal affiliation should be entered into and carried out in accordance with certain procedures; and WHEREAS, certain legal obligations and responsibilities will attach to such affiliations when established. NOW,THEREFORE,IT IS MUTUALLY AGREED AS FOLLOWS: 1. The above recitals are incorporated into and made a part of this Agreement as if fully recited herein. 2. The UNIVERSITY shall assign students to participate in an internship program under the terms and provisions provided for herein (hereinafter referred to as the "Program"). The number of students assigned and the dates of their assignment shall be mutually agreed upon in writing. 3. The UNIVERSITY agrees that the academic preparation of the students supplied by it shall be in keeping with the objectives and requirements of the Program. 4. The UNIVERSITY agrees more specifically as follows: A. The UNIVERSITY shall advise all students assigned to or making use of any clinical area of the INTERNSHIP SITE that they must adhere to appropriate rules, regulations and policies, including fulfilling the health status requirements, of the INTERNSHIP SITE during the term of their assignment. INTERNSHIP SITE will inform the students of its immunization requirements. Participating students will furnish to the INTERNSHIP SITE, at the commencement of the internship,verification of compliance with such health requirements. B. The UNIVERSITY shall withdraw, upon recommendation, any student who fails to meet any standards mutually agreed upon by the parties hereto. C. The UNIVERSITY shall provide to the INTERNSHIP SITE student evaluation information, including a format for evaluating students during the affiliation term. D. The UNIVERSITY shall assign a faculty member who will serve as liaison with the NIU University Legal Services—7-2007 rev INTERNSHIP SITE, and who will be responsible for assignment of grades. E. Participating students will be required to carry their own personal health insurance. F. Participating students will be required to obtain and maintain personal student professional liability insurance with limits of at least One Million Dollars ($1,000,000.00) per occurrence and Three Million Dollars ($3,000,000.00) aggregate. A copy of a certificate of insurance for such student professional liability insurance will be made available to the SITE upon request. In the event of insufficient coverage INTERNSHIP SITE reserves the right to terminate this Agreement. G. Subject to the terms, conditions and limitations of applicable Illinois law, UNIVERSITY and its faculty and staff are provided liability claims and defense protections by the State Lawsuit Immunity Act, Illinois Court of Claims Act and the State Employee Indemnification Act. H. The INTERNSHIP SITE may unilaterally discontinue the participation of any student for any reason, at the INTERNSHIP SITE's sole discretion, without liability to the UNIVERSITY or any such student. 5. The INTERNSHIP SITE agrees more specifically as follows: A. The INTERNSHIP SITE shall use its best efforts to provide the reasonable facilities, experiences and personnel necessary to meet the UNIVERSITY'S standards for the provision of internship education. B. The INTERNSHIP SITE shall cooperate in formally evaluating students consonant with educational objectives and procedures jointly discussed. C. The INTERNSHIP SITE shall designate one person who shall serve as the internship preceptor. Such person will have met the academic and other standards required by the parties hereto. D. The INTERNSHIP SITE shall ensure that all records relating to a student's performance during the affiliation period shall be made available to the parties hereto, and the student, and not to other persons, as required by the Family Educational Rights and Privacy Act of 1974, 20 USC 1232(g), except to the extent as may be required by law. 6. The UNIVERSITY and the INTERNSHIP SITE mutually agree that at no time shall they discriminate on the basis of race, creed, color, religion, national origin, sex, or handicap as to employees, students, or service population. 7. The UNIVERSITY and the INTERNSHIP SITE mutually agree that neither shall be compensated by the other as a result of this Agreement. 8. The UNIVERSITY and the INTERNSHIP SITE shall cooperate in working out the details of the implementation of this Agreement. 9. The parties agree generally to respect in good faith the need for maintaining privacy of sensitive personal patient and student information that may come to the attention of their respective employees and students during the term of this Agreement. The confidentiality of treatment records and other information concerning patients will be maintained in accordance with applicable state and federal statutes and regulations, including the Freedom of Information Act and the Standards for Privacy of Individually Identifiable Health Information as required under the Health Insurance Portability and Accountability Act. The parties will notify one another if there are known breaches of this confidentiality. NIU University Legal Services—7-2007 rev 2 10. Any amendments to this Agreement must be in writing and signed by both parties. 11. This Agreement shall be construed and enforced in accordance with the laws of the State of Illinois. Except as required by law, venue for the resolution of any disputes or the enforcement of any rights arising out of or in connection with this Agreement shall be in the Circuit Court of Kane County, Illinois. 12. The term of this Agreement shall be from August 4, 2010 until August 4, 2011. 13. The terms of this Agreement shall be severable. In the event any of the terms or provisions of this Agreement are deemed to be void or otherwise unenforceable for any reason, the remainder of this Agreement shall remain in full force and effect. 14. INTERNSHIP SITE shall not be required to take any minimum number of students pursuant to this Agreement. 15. Subject to the limitations of applicable Illinois law, including the Court of Claims Act and the State Employee Indemnification Act, the UNIVERSITY hereby waives and releases, and shall hold harmless and indemnify the INTERNSHIP SITE from and against any and all lawsuits, claims for damages, causes of action and any and all other liability of whatsoever nature and in whatsoever forum, arising out of or in connection with the UNIVERSITY's negligent actions or omissions under this Agreement. IN WITNESS WHEREOF, the parties hereto have set their hands and seals as of the day and date set forth above. ACCEPTED BY: BOARD OF TRUSTEES OF NORTHERN ILLINOIS UNIVERSITY By I v V , Date: 81 72)/10 E ecuti Vice-President and Provost Northe Illinois University PUBLIC HEALTH AND HEALTH EDUCATION PROGRAMS By R (?öki111Date: Ir-lei"" `Q Coordinator ublic Health and Health Education Programs School of Nursing and Health Studies Northern Illinois University ACCEPTED BY INTERNSHIP SITE: C fy oc Eij ;n Agency /S° LeX Street Address El ;.n 14_ 0/. City J State Zip 31/17 ) 93/- 3•71 Phone. No. NIU University Legal Services—7-2007 rev 3 // By Date:Date, ,�f��G7 (Sign e) (Typed or Printed) Title: e/ r Nxfrig4— NIU University Legal Services—7-2007 rev 4