Educational Affiliation Agreement Between

EDUCATIONAL AFFILIATION AGREEMENT BETWEEN

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and

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

THIS AGREEMENT is hereby entered into by and between Click or tap here to enter text. (“FACILITY”) and the Board of Trustees ofBOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY, a body politic and corporate of the State of Illinois, by and on behalf of its Click or tap here to enter text. at Southern Illinois University Carbondale (“UNIVERSITY”).

WHEREAS, UNIVERSITY has an established academic program or programs which needs to providefor which practical, hands-on internship experiences (“Internship”) for its students are required; and

WHEREAS, Facility has the ability to provide such internship experiences; and

WHEREAS, UNIVERSITY and Facility desire to enter into an agreement to provide Internship opportunities at Facility for to qualified University students to become competent practitioners.

NOW, THEREFORE, in consideration of the terms, conditions and covenants, mutual or otherwise, as hereinafter set forth, the parties hereby agree to be bound to the following terms and conditions: as stated herein.

I. TERM & TERMINATION

A.  Term: The term of this Agreement shall be _Click or tap here to enter text. years commencing on Click or tap to enter a date.(“Effective Date”) and expiring on Click or tap to enter a date. unless earlier terminated in accordance with Section I(B). Notwithstanding the foregoing the parties agree that no University student then participating in a clinical experiencean Internship pursuant to this Agreement shall be deprived the opportunity to complete course requirements solely due to the aforementioned expiration or termination of this Agreement.

B. Termination: This Agreement may be terminated by either Party, with or without

cause, by providing written notice thereof to the other Party at least 60 days in advance of the date of terminationupon no fewer than 60 days advance written notice thereof.

II. PROGRAMS: The University academic programs to which this Agreement is applicable are identified Exhibit A hereto. The Parties covenant and agree that additional academic programs may be added by written agreement of the Parties.

III. UNIVERSITY DUTIES: UNIVERSITY shall be responsible for the following obligations and conditions:

A. Administration of Internship: UNIVERSITY shall assume retain responsibility for the administration of the internshipacademic Programs identified in Exhibit A hereto, including, but not limited to, curriculum development, grading, requirements for matriculation, credits, scheduling, and clinical Internship hours.

B. Notify of Internship Objectives: UNIVERSITY shall provide Facility clinical personnel with the overall objectives of the internship Internship and provide the appropriate educational objectives and documents for clinical Internship experiences. Prior to participationcommencement of the Internship, UNIVERSITY will make available catalogs and program Program information.

C. Selection and Assignment: UNIVERSITY shall be responsible for determining students’ eligibility to participate in the Internship. UNIVERSITY shall be responsible for the selection and assignment of students for the internship.

D. Coordinate Activities: UNIVERSITY shall coordinate the clinical Internship activities in conjunction with Facility. For each Academic Program identified in Exhibit A hereto, University shall identify in writing at least one qualified faculty member to act as a liaison with Facility for purposes of administering the Internship..

E. Faculty Visits: UNIVERSITY will provide Facility with a schedule of faculty visits, if any.

F. Regulations of Facility: UNIVERSITY shall inform student(s) that they will be subject to the regulations of the Facility while on tparticipating in the internshipInternship. Further, UNIVERSITY shall inform the student of applicable requirements of the Facility under The Joint Commission on Accreditation of Healthcare Organizations. Each student shall be required to comply with such Joint Commission on Accreditation of Healthcare Organizations regulations during his/her internshipInternship.

G. Meals, Lodging, MiscPersonal Expenses.: UNIVERSITY shall inform student(s) that they will be responsible for their personal expenses during the Internship, including without limitation own meals, lodging, transportation, uniforms, laundry, and health insurance for the internship.

H. Liability Insurance: The Parties to this agreement acknowledge and agree that University provides coverage for general liability, errors and omissions, personal injury, and professional liability coverage through a Self-Insurance Program established and administered by the University and/or the State of Illinois. For the term of this Agreement, University agrees to maintain the following insurance coverage:

1.  Comprehensive general liability insurance coverage provided through the Southern Illinois University Self-Insurance Program with limits of $1,000,000 per occurrence and a $3,000,000 general aggregate covering its employees acting within the scope of their appointments and its enrolled students while acting in the scope of an approved unpaid Internship for which academic credit or the equivalent may be awarded ;

2.  Workers’ compensation and employer liability insurance coverage provided through the State of Illinois Self-Insured Workers’ Compensation Plan, providing statutory limits of coverage for all State employees;

3.  Automobile liability coverage furnished to the University by the State of Illinois through the State of Illinois Self-Insured Automobile Liability Plan and administered by the State of Illinois Department of Central Management Services, providing coverage of $2,000,000 for all state-owned and leased vehicles while engaged in state business; and

4.  Professional liability insurance coverage provided through the Southern Illinois University Self-Insurance Program with limits of $1,000,000 per occurrence and a $3,000,000 general aggregate covering its employees acting within the scope of their appointments and its enrolled teacher candidates while acting in the scope of an approved unpaid Internship for which academic credit or the equivalent may be awarded.

University will provide written certificate(s) verifying such insurance coverage upon request.

Liability Insurance: The Parties to this agreement understand and acknowledge that University provides coverage for general liability, errors and omissions, personal injury, and professional liability coverage through a Self-Insurance Program established and administered by the University. For the term of this Agreement, University agrees to maintain the following types of insurance:

Comprehensive general liability insurance coverage for bodily injury liability, including death, property damage liability, for all its employees acting within the scope of their appointments, and similarly provides such insurance coverage for any of its enrolled students while acting in the scope of an approved unpaid clinical program for which academic credit or the equivalent may be awarded. This “occurrence” basis coverage for paid employees and unpaid student interns is provided through the Southern Illinois University Self-Insurance Program, and is limited to $1,000,000 per occurrence, with a $3,000,000 aggregate coverage;

Workers’ compensation and employer liability is provided through the State of Illinois Self-Insured Workers’ Compensation Plan, providing statutory limits of coverage for all State employees;

Automobile liability coverage furnished to the University by the State of Illinois through the State of Illinois Self-Insured Automobile Liability Plan, administered by the State of Illinois Department of Central Management Services, providing coverage of $2,000,000 for all state-owned and leased vehicles while engaged in state business. This coverage is excess of other available insurance and coverage details can be found at http://www.cms.il.gov/cms/2_servicese_ben/autoplan.htm, or by printed copy upon request; and

Professional liability insurance coverage for all its employees acting within the scope of their appointments, and similarly provides such insurance coverage for any of its enrolled students while acting in the scope of an approved unpaid clinical program for which academic credit or the equivalent may be awarded. This coverage for paid employees and unpaid student interns is provided through the Southern Illinois University Self-Insurance Program, and is limited to $1,000,000 per occurrence, with a $3,000,000 aggregate coverage.

I. Indemnification: To the extent permitted by Illinois law and not inconsistent with the doctrine of sovereign immunity, University shall indemnify and hold harmless the Facility for any claims, demands, costs and expenses, including reasonable attorney’s fees, arising out of negligent actions by University, its officers, employees and agents in the performance of obligations under this Agreement; provided that said claims, demands, costs and expenses have not been caused or alleged to have been caused in whole or in part by the negligence or willful misconduct of the Facility. The parties agree that all claims against University are subject to the Illinois Court of Claims Act, 705 ILCS 505 et seq.

J. Federal RegulationRegulatory Requirements: UNIVERSITY shall instruct students regarding Occupational Safety and Health Administration Bloodborne Pathogens and Tuberculosis regulations before beginning clinical experiencesthe Internship, in addition to potential requirement for a criminal background check and/or drug screen prior to gaining access to the Facility.

K. Immunizations: UNIVERSITY and shall inform participating student(s) that compliance shall comply with the immunization requirements of Facility is a prerequisite to participating in the Internship at Facility. All students must have the following immunizations with documentation available upon request:

1. TB skin test. The test or chest x-ray must be negative.

2. Rubella (German Measles) immunization or positive Rubella Screen or titer.

3. Rubeola (Red Measles) immunization or positive Rubeola Screen or titer.

4. Mumps immunization in 1969 or later or physician diagnosed illness. (After 1969, written documentation of immunization of live mumps vaccine at 12 months of age or later.)

5. MMR (Mumps, Measles, Rubella) immunization. (Two doses of MMR separated by more than one month and given on or after the first birthday eliminate the need for 2, 3, and 4 above.)

L. Hepatitis B Vaccination: Upon request, UNIVERSITY shall submit evidence to the Facility that each student has received Hepatitis B vaccinations or signed a waiver registering they are aware of the risks without vaccinations.

M. Enrolled in InternshipStudents: UNIVERSITY shall take all necessary steps to ensure that any student presented to the Facility for affiliation through this Agreement isonly currently enrolled at UNIVERSITYand academically qualified students are selected to participate in the Internship.

N. Student Attendance: UNIVERSITY shall notify the Facility of student names and dates of attendance at Facility for purposes of the Internship. Students shall maintain documentation of his or her Internship attendance/hours and present for concurrence by the Facility.

IV. FACILITY DUTIES: The Facility shall be responsible for the following obligations and conditions:

A. Confirmation of Acceptance: Facility shall provide University with written verification confirming the student’s acceptance and placement in the Internship at Facility.

Structure of Internship: Facility shall provide participating students with a sufficient variety and number of practice and learning experiences appropriate for successful completion of the internshipInternship and . The Facility shall provide learning experiences that are that are compatible with the missions of UNIVERSITY and the academic goals of the Program. The Facility shall accept an agreed upon number of UNIVERSITY student(s) in the internship. For each Program identified in Exhibit A hereto, Facility shall identify at least one qualified employee to act as Facility’s liaison with University for purposes of administration of the student’s academic experience.

BC. Supervision: Facility shall be responsible for the professional supervision, direction and control of each student, which shall include but not limited to the appointment of a training supervisor who meets the qualifications as stated in the internshipInternship documentation, and a qualified staff member to directly supervise each student during the performance of any clinical procedures. Facility shall provide students with sufficient numbers and variety of procedural experiences to satisfy requirements for the internship.

CD. Progress Report: Facility shall complete a performance appraisal for each student during participating in the internshipInternship, as prescribed by internship Internship requirements.

DE. Orientation to Facility Rules & Regulations: Facility shall be responsible for providing an orientation to participating students of all applicable policies, procedures, rules, and regulations of the Facility, and to such other policies, procedures, rules, and regulations, as the Facility deems appropriate.

EF. Lockers, Eating Arrangements, Etc.: Facility will provide the students with dressing facilities, locker, and eating arrangements similar to those of its employees, if any.

FG. Unsatisfactory Conduct or Performance: Facility shall promptly notify UNIVERSITY of any unsatisfactory conduct or performance of any student assigned to the Facility pursuant to this Agreement. The Facility shall permit UNIVERSITY faculty members access to the Facility site and/or the students assigned to the Facility. Facility may require the removal of a student, if it is deemed necessary by Facility in the interest of patient care.

GH. Emergency Care or Injury: In the event of injury or illness, a student will be required to report to the Facility emergency care unit or the nearest emergency care unit, where the physician on duty will be responsible for determining the proper course of treatment. Any cost or expense associated with such care or treatment shall be the student's sole and individual responsibility, except when an injury results from acts or omissions of the Facility, its agents or employees.

HI. Patient Care Responsibility: Notwithstanding any other term or condition of this Agreement, Tthe Facility shall retain solefull responsibility and for provision and supervision for theof medical care and/or treatment of, or any otherthe services to, its patient(s) and/or client(s).

IJ. Indemnification: To the extent permitted by law, Facility shall indemnify and hold harmless UNIVERSITY, its agents, officers, participating students, and employees, from and against any and all liability, claims, demands, costs and expenses, including reasonable attorney’s fees, arising out of the negligent actions or omissions of Facility, its officers, employees or agents, or their willful misconduct, in connection with performance under this Agreement.

Facility shall indemnify and hold harmless UNIVERSITY, its agents, participating students, and employees, from any claims, demands, or actions for injury or death of any person, or damage to or destruction of property, which arises out of the act, failure to act, or negligence of the Facility, its agents or employees in connection with the activity which is the subject of this Agreement.

JK. Liability Insurance: Facilityshall procure and maintain during the term of this agreement insurance coverage as listed below.

1.  Worker's Compensation and Occupational DiseasesStatutory Limits

Employer's Liability $500,000 per occurrence

2.  Commercial General Liability $1,000,000 per occurrence

General Aggregate$3,000,000

3.  Commercial Auto Liability (including owned, hired and non-owned)

Combined Single Limit $1,000,000 per occurrence

or

Bodily Injury $1,000,000 per occurrence

Property Damage $500,000 per occurrence