Backup Documents 10/25/2022 Item #16E1ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 E 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines #1 through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exception of the Chairman's signature, draw a line through routing lines # 1 through #2, complete the checklist, and forward to the County Attorney Office.
Route to Addressees (List in routing order)
Office
Initials
Date
1.
2.
3. County Attorney Office
County Attorney Office
lkk
f 8
4. BCC Office
Board of County
Commissioners
5. Minutes and Records
Clerk of Court's Office
1F
to. 9t
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above, may need to contact staff for additional or missing information.
Name of Primary Staff
Cherie DuBock
Phone Number
239-252-3756
Contact / De artment
Agenda Date Item was
10/25/22
Agenda Item Number
23672
I6
Approved by the BCC
• F_
Type of Document
Field Internship Agreement
Number of Original
1
Attached
Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is
Yes
N/A (Not
a ro riate.
(Initial)
Applicable)
1.
Does the document require the chairman's original signature?
CD
2.
Does the document need to be sent to another agency for additional signatures? If yes,
CD
provide the Contact Information(Name; Agency; Address; Phone on an attached sheet.
3.
Original document has been signed/initialed for legal sufficiency. (All documents to be
CD
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney.
4.
All handwritten strike -through and revisions have been initialed by the County Attorney's
CD
Office and all other parties except the BCC Chairman and the Clerk to the Board
5.
The Chairman's signature line date has been entered as the date of BCC approval of the
CD
document or the final negotiated contract date whichever is applicable.
6.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
CD
si ature and initials are required.
7.
In most cases (some contracts are an exception), the original document and this routing slip
CD
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8.
The document was approved by the BCC on 10/25/22 (enter date) and all changes
CD
N/A is not
made during the meeting have been incorporated in the attached document. The
an option for
County Attorne 's Office has reviewed the changes, if applicable.
this line.
9.
Initials of attorney verifying that the attached document is the version approved by the
N/A is not
BCC, all changes directed by the BCC have been made, and the document is ready for the
A
an option for
Chairman's signature.
this line.,
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12
16E2
AGREEMENTFOR FIELD INTERNSHIP EXPERIENCE
MEDICAL CAREER ACADEMY AND
THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AGREEMENT entered into this 2501 day of 0cf0 cr 2022, by and
between Medical Career Academy, Inc. (MCA or School) 7741 N. Military Trail, Suite 5, Palm
Beach Gardens, FL 33410 and the Collier County Board of County Commissioners, on behalf of
the Collier County Emergency Medical Services Department (CCEMS).
WITNESSETH:
WHEREAS, MCA provides an Emergency Medical Technician and Paramedic Program
as a part of its curriculum for its enrolled students; and
WHEREAS, MCA desires to augment said programs by providing skill training/field
experiences for its students through the association of certain of its student with the activities and
practices of the Collier County Emergency Medical Services Department, and
WHEREAS, Collier County Emergency Medical Services Department has the ability to
assist MCA in said Program endeavors, including providing opportunities for students to observe
and perform appropriate Emergency Medical Technician and Paramedic skills under supervision
during field and classroom experiences; and
WHEREAS, the objective of the herein described relationship of the parties is to benefit
the community by and through the enhance education of its students.
NOW, THEREFORE, based on the premises and the mutual covenants, conditions and
considerations hereafter expressed, the parties agree as follows:
SECTION ONE: Term
This Agreement shall become effective upon approval by the Board of County
Commissioners and shall automatically remain each year unless one party gives the other party
notice it wishes to amend or terminate the Agreement. This Agreement may be amended only by
written agreement of the parties executed with the same formalities as entered into.
SECTION TWO: Instruction and Curriculum
a. The COUNTY rules and regulations shall be followed by all students and faculty of
SCHOOL when they are receiving training and education provided by the terms of this agreement.
All MCA students shall be required to wear identification mandated by both MCA and the
COUNTY in accordance with the policies of the COUNTY and SCHOOL.
b. The COUNTY shall not substitute students of SCHOOL for paid COUNTY staff for any
purpose, function or task while the students are participating in any activity that is covered by this
Agreement. No student shall be considered to be an employee of the COUNTY during the clinical
courses.
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c. Prior to participating in any of the COUNTY programs pursuant to this Agreement, all
students must have completed training on compliance with the confidentiality and privacy
provisions of the Health Insurance Portability and Accountability Act (HIPAA). SCHOOL is
required to provide documentation of this training for each student prior to the student participating
in any COUNTY program.
SECTION THREE: Compliance with HIPAA. SCHOOL and its agents, students, faculty,
representatives and employees agree to keep strictly confidential and hold in trust all confidential
information of the COUNTY and its patients and not disclose or reveal any confidential
information to any third party without the express prior written consent of the COUNTY.
SCHOOL will train all students related to current HIPAA compliance prior to enrollment in any
program pursuant to this Agreement. SCHOOL agrees to comply with the applicable provisions
of the Administrative Simplification section of the Health Insurance Portability and Accountability
Act of 1996, as codified at 42 U.S.C. § 1320 through d-8 ("HIPAA"), and the requirements of any
regulations promulgated thereunder, including, without limitation, the federal privacy regulations
as contained in 45 C.F.R. Part 164, and the federal security standards as contained in 45 C.F.R.
Part i42 (collectively, the "Regulations"). COUNTY shall not use or further disclose any protected
health information, as defined in 45 C.F.R. 164.504, or individually identifiable health
information, as defined in 42 U.S.C. § 1320d (collectively, the "Protected Health Information"),
other than as permitted by this Agreement and the requirements of HIPAA or the Regulations.
SCHOOL will implement appropriate safeguards to prevent the use of disclosure of Protected
Health Information other than as contemplated by this Agreement.
SECTION FOUR: Obligation of MCA
MCA and its Emergency Medical Technician and Paramedic Program shall:
1. Provide current copies of the Program's objectives, curricula, and course objectives, and
field experiences objectives to the Collier County Emergency Medical Services Department.
2. Provide a schedule of students' related courses/activities to the appropriate personnel of
the Collier County Emergency Medical Services Department. Schedules will include names and
identification numbers of students, dates and times of student association/experience(s) with
Collier County Emergency Medical Services Department and its personnel. The determination of
the number of students to be assigned to the COUNTY and their scheduled placement shall be at
the sole discretion of the COUNTY and shall not be altered by the SCHOOL or the student.
3. The SCHOOL provides professional liability insurance coverage for students participating
in externship activities in the amount of $1 million per claim/$5 million aggregate.
4. It is understood between the parties that those students participating in this program shall
not be deemed to be employees, servants, agents, or volunteers of the Collier County Emergency
Medical Services Department or the Collier County Board of Commissioners and that the Collier
County Emergency Medical Services Department and the Collier County Board of Commissioners
shall not be liable for injury to a participant under Ch. 440, Florida Statutes, Florida's Workers'
Compensation law.
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5. Neither the Collier County Emergency Medical Services Department, the Collier County
Board of Commissioners, nor their employees, or agents shall be responsible for the compliance
of participants with State or Federally mandated occupational safety laws. MCA shall ensure and
document if appropriate that students and interns maintain compliance.
6. All students must complete background screening through Collier County Facilities
Management Department at students' expense in compliance with Ordinance No. 04-52, as
amended. The COUNTY will only allow students who have passed the screening to participate in
the program.
SECTION FIVE: Obligations of Collier County Emergency Medical Services Department
The Collier County Emergency Medical Services Department shall:
1. Provide opportunities for those qualified students of MCA to observe and perform
appropriate Emergency Medical Technician and Paramedic skills during field experiences with
department personnel.
2. Provide for direct supervision of the student interns while in association with the
Department and during field experiences, observation and training.
SECTION SIX: Mutual Responsibilities and Goals.
The Parties shall:
1. Communication. Communicate and act cooperatively through meetings and operational
plans to plan and evaluate the field experience segment of the Emergency Medical Services
Technology Programs and assist each other within the limits of their respective professional
abilities to ensure a successful field experience program for qualified students. Students will be
evaluated by Collier County preceptors on evaluation forms furnished by MCA.
2. Resolution. Utilize established lines of authority and communication in effectuating this
Agreement or addressing/solving problems which may arise in the implementation of this
Agreement.
3. No compensation. Each party shall perform the duties and responsibilities specified in this
Agreement without compensation. Participating students shall be treated by the COUNTY as
trainees and shall have no expectation of receiving compensation or future employment from either
party. Students shall pay for their own meal and expenses, if any, while participating in the
program.
4. Participant's Medical Care. MCA and/or students participating in the program shall be
responsible for arranging for the student's medical care and/or treatment, if necessary, including
transportation in the event of illness or injury while participating in the program provided at the
COUNTY'S premises. In no event shall the COUNTY be financially or otherwise responsible for
said medical care and treatment.
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Emergency Health Care Services. The COUNTY shall provide immediate emergency
health care services to students participating in the program in the event of accidental injury or
illness while on the COUNTY'S premises. At the time of providing such services, the COUNTY
and emergency health care facility shall accept assignment of the affected individual's personal or
student basic accident insurance policy. The COUNTY shall not be responsible for costs involved
in the provision of such services, the follow-up care, or hospitalization.
6. Professional Liability Insurance. The SCHOOL shall furnish to COUNTY,
Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets
the requirements as outline below:
A. Commercial General Liability Insurance on a comprehensive basis in an amount
not less than $1,000,000 combined single limit per occurrence for bodily injury and
property damage. Collier County Board of County Commissioners must be shown
as an additional insured with respect to this coverage.
B. Professional Liability Insurance in an amount not less than $1,000,000. If the
SCHOOL changes its name, the COUNTY must be notified immediately and a new
Agreement must be entered into under the new name. A Certificate of Insurance must
be resubmitted with the current name of the SCHOOL. When the COUNTY is notified
of such a change, the student rider program will be suspended until a new agreement is
signed and new certificates of insurance are approved by Collier County Department
of Risk Management.
SECTION SEVEN: Termination
1. At any time, Collier County Emergency Medical Services staff may refuse any MCA
student(s) from participating in the Program including but not limited to: performing observation,
ambulance ride time or practice.
2. Either party may terminate this Agreement upon ten (10) days written notice.
SECTION EIGHT: Government Regulations
To the extent applicable, the parties agree that they will comply with:
1. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et seq., which
prohibits discrimination on the basis of race, color, or national origin in programs and
activities receiving or benefiting from federal financial assistance.
2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which
prohibits discrimination on the basis of handicap in programs and activities receiving or
benefiting from federal financial assistance.
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3. Title IX of the Education Amendments of the 1972, as amended, 20 U.S.C. 1681 et. seq.,
which prohibits discrimination on the basis of sex in education programs and activities
receiving or benefiting from federal financial assistance.
4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which
prohibits discrimination on the basis of age in programs or activities receiving or
benefiting from federal financial assistance.
5. The Omnibus Budget Reconciliation Act of 1981, P.L. 97-35, which prohibits
discrimination on the basis of sex and religion in programs and activities receiving or
benefiting from federal financial assistance.
6. Executive Order 11246 of September 24, 1965 as amended, and of the rules, regulations,
and relevant orders of the Secretary of Labor, which prohibit discrimination in
government employment on the basis of race, creed, color, or national origin.
7. The Vietnam Era Veteran's Readjustment Assistance Act of 1974, as amended, 38 U.S.C.
219 et seq., covering rehabilitation measures for Vietnam Veterans.
8. The Americans with Disabilities Act of 1990 and the Americans with Disabilities
Amendment Act, which prohibits discrimination on the basis of disability and/or
perceived disability.
9. Chapter 760, Florida Statutes, which prohibits discrimination on the basis race, color,
religion, sex, national origin, age handicap, or marital status.
10. Title 45 C. F. R. 160.103, Health Insurance Portability and Accountability Act which
governs privacy regulations associated with medical information.
11. All regulations, guidelines, and standards which are now or may be lawfully adopted
under the above statutes, as well as any other federal, state, or local rules, regulations and
ordinances.
SECTION NINE: Equal Opportunity
MCA is committed to providing an educational and working environment free from discrimination
and harassment. All programs, activities, employment and facilities of MCA are available to all
on a non-discriminatory basis, without regard to race, sex, age, color, religion, national origin,
ethnicity, disability, sexual orientation, marital status, genetic information or veteran's status. The
school is an equal access/equal opportunity institution. Questions pertaining to educational equity,
equal access, or equal opportunity should be addressed to MCA Operations Director, 7741 N.
Military Trail, Suite 5, Palm Beach Gardens, Florida 33410.
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SECTION TEN: Indemnification
To the maximum extent permitted by Florida law, the SCHOOL shall indemnify and hold harmless
Collier County, its officers and employees from any and all liabilities, damages, losses and costs,
including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused
by the negligence, recklessness, or intentionally wrongful conduct of the SCHOOL or anyone
employed or utilized by the SCHOOL in the performance of this Agreement. This indemnification
obligation shall not be construed to negate, abridge or reduce any other rights or remedies which
otherwise may be available to an indemnified party or person described in this paragraph. This
section does not pertain to any incident arising from the sole negligence of Collier County. The
foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits
set forth in section 768.28, Florida Statutes.
SECTION ELEVEN: PUBLIC RECORDS COMPLIANCE
IF THE CONTRACTOR/SCHOOL HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO
THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT
Collier County Communication and Customer Relations Division
3299 Tamiami Trail East, Suite 102
Naples, FL 34112
(239) 252-8069
PublicRecordRequest@colliercountyfl.gov
The CONTRACTOR/SCHOOL is required to comply with the public records laws, specifically
to:
1. Keep and maintain public records required by the public agency to perform the service.
2. Upon request from the public agency's custodian of public records, provide the public agency
with a copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise
provided by law.
3. Ensure that public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of the
contract term and following completion of the contract if the contractor does not transfer the
records to the public agency.
4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in
possession of the contractor or keep and maintain public records required by the public agency to
perform the service. If the contractor transfers all public records to the public agency upon
completion of the contract, the contractor shall destroy any duplicate public records that are exempt
or confidential and exempt from public records disclosure requirements. If the contractor keeps
and maintains public records upon completion of the contract, the contractor shall meet all
applicable requirements for retaining public records. All records stored electronically must be
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provided to the public agency, upon request from the public agency's custodian of public records,
in a format that is compatible with the information technology systems of the public agency.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement, this 25+4
day
of �7G44e-r , 2022.
ATTE,�,f: 3�
CRY8 AL K.,,r.IN'ZL `,CLERK
Anorove rift
l!
Jeffrey A:
WITNESS:
Name and Title
WITNESS:
Name and Title
Clerk
gality:
County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER CO IDA
BY:
C'
Willfrn L. McDaniel, Jr., Chairman
Medical Career Academy. Inc.
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